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N° 2F mage of mffieY5 Minn. BUILDING PE MW Office of M]PECTOR OF BUHMMOS f Owner Architect Fridley, Minn., • 19 Builder L LOCATION OF Bun I)I TG No. Street art of (L?or Lot Block_ Addition or Sub -Division • �� A / 7!I'TIO1�T OF BUII.D](l0iG C' o Front ep - ' Height -3 DStories Manner of Construction_ To be used as To be completed 2'1A ' Estimated Co -`a -40. L_. 0 k Permit is hereby ted to to the buildffi :described in the above statement. This permit is granted upon the express c6ddition.that therson:o whom ifjis granted, and his agents, employees and workmen, in .all the work done in, llarolmd end upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley,1,' Minn., regarding the construction, alteration, maintenance, repair and moving of buildings within the city ts, •and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 1d �+ speetor of Buildings. AGREFM10T AND SWORN STATE ERM in cons-derItion of the issue and delivery to me by the Inspector of Buildings of Fridley of the abovepe t, I hereby agree to do the proposed work in accordance with: the description above set fort and according to- the provisions of the ordinances of Fridley, and, being first duly sworn, I her eb state and say that the facts stated by me and contained in the above permit are true as therein ted.' Subscribes d sworn to before me at Fridley, Minnesota, hig day Af A D'. 15 9 �I I' • APPLICATION FOR BUILDING PEMUT CITY OF FRIDLEY, MINNESOTA OWNER'$ NAME PLILDFR r . ADDRESS r S ADDRESS LOCATION OF BUILDING No. Street Part of Lot LOT BLOCK ADDITION OR SUBDIVISION Corner Lot, Inside LOT Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Dept h Height Sq. Ft. Cu. Ft. Front Depth_Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost �O n To be comple The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in s.tricr 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 (Schedule of of Fee ee /2,�* �9,41' �. A__4 el Costs can be found on the Reverse Side). d :7 .fr BUILDING PERMIT FEE -SCHEME' SECTION 2. The Inspector of.Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any existing build- ing or structure, or for any alterations or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and'in"the"manger herein._ provided to -wit: 2.1. For any such permit for the erection of any fire -proof building, other than a garage, warehouse,jactorT or grain. elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building, shall be.,at the.rate of $1.40 for each.one thousand cubic feet, or fraction thereof, in such dubical contents. ou_ 16r -any such permit for the erection of any fire -proof -garage, Warehouse, factory,or grain elevator, or for the erection of any fire -proof- addition; for similar occupancy, to -any existing Building shah be at the rate of $1.25 for each :,one thousgndd cubic feet, classified as "fireproof" by, Section'502 of th6 Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building, other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.QO.for each one thousand cubic feet. GARAGES. 10C For'any such permit for`the'erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition-" for similar occupancy, to any'dkisting building or for each such building or addition -,ninety cents ($0.90),for, each one thousand cubic feet or"fraction thereof, in the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees -for building permits, the cubical contents of any building or addition to a uniform height throughout by multiplying,the ground 'area covered from a point six '(6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height.of the roof surface of the main,gable of a,pl tched roof., For repairs.or alterations to an:existing.structure, the fee shalX.,:> be at the rate;of $3.00 per each Five: Hundred Dollar's -($5,00.,00) or. frgction , thereof in the cost of all proposed work. 2.6. in no case shall the fee charged for. any permit as set forth in Section. 2 be less -than $4.00. 0 is 40 City of Fridley, Minn. N° 7901 BUILDING PERMIT Date: June 15, 1965 Owner: Albin Larson Builder G.L. Miller Co. Address 465 lusstsstppt St. Address 4237 W 25th St. Mpls. 465 Mississi�WTION OF BUILDING No. Street Part of Lot Lot _ Block Addition or Sub -Division Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation ` _ Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft Front Depth Leight Sq. Ft Cu. Ft Est. Cost 2, 000 To be Completed Repair Storm Damage 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 ab ov se rth d a in compliance !� with ail provisions of ordinances of the city of Fridley. mo—, In consideration of the payment of a fee of $— , permit is hereby granted to G.L. Miller Co. to construct the building or addition as described above. This permit is granted upon the ery condition that the person to whom it is granted and his agents, employees and workmen, is all work doneFridlnnesota g location, conatructfon, alteration, maintenaace, repair and moving of buildiaga within the dty limits this permit may be revoked at any time upon violation of any of the provisions oP said ordinances. Allen Jensen Building 1aspector NOTICE: M pemh dos not serer the conatrudon, hutaMw for vdrin& plumbing, gas hsadeg, sewer w water. Be sm a to we do sodding b qm for for aparaM permht for thea hems. STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD 1. LOCATION 0► WELL MINNESOTA UNIQUE WELL NO. (leave blank if not known) County Name Anoka Township Name Township Number Range Number Section No. Fraetion N E k kof k Fridley 30 Sr 23 or 23 SE SE NW Numerical Street Address and City of Well Location or Distance from Road Intersection 465 NE Mississippi Street, Fridley Show exact location of well n.) (in section grid with "X") Sketch sup of well location N n MEME W J I-- 1 .i it 2. PROPERTY OWNER'S NAME James Chatelle 3. FORMATION LOG 0 If not known, indicate 7875 dress if different than ad ss indicated above a t River Rd. Apt. 20 COLORFO�NATION FROM TO on from n w well or nearby well. EMARKS, ELEVATION, SOURCE Gir DATA - CASINGS REMOVED. CASINGS PERFORATED, ETC. FFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) ZNPMTANTt PILE IPZTB nmm 4. WELL DEPTH (completed) Date sealed 79 ft. 2-20-90 S. DRILLING METHOD (if known) I® Cable tool 40 Reverse 70 Driven 100 Dug 20 Hollow Rod 50 Air 80 Bored 110 3(] Rotary 60 Jetted 90 Power Auger 6. OBSTRUCTIONS Wel 1 obstructed ® Yes 0. No Obstructions removed ® Yes 0 No If obstructions cannot be removed, contact MON before sealing. 1. USE 11M Domestic 4[3 Monitoring 80 Heat Loop 20 Irrigation 50 Public g0 Industry 30 Test Well 60 Municipal 100 Commercial 70 Air Conditioning 1113 8. CASINGS) 1® Black 40 Threaded 70 20 Galv. 50 Welded 30 Plastic 93 Stainless Steel 3 in. to 79 ft. 1n. to ft. 9. SCREEN 0 Screened well from _ ft. to ft. (If known) [3 Open Nola from ft. to ft. 10. STATIJ JIATER LEVEL J ft. ® below ❑ above land surface Date Measured 2-20-90 11. WELLHEAD COMPLETION 10 Pitless Adapter 40 Found Burled 20 Basement offset so 3® Well Pit 12. GROUTING INFORMATION 1K] Neat cement 20 Bentonite 30 Grout material 32 bags from 5 te79 ft. cu. yds_ 13. N REST SOURCES OF CONTAMINATION 10 feet N_ direction sewer 12iM type Well disinfected before sealing? ® Yes 14. PUMP &] Removed 0 Not Present Type: ID Submersible 30 L.S. Turbine 0 Reciprocating 20 Jet 40 Centrifugal 60 15. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) Other unused wall(s) an property? 0 Yes ® No Abandoned: 0 Permanent 0 Temporary ❑ Not sealed 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my'knowiedge and belief. MORK WELL COMPANY, INC. 02133 Licensee Business Name License No. Addre 3 Sign ate 2-21-90 Tim Blum Bate 2-20-90 or 010 Elm = ME J I-- 1 .i it 2. PROPERTY OWNER'S NAME James Chatelle 3. FORMATION LOG 0 If not known, indicate 7875 dress if different than ad ss indicated above a t River Rd. Apt. 20 COLORFO�NATION FROM TO on from n w well or nearby well. EMARKS, ELEVATION, SOURCE Gir DATA - CASINGS REMOVED. CASINGS PERFORATED, ETC. FFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) ZNPMTANTt PILE IPZTB nmm 4. WELL DEPTH (completed) Date sealed 79 ft. 2-20-90 S. DRILLING METHOD (if known) I® Cable tool 40 Reverse 70 Driven 100 Dug 20 Hollow Rod 50 Air 80 Bored 110 3(] Rotary 60 Jetted 90 Power Auger 6. OBSTRUCTIONS Wel 1 obstructed ® Yes 0. No Obstructions removed ® Yes 0 No If obstructions cannot be removed, contact MON before sealing. 1. USE 11M Domestic 4[3 Monitoring 80 Heat Loop 20 Irrigation 50 Public g0 Industry 30 Test Well 60 Municipal 100 Commercial 70 Air Conditioning 1113 8. CASINGS) 1® Black 40 Threaded 70 20 Galv. 50 Welded 30 Plastic 93 Stainless Steel 3 in. to 79 ft. 1n. to ft. 9. SCREEN 0 Screened well from _ ft. to ft. (If known) [3 Open Nola from ft. to ft. 10. STATIJ JIATER LEVEL J ft. ® below ❑ above land surface Date Measured 2-20-90 11. WELLHEAD COMPLETION 10 Pitless Adapter 40 Found Burled 20 Basement offset so 3® Well Pit 12. GROUTING INFORMATION 1K] Neat cement 20 Bentonite 30 Grout material 32 bags from 5 te79 ft. cu. yds_ 13. N REST SOURCES OF CONTAMINATION 10 feet N_ direction sewer 12iM type Well disinfected before sealing? ® Yes 14. PUMP &] Removed 0 Not Present Type: ID Submersible 30 L.S. Turbine 0 Reciprocating 20 Jet 40 Centrifugal 60 15. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) Other unused wall(s) an property? 0 Yes ® No Abandoned: 0 Permanent 0 Temporary ❑ Not sealed 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my'knowiedge and belief. MORK WELL COMPANY, INC. 02133 Licensee Business Name License No. Addre 3 Sign ate 2-21-90 Tim Blum Bate 2-20-90 or e SUBJECT PER City of Fridley 219 5 5 AT THE TOP OF THE TWINS BUILDING PERMIT i?�,(z��,_T_ O. COMMUNITY DEVELOPMENT DIV.�OL r i PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/6/93 JOB ADDRESS 465 Mississippi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Rice Creek Terrace Plat 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James. Wenzel 465 Mississippi Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Merchants Maintenance & Const. 12020 Radisson Rd NE Blaine - 4359 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 Handicap accessibility modifications 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Showers or combination shower/bath shall be provided with a pressure balancing or thermostatic type anti -scald type control valve. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS 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 $25 $12.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT IOOO 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 - TR C NOR THE PERFORMANgg OF CONSTRUCTION. $252.00 Fire SC $25,00 PLAN CHECK FEE TOTALFEE P r License SC 5.00 294.50 s SIGNATURE OFCONTRACOR RAUTHORIZ GENT IDATEI ' ti WHE P RL LOCATED THIS IS YOUR PERMIT - -7 BLDG INSP DAT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI e NEW ADDN ALTER [l [l Construction Address: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application L%S Effective 5/26/93 Owner Name & Address: � u� CKz1c4-ij _-) aV_ _- Tel. # Contractor: G MN LICENSE #oco VS s Address: Tel. # ?S S - o �®Cl 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: Corner Lot [ J Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 25 Approx. Completion Date: (Cost on Back) Driveway Curb Cult Width Needed: Ft. + 6 Ft = Ft x $ _ $ "-aDATE: — , � APPLICANT: Permit Fee Fre Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 5.2 00 Fee Schedule $ S-, 00 .001 of Permi $ - 1.). �;-6 $.50/$1,000 N $ $750 per SAC $ 5-,00 $5.00 (State I $ Alt. "A" or A $ Conservation $ Fee Determin $ $ a9 L7, n Agreement Necessary [ j Not necessary I t - -- 11 STIPULATIONS: } ;s - ©ppb/ BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $15 (Minimum Fee is $15 plus surcharge) $501 to $2,000 $15 for fust $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for fust $2,000 plus $9 for each additional $1;000 or fraction thereof, to and including $25,000 $25;001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $100 or fraction thereof, to. and including $50,000 - $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 -to $1,000,000.. $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus,6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide. approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 'Prom UD&C o� Saint Pavl PHONE No. 612 735 1533 Jun.07 1993 11:46AM P05 t� v rl n � �nnF 7s13 ` z tie d w + a r L it T 41 ' 4 r c zs a� a (� L 70 HAROLD June 9, 1993 DEAN KIEWEL, AIA Brandon Miller Special Compensation Fund MN Department of Labor & Industry 2066 443 Lafayette Road E Minnehaha Av Saint Paul, MN 55155 Saint Paul, MN 55119 3930 Re: James Wenzel, home renovation proposal for 465 Mississippi St., Fridley 612/735 1533 Dear Mr. Miller: voice & fax I met with Mr. Wenzel and his preferred contractor, Mr. Bogie of Merchant's Maintenance, at the property June 5th. We reviewed Mr. Bogie's proposal and discussed alternative methods for meeting Mr. Wenzel's accessibility needs. I have attached a sketch of the property (Attachment A) to clarify my findings which are outlined below. I will present each room and its requirements in order of access from outside. Garage: �t�rer's gv- ■ Modify the garage door opener, and door track mounting to assure proper clearance for a van. Relocate wall switch for garage door opener to within 44" of platform surface. / jj W, ■ Install a 6'-0" wide platform, approximately 1 'high along the east wall of the garage to serve the Breezeway. A ramp should provide access from the platform back down to the driveway. As thig ma be con. sidere an emerge(� cy egress ramp slope may be 1:8. FA ■ Modify passage door to Breezeway as required to accommodate raised floor in Breezeway; replace hinges with "swing-clear' type and latchset with lever-trim type. Breezeway: ■ Raise the floor level; approximately 5" at garage, and approximately 8" at house; some of this elevation change may be ramped in the applicable door thresholds. Provide full width ramp between levels of floor; maximum slope 1:12. ■ Remove existing storm doors; and install new wood, lockable entry doors (min. 2'-8" doors with swing clear hinges) in existing window locations. Reinstall existing windows in previous door openings. ■ Provide new concrete landing and ramp at south (front) side of Breezeway; widen existing front sidewalk from ase of ra��� driveway. "Sf�p .ems t'�v� (pg ► Option: Install preservative-treated wood landing, ramp and stairs at north (rear-yard) side of Breezeway. Access to the rear is available by traveling at grade through the front and side yards. H. D. 10owol Page 1 Kitchen: ■ Replace entry door hinges with swing -clear type and door lockset with lever -handle type. ■ Relocate refrigerator; and provide new pantry type cabinet with beveled face at west end. ■ Modify existing base cabinets: o lower counter height to 33" (existing height is approx. 3T), E3 modify door/shelf base at sink and bread board to have open knee space, not less than 29" wide and 29" high, excluding sink basin, El remove open shelf return and install 4 drawer base, o Install pull out shelves and racks In remaining base units, and o insulate piping under the kitchen sink. ■ Lower upper cabinets approximately 6'. ■ Lower wall phone jack to less 44" above floor. ■ Remove south-east corner enclosure of dining area including pocket door; patch floor and wall finishes as required. Note: hardwood matching existing hall floor may be salvageable from bathroom closet. ► Option: Replace kitchen sink shallow -basin, rear -drain model; Kohler: Lakefield, Elkay: GECR 3321 etc. Hail: ■ Install transparent plastic corner guards on external corners of hall closets. Living Room: ■ No changes. Entry: ■ No changes. Bedroom No. 1: ■ Replace door latchset hardware with lever -handle type, and hinges with swing -clear type. ■ Remove wall segments dividing existing closets; replace doors with 3 -panel, by-pass sliding doors and replace rod and shelf with accessible, full width units. Cut opening in floor for installation of vertically traveling platform lift; protect opening with half -wall or railing. Lift -gate should be interlocked with lift so that it can not be opened unless the lift Is at the upper landing. Coordinate control locations with Mr. Wenzel's reach limits. H. D. IQewel Page 2 P Bathroom: ■ Remove.linen closet, bathtub and vanity. ■ Remove existing door and replace with 2'-8" min. sliding pocket door. Install offset staple pull (like Brookline No. 050) so that door can not be fully concealed in pocket, provide strike plates on door jamb to protect wood finishes from door pulls. ■ Install wall hung lavatory with new single -lever mixing valve; Insulate or shield piping exposed under the lavatory. ■ Install roll—in shower; reinforce walls as required to install continuous horizontal grabs on three sides of shower. Shower unit should be flex -hose, hand-held unit with two or more mounting pegs located as directed or a vertical height adjustment bar. Bedroom No. 2: ■ Replace door latchset hardware with lever -handle type, and hinges with swing -clear type. Basement ■ install platform lifting device in Family -Room; provide power circuit, structural support of Bedroom No. 1 floor and incidental construction as needed. Coordinate control locations with Mr. Wenzel's reach limits. Note: The installation of the new power circuit for the lift may require upgrading the electrical service from 60 to 100 amps. tJhese modifications are required to allow Mr. Wenzel a reasonable level of Independence in his new residence. Sincerely, Harold can Kiewel, AIA Registered Architect Lieense No. 20151 p • enclosure cc: J. Wenzel / B. Bogie �2 Gf�C` �2/d 0 H. D. laewel Page 3 f ra, CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARKNUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: . ... Ur' nalGas Shower ...aDrain . QStories .::.. Auto ....•. Washer Gas Range Beer Dispenser erFloo Water Heat $ 5.00 Blow Off Basin Elec ase B ment Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance Floor 1 $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Gas Range $10.00 F oor 2 I $10.00 Back Flow Preventer Required ( )Yes () No Type • $5.00 Fioo 3 r Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4:00 Beer Dispenser $ 5.00 Blow Off Basin $ 7,00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type • $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge $ q .50 TOTAL FEE $ /•���� JOBADDRESS 70J ��'SS�SS ��� �7- The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. v , 1993 Owner I Building Used As zFS- Estimated Cost PERMIT NO. l Q PLUMBING COMPANY SIGNED BY Approved By Rough—In Date TEL N0. Final Date0 MINIMUM' FEE 'FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 _STATE SURCHARGE SUBJECT MIT NO. City of Fridley 32740 AT THE TOP OF THE TWINS BUILDING PERMIT R O. • COMMUNITY DEVELOPMENT DIV. _ f PROTECTIVE INSPECTION SEC. 37,97 NUMBER REV DATE 7/1/02 PAGE Of APPROVED BY j �'"1 CITY HALL FRIDLEY 55432 �""�" �'' 612-571-3450 910-F15 JOB ADDRESS 465 Mississippi St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 XXXXX Rice Creek Terrace Plat 1 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Fridley Roofing, 830 W. Main St. #105, Anoka, MN 55303 20264030 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 ❑X NEW ❑ ADDITION O ALTERATION O REPAIR ❑ MOVE - O REMOVE 8 DESCRIBE WORK Re -roof / Tear -off (23 sq.) 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 $2,465.00 $1.23 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI NS Of,#fgV OTHER STATE OR LOCAL LAW REGULATING CON- H PER_ f09MAN OF CONSTRUCTION STRUt TI N�11 $83.25 $2.47 _tea , 7- - Cn, PLAN CHECK FEE TOTAL F Licen . 00 $9 .95 SIGNATURE OF CON"RACTOR OR AUTHORIZED AGENT IDATEI EN OPE IDATE T S IS YOUR PERMIT BL IN$F' • ""O4� / TIATE S,GNATURE OF OWNEROF OWNER BUILDERI ,DATE, NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDIS! [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 5722604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: % 5 �' - Legal Description: Owner Name & Address: Tel. # Contractor. -04 os-0[(ev MN LICENSE# BC- -a0-167C73c::) Address: 916 U M.11"IX 14 * i O 5 Tel. # /kHv ka, MW S53c)"L-, Mach 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: Re- (c90r Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ S4 DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL C�3tilr���•IiL4� Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Oficial shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $5002001 to $1,000,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1, 000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only W CITY OF FRIDLEY FIRE DEPARTMENT FIRE MARSHAL'S OFFICE DEPARTMENT OF FIRE PREVENTION NOTICE OF BUILDING FIRE To: Building Inspection Assessing Water Billing City Manager From: Ralph Messer, Fire Marshal Date: November 14, 2007 Subject: Fire Damaged Building Location of Fire: X465 Mississippi Street, N.E. Date of Fire: `November 14, 2007; 0057 hours Other pertinent details: This fire is believed to have started in the garage -breezeway area and spread into this single family home. There were no injuries to civilian occupants or firefighters during this early morning blaze. Columbia Heights FD assisted us with this fire. There is heavy fire damage to the double garage and breezeway and significant heat and smoke damage throughout the home's living area. Electricity and natural gas service to the residence was disconnected by the appropriate utility companies during the fire. The residence appears to be uninhabitable due to the fire. The cause of this fire is currently under investigation by the Anoka County Fire Investigation Team and the Fire Department. If you have questions concerning this fire, please contact me at x3621. ADDRESS PIN LEGAL DESC PERMIT TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 _ (763) 572-3604 FAX: (763) 502-4977 PRINTED WITHOUT ISSUING 1/29/2009 : 6401 CENTRAL AVE NE : 133024420024 : UNAVAILABLE : LOT 0 BLOCK 0 : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION PERMIT NO.: 2007-02364 DATE ISSUED: 12/19/2007 VALUATION : $ 152,227.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED ADDITION AND REMODEL PER PLAN NO WORK STARTED. NO INSPECTIONS DONE AS OF 9/30/2008. PERMIT EXPIRED PER MINNESOTA RULE 1300. STATE LICENSED CONTRACTOR? 1 APPLICANT NORTHERN EXPOSURE EXTERIORS 9097 S HWY DR LEXINGTON, MN 55014- (763) 783-1121 OWNER CALDERON, BOB M JR 6401 CENTRAL AVE 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 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date. BUILDING PERMIT FEE 1,290.55 PLAN CHECK FEE 838.86 STATE SURCHARGE, BLDG VALUE 76.11 FIRE SURCHARGE 152.23 LICENSE SURCHARGE 5.00 TOTAL 2,362.75 PAID WITH CHECK # 5242 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Fridley City Code Organization and Enforcement. Section 206.03.3.A (4) A. Application, Administration and Enforcement. The application, administration and enforcement of the code shall be in accordance with Minnesota Rule Chapter 1300. The code shall be enforced within the extraterritorial limits permitted by Minnesota Statutes 1613.62, Subd. 1, when so established by this ordinance. (Ref 1190) B. The Building Inspection Division shall be the Building Code Department of the City of Fridley. The Administrative authority shall be a State Certified Building Official. (Minnesota Statute 1613.65) C. The City Manager shall be the Appointing Authority and designate the Building Official for the jurisdiction of Fridley. (Ref. 961) 206.02. CONFLICTS In the event of any conflict between the provisions of this Code adopted by the provisions of this Chapter and applicable provisions of State law, rules or regulations, the latter shall prevail. 206.03. PERMITS AND FEES 1. The issuance of permits, and collection of fees shall be as authorized in Minnesota Statute 1613.62 subdivision 1. 2. Violations and Penalties. A violation of the code is a misdemeanor (Minnesota Statute 1613.69) and Minnesota Rules Chapter 1300. The fee schedules shall be as follows: A. Plan Review Fees. (1) When a plan or other data are submitted for review, the plan review fee shall be 65% of the building permit fee. (Ref 1190) (2) Where plans are incorporated or changed so as to require additional plan review an additional plan review fee shall be charged. (3) Applications for which no permit is issued within 180 days following the date of application shall expire by limitation and plans and other data submitted for review may thereafter be returned or destroyed. The building official may extend the time for action by the applicant once for a period not exceeding 180 days upon request by the applicant. (4) Permit and Plan Review Refund Policy. The Building Official may authorize refunding of any fee hereunder which was erroneously paid or collected. The Building Official may authorize refunding of not more than 80% of the permit fee paid when no work has been done under a permit issued in accordance with this code. The Building Official may authorize refunding of not more than 80% of the plan review fee paid when an application for a permit for which a plan review fee has been paid is withdrawn or cancelled before any plan reviewing is done. The Building Official shall not authorize refunding of any fee paid except on written application filed by the original permittee not later than 180 days after the date of the fee payment. (Ref 1190) " CITY OF FRIDLEY MOVING [ ] DEMO [ ] PERMIT APPLICATION i1 University Ave NE F � 2 '00ami Fridley MN 55432 (763)572-3604 FAX (763)571-1287 Job Address: Legal Description: Owner & Address: Contractor: Peow Address: 5123 (-c>Q MFINVWa '5-� p% _ TECD MAR 05 2008 _ate License # _ DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. GARAGE: Length Width �'yHeight _ Sq. Ft. OTHER: Length Width Height Sq. Ft. Estimated Cost $-T ( (OS)-- -��0 CS Approx. Completion Date CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY Moving Route: APPROVAL(S) REQUIRED PRIOR TO ISSUANCE: ❑ Bldg Official Conditions Engineering Conditions Fire Marshal Conditions ❑ Water Bill Paid: Yes[ ] or Collect[$ ]Signature Tel. # 773-2�_��3a Tel. # 7,63 - Cu. 3 - Cu. Ft. Cu. Ft. SZg Cu. Ft. 5—/2` $ The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. )EMOLITON DEBRIS. INCLUDING FOUNDATION & SLAB. SHALL BE REMOVED FROM SITE. Mrr_h O's- Date SDate Signature Moving-- -- Wrec ' Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the to _qog--. Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 fo each $500.00 J or fraction. PERMIT FEE: "' , MINIMUM $20.00 Office Use Only: SAC -D form completed Effective 3/29/07 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 502-4977 REPRINTED ON 3/5/2008 ADDRESS : 465 MISSISSIPPI ST NE PIN : 143024240002 LEGAL DESC : RICE CREEK TERRACE PLAT 1 : LOT 2 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMOLITION PERMIT NO.: 2008-00259 DATE ISSUED: 03/05/2008 NOTE: 24' X 2T GARAGE DEMO DUE TO FIRE. HOMEOWNER TO PROVIDE SECURE FENCING AROUND SITE DURING DEMO/CLEAN UP. CALL ALL UTLITIES FOR DISCONNECTS BEFOR WRECKING OR MOVING STRUCTURE. ALL DEMOLITION DEBRIS SHALL BE REMOVED FROM SITE. CITY ORD. REQUIRERS THAT DWELLINGS SHALL HAVE A MIN. 2 CAR STALL GARAGE ON THE LOT. 500 APPLICANT BENEDIX DARREL S 465 MISSISSIPPI ST NE FRIDLEY, MN 55432 OWNER BENEDIX DARREL S 465 MISSISSIPPI ST 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 wof will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ricopy DEMOLITION FEE (PROJ COST) TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 20.00 20.00 Apri124, 2006 Darrel Bendix 465 Mississippi Street Fridley, MN 55432 RE: Fire damage at1465 Mississippi Street NE, Fridley, MN 55432 On November 14, 200 an inspection was conducted to assess the damage caused by the fire. There washeavy fire damage to the double garage and breezeway area and spread into the home. The damage is severe enough to deem the structure a hazard. Section 1300.0180.2006 MN State Building Code, states in part "any structure that constitutes a hazard to safety or health, or public welfare by reason of disaster or damage, shall be considered unsafe. All unsafe buildings shall be declared a public nuisance and shEill be abated by repair or demolition, as referenced in the MN Statutes Sections 463.15 to 463.26." Submit permit applications and approved plans for all fire repairs or apply for a demolition permit for the entire building by July 1St 2008. If the applications and plans are not submitted'. by July 1 St, 2008 the above noted building is a hazardous structure and will be posted per MN Statute 463.17. If you have any 763-572-3603. Sincerely, Dave Jensen Building Inspector Cc: Ron Julkowski Building Offici Scott Hickok Director of Cor concerning this matter, please feel free to contact me at Development Building, ` 911, BUILDING Permit No. -&® Inspections ` RESIDENTIAL APPLICATION Received By 763-572-3604 $ ('7 License Surcharge '" SAC Charge $ CITY OF FRIDLEY Dat -�"-P: :� � 763-572-4977 FAX $ Park Fee , Sewer Main Charge $ EFFECTIVE 1-1-08 $ / DATE YOUR E-MAIL ADDRESS /a�szl ey1 SITE ADDRESS THIS APPLICANT IS: ❑ OWNER )gCONTRACTOR PROPERTY OWNER/ NAME: 4z`eA e_ ADDRESS: YSJ'%�r 7�CITY STATE IPf';�9Z_ TENANT PHONE: NAME: o CONTRACTOR ADDRESS: .1� —/0 CIT TE`f' I ZIP -;GW--?— SUBMIT A COPY OF PHONE % �-��' FAX J -_%:rV YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPESINGLE FAMILYN W CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ADDITION ARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ROOF ❑DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONS UCTIONDITION ❑ MAINTENANCE/RE AIR REMODELING DESCRIBE WORK BEING DONE: // %® Z J P SIZE OF IMPROVEMENT LENGTH ��' WIDTH _:W HEIGHT /_ so FT e S ROOFING 0 HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES �ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: 3 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: oh� Soffit Trim Fascia 1. Site Plan/Survey showing the existing structures and proposed project. L u� 2. Two sets of construction plans WINDOWS 'v"1 3�— 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 VAL%kTION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ ` 911, Permit Fee $.a Plan Review $ �' ` G ' Fire Surcharge $ Surcharge $ ('7 License Surcharge $ ., d SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ OCCUPANCY TYPE 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; the tand 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 accof e a ov plan in case of all work which requires review andapprovalof plans. SIGNATURE OF APPLICANT PRINT NAMEDATE t 7 APPROVED BY DATE Building- MECHANICAL Permit No..V 03- r%5 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY vat 763-502-4977 FAX EFFECTIVE 1-1-09 DATE— _ Y E -ADDRESS L TEM SITE ADDRESS TH[S APPLICANT IS: ❑ OWNER )NCOCTOR PROPERTY NAME: OWNER/ ADDRESS:✓� 1 S� 1 ii i A®1 CITY . STAT> 72 TENANT PHONE: 7 -- (—is/ 32: CONTRACTOR COMPANY NAME: P N NOTE: SEPARATE CITY CONTACT PERSON: EXP DATE STATE LIM SsE� #(/ LICENSES ARE SAND HVUIRED FOR AC G` y a � r ADDRESS: J i / CITY STAT42AJM J �Z/ SUBMIT COPY OF BOND PHONE —](�—)V — � / FAX AND INSURANCE PERMIT TYPE �SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE TYPE OF WORK: � NEW D REPLACEMENT O ALTERATION/REMODEL DETAILED PESCRUMON OF WORK `— PER MR 1 .665 the fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) �°-� Equipment Installed MFG: MODEL: 313 XR SIMBTU�j-M MFG: MODEL: f SIZFJBTU Z `J MFG: MODEL: SIZEIBTU ��e A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _& X A1R TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00ACE $35.00 GAS UNIT HTR $10.00 CHMINEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 TOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ ` Surchu'ge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ .Gp OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ tate Surcharge = $ SO MINIMUM $1550 MIlNEMI $1$15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I aclmowledge that onmtion above is complete and adnate; that the work will be in conformance with the ordinances and codes of the City of Fridl'� ey with the Co Codes that I understand this is not a permit but only an application for a permit and work B m start without a be ved p m all work whic review and approval of plans. permit;AAP SIGNA OANT a -� NAME gATE�" ' APPROVED BY DATA E PLEASE NOTE: S ABATE ;PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ff, 2 FI R 3T FL o OR p L A N Darrel S Benc& Residence Darrel S Banc& 1sE HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION MINNEAPOLIS. NUNvN. Weatherstrips A' Construction No. Insulation -_ Guide Windows Doors Reference Out. Wall Int. Will Ceiling Roof Floor I Kind How Applied — t es—tio I yes— o 19._ n ^/s, R—m, I Lenoth Width I q'Height WJAZws and oors—C,rackage and Area _Coef. +o tt•.etn Hot gnt No. of Lineal ft. Area of Dane of Dant lights of crack sq. ft. j IFLI i !r..^:: atlon :ass Coef. Btu Inraratioa— II Ltration i2 v Glass + Exp. wall All, Act 'yet exp. wall !r.t. wail Width ATV Floor 2 otal fits+. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FlAn 1 Room I L.enath WidtA 14 Height if Windows and Doors--Crackage and Area _Coef. -- w':�•. Htignt No. of Lineal ft. Area ..+c I of D•nt of Dant lights of track sq. it. 1•o It'tate Height No. of Lineal it. Area cf Dant of pane it his of Crack sq. Il. j 'I i !r..^:: atlon :ass Coef. Btu II Ltration i2 Net exp. wall las. wall D a tip— E -P. wall All, Act 'yet exp. wall rt 11/2. R,, — I Lenath Width !nt. wall 1 Floor 2 -3( -0 Ceiling -7 1 VQ U) Floor TS oia, ate. ZS � Require tq. ft. E.D.R. or sq. ins. W.A. Leader area I FD Rmm, Iltneth ITWidth / Heiaht 1L indowt and Dtwrs--Crackage and Area _Coef. -- w':�•. Htignt No. of Lineal ft. Area ..+c I of D•nt of Dant lights of track sq. it. I j 1cocf.1 Btu !r..^:: atlon :ass _ __ �..-- Exp. wall Int. wall Net exp. wall las. wall D _ ._ Ceiling�P Total Btu. Required K. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 tj ItAjRoom Length Width f 9 Height --T_ _Windows and Doors—Craekage and Area Wldlh Height No. of Llaeal ft. Area No. ot,pane of Dan• Ilghts of crack eq. ft. ,. H a �9„Co )qtg_ 7 Windows and Doore—Crackage and Area _Coef. Width .Height* No. of Lineal ft. Area No. of pan of Dane llghte of crack sq. ft. Btu -- _ Infiltration Glass Exp. wall Coef. to _ __ �..-- Net exp. wall �tibty Int. wall .S D _ ._ Ceiling�P Floor y0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Int. wall rt 11/2. R,, — I Lenath Width HeiD.iir Windows and Doore—Crackage and Area _ Width .Height* No. of Lineal ft. Area No. of pan of Dane llghte of crack sq. ft. yy �. /1 1 53 -15T ^sq. O l vv Coef. to Infiltration _ Glaze .S Exp. wall _-- Net exp. wall . Z Y32 - Int. wall IL Ceiling -%vu I I U) Floor 2 -3( -0 Total Btu. l Required sq. ft. E.D.R. or sq. iris. W.A. Leader area Ti+r t. t l tvu.l rl.l V Windows an .........trn...6... - -- Doors—Crackage and Area ` Width Height No. of Lineal ft. Arta No. of pane of pane llghte of crack it. ^sq. O l vv Coef.1 Btu _ Infilt:stion Glass f 119, -_ _ Exp. wall Net exp. wall L Ini. wall I I_ Ceiling -7 1 VQ U) Floor TS Total Btu. 2— Required sq. h. E.D.R. or sq. ins. W.A. Leader area Building PLUMBING Permit No.: -OUCH Inspections RESIDENTIAL APPLICATION Received By:"M, 763-572-3604 CITY OF FRIDLEY Date Rec'd./&,6 a1^ 763-502-4977 FAX EFFECTIVE 1-1-09 DATE -z d YOUR E-MAIL ADDRESS SITE ADDRESS C�- F 2i ®LEY �tl ky c- r THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME:_ AROC-L DPZ OWNER/ ADDRESS: L14!r !r CITY 1491046- STATEMAZIP L�3 Z TENANT // PHONE: b % Z - 6F/9 - % % y:5 CONTRACTOR NAME: C 1 fwT y L K tnTi ti- G, 4- 14eA T' n - Co SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF �y ADDRESS: ZIY.75-- 1600--501%- ST CITY ?Z -?-J4 61 STATE /"V_ZIP,S VW INSURANCE PHONE S' FAX PERMIT TYPE kSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW )"PLACEMENT DETAILED DESCRIPTION OF WORK LA( -_'r IC --T- IC)1n (A eEf PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL �aWBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/LAV DRAINS SHOWER WATER PIPING _FLOOR _ _ BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) _CLOTHES WASHER %'' KITCHEN SINK p�� WATER CLOSET _BACKFLOW PREY. ($15) __ _ DISHWASHER 6 _LAUNDRY TRAY �� WATER HEATE ($35) FOR IRRIGATION WATER METER —OTHER qqyy . y Number of fixtures @ $10.00 x $10.00 = Permit Fee $ f G S" . 071 Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $� TOTAL DUE $ /Q jr— .52s _L State Surcharge = $ /Q .50 (MINIMUM $15.50) (MINIMUM $15.50) Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 pernA and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the all work h ch requires review and approval of plans. / /� ��- -��� l & c /V SIGNATURE OF APPLICANT PRINT NAME DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING PermitNo.:_ l� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DIRiMA 'L% 2 3 2b 0 763-502-4977 FAX EFFECTIVE 1-1-09 DDATE'Z � c YOUR E-MAIL ADDRESS SITE ADDRdS V�� THIS APPLICANT 1S: -DOWNER NTRACTOR PROPERTY OWNER! NAME:�l_ 'CITY :'d STATE N LIP -9V• -f �' TENANT ADDRESS: 1�GS� �'Al • e v PHONE: >6a S-)/ ivy 4- CONTRACTOR NAME STATELICENSE1/ EXP DA-TrE G /a STAT�irs SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS. IWO el -VII, CITY %GS'—� t•/-dS3'L7 INSURANCE PHONE �ZS�' / FAX PROPERTY TYPE SINGLE SILE— CONSTRUCTION STORIES TWO FAM ILYINEWECONSTRUCTION pERM1T TYpE ❑ ADDITION ❑ GARAGE'SHED 0 BASEMENT FINISH 0 ROOF R I N WS TI DRAIN TILL ❑ DECK. ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOMECONSTRUCTION U ADDITION MAINTENANCEIREPA1R ❑ REMODELING DESCRIBE WORK titilNG DONE: /i/eery EC/.�ltO� ` i SlLEOFiMPROVEMENT LENGTH WIDTH HEIGHT PT 120 FIV : 1:1 HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Moor Plan GARACIM 13A7TACHEDGARA0E ❑ DETACHED GARAGE 2. Proposed floor plan 3. List of stnictural members to be Lived PROPOSED SIZE: PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, q1D nG AI)I?MONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site PlaWSurvey showing the existing stmems ❑ Altmantun ❑ Trim and Proposed project. ❑ Other 0 Fascia 2. Two sets ofconslrnction pleats 3. Energy Calculations VYIV8OW9 IN EXISTING OPENINGS, Yes ❑No LOCATION OF WINDOWS Olt FOR NEW OPENING WESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED 11/y1 1 NUMBER OF WINDOWS �O .n mac• i"An AWN%SA A h`T.nv A f Co ALL FEES ARE BASED IDN VALUA•CIVIN, IINkAbLUJIltvv i HE Uwe A Ur LA&M R —N ,,,r, • (USING THE E 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit FCC S d Sec Back Page- for Foe Schedule Plan Reviow S 65% of Building Permit Fee Fire Surcharge S .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ S5.00 (State Licensed Residential Contractors) SAC Charge $ S2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = S_ T Erosion Control $ $450 Conservation Plan Review Park Fee S Fee Determined by Engineering Sewer Main Charge $ Agreement neemsaly, ( ) Non Necessary ( ) Total Due $ / Make checks Mable to: Cf of Frit9le Attach Sti alations 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 codec of the City of Fridley and with the Minnesota Construction Codes; that 1 undctstand this is not a permit but only an application for a pertnit 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,' vlorpereview and approval of plans. �- , SIGNATURE OF APPLICANT �e�!�7�a�-" PRINT NAME �y I�iG/E%. DATE'" Z �,1 Building BUILDEW PamitNozzAmm eons RESIDENTML APPIUCATION RwdvW BY 763-572-3604 CITY OF FRWLEY DaWAM JAN 2 3 763-502-4977 FAX EFFBcTIVE I_I.M DATIi YOUR6 MAil. mmFSS Z,!gA/**T ra 0 t'0 # OL ► CQ IVB gnADDRESSH.25 -MtgSiSStPp! ST NS FRtt7LeV M#O SSIV32- THEAPPLICANTIs: vtOwmm CCOMMCKK PROPzz i O n NM ADDRESS: L1.fe5 MtSSISS I®1 $T ©T7(t i �iI�RF 4' STATE�ZlP TENANT PHDNB wvp bow CONTRACTOR NAS AwRBSj (o O b �C 1 Ti a'O d D CITY mI DLE p sTATE rnp 2. SUBMIT A COPY OF pMM '710,3 q —a 9 q j FAX YOUR STATE LICENSE S&V STATEN MM# EIiPDATE PROPERTY TYPE ARSINGLE FAMILYMEW CoxslMCMW F 0 TWO FAbMYIN W comsTpjjcnaN SI9OVM PERMIT TYPE O ADDPr1aH+T D D HASBMENTFDM R ROOF D DRAW THE ODEM Osmm Ban=- FIRE REPRIP, DSWDOAMPOOL V% i M— TYPE OF WORK; O NEW HDME COm RULR7ON O AUDnXRY 41MAIMINANCFAMAM d REMODUM C, all vx F :41 YrA: i7 el. iu- ■ iJS�lS1! ;1� Ir c M V 1-1 Mr LI 4GM vn O FOM ONLY 0 HDEM&GARAQE D ATTACHM GARAGE D DETACHM GARAGE dSwm R Tdm AFas is LOCATION OF9MNDOWS Ig NUMMCWWDCKWS IALUATii A RKL M— TRE COSTov Wm TBE 1997 G RASEMIDEREMINIRIAMMUMM I. EdsdngFkwPkn 2. Pmposedttoorpko I Ljstofmmcwwmm&w1obcUscd q n:rr See%* Pie fbrFce s&c" 65'/OafPetmitFee �1 tm�s t� tt�ai,jab vat 0005 x Permit Valttshm M mmmn SSO $5.00 (State Lied R1 Cis) SICS per SAC Unit (Pknsla MWCC far ) $+68= 8x$21=$ $450 Cmwavaion P1w Rehr Fee Ddmdmed by Ag ► ( ) N=NeccmmY ( ) TIES IS ANAPPLICATWN FOR AP!ERfiffI' NDT VAL>DUEYRL pVDCgMW I q* fora permitmd I gdmwW Ig de the abava s aon� eod a,m tbUdmvm* vM be in conb ttomce wide dre s and codes of d a City of Fridley oral v� the hftmcsft C Ccdes; that I dds s nota Permit bm ody an fora punk oral vwrk is no to affil widtoat a ?sraRffi site; that�irewedc will be m wd6 da3apptttmed plan indxcass�aU wm& vdid�nap� ratriawaod eppts� ofplans. SIC�NAT[IRE ` A 1T PRIN Mbfflo�1¢ � F c3C- N EV) DATE & 1-2-- d 9 UMVED BY DAZE ' 0-7--�