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PRE 2010 DOCSof Fridley SUBJECT FPECity 13293 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION R ^ �l r SEC. 1 I � �l �"•1 CITY HALL FRIDLEY 55432 ,�J NUMBER REV. DATE PAGE OF APPROVED BY L•••'� 612-560-3450 910-F15 110/31/75 JOB ADDRESS 5760 Matterhorn Drive N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Grace High School Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Gorham 9050 Collins Drive N.W., Anoka 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 7 CLASS OF WORK ❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 44' x 43' Dwelling approximately and a 24' x 24' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. Provide sod in the front and side yards. Owner will provide underground utilities for the 14 residential lots in Block 2 of this plat. Owners will work with the City of Fridley Engineering Dept. regarding drainage and elevations in Block 2 of this plat. Owners will plant one tree on each lot in Block 2 of this plat, each tree to be 1-1� to 2 inches in diameter. SEWER LOCATION: (15' Deep) 70' North of Manhole (Inv. 930.97) WYE ELEV: 930.26 TOP OF FOOTING: 933.26 Minimum WATER LOCATION: MUST BE TAPPED 6" CIP watermain 5' east of east property line of Lot 9. wARNIN --IMPORTANT--' N01IFY THE FRIDLEY ENGR. Before digging ed 1=1 utilities II ON CUR(B�T TELEPHONE - ELEC'i'R!C • GAS DID. ppilll �R�{EGApR�DpI�NeG� WNAM9�C/1<LDFiL77T31B1NG'� ITTG, TYPE OF CONS #VR1J C��1FjANCY LOAD SEPARATE PERMITS ARE REQUIREt VENTILATING OR AIR CONDITIONINGAT DRIVEWAY OPENINGS. Wood Fr V D ,t!/ 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 R-1 23,144+5760 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $35,550 17.93 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $53.47 $325.00 PLAN CHECK FEE TOTAL FEE ,,,// �� oo e .04r v /0-3%-73 396.40 SIGf,IATURE0 ONTRACTOR OR AUTHORIZED AGENT (DATE) ^ WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT G' /h�L/C -rte a BLDG INSP DATE .' SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) -APPLICATION FOR RESI'DL'NT1AL, ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S ME : o, / 7 Car 4 h, BUILDER: 1 o ,r 4 a rN C ADDRESS: FOr �%ol f �Nf �ri tyw A^,c+l'/o-., ADDRESS : caj-o' tiay zloo° 44-0k,, NO:. STREET: /ICA. ttr r -/C- S-^) /fie^ Cj o� ADDITION: 7 -OT : BLOCK: (s �. e �e �', �� c✓ ��� o CORNER LOT: INSIDE LOT: SETBACK: 3S SIDE -YARD: `® • E Applicant attach to this form 1%.7o Certif icates . -if Survey . of L-ot and. proposed • ' building location drawn. on these Certificates. DESCRIPTION OF BUILDING ° To Be Used As: ' les i��..Ll Front: 6Y Depth: IY3 Height: (' Square Feet:— 1i `/ Cubic . Feet : Front:* Depth : Height: Square Feet; Cubic Feet: i Type of Construction: Z'✓oo® rra,r,e Estimated Cost: qr To Be Completed: a,✓ /7 7 J�,8S0 The undersigned hereby makes application fora permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • DATE: •/4 - D.9 _76- SIGNATURE: f �✓'✓ �� (See Reverse Side For Additional Information.)' PIT L !S73. y7 -�� 19l_l AiluitiSi(1,� 1�Cet�Ef1 %`h6A1 'r�o�l���w oq� • t - Lpan� sg) X hobs _ o _ oh 9bhl i� �Ad Lh LS IS Et XL -L I boo Yos: x -_ i �z h _ ��• c, x acs - 7 LZ X 1 1 ..P - -s z� 929 '� x 1 ts -"L1 01 Z X 3s a = ENI X 02 og -� 0"U; 45026 i xE fir► w - 'r�o�l���w oq� • t y 1 I A, F1 EIS®& NOWAK, 7415 WAYZATA sura MINNEAPOLIS, MINNESOTA CEMTIFICATE OF SUMVEY For Z ko 143.52 1Aw1 0N d � � 1 1 1 Z J O h t0 b Q bof J • • O 1 1 1 c 1 V h I ;tea I o ao - e I 1 1 �I Q 1 I y 1 I A, F1 EIS®& NOWAK, 7415 WAYZATA sura MINNEAPOLIS, MINNESOTA CEMTIFICATE OF SUMVEY For Z ko 143.52 1Aw1 0N d � � 1 1 1 a -- -- 147.0$ 11'Cz � --- C !floc® digging CON 1=1 UMft�11�.i..•1► fit PN01-ELSM-GAS Eht, M VM REC,�UIRED BY LAW tr INE FRit qjVjj10N REGARDING 6UMN §gM@ DYNE DESCRIPTION: Lot 9, Block 2, GRACE HIGH SCHOOL ADDITION. Of SCALE: 1" 30' We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of allbuildings, if any, thereon, and all visible encroachments, if any, from or on said land. Dated this18th day of July 1975 EGAN, ELO a NO iHt: /) urveyo Sri i le No 5299 Bootc_ No, by / ,Qh.v�,n• Z . �% QC h t0 b Q bof J • • O 1 a -- -- 147.0$ 11'Cz � --- C !floc® digging CON 1=1 UMft�11�.i..•1► fit PN01-ELSM-GAS Eht, M VM REC,�UIRED BY LAW tr INE FRit qjVjj10N REGARDING 6UMN §gM@ DYNE DESCRIPTION: Lot 9, Block 2, GRACE HIGH SCHOOL ADDITION. Of SCALE: 1" 30' We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of allbuildings, if any, thereon, and all visible encroachments, if any, from or on said land. Dated this18th day of July 1975 EGAN, ELO a NO iHt: /) urveyo Sri i le No 5299 Bootc_ No, by / ,Qh.v�,n• Z m QC h t0 b Q bof J 1 1 a -- -- 147.0$ 11'Cz � --- C !floc® digging CON 1=1 UMft�11�.i..•1► fit PN01-ELSM-GAS Eht, M VM REC,�UIRED BY LAW tr INE FRit qjVjj10N REGARDING 6UMN §gM@ DYNE DESCRIPTION: Lot 9, Block 2, GRACE HIGH SCHOOL ADDITION. Of SCALE: 1" 30' We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of allbuildings, if any, thereon, and all visible encroachments, if any, from or on said land. Dated this18th day of July 1975 EGAN, ELO a NO iHt: /) urveyo Sri i le No 5299 Bootc_ No, by / ,Qh.v�,n• 3. Nei DIAL4 A,I� A-10 0 0/7 CCC l/V� fA/OA/� 6 JJJ��. o� a��34 � c� � y� 3 in 3� a _ re.. .. .ti.,. yy e Y g w Y.Y. /"*' .!.}� <.p�J, n4. N?. ♦ .a!p�Rl 1�. d ' d��ut: f �'u7i co ra r.p •y • �-Bo. If v>Cs'V:.i 1.�+•�.c ie �n • •�Y..a;.aG Eweyn q Vet�w*Krco[i �0 ''biCn'�It.u. it lPidaG@ fit On r:.L�+a4 V6�i4�� p?1 l:s �"_'r..,.�•r i�m'r^t�-e� '4],Aw�.fR�!. 9 .�•y ,std fpr. ��,,.,��5",4^. mS �vsmkLn,::aec+w.+woi•o ,,.�ed5�a4t?.v mLa1:.9 ���s6w.;v PARTIAL. IZATE SCHEDULE GItA VtTi! WARM AIR: 1"'a TOTAL Furnace Shell & I}f;et Work $IO.00 $ Replacement of Furnace 6.00 $ P.rpai-c & Alterations -up to 5500.00 60 S Repairs & Alterations each add. 5500.00 300 $ Kzcz-L WARM AIR F'urraee Shell & Duet Work to I20,000 BTU .$1000 each add. 60.000 BTU 3XK) S R.epdreemcn. of Furnace 6.00 3 Repairs & Alteratiors--up to $590.00 6.00 $ Repairs & Alterations each add. 5304.00 3.00 $ STEAM az HOT WATER STSTEBI Furnace Shell & Lines --to 400 sq. it F.DR Sterni $lO.00 3 Furnace Shell & Line --to 640 sq ft. EDR Hot Water 1000 S. Each add 200 sq. ft EDR Steam R on 5 Each add. 320 sq. ft EDR Hot Water 3.00 S Ia pt. of Blaga. Phone i M.= City of Fridley: The undersigned hereby makes application for a permit for the work herein specified agrc- ing to de all work in strict accordance with the City Ordinance: and ruting•of the Depa:tment of Buildirgs, and hereby declares that an the fnzif and reprecPntatiuns stated in this application are true and correct. r Fridley. Minn- b4770— �1l Owner -7 . Kind of Building Used as To he completed aabto�u-t``_ Estimated Cost; S Old . ew. Building Permit No. _.__ __ pormit No. nza—call- IOIT or WO -ax OIL BURN -EF -to 3 gal. per hour 6.00 $ TING or PO:V'R FT.ANT'rs-.-tezm, Not Water, Warm Air over 3 gal. per hour -See Tree Schedule C Trade Name f -No Size No-) GAS BURNER (up to L09,C4O BTU) &03 5 over 1S3.000 BTU see Fee 8ckeduic GAS FITTING FEES. 1I0 RATE. TOTAL Capacity..-- -- Sq. FL E.D.R BTU SP 1st 3 Fixtures z<•, X00 S Total Connected Lc+ad 7 Kind a rut Additional Fztures _ X S___ .7$ BURNER - Trart.,e Nam Size Ida Gas Range to M.000 2$ &00 $ State Surcharge .50 cartacity SQ. IeL ED -R IiR'iJ Z� AIR C0 STIOEi:.Gr a FAR'. 5T13T=2 71XZn.A77IZG JLLTF,.AT71=3 & FLEPAIAS TOTAL rmm 92 -?-26 - (CMAaxs-Cret) 4 -.T? 60 ? rT W -e/1 d end �iQ t. HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION Moo" Weatherstrips Guide Construction No. Insulation Windows I Doors Reference' Out. Wall Int. Wall Ceiling Roof Floor Kind How fes—No Yea—No 1 19— .w. 9_:._.w. 1 . . 1 1. - — e u A rl T- . A r 7 D____1 i _... IL / A-4 ® W.'At6 a a.1 4.. v ery %_r &�w—.1 -s— I f — 11 -- .....p... Width Height No. of Lineal 1t. Area No. of pane of pane, lights, of crack sq. ft. Windows and Doors—Crackage and Area 6 e C. A 29 Width Helght No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Infiltration Glass a Exp.. wall Coef.. Btu -Lj Infiltration ,�'� Int. wall h V.� Glass Floor Ab S-0 Exp. wall Exp. wall ` Net exp. wall Exp. wall / ® r Int. wall n 4 1_ Ceiling 0 Int. wall 3 Floor Z 5,70 Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A.- Leader area Windows and Doors—Cratckage and Area 11 -- WidthHeight No. of - Lineal ft.. Area No. of pane of pane : Alshts of crack sq: ft. Width Height No. of Lineal 1t. Area No. of pane of pane, lights, of crack sq. ft. 00 W®t D 6 � 6 e C. A 29 Coef. = Btu Infiltration Glass a Exp.. wall Infiltration Net exp: wall / Int. wall h V.� Ceiling :' % a3© d'(s �• ®�� Floor Glass 001M Btu. Required sq. ft. E.D.R. or aq. ins. WJL-L.eader. area t in I AA R.;.e lIAfh¢th k%L"' lrttdtk:®.-3Z "'Height g 1Vindowa and Doors-Crackage-. ZZMa 11 -- - Width Height No. of Lineal 1t. Area No. of pane of pane, lights, of crack sq. ft. 00 W®t D 6 � 6 e C. A 29 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. it. 2- o Coef. Btu Infiltration Infiltration Infiltration % / h V.� . Glass v Glass ISO Exp. wall Exp. wall ro o Exp. wall / ® r Net exp. wall n 4 1_ Net exp. wall 0 Int. wall 3 Floor ® 0 5,70 Int. wall Ceiling Floori' .2• eA Total Btu. T Required sq. ft.. MR. or sq. irw W A. AAder area /SVFG®4 91ti0 8'rca i� 1E.. mm. a a.1 0 --e--- v -s --- .o Windows and Doors—Crackage and Area 11 -- - Width Height No. of Lineal ft. Area ffypane of pane lights of crack sq. ft. No. of 00 W®t D 6 � A 29 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. it. 2- o Coef. Btu Infiltration Infiltration % / -57— ?_g^ v Glass ISO Exp. wall ro o Exp. wall / ® 2 To Int. -wall . . n 4 1_ Net exp. wall A® 3 Floor ® 0 5,70 Int. wall Ceiling o'® ted[ Floor `�/ Total Btu. ® , Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.1 31v T14 Room I Length 9 ' Width Height Y' Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. it. 2- o Coef. Btu Infiltration % / -57— Glass .g ® ISO Exp. wall Net exp. wall / ® 2 To Int. -wall . . Ceiling A® 3 Floor 17, Total Btu. Required .sq. ft. ED.R. or sq. ins. WA. Leader area Room I Length �� ` Width Windows and Doors—Crackage and Area Infiltration Glass Exp. wall Net exp: wall Int. wall �� .. Ceiling 10 Total Btu. r Required sq. ft. B.D.R. or W ins.. WA, Leader area Btu HEAT IOSS CALCULATIONS DEPARTMENT OF INSPECTIOP . ' Weatherstrips Construction No. Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No Yes—No 19— / FI -I / _ Z',, V..Rmrn I Lenath ®r" IN 3-1 Heutht 9 o II R FU 00re . Windows and Doors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. or pane of pane lights . of crack sq. ft. 2t� 2. '_3 / Coef. Btu Infiltration Coef. Btu Infiltration Infiltration Infiltration Net exp. wall Glass 700 Glass q V. Exp. wall 20 7 02 Exp. waU Net exp. wall Int. wall 16c!% n If ® A _Z-0 CeilingU,/ e�' /A % / 0 Floor Int. wall Int. wall o Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FLIXAmIn Room I Length Ij :�I®® Widthe , °D Height Windows and Doo, rs—CrackaSe and a Width Height NoAre . of . Lineal ft.. Area No. of pane of pane lights of slack sq: It. ® 2 /S. Coef. = Btu Infiltration G Glass : 5 Exp.. waU Net exp: waU- Int. wall Ceiling FIoor Btu. Required sq. ft. E.D.R. or, sq. ins. WA. Leader.'area /:R.1 10 a tKjm Room ILength.// Width: A-67HeiKht Windows and Doors-Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Width Height No. of Lineal ft. Area Na of pane of pane. lights. of crack sq. ft. 7- 2 ev Coef. Btu Infiltration Coef.1 Btu Infiltration Infiltration Net exp. wall .3-1-1 700 Glass q V. /.T' Sol 7 02 Exp. waU SIMI 16c!% n Exp. wall Net exp. wall e�' Net exp. wall Int. wall Int. wall o Ceiling :Ceiling Floor Ceiling Total lstu. O Required sq. ft. E.D,L or aq. im `WLA. t ender area I f MOMMUS. NI1ltUN1. Insulation Kind How Applied t,T,Anom I Length 4t i,, Width 1 Height i ?,'f Windows.and Doors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Width Height No. of ,Lineal it. Area No. of pane of Dane lights of crack sq. ft. �®y 2—G 2 ev Coef. Btu Infiltration Glass Coef. Btu Infiltration Net exp. wall OPO Int. -waU . 3 q V. Glass Floor MQ ®s' 7 2 SIMI 16c!% n Exp. wall e�' Net exp. wall est 0 Int. wall Int. wall :Ceiling Ceiling Floor ���� ? Total Btu. Y7-17- Jt, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area lA FI -I 17 F_ A22 Room 1 Length /V Width-// Height's AA Windows and Doors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. or pane of pane lights of crack- sq. ft. 2 ev Coef. Btu Infiltration Glass Coef. &p. wall Infiltration _ Net exp. wall z 0 4 ao Int. -waU . Ceiling Floor MQ ®s' Windows ind Doors—Crackage and Area Width Height No. of Lineal ft. Area No. or pane of pane lights of crack- sq. ft. 2 ev Coef. Btu Infiltration _ T'� Glass J Exp. wall 6 Net exp. wall est 0 Int. wall :Ceiling Floor" ITotal Btu. 169-064 Required sq. ft. E.D.R. or sq. ins.. WA.. Leader area City of Fridley Ad-sPliccstlOn fOr PLUM d"I'9 C,d Gas u 1fi n c it Dept. of B1dp3. Phone SQA -3430 t)ESCRIPTIOIi OF Mori Locatias 76 ®_- Num!>a-, KLnd a..nd Loerlion of Fixtures . • Futuza Cczn6t2lcn Cr?; n1r;;a �.�. _ Sever * Ides Fixture. Old CJ,eairSs Cecapeol PARTIAL RATE SCHEDULE LUMBING FIXTURE RATES: NO. RATE TOTAL N=.ber Fixtures . • ...... • • ...... x x.2.00. $ Future Fixture Opening ......... x 51.50 $ -• New Fixture Old Opening • . • .. e • . • • X $1.50 $_--- Catch Basin .................. •. x $3.25 $ Water Beater 'Up to 99.000 BTU)... • - / - x 53.00 $ .New Ground Run Old Bldg......... x 5.3.251 $ Eloctrk- Water Heater...... • . • • • .. • a ZAS FITTING FEES: NO. RATE TOTAL ISt 3Fixtures • • . • • ..... • . • ... • . x SM y City of Fridley:. The undersigned hereby crakes application for a permit for the- work hereI specified, agreeing to do all work in strict accordance with the Cit? Ordirarc¢ and ruling of the Department of Buildings, and hereby declares that all Me fact and represe:itations stated In this applicason are true and correct' Fridley. Minn r /^ / `ueI� Owner V®�61r Kind of Building Ile S Used as _ _ s To be completed about . ) -- Estimated Cost, $ Old ew B-uilding Permit No. P•r�it No.,_„_,_2 It Signed By Business Phone Idol—=3� ROUGH FINAL -3 Addlticnal Fixtures . . . . . ..... .. . . . x $ .75 $ Gas Range to 199.000 BTU ............ -- x $5.00 6 . P:4::iS & ALTERATIONS—P.ofor to Code .50 State Surcharge T)e cription...............:........................$ 3.�,�, TOTAL FEE 3 N WATER MTA. oCAS z; s ncG a M f G _a s3 <; �• �� _ _•� / Bsst :rd 3rd {th • Futuza Cczn6t2lcn Cr?; n1r;;a �.�. _ Sever * Ides Fixture. Old CJ,eairSs Cecapeol PARTIAL RATE SCHEDULE LUMBING FIXTURE RATES: NO. RATE TOTAL N=.ber Fixtures . • ...... • • ...... x x.2.00. $ Future Fixture Opening ......... x 51.50 $ -• New Fixture Old Opening • . • .. e • . • • X $1.50 $_--- Catch Basin .................. •. x $3.25 $ Water Beater 'Up to 99.000 BTU)... • - / - x 53.00 $ .New Ground Run Old Bldg......... x 5.3.251 $ Eloctrk- Water Heater...... • . • • • .. • a ZAS FITTING FEES: NO. RATE TOTAL ISt 3Fixtures • • . • • ..... • . • ... • . x SM y City of Fridley:. The undersigned hereby crakes application for a permit for the- work hereI specified, agreeing to do all work in strict accordance with the Cit? Ordirarc¢ and ruling of the Department of Buildings, and hereby declares that all Me fact and represe:itations stated In this applicason are true and correct' Fridley. Minn r /^ / `ueI� Owner V®�61r Kind of Building Ile S Used as _ _ s To be completed about . ) -- Estimated Cost, $ Old ew B-uilding Permit No. P•r�it No.,_„_,_2 It Signed By Business Phone Idol—=3� ROUGH FINAL -3 Addlticnal Fixtures . . . . . ..... .. . . . x $ .75 $ Gas Range to 199.000 BTU ............ -- x $5.00 6 . P:4::iS & ALTERATIONS—P.ofor to Code .50 State Surcharge T)e cription...............:........................$ 3.�,�, TOTAL FEE 3 City of Fridley SUBJECT iT 136'74 THE TOP OF THE TWINS BUILDING PERMIT Ir?AT � ECEIPT0. O; COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r 1 SEC. 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 7/30/76 JOB ADDRESS 5760 Matterhorn Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Grace High School Addn. SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Gerald Scovil 5760 Matterhorn Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Pools Inc.703 East Excelsior Ave. Hopkins, Mn. -'Z-ARCHITECT OR DESIGNER-AILADDRESS 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 Construct a 191 x 431 Pool 9 CHANGE OF USE FROM TO STIPULATIONS See letter dated 7/30/76 written by Environmental Officer stating stipulations. REIZUIRED FOR 'W'RtNG, SEDERAIE PERMITS AND SIGNS. WARNING p�U1NBING HEATVNG* Before digging call local utilities TELEPHONE - ELECTRIC - GAS Eta. REQUIRED BY LA'V'A 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,500 $2.75 DOES NOT PRESUME TO GIVE THORITY TO VIOLATE OR ANCEL THE PERMIT FEE SAC CHARGE PROVISI OFA OTHER T TE R LOCAL LAW R G ATING CON- STRUC O OR T PERFO CE F CONSTRUC $34.00 PLAN CHECK FEE TOTALFEE $36.75 SIGN U OFC TRACTOR ORAUTHORIZED EN (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT n n " 7 BLDG INSP DATE �C�VATURE OF OWNER IIF OWNER BUILDER) (DATE) I CITY OF FRA:DLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION,.. OR<; REPAIR BUILDING PERMIT OWNER'S NAME : (� BUILDER: S ADDRESS : 046�a, ADDRESS : X33_ Z z�`s NO:. STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK:' SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As:z z Front : -3 Depth: Height : , Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ Co .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: 7c SIGNATURE: (See Reverse Side For Additional Information.) U 3S,S V I,-00 s v �s $ 1 . 560-3450 Cit 'y of 7rijley ANOKA COUNTY 6431 UNIVERSITY AVENUE NE July 30, 1976 FRIDLEY, MINNESOTA 55432 Mr. Tim Hannan Custom Pools, Inc. 701 East Excelsior Avenue Hopkins, Mn. 55343 Re: Swimming Pool Construction at 5760 Matterhorn Drive N.E. Dear Mr. Hannan: This letter is to make clear this departments requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6-8 hours. 5. A deck of at least three (3) feet wide, measured from the pool water's edge, shall be provided which extends completely around all private residential pools. Above ground private residential po..)ls may be provided with decking of a minimum of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. A fence or other suitable barrier, a minimum of six (6) feet high, that affords no external hand or foot holds and which is impenetrable by toddlers, must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and self -latching devices which are capable of being locked. 8. An automatic chlorinator should be provided with a suitable test kit. 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All electrical lines must be 10-20 feet or more away from the pool surface. 11. The pool fill spout must be air gapped or protected by a vacumn breaker. Mr. Tim Hannan July 30, 1976 Page 2 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is 11i times the pool diameter, and shepards crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115 Swimming Pools. The building permit is approved contingent on final inspections and approval by the City. If any questions.or problems arise from this letter, please feel free to contact me at 571-3450, ext. 170. Sincerely, STEVEN.J. OLSON Environmental Officer SJO/mh CC: Mr. Gerald Scovil At' . u A Ng • CRY Of r is �y • Appliccitfion fo% Plurr:b.=:M3 (='d G—as�fis�� �'ef:�t� • ' ------------ Dept. of Blap. Phoro 8.10.3450 DESCRIPTI011 0: 4?Olt% LOCALq7 0 M Numb,_?. KLjLd cad Lctr:lca of rixturas City of Mdlcy; � T4.6r 7 g i,. s ' 2 = 7 0 A s k WATf� NTa. r.As nfc. . ' The undersigned hereby nukes application for a permit ter thr work S with the Ci4r O:+d:r 3 s 0 r 3 t u j specified, a� eeing to do all work !a .tract occo:da^•ce hereby declares that ayI tht to isi� and ruling of the �;psrtmeat of nulli,a2z, and are true and correct' Es:r I • , and represcrtauons stated is Lhis app:icat:on , 'ns al ill Fridley. b:inn 8-13-76 pyyncr G' 3:d _. Kind of Building f rame Gaz.ttt:.d with • FL r:o Cc�a:.::� O�i: Uccd as s Naw FI_tur9. Old 0;4 Cs c[] ' —s _ __•_•..� To be completed about - PARTIAL RATE SCHEDULE Estirrat.ed Cost. S p.ratt tio. Old—SM Building Permit L MS1110 FIXTUVE RATES: NO. RATE TOTAL Sinned Number ilxturrs ...... • • • • • • • • • • ...------ MINtu� By"-. " Future Fixture Opening . • • • • ••• • • • • •--•-- • x 51.50 S . .•— SusinvKrs T'hurc No few Fixture OldOpening. • • • • •'• • • • ---- x 31.50 i...-:--•-- x $3.25 S. Catch Dasin . ........0660.. .... �.-- ' Water Ueater VP' to 99.000 BTU) • • • • e ..__--- x ,3.00 S • � ROUGH - • I'm Ground Run Old Bldg. xS._------ .ttr'.c Ylatar Hwstas. s 3.00 S TOTAL FINAL ,3,-,9 118 ;'iTTItiG F1;FS: NO. Rn::: • Ist3 Fixtures •••••••••••••'•"' "..... Ad:luanal Fixtures ..:............ ...... -- Gs Ra.:ir to IW.000 BTU $5.00 .50 State Surcharge ' _S'?.1::13 s: xLT>:RA?IONS--P.ataf to Cods .I)e:.crfyuon 0000 6 6 .......:.:....................... ��._,rch.�rbe •50 • TOTAI.14'T.:E ' • • 53-8h-879001 KO. RATE TOTAL it Ci1�'�► Of F-didICY ' APpIic:,,ftfion for Plumbi i- Cod G"S Mr ;4 Future Fixture 011ening • • • • • •'• go!* ------- x $1.50 L)opt. of Bldoz, phone S,NJ•3480 . DESCRIPTIOlf 0: V1011r Lo=Uo,,' X760 • Ma TERHORN DRIVE v.Ltd a.•:d Lctr:loa of Fixture3 ' Catch Basing ................... w2ter lfeater •L'p to 99.000 BTU)• • • • S.3-00 --- x .3.00 S City of ,nidlcy; - _ • + 7 8 �`< _ _ S2 � S 7 7 _ ► w WATt� ire. thet aAs IL The undersigned hereby tnakcs applcation for a permit ter Cit CrY in accorda.. with the Cit? O:�b . 1st3Fixtures ••••�••••••••'"" -------x3240 3 t u o . i° . MANtlQual Fixtures ..:............ ---- G:s R _-Za to 199.000 BTU .............—r--- specified, ay eeing to do all work strict Build.'aZr, and hereby declares .4. a:I L�f - and ruling of the I'oWtrr It of I:% I I I *`_I 11 ca 2nd, 3:d I • --_.. • FL':::o Cc�o.ua Cr�.r:ir.:s s Raw Thuturv. Old 07x:•b%C% h PARTIAL RATE SCHEDULE Sc•taar n C.c ::col ❑ P L1:-i8INC FIXTU?E RATES: KO. RATE TOTAL Number lI Future Fixture 011ening • • • • • •'• go!* ------- x $1.50 S , New Fixture Fixture Old Opening 8.4 • • ••• • • • x $1.50 x $3.25 $ Catch Basing ................... w2ter lfeater •L'p to 99.000 BTU)• • • • S.3-00 --- x .3.00 S • New Ground Run Old Bldg.:..:. • .. _.. x ;1.25 3 ---- Vsctec Water V.6aw... • .:..... � ; ......-- _ S2 � S Z .S F1 TING MES: N0. Rn::: TOTAL S•. -- . 1st3Fixtures ••••�••••••••'"" -------x3240 x S .75 S - . MANtlQual Fixtures ..:............ ---- G:s R _-Za to 199.000 BTU .............—r--- x $S.CO 5-.----- • and representations stated in -his appltcat:oa are true and corre� , • Fridley, Minn 8-24-76 Owner JERRY SCOVIL Kind at Building Used as 8-31-76 To be completed about Estimated Cost. S P•toit Old—New. Building Permit Tlo. • Slzn a . • By Ali Busin= Phone NO ROUGH MIT PS'?.1::'S k AL T SAATIONS—Pater to Code . .50 State Surcha 5e . TOTAL lr'= 3---�— . go - to I w fr4 0 51 119 'Z4 ad G - to I w fr4 0 119 'Z4 ad G —4 Cb s(I t - to I w fr4 0 SUBJECT "PERMIT NO. City of Fridley 22662 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. Q r PROTECTIVE INSPECTION SEC. ) /'••1 CITY HALL FRIDLEY 55432 NUMBER REV GATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/1/94 JOB ADDRESS 5760 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Grace High School Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald/Nora Scovil 5760 Matterhorn Drive NE 571-8130 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW �] ADDITION O ALTERATION D REPAIR O MOVE D REMOVE 8 DESCRIBE WORK Construct a 26' x 10' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $29119 $1.06 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $2.12. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $57.18 SIGNAY EOF CONTRACTOR OR AZAGENT I EI WHEN P RLY VALIDATED THIS IS YOUR PERMIT G r L . BL 1NSp 4ATE SiGNA RE OF OWNER IIF OWNER IDATEI NEW II ADDN j ( .CITY OF FRIDLEY. ALTER (I SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: — - -- - --- _- -- -- — - Owner Name & Address: 6e,64 1-, f Tel. #_ Contractor: O fir% /✓ MN LICENSE # Address: Tel: # Attach to this application,. a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. . , , DESCRIPTION OT ,IMPROVEMENT-. Effective 1/ 1/94 ,5 7/ 9/-36 LIVING AREA: Length Width Height , Sq. Ft. GARAGE AREA:: Length ' Width Height Sq., Ft. DECK AREA: Length' Width i6) Hgt/Ground Sq. Ft. � OTHER: Comer Lot [ ] Inside Lot [ J Ft. Yd Setback Type of Construction: _R F e T� p Approx. Completion Date: Side Yard Setbacks Estimated Cost: $� (Cost on Back) Driveway Curb Cut Width Needed: Ft. 6 Ft = Ft x $ _ $ DATE: �%9� APPLICANT: Tel. # 5- 7/ - CITY /- STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ J , D $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ $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 ( J TOTAL $ S2, e STIPULATIONS: CfiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 August 9, 2000 Gerald Scovil 5760 Matterhorn Drive NE Fridley, MN 55421 Re: Final Inspection at 5760 Matterhorn Drive NE Contractor: Blaine Htg. A/C Elect., Inc. Dear Mr. Scovil: A mechanical permit was issued on April 7, 1999 for the property located at 5760 Matterhorn Drive NE for a furnace. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVE JXISEN Buildin&rhspecl r CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 6431 University Ave NE �4�1 &I Q Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 57 CQ U MQ� JR4 0�_ , LI? P - 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 in this true Also Replacement Furnace $ 30.00 $ representations stated application are and correct. 99 (Side Vent — Fill Out Back) L/ " 7 Gas Piping (Needed with new furnace) $10.00 $ ��2,V OWNER d S�©Vl l Gas Range $10.00 $ BUILDING USED AS !i1 GI Gas Dryer $10.00 $ ll ESTIMATED COST � � �� • � PERMIT NO. 9� kin Conditioning -All Sizes $ 25.00 $ 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) Iarm Ai Trade Name J,,�SJa_4Y Size No.�� j� (Q l Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel 'AJ Total Connected Load State Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE. BLAINE HT®. A;C ELECT., INC. 13562 CENTRAL AVE. N.E. HEATING MP KA, MN 5�^"4 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed Tel No. PLUS THE $.50 STATE SURCHARGE. REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date 9 *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE 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 Yes No ( ) 3. Has no foreign objects lodged within Yes) No ( ) 4. Is securely supported Yes (�) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( No ( ) 6 Has total heating BTU's of /00 , All other BTU's U , TOTAL BTU's ( L/ U r D 7. Has a liner been provided for water heater Yes ( ) No M 8. Has combustion air been provided for water heater Yes (Y-) No ( ) Remarks: List ALTERATIONS Being Done: BLAINE HTG. A,C ELECT., INC 13562 CENTRAL AVE. N ANOKAAAN Wer',' HEATING CO: I e Signed By: i � \ J V�X��� Date: LJ'�'�� Pri SuBjECT City of Fridley 30373 AT THE TOP OF THE TWINS BUILDING PERMIT 1 1 COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. I , CITY HALL FRIDLEY 55432 NUMBEA REV DATE PAGE OF APPROVED BY 612-571-3450 910-FIS 10/8/99 JOB ADDRESS 5760 Matterhorn Drive NE I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Grace High School Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald J. Scovil 571-8130 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and irarage 30 Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $2622 $1.31 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 83.25 FirA SC $2.62 PLAN CHECK FEE FEE 7w/.18 SIGNATT1 CONTRACTOR OR AUT A6GE_NTT (DATE/ HEN RO VALID THIS IS YO/^UR PERMIT //FJ/0F STATURE OF OW NER..F OWNER BwE R. iOATE BED -NSP NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ,� d,=.r Construction Address: � Z�, 0 Mw -r cc /�> �� �f Legal Description: Owner Name & Address: f R f-- D J-1 SCo C14'L _9,7 rf z' Tel. # T Contractor: D C641151� MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. /\ OTHER: /f®D If o cam? KW 4:;6 '� '! �q .S4 eJ.4 e S Construction Type: Estimated Cost: $ c ")(--, Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ YDATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: G CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$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 [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 JFAX: (763)571-1287 PENO.: 2004-00912 DATE ISSUED: 2004 \ ADDRESS : 5760 MATTERHORN DR NE PIN : 243024240011 LEGAL DESC : GRACE HIGH SCHOOL ADD GAS DRYER FEE : LOT 9 BLOCK 2 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 1,500.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT ANDERSON HEATING & AIR COND 4347 CENTRAL AVE NE COLUMBIA HEIGHTS, MN 55421 OWNER SCOVIL GERALD J & NORA E 5760 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 the provisions Aany other state or local law regulating construction or therform ce of construction. Applicant Date Bldg Insp. HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 25.50 PAID WITH CHECK # 23779 [1TTl l T A - T\ ➢ dTTf1 T1 T/1T TTTI TT\ -%" TT TA- 11T - TT T A %T -n"T- / Tl 11T T IJLl Al\[> 1 L 1 Ll\1T111 V 1W1� V 11WL 1 Vl\ ♦♦ V1U> V 111L1\ l ll[>1\ LLIJVl\1LLL <lLV 1 L. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range —52g I Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 57&Q Fee Total n / Owner / �[ DEQ &0 $35.00 $ Building Used As � vv $10.00 $ ESTIMATED COST /5 PERMIT NO 6CA ' 't✓�l+� $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) _ Trade Name Size No. *Air Conditioning - All Sizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Burner Trade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct. State Surcharge $ HEATING COG�tih lf✓ TOTAL FEE $ o�� Signed ` ��G �i�/l ��l/I.Q Tel # REINSPECTION FEE $50.00/HOUR FAX # 11P�' ���— CP�r �l Date LD — ?-04/ *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () 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 �G BTU Input cR 0d0 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: = W� L Z�Z Date: 3uilding BUILDING Permit No.: o'er -a [nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat d1..qrP 9, 3 20nR 763-502-4977 FAX EFFECTIVE 1-1-08 )ATE 7i O YOUR ADDRESS ---q-- ;ITE ADDRESS �pY—O/UR Q0 �j�" ' PHIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: 44 a.'ry CJJ' S (J� 1M�!` ADDRESS: tTl �e o Male-�-�r i�nv..n. \) -- CITY k=—;. 4 .o .A STATEZIP TENANT PHONE: NAME: POW CONTRACTOR ADDRESS: !�an STATE YL xaZIP rS�l 0 SUBMIT A COPY OF PHONE ayl-- pr-\> FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE i&SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER JA SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project ❑ Other ❑ Fascia 2. Two sets of construction plans WMOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USI�G THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ Q 0C. © OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due Emki'mmirl"Mcnomys See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT"'2.' ,�� PRINT NAME a rnr %h DATE n; -per APPROVED BY _ DATE