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PRE 2010 DOCSdpi City of Fridley, Minn. � 3 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: April 11-1972 Owner: -- 3I -M 6enst=0tion lxns� Builder S Address __10._East Golden Lake Lane Address ___Same LOCATION OF BUILDING No. _.. .6.X9 Street ._._......_.matter orn Drive Part of Lot Lot ._.__..6._._......_..._ Block La _ _ .____ Addition or Sub -Division Innchrnnk Wnr h Arldi i on Comer Lot Inside Lot X Setback 191 - Sideyard 151 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Dwelling___ Front 52' Depth 26-4" Height 20' Sq. FL 1367' Cu. Ft. 27,9161 Front — Depth Height Sq. Ft. Cu. Ft. Type of Construction — Frame I Est. Cost - $29.9-27 - 00 _ To be Completed 6 months Stipulations: Sewer may be interuptable. Nail in tree is 4 feet above centerline of street at centerline of garage for elevation. Hook up to sewer. Provide a hard surface drive and a verifying survey before capping. 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 jorth and in wi ail provisions of ordinances of the city of Fridley. 14.61 State Surcharge In consideration of the payment of a fee of $-52.00permit is hereby grantedto Winer Cons traction 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 ordingrices of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings }yithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. &D1�p�De Building Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to am the Building Inspector for separate permits for these hems. 9 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER: ADDRESS:1o3 64k "AD–DRESS: Ile NO:. STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT:SETBACK: 3 snEyARD: 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: Front: :�7 Depth: Ae5� Height: �0 Square Feet: Cubic Feet., Front: Depth: j Height: f Square Feet;— Cubic Feet: 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 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. DATE:—*,– —7 -9 -- SIGNATURE : (See Reverse Side 'cr Addiftoral Information.) . Land Planning s��t�.�;�� f 6875 Highway No. 6S N. E. Land Surveying �' ' ' [ Minneapolis, Soils testinglIQG h�1 P``'• Minn. 55432 Civil Engineering CJ Telephone ?84-6066 Municipal Engineering Engineers & Surveyors Area Code 612 Certificate of Survey for ULMIR C-00R ION CQ ..rte NORT" 101 (10 741-2I N � , r4 cy I I 17-T 10 ° r0 24.94 0 - - Denotes Drainage Ufili} Easerna4 Bearings shown are assumed 0 Denotes iron manurneni- (►gip to C6n4rw.f1O1i lei Lor►Wy nal 1,04 be LoT h' Bwel< 4 INNS13!1 u�k Nam ii 1 hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the location of all buildings, thereon, and all visible encroachments, if any, from or on said land. As surveyed by me this day of A.D. 10Lt. "—T 1 n SUBURBAN ENGINEERING, INC. / ! O /� 0 f!@� Engineers f Su v ora 91L J „ '+ 5 a L Land Planning Land Surveying 8875 Highway No. 6S N. E. eJtltt �f-ffJl r. • • Minneapolis, Sails Telling �'lt 11#1ele ,vitt'. Minn. ss432 Civil Engineering Telephone 784-6060 Municipal Engineering Engineers & Surveyors Area Code 612 Certificate of Survey for ULMER CQNSTQUCTION C NORT" la (10 In (l o (� n w• �,1., y a sn pI GO .,- • �N �y I 2 -37. S 0 F r to 5.0 R ---- -- - Denote-, Droaenv- Uf 14l Ea -,ern -a4 Bearings shown are assumed o Deno�el1s iron monument t \ (IXC �� CGrt9tru�ff`�rl 1C; :G►7i`i5 »zI� n� Le n3.1 LoT BLOct< 4 NOc-M-1 AiOxt, CoUWTY I hereby certify that this is a true and correct representation of 6 survey of the boundaries of the above do^crited land, and of the location of all buildings, thercao, anti all visials oneroachments, if ani:, froryt syr oh tuid land. As surveyed by me this cloy of A.O, 191%, SUBURBAN E� GINEERING, INC. ea j 1 e : Vn-c-400"' - Engineers surveyorsby e r h C' Fridley �Y of Fre Y pG and Gas RNI" Pamdt Dart. of Blaq. Phone 580 -UW DESCRIPTION OF WORE Number. Iliad and LocaBon of Fixtuw" PARTIAL RATE SCHEDULE wAT" ". City of Fridley: D I N I GAS [LEC. PLUMBING FIXTURE RATES- NO. RATE TOTAL Number Fixtures ............ • • .. 1//A�_- x $2.00 = - 0 Q Future Fixture Opening .... :...... x $1.50 $ .. New Fixture Old Opening .......... x $1.50 i Catch Basin . .. .. .. . . . . . . ... . ... x 33.26 =- Water Heater ,Up to 99,000 BTU) • . • • _� x $3.00 New Ground Stun Old Bldg......... x $3.25 4 Electric Wates Heater .............. a $2.00 3 GAS FITTING FEES. NO. RATE TOTAL 1st 3 Fixtures • • .............. • • _ x $2.00 $ 2, - 0 Additional Fixtures ............... x 8.75 i Gas Range to 199.000 BTU............ s $6.00 $ State Surcharge $ .50 BE PAIRS it ALTERATIONb—Refer to Coda _ Description ........................................... TOTAL FEE 6 ' The undersigned hereby makes application for a permit for the work herei, spec!ffied, agreeing to do all work in strict accordance with the C ItT Ordinance and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Fridley. W l. I C Owner _ _ Kind of Building Used as To be completed about 6,1 Estimated Cost, $ �00 Old New. uilding Permit No. Permit No. IF Signed a .- - - , By C1 i FIA. Business Phune No ROUGH FINAL U t AppRcatia� for Power Planes and Hea ft Cooling, Ventilation. Rshlger�ation and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: MTN TOTAL Furnace Shell & Duct Work . $10.00 : Replacement of Furnace ..... . ..... .. 6.00 ; Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ...... . ..$10.00 $�® each add. 60,000 BTU .................... .. 3.00 ; Replacement of Furnace .. .... 6.00 $ Repairs & Alterations—up to $500.00 .. 6.00 $ Repairs & Alterations each add. $500.00 &00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 Furnace She]] & Line --to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3,00 $-_- ---_ Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ — over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 198,000 BTU) 6.00 $ 5� over 199,000 BTU See Fess Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 7.W $_ 2 A Additional Fixtures x .76 $ Gas Range to 199,000 X$ 6.00 $ AIR CONDMONING v � ' .Z 6 6- 30 P 4 k,Z t&� /4 OV /coo F/'( �—r-- FAN HEATING SYSTEM Sao Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ 21° -_00 ROUGH FINAL i - ,2 1 - 76 (SURCHARGE $_,50) Dept. of Bldgs. Phone W -3M 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 Ordinance: 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. Minn '26 1g 22k Owner —Ainn'u'," [ lieu .SIA' Kind of Building ._ _ Used as -- - -. To be completed about _fid ' % A Estimated Cost, $..�t_ 01&14e�. Building Permit No. Permit No. 11�® DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No 1 Trade Name Size Ne -6/_ .S / $ Capacity % Sq. Ft. E.D.R BTU H.P Total Connected Load J- Z Hind of Fuel BURNER — Trade Name Size 1�io Capaci Sq. Ft. EMjt BTU ESP. (REMARKS—OVER) D-36 '° .42 HEAT LOSS CALCULATIONS, -e /4- DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No Yes—No 19_ I FII R....... I i ---.L .o A.1- vmlt. Lr_ _t - a r, i n Windows and oors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. ofyy pane of pane lights crack ett. ft. �of c� ® f Width Height No. of Lineal ft Area No. of pane or pane lights of crack sq. ft. t Coef.1 Btu Coef. Btu Infiltration 's- 3'? a �- Glass 1 Exp. wall ,3 Glass t LY Net exp. wall / Exp. wall Int. wall Glass Exp. wall Net exp. wall Ceiling �� Floor / 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.1 Room I Length V Width I Heiaht L Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. a� J Width Height No. of Lineal ft Area No. of pane or pane lights of crack sq. ft. t Coef.1 Btu Infiltration , Coef. Coef. Btu Infiltration 1 /,3,3 Glass t LY Ceiling ZQ,y / Exp. wall J( Glass Exp. wall Net exp. wall Net exp. wall / Int. wall Int. wall Int. wall Ceiling Ceiling TT / Floor Floor Floor 1 otal 15tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I Fl.I Re, „0 Room I Length //3-4 Width ,P-4- 14Aaht 9 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. a� J Windows and Doors—Crackage and Area Width Height No. of pane of pane Coef.1 Btu Infiltration , Coef. Glass / i Exp. wall Net exp, wall Glass Int. wall Coef. Btu Ceiling ZQ,y 17 - 9ax Floor l � / (o Tbtal Btu. ft. E.D.R. or sq. ins. W.A. Leader area FRIDLEY, MINN. Insulation Kind How Applied m -- It --_.t / avr_-J.t_ / tt -L. _. ..l ..a... — a ....e... Windows and Doors—Crackage and Area Width Height No. of pane of pane No. of Lineal ft. Area lights of crack sq. ft. Infiltration Coef. Glass / i Exp. wall / Net exp. wall Glass Int. wall Coef. Btu Infiltration 17 - 9ax 7 � / (o Glass Exp. wall Net exp. wall % Net exp. wall Int. wall Int. wall Ceiling Ceiling Floor Floor �71 9"A Total Btu. —d /,,,5:571, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FI -I -J Rnnm I I Pna&h j t W;Ath / i� M.Wkt ry Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack I sq. ft. , 7 1 -?t Ji t Coef. Btu Infiltration Coef. Glass Infiltration Exp. wall / Net exp. wall Glass Int. wall Ceiling s -x Tj i 2- J� 17 - 9ax Floor / 222h ' 1 -J,:3 Vy 1 otal btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I PI -1 A,7 ll! �/ RM... I t ... s►l. C/✓ _ W,.4, . iii 14.6-1-6 C/ Windows and Doors-Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Ji t Coef. Btu Infiltration 3, �✓ Glass �.. Exp. wall Y Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader arra r.-7,, ' .., `r,az HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows es I Doors Reference Out. Wall Int. Wall Ceiling RoofTTOO:r:: Y—No Yes—No 19— F1.1 dq, . Room I Length l Width a Height J' II Fl.l Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane Iighte of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall --� Net exp. wall Int. wall Ceiling Floor S — 1 otal btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.1 n7 b --R.. I I moth J-2 W;Ath i, L 14.;A► ri Windows and Doors—Crackage and Area Width Height I No. of Llneal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration, Glass Exp. wallI Xff Net exp. waA Int. wall Ceiling Floor I otal tStu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.1 , , Room I Lenath 4 Width j Height 0 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Coef. Btu Infiltration , Glass , Exp. wall Net exp. wall Int. wall Ceiling FloorI/ey I Require&sq. ft. E.D.R. or sq. ins. W.A. Leader area FRIDLEY, MINN. Insulation Kind How Applied Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane ilghts of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor — Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors---Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor — Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor — Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area SUBJECT ERM I City of Fridley ®1324 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 1•--- �'J 612-560-3450 910-F15 10-7-75 JOB ADDRESS 5610 Matterhorn 1 LEGAL LOT NO. 6 BLOCK 4 TRACT OR ADDITION SEE ATTACHED Innsbruck North Addition DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Derek Roek 5610 MatterhornDrive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential -T-CLASS OF WORK ❑ NEW ❑ ADDITION (A ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK finish recreation room 9 CHANGEOFUSEFROM TO STIPULATIONS 0A tog FWD w W E"'Et P�R�11!S SSP AN® SIGNS. PI.U�BING HEpTiNG, 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 ANYTIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 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. $2,000 1.00 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- $12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 13.00 OR OR AUTHORIZED AGENT IDATEI N PROPS LY V I ATED THIS IS YOUR PERMIT "11NATIRCON _ 0_3 -q) le--l- BLDG INSP DATE SIGNATURE OF OWNER AF OWNER BUIL RI (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: L Ie K _�O CK BUILDER: EL— F ADDRESS : S I G MND OZ �bR o ADDRESS: NO:. STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach .o this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Square Feet; Cubic Feet: Type of Construction: To Be Completed: - \ Height: Estimated Cost: _$ U W� 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. DATE: l - SIGNATURE: iho_� (See Reverse Side For Additional Information.) 0J i SUBJECT P City of Fridley 27891 AT THE TOP OF THE TWINS BUILDING PERMIT r R ECEtPrIM . `- COMMUNITY DEVELOPMENT DIV. _ f " PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 I.' NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 9/21/98 JOB'ADDRESS 5610 Matterhorn Dr NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DEscR. 6 4 Innsbruck North Addition I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 571-8619 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO American Roofing & Const Inc 23624 St Francis Blvd St Francis 55070 753-7451 2010939 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 .0 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house & garage (22SQ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,885.00 $.94 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- $59.50 Fire SC $1.88 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE;rL FEE Lice SC $5 0 $67.32 SIGNATUR F CONTRACTO R AUT Wa DA IDATEI EN PRO Y VALI D THIS 01UR P.EaMIT t S.GNATURE OF 0WNEP,1F OWNER BUILDS I IDATEI 8 G INS05DA tE i NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: _ Owner Name & Addr Contractor: Address: Effective 1/1/98 Tel. # (5'7/'-n MN LICENSE # Tel. # r Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: % 'i DESCRIPTION OF EMPROVEMENT Width Height Sq. Ft. _ Width Height Sq. Ft. _ Width Hgt/Ground Sq. Ft. _ r Construction Type: Qs Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = c = $ CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $.50/$1,000 Valuation ' $ $1000 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 [ ] f CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432, 572-3604 RATE SCHEDULE Residential APPUCATION FOR POWER PLANTS AND HEATING, COOUNG, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacemenfi�umace (Side Vent -Fill Out..Back) Gas Piping (Needed withnew furnace) Gas Range Gas Dryer 'T) *AirConditior Ing -All Sizes . N T All Others/Repairs`3<Alterations (UST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $10.00 $10.00 •:i $ X0.00 n; .b • $ x.00 . `r HI $ 30 $ State Surcharge $ .50 TOTAL FEE $ 55. So MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 1998 JOB ADDRESS 6t V IV -47TtWP R d ,0P. 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 andrte L OWNER_ _ MAS VARA /H/,4�x- BUALDING USED AS O 1 ;: 13911 n ESTIMATED COST ��/S• PERMIT NO. / 3 / l 1 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Cirde One (Steam) (Hot Water) (Warm AI Trade Name Am,ArYsq Size No. 014$6 070 30 BTU 10, DSD HP EDR Fuel A1 -4-r. Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY 6114j61A)tj?A: Signed By Ca".t+% Tel No. Approved ByqTA Rough-In Date Final Date �- % -)- \0 FILL OUT BACK SIDE FOR ERIACA71ON ON REPLACEMENT FURNACE Remarks: List ALTERATIONS- Being Done_ HEATING CO: Signed By: Date: 7,Q CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the. existing chimney or stack: 1. Has been carefully examined Yes (a No ( ) 2. Is free from rust or deterioration Yes (rJ- No ( ) 3. Has no foreign objects lodged within Yes (-�-No ( ) 4. Is securely supported Yes (✓l No ( ) 5. • •L Meets all current Code requirements for size and total BTU's connected Yes (✓f No ( ) 6 Has total heating BTU's of 70.1 a 0 0 All other BTU's TOTAL BTU's IJ 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: 7,Q FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 March 23, 2001 Clara Miller 5610 Matterhorn Drive NE Fridley, MN 55432 Re: Final Inspection at 5610 Matterhorn Drive NE Contractor: Suburban Air Dear Ms. Miller: A mechanical permit was issued on July 7, 1999 for the installation of a furnace and air conditioner at your address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a final inspection shall be performed on the mechanical permit. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the appliances were installed correctly. We also need to check for the installation of combustion air, vent and connector sizing. - - If you would like the installation inspected, please contact us within 30 days to arrange the inspection. If we do not hear from you we will expire the permit and note that no inspection were called for. Any questions can be addressed to myself at (763) 572-3603. ly, DAVESEN Build i nspector DJ/mh SUBJECT " City of Fridley ("PC 31939 AT THE TOP OF THE TWINS BUILDING PERMIT _ COMMUNITY DEVELOPMENT O r � - PROTECTIVE INSPECTION SEC.. 572 3604 SY®3 { I �'�'1 CITY HALL FRIDLEY 55432 �"-"� NUMBER REv DATE e PAGE OF APPROVED ev 612-571-3450 910415 6/27/01 JOB ADDRESS 5610 Matterhorn Drive NE, I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 4 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clara Miller 5610 Matterhorn Drive NE 763-571-8619 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Custom Remodelers Inc 474 Apollo Dr, Lino:jAkes, MN 55014 651-784-2646 1748 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 a" ADDITIONS 0 AL ER ON REPAIR O MOVE O REMOVE 8 DESCRIBE WORK �o Install egss window 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. rermit Inspection Cams ill Be Mailed TOW 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 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 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 $3,000 $1.50 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 F TOTA FEE Licen S $5. 0 1 r2.75 SIGNATURE OF CON TRACTOR OR AUTHORQEO AGENT (DATE, MEN R P Y ALIOAT D HIS IS YOUR PERMIT a/ 8LD mNSP - hAtE S-GNATURE OF OWNEROF OWNER GUILDER, iDATE, NEW [J ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor: -U Address: H I Effective 1/1/2001 (763) 572-3604 Bldg Insp Tel. # Ib�- 5-7 f` 4Kk19 :NSE # 17 TK j Tel. # 6 5'1 - 7 T I -L a N I� 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: Construction Type: WjLft�Estimated Cost: $ �. D 0'0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ UUt DATE: 1p "d d'b APPLICANT: Tel. # 6 h �7 ��J�� "l CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Call (763) 572-3604 for Permit Fees if mailing in application S 93 a 5 Fee Schedule on Reverse Side $ 3. civ .001 of Permit Valuation (1/10th%) $ I .5 D $.50/$1,000 Valuation $ $1150 per SAC Unit $ K, 0 $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 [ ] STIPULATIONS: 00 Custom CRI Remodelers, Inc. HOME IMPROVEMENTS 474 Apollo Drive Lino Lakes, MN 55014 (651) 784-2646 lol'sl 01 /o •/40• to/ E ORDER DATE 10 j DEPARTMENT -zAag�;- p/i F 73111 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY _ SUPPLIER < S ADDRESS S / �%Q MDLUPHONE N0.` ! �t� 6431 UNIV. AVE. N.E.FRIDLE 763-57 - 45 55432-4364 ® CONTACT 763-571-3450 PRINTED ON RECYCLED PAPER. PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. /O •�� • O/ DA • ',I AA&&4tk PAYMENT AUTH IZED BY ACCOUNT CITY. UNIT PLEASE ENTER OUR OR ER FOR THE FOLLOWING UNIT PRICE AMOUNT /J3 S616 /o - d �av^ �� f tr l Vo TOTAL THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD.