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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT (::4896 Date:._.._____ Owner: ...... _.... _._._....___.._..__..._.....__...._ _.__ ------ Builder Address__._......... Address _.-.._.._._.._.....__..___ ____...w. _._.. .._.._. _......_..._... LQCATION F BUILDING Street _.:sg_a Part of I.tit Lot ._.....: ._..._. Block '. ----------- Addition or Sub -Division _ ..... Corner Lot ...__.............. ._._........ Inside Lot ......_............... ,.. Setback ...,,,.,�............. Sideyard .................................. Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: f / �* / / �+ Front Depth �l,,Height .... {...._.. Sq. Ft.®"'' Cu. Ft. ►*_ !r� r ........ ............................................... . Fron ....._..._.._...._. Depth __............._._.. Height Sq. Ft . ..................... Cu. Ft.. .............. ..... ....__,......,... _ Type of Construction ..'3,=s-........ Est. Cost.�!....pE ._._.. ... ...... To be Completed ..... .............. _............---....._.....--- In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. J� ..-j •__._._.._... In consideration of the payment of a fee of $:.�'."... ...;�`�........, permit is hereby granted to...._..__.._...--------•----•------•-_--- _ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon Violation 6f,,any of the provisions of said ordinances. i3uilding Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. C p UTIgN 4 "nig '- '�IVJIT DOES NOTAVTH0RIH VIOLAT- ION C- Ay P; ;•,;ATE LAND COANANTS AND -' CUiLDjNt RESTRICTIONS:---- APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address Address LOCATION OF BUILDING No. �� / Street��� Part of Lot Lot Block ZAddition or Sub,Div. o' Corner Lot Inside Lot-4—Set Back � 6_ Side-Yard„�42 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: n Front `AI Depth �-A Height / Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of ConstructionEstimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE SIGNATURE=2%ix-o (A Schedule of Fe® costs can be found on the Reverse Side.) SUBJECT ITN City of Fridley ® 15148 AT THE TOP OF THE TWINS BUILDING PERMIT t � CEIPT • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 �••'• ,'J NUMBER REV. DATE PAGE OF APPROVED BY 812-880-3450 910-F15 4/25/79 JOB ADDRESS 831 Pandora Drivet N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 4 BrookView Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis Jaksha 8311 Pandora Drive N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. D & D Home Improvenent 1670 Camelot Lane, Fridley 574-1398 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 X 8 DESCRIBE WORK Install sidi trim combination windows 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REt'UIRED FUK 1�N wal HEATING, PLUMBING AND SIGNS. 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 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, $3,698 $1.85 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION R THE PERFORMANCE OF CONSTRUCTION. $24.00 CHECK FEE TOTAL FEE SMI _4 -)paw ,75' $25.85 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI'- WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT I� q BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY . APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS,' OR REPAIRS) OWNER: �ENAJ j S 7TARSh A � BUILDER: J *2% TI0MF-��gU�AG-�%'/�lU� Address: 1-3) %J!f•/®1 d0j0 d Mk- Vi— Address: 1670C fi M E I a 144NE- Tel. No. J Bl� 13c1 g No.: Street: n —7— LOT: 25— BLOCK & : '� ADDITION: ool �Eu /F-,TF3,ed CORNER LOT: INSIDE LOT: SETBACK.: SIDEYARDS: Applicant attach 'to this form Tajo Certificates of Survey of Lot and proposed • building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: • Square Feet: Cubic Feet: Type of Construction: 1 I ��r'�� w Nos®� Estimated Cost: $-,(PC(S_Q© To Be Completed: / 1—noN T}1 Alt. A Alt. B Prciposed Driveway width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a 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. See reverse side for additional information. DATE: 2 SIGNATURE:�%2 Stipulations: CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL RATE Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 Gas Piping $ 10.00 (piping needed with new furnace) Gas Range $ 10.00 Gas Dryer $ 10.00 * Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE TOTAL $a Attach stack verification form with.replacement furnace permits *Air Conditioners can not be placed in side yard without -written permission from adjoining neighbor. Effective Aug. 1, 1981 Job Address 2__3L_ or f, Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica ion a e true and correct. & Fridley, Minn. ! Z , 190'1 0 a w OWNER KIND C USED AS TO BE COMPLETED ABOUT s ESTIMATED COST 7•7 OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water arm Air- o. Trade Name W k , t Size No. Sp A city Sq. Ft. EDR BTU ® ® HP Total Connected Load —If-? y Z Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR TU HP Company C r Signed By Tel. No. Winnows and' DoorD-Cratere and Area woe_,1 Hmuet /.o. of S.ae.sl tt. carom r:o, •eT paw• 'ot We• w"s el eraet K. tt toe DEPARTMENT OF INSPECTION �• '" >^ HEAT L=TiOT�S Coef. Stu lnfiitrailon G{au ira lneataa Weat6rswips GuideA Aloof. Flow Witwbtlro Doan Reference fes. VAD tat Wall Cell . sr 19. Fl. ls.. Width latr4tt . ' A.i Room Lelth Width freight Waldo" ldotnn aeon j ecoea rael<age amd urea Wisdom and Doom--Crackatrc and Area aea�rmt to�ea a4 Wit.. wrote a.uwt o. swwl et. A•®a Itfat• N met eo. it. was. of IMem st me• i aavwto 04 erast ea: st. Mt. 04 neo• of pw• L. 1Coef. Stu �.. t ��� infiltration infiltration /'S� CUSS Chau G UP. wall Exp- wall Net c»p. wall/Z- z - Net =P. wall IDLwaU lnt wall _�.,.., Ceiling Floor z / Z_. Floor °Tww Biu. Total Btn. Required aq. ft. E.D.R. or so. iaa WA Leaner area 4 _,,, Required aq- ft. E.D.R. ar aq. inA. WA Leader am; e F1.1 Room I Length Width Height Length idtta I `islindows and Doors—Crack rc and Area Windows ar►d n—�aackagc acid tt. Kra•,.. w 60 t8 si m�arel No. of ytemal 8t. A•ma Itleq o4 eraC 00• tt. iOtA sia at No. et ..- �s16ea} ria, m 1 5 04 @fres° ttarta of e'r�8tc oC• r4. Ala- et tames• of pews O Coef. Btu Iafiltratioa Infiltration Clan ---wall Exp -waif Leet eatP. wall Net sup. waU lot. wall Int. wall 4 ceiling Ceiling Floor Floor ... .. _ _. Total Stu Total Btu Required 1Q. E.D.R Or aq!'taa �.�► Liddel irep Reosured a4/ fL E.D.R. or so, iAS. `1Td k Lteaner area fl, Room I Leageh idK} 1~ieigint Fl:� Room 11."Ith 'Q Wily' how Winnows and' DoorD-Cratere and Area woe_,1 Hmuet /.o. of S.ae.sl tt. carom r:o, •eT paw• 'ot We• w"s el eraet K. tt I Coef. Stu lnfiitrailon G{au Earp. wall Winnows and D�rsTaskae and Area wbte kametec . 8.0. o%" eoga ra. w»m � / Alm et prem at pama Ira eu at araaffi •o, ri CM Stu Inbit:atioa Cilaaa EMP. wall Net esp. Net exp. wall t I waD 1st. wall Int. wall � Ceiling Ceiling Floor TOW Tota) Btu Total Btu. Required sg ft )eD R or ao. 6& QIA. Leader area Required a¢ ft• or aq: ins. '�'A Leaner area SUBJECT PERMIT NO. City of Fridley 33106 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. _ _ r PROTECTIVE INSPECTION SEC. NUMBER REV OAT PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J\ 763-571-3450 910-F15 9/20/02 JOB ADDRESS 831 Pandora Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 4 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis Jaksha 831 Pandora Drive NE 763-574-1012 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Stevens Co 10650 Co Rd 81, Maple Grove, MN 55369 763-315-6622 20321894 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 3P REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (18 Sq) 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 OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,929 $.96 WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TALFEE Lice C $ 0 /477.14 SIGNATURE OFCON TRACTOR OR AUTHORIZE AGENT iOATE. HE PR BLj%, INS LY VALID ,*ED THIS I�RP T ,,fin1,41 I /J� OA t �j/ S-GNATURE OF OVVNER,IF OWNER BUILDER. iDATE, NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 672-3604 Bldg Insp ALTER- SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �3 1 PA 0,46 R fl 0R . Legal Description: Owner Name & Address: I r`� 7A K -S �A /�3/� Vdo6A .Dr? Tel. # Contractor: Z;FyF'V-S C'©. MN LICENSE# -?b32- Address: lo(e 5o�! ' M4RIe C"Po�C Tel. # 743 3/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: <Mf — oFi AC Estimated Cost: $ '06 - Drivewa 6- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT, Tel. # 7 '3!5 �aa CITY USE ONLY - Call (763) 572-3604 for Permit Fees if, mailing in application Permit Fee $ 9' 95 Fee Schedule on Reverse Side Fire Surcharge $ l.. .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ 3 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ T7. / STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** 83 i VayOoya Dv - DATE: y � lac W�40- Gr The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the facts $10.00 and representations stated in this application are true and correct. $10.00 $10.00 $10.00 DATE: .Al2rl I P5,900A , 20 $35.00 OWNER D0nV11S JLLK.410, $35.00 $35.00 BUILDING USED AS Y2 SlA1,1n CP_ $10.00 Gas Dryer** $10.00 ESTIMATED COST Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr /�� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance IGi•Oo State Surcharge TOTAL FEE $ .50 PERMIT NO. PLUMBING COMPANY SIGNED BY TEL N0. tj63�_1' 04x4 Approved By Rough -In Date Final Date $—L. -I12-0 OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE i 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 terminatidn. 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 Fumoce Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter. in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date :