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PRE 2010 DOCS° SUBJECTRMI City -of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2 5 E 5 8 r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��� r CITY HALL FRIDLEY 55432 NUMBER REV7 DATE PAGE OF APPROVED BY L J` 612-571-3450 910-F15 10/31/97 / / JOB ADDRESS 5711 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 0lympia`Construction Co Inc 2105 Long Lake Rd, New Brighton MN 55112 633-4515 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 2138 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 CR NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 27' x 42' Dwelling; a 24' x 32' Garage; and a 12' x 16' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. Contact City Engineering Dept for sewer & water locations. Paid Park Fee of $1,500.00. WARNW6 Before digging call fef all utility locations 454.0002 SEPARATE PERMITS REQUIRED FOR REQUIRED BY -LAIN. WIRING, HEATING, PLUMBING AND 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 Fire SC AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $147,821 $73.66 $147.32 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- STRUCTIO R E PERFORMANCE OF CONSTRUCTION $1,127.25 $950.00 r19 11 7 ( PLAN CHECK FE TO L FEE Lic ns S $5.0 ,303.23 + PF SIGNA RE OF CON';CTO.'IF RIZED GENT (DATE) HENRO Al 04 Ip SP VALID A E THIS IS YOUR PERMIT 1- �O gaTE SIGNATURE OF OWNER iiF OWNER BUILDERI IDATEI Viv'?EW [ ADDN [ ALTEIZO" [ J Constructi'o'nAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION aL 1 -)e - Effective 1/1/97 C � Legal Deseription: �' �a Tj�D �TioirJ Owner Name & Address: ;g um ea Tel. # Contractor:o; ,,� O&A j MN LICENSE # Address: a/OS"1.�,,�o ,�,�� �. �r�,/�— Tel. # 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. 0,6114* /Z, Z / = 1&"4;ze = 131YaYpv 2610/,. 37 DESCRIPTION OF BIPROVENIENT Length oZ,�r • Width %i?'* Height Sq. Ft. lfo7 Length RY / Width 5,;.? Height JK Sq. Ft. -Len , Width /6, Hgt/Ground S'� Sq. Ft. I73��Y1613,y3, L Construction Type: yp 4lmn �ion� Estimated Cost: $ � (Fee Schedule o� Driveway Curb Cut .Width Needed: /8 Ft. + 6 Ft = 2Ft x $ DATE. -IO -AP -97 APPLICANT:_ ,�.. ��y,., Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge driveway Escrow ?rosion Control 'ark Fee ewer Main Charge TOTAL uPULATIONS: CITY USE ONLY $ 2%, �� Fee Schedule on Reverse Side $-JY7,3z .001 of Permit Valuation (1/10th%) $ 73.GG $.50/$1,000 Valuation $ cep $950 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above /,Soo . 00 803- a3 $450.00 Conservation Plan Review Fee Determined by Engineering Agrgment Necessary [ ] Not Necessary [ ) ®V -12" RCP CL 4 ® 0.4% �\ 38 L.F. 12' CASING • 40 LY 64 P.V.0 _ C.0.1 INV.948.73 EX. R.E. 954.23 \ v` INV. 933.70 INSIDE DROP C.O. 2 \ M. 954. Ep �9 x.00 NOTE: WATER SERVICE FOR \ — LOT 1„BLK J TO BE CONNECTED `\ _ TO 14 W.M. ON LOT LINE. ALSO LOT ¢ BLK * I. Q \ \\\ h6 MATTERHORN PreD), certify that this p/an was prepared by me or under direct supervision and that / am o duly reUistered pro— ioncl enq%neer under the lows of the State of Minnesota. S-0+24 S-1+10 'EXIST. 14 " WATERMAIN DRIVE TOTINO GRACE AMMON FRIDLEY, MMIES(DTA CITY OfFFUDLEYINSPECTION DIV, Effective QnJanuary 1.1sa7 6431 University Ave NE Fridley, MN55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3sO4 MARK NUMBER OFFIXTURES TO8EINSTALLED ONEACH FLOOR vv Wash Floor Z Water Heater Stories .011 . s ..... Urinal T Shower I Trav Drain asm: Washer pp Range 1- as Elec Basement 777 Floor 2 X. Floor 3 [Floor 4 PLUMBING FIXTURE RATES: WO. RATE TOTAL JO8ADDRE8 New Fixtures [> ���_ $7.O0 �� The undersigned hereby makes application for apermit for the work herein Old Opening, New Fixture $4.00 specified agreeing todoall work instrict accordance with the city codes Beer Dispenser *5.00 and rulings ofthe Building Division, and hereby declares that all the facts Slow Off Basin *7.00 and representations stated inthis application are true and correct. Catch Basin ----- �7.�O ------- Rain VVoterLeader $7.00 / ~) -/c/ / 8ump/RoceivingTanh $7.00 �° . 1997 Water Treating Appliance *10.00 Owner Water Heater —Electric �7.�� x VVaterHeoter— 8om*^ $10.00 Building Used As Gas Range" $1�.O� Gas Dryer** / *1¢.00 16,0 Estimated Cost PERMIT NO. O.800hF|ovv Back FlowPreventar Required ( )Yeo ( ) No ���------' - Type �15�Oo _----__ PLUMBING---....'. 4A6 _101m, Reinspection Fee $42.00/HrY TEL NO. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5%ofValue ofFixture orAppliance State Surcharge h arge ���� � TOTAL FEE 70 PLUS THE $ 501 STATE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 UniversityAve NE Fridley, MN 5532 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES TOTAL FEE MINIMUM FEE FOR ANY HEATINGtCOOUNGNENTILAT10N REFRiGERATIONIAIR 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. HEATING COMPANY Signed By/�;, -�f f,�,F Tel No. Approved By Rough—In Date Final Date FILL OUT BACK SIDE F STACK VERIFICATION ON REPLACEMENT FURNACE M r I kD 0 3 n 0 03 00 A r m N JOBADDRESS 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 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) L ;_2 A- ,1997 Gas Piping (Needed with new furnace) $10.00 $ OWNER' Gas Range $10.00 $ BUILDING USEDAS, Gas Dryer $10.00 $ E3TIMATED COST //61 1 PERMIT NO. -I �L! "Air Conditioning — All Sizes $ 25.00 $ ' DESCRIPTION OF FURNACE AND OR BURNER All OtherslRepairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Stec Hot Water) (Warm Air) Trade Nameti) �� moo. M&_. &(D -Z) CommerciaUlndustrial BTU ,14M'Q HP EDR 1.25% of Value of Appliance or Work $ Fuel_ j) ( . Total Connected toad State Surcharges Burner Trade Name Size No. BTU HP EOR TOTAL FEE MINIMUM FEE FOR ANY HEATINGtCOOUNGNENTILAT10N REFRiGERATIONIAIR 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. HEATING COMPANY Signed By/�;, -�f f,�,F Tel No. Approved By Rough—In Date Final Date FILL OUT BACK SIDE F STACK VERIFICATION ON REPLACEMENT FURNACE M r I kD 0 3 n 0 03 00 A r m N 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 S-1 1,/�.t212>� 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 $� representations stated in this application are true and correct. (Side Vent - Fill Out Back) 1997 Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $10.00 $ BUILDING USED AS � �- �• Gas Dryer $10.00 $ ESTIMATED COST (o,S-r�� PERMIT NO. *Air Conditioning - All Sizes $ 25.00 $=aEL= 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) 6.rarm Air Trade Name �7Vy P �� Size No.9Qn m CommercialAndustrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel L)A -CSS Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE HEATING COMPANY C.S,1�,_ �,xzQp2�S� S MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed B 1LG Tel No.1®Cc,1 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 FO STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNAC CHIMNEY 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 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes No Yes () No ( ) Yes () No ( ) Yes ()No() Yes No Yes No NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Address: oP/OS" Zo.4 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: s j'r ea .rr� Effective 1/1/98 Tel. # 6f? - e'�0 1.y c , MN LICENSE # A/ 3V ,d, Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ (Fee Schedule on Back) o0 Driveway Curb Cut Width Needed: /8' Ft. + 6 Ft = gLFt x $;pf--— = $-3W DATE: APPLICANT: !ten O`�/.P.r�ro�, Tel. # Permit Fee $ Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.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 [ ] CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 November 17, 1998 Olympia Construction Co Inc 2105 Long Lake Rd New Brighton, MN 55112-5165 Re: Final Inspection at 5711 Matterhorn Drive NE, Fridley, MN Dear Sirs: A final inspection was conducted on November 17, 1998 for the above noted address. We found that the construction of the building complies, to the best of our knowledge and belief, with all the requirements of the building codes of the City and the State of Minnesota relating thereto, and permission is hereby given for the occupancy of said dwelling. If you have any questions on this matter, please feel free to contact me at 572-3602. Sincerely, RON JU Building RJ/mh CITY OF FRIDLEY INSPECTION DIViSION �j �"� Effective On January 1, 2000 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 'Z . RATE SCHEDULE OWNER Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/ Industrial 1.25% of Value of Appliance or Work Rate TOTAL. (/ BUILDING USED AS RESIDENTIAL $ 30.00 $ ESTIMATED COST o f ` PERMIT NO. l 41-7 —472 $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units - Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ Fuel Total Connected Load FIREPLACE --- Burner Trade Name ; 6) (ooc�-irc Size No. $ �S� BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all'work in strict accordance with the City Codes an $ :50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING CO ALLIED FIRESIDE dba FIRESIDE CORNER Signed �%1� ic, TEL # (s/ -63L -X -4-'r Approved By Rough -In Date Final Date �`CI 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 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 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: 441 - 4l 70 1 t44�-A76- rE� 711 153ub L -w 'SS(Das- 4-7-) - -?S,-- a SUBJECT � RMI N City of Fridley 32222 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ,. �------, INSPECTION SEC. 572® �96 f � � PROTECTIVE ---,• CITY HALL FRIDLEY 55432 i A ; NUMBER REY DATE PAGE OF A0PROVEO BY ,fir ---- 1 J` 612-571-3450 9 10/5/01 JOB ADDRESS 5711 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry/Bonnie Pettipiece 5711 Matterhorn. Drive NE 763-571-0658 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Olympia Builders & Designers Inc 2105 Long Lake Rd, New Brighton, MN 55112 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 651-633-4515 20173164 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION 0 REPAIR O MOVE O REMOVE X B DESCRIBE WORK Construct a 20' x 12' Additional Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS,AM WARNINU REQUIRED FOR: WIRING HEATING, Before digging call for PLUMGINd AND SIGNS all utility lbbations �< NIQUIR90-10WILAW 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 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 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 $2s 76O $1.38 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 NY OTHER STATE OR LOCAL LAW REGULATING CON. $83.25 Fire SC $2.76 STR CTION OR T E PERFO NCE OF CONSTRUCTION PLAN CHECK FEE TOTA EE License SC $5.00/2.39 SIGNA4AE OF CON -RACTOR AUTHORIZED AGENT IOATEI EN ROP Y ALIDATE HIS IS YOUR PERMIT / BL -NSP OATE SGNATURE OF OWNER OF OWNER BUILDERI IDATEI a NEW [j ADDN ALTER [ j Construction Address: Legal Description: _e Owner Name & Address Contractor: Address: R/b iia' c LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Effective 1/1/2001 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 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 i Width_ Hgt/Ground Sq. Ft. o?,76 �O f� CE Estimated Cost: $ .1 a2 YO Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /�_®/ APPLICANT: Tel. # CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ aJ� Fee Schedule on Reverse Side $ 7/0 .001 of Permit Valuation (1/10th%) $ . 3 g $.50/$1,000 Valuation $ $1150 per SAC Unit $ 6, 00 $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 [ ] IMN SUBJECT < P City of Fridley 2282 AT THE TOP OF THE TWINS BUILDING PERMIT r R COMMUNITY DEVELOPMENT DIV. TECTIVE INSPECTION SEC. 60 V9 r 1 PRO 1 � NUMBER REV DATEPAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910415 10/29/01 JOB ADDRESS 5711 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Terry Pettipiece 5711 Matterhorn Drive NE 763-571-0658 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Patio Enclosures Inc 2123 Old Hwy 8 NW, New Brighton, MN 55112 651-631-1100 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1676 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 14' x 15' Three Season Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 'a. WARNINIff- SEPARATE PERMITS Before digging call for REQUIRED FOR. all utilioocationS UI�iNGa�NG ilo2 Sift REQUmmD BY LAW '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 BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 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 @ $3.43 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,850 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- ST CTION PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE T TAL FEE Lice C $5. :,$154.53 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEtHE PROP Y VALID E THIS IS YOUR PERMIT - gAfE S-GNATURE OF OWNERoF OWNER BUILDERi iDATE,e"011NSF' NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION . Construction Address: 7// /YJ� 7�tC�e 1-�r���l b-12 `::L'jLA.0.� 11 1 5;'543p Legal Description: filon jl:neket'l� �n vi,�.ncSte U�7v3Owner NameSAddress Aw p- CSS a,Nei. # Contractortn CAClocl A2PS �n t_.. MN LICENSE #�G —1(p—1 p Address: 4i ,93 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: �c d crr) Construction Type:, k0i oa6or) Estimated Cost: $ ( A Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 16-,5- 0( APPLICANT•, %71c� Jl IL Tel. #(®S/'(�3/- CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ 13q, 19'�7' Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ 3 $.50/$1,000 Valuation $ $1150 per SAC Unit $ 00 $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $/�0 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ADDRESS : 5711 MATTERHORN DR NE PIN : 243024130011 LEGAL DESC : TOTINO GRACE ADD : LOT 8 BLOCK 1 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK PERMITO72004:-0�0466 DATE ISSUED: 04/08/2004 VALUATION : $ 4,520.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 26'X 14' DECK STATE LICENSED CONTRACTOR 1 APPLICANT OLYMPIA BUILDERS 2105 LONG LAKE RD NEW BRIGHTON, MN 55112 PETTIPIECE TERRY J & BONNIE J 5711 MATTERHORN DR 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 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 te provisions of any other state or local law regulating cqAtqjctioq5§X tdrformance of constructign. /1 . BUILDING PERMIT FEE 111.25 FIRE SURCHARGE 4.52 STATE SURCHARGE, VALUE 2.26 PLAN CHECK FEE 72.31 LICENSE SURCHARGE 5.00 TOTAL 195.34 PAID WITH CHECK # 112488 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: IY56 Effective 4/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax 'L 0[ Legal Description: Owner Name & Address: Tel. Contractor. ,` �S ' ,,P MN LIQ NSE # Address: Tel. # 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. �C) DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length d6 Width f 1Y i Hgt/Ground �O Sq. Ft. 33% Construction Type: ©i G ±! Estimated Cost: $_T Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: l ' "69? APPLICANT: Tel. # 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 $ ,05 $ -7a.3/ 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 [ ] TOTAL $ S a 3 STIPULATIONS: Building BUILDING Permit No. �U Inspections RESIDENTIAL APPLICATION Received % 763-572-3604 CITY OF FRIDLEY D 0 DATE � I % � O YOUR E-MAIL ADDRESS �n � ►s �+t-fir . G, Se �4 ✓DD . C -Orr -% SITE ADDRESS 57I / br- THIS APPLICANT IS: ❑ OWNER PkQNTRACTOR PROPERTY OWNER/ NAME: .gam. -e- l,CC TENANT 11 .I ADDRESS: %� a Pr CITY Fr Id STAT)gfIP� 3Z. PHONE: ro/9-42A-7-a94 CONTRACTOR NAME: R, JNV- INC SUBMIT A COPY OF STATE LICENSE # e i on mif1 i .Ci()R RT W- DATE YOUR STATE LICENSE ADDRESS: ST LQiTIS PARK' A1N 55416 CITY STATE ZIP WITH APPLICATION PHONE ID #0001050AX PROPERTY TYPE RSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT 'TYPE O ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH a'POOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMOD LING DESCRIBE WORK BEING DONE: f ¢ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT __Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES OHOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS []Yes [No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL!MBASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) T VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ t 00 .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work =4� equires reviewand ap roval of plans. SIGNATURE OF APPLICANT �� PRINT NAME &jgnr.. I , c lC DATE i