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PRE 2010 DOCSCity ®f Fridley, YHnn. BUILDING PERMIT Date: Oct. 25, 1967 Owner: Charles Johanson Builder Same Address 16.0 Hartman Circle Address Same Fridley, Minnesota LOCATION OF BUILDING N9 9524 No. _.. N 511 Street Rice Creek Blvd. ____, Part of Lot Lot 8 Block 2 Addition or Sub -Division _._ Holiday Hills Corner Lot _ Inside Lot — R Setback _ 35' -- Sideyard _,.15' -20' Sewer Elevation 825-.61 _ 828.61 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 54 ' Depth 26' Height 28' Sq Ft. 1400 Cu. Ft. 28080 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction F'ra= Est. Cost To be Completed SEWER LOCATION -74.5' South of Manhole WATER LOCATION - 62.5' South of Manhole In consideration of the issuance to me of a permit to c the proposed work in accordance with the description above ordinances of the city of Fridley. 100.00 Sewer ading'discribed above, I agree to do In Aom fiance with all provisions of ion Char In consideration of the payment of a fee of $ 42.00 , permit Is"by granted to— Charles Johanson 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 of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This posit does not cover the construction, hptallation for wiring, plumbing, gas heating, sower or water. Be sure to see the Building Inspector for separate permits for these heap. APPLICATION FOR BUILDING PEaITT CITY OF FRIDLEY, 14INNESOTA OWNER'S BUILDER 160 Hartman Circle 160 Hartman Circle ADDRESS ADDRESS 313A LOCATION OF BUILDING NO. 5 STREET PART OF LOT -------- 1-11.6. & /r, vx-, - — LOT BLOCK _ ADDITION OR SUBDIVISION L _Z _ r CORNER LOT INSIDE LOT SETBACK 3 S® DE -YARDZ SEWER ELEVATION' Applicant attach to this form Two Certificates of Survey of Lot alid Pro building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used Ad: Front Depth A & Height Sq. .,—Front. Deptb----- Height Sq. Ft. Cu. Ft. Type of Construction Estimated 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 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. DATEg2L-- _4�2 ���SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). 5, V00A d-2 Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices ,> PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR >,�,OU Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $-, each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Linc—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ............. $ `7 Q .......... 5.00 a over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO - RATE TOTL 1st 3 Fixtures x$ 2.00 $-�� Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE $ Dept. of Bldgs. Phone 560-3450 Location Q�'-/s - aaj City of Fridley: The undersigned hereby makes application for a permit for the work herein. specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn P 19- Owner 9- Owner v Kind of Building✓� - Used as To be completed about Estimated Cost, $ Old NewBuilding Permit No. �!� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --.Steam, Hot Water, Warm Air—No Trade N2 -�? Size No—4 %d S `..,;X% Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load X, ��/sL�l Kind of Fu BURNER — Trade Name Size No /,70, O 0 0 Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed By Business Phone No- 7 % ✓ . q Compliments of North Central F HFAT LOSS CALCULMONS Weatherstrips A.S.HSM Guide Windows Doors Reference O Yes—No I Yes—No 19........ Fl. I%, Room I Length �V Iblic Service Co., // z� O A - DEPARTMENT OF BUILDINGS VILLAGE Construction No. Insulation Wall I Int. Wall) Ceiling I Roof Floor Xind How dth Height Fl. � R V Room I Length Y Width Windows a d Doors—Crackage and Height, of patine _ Area sq. ft. No. Width of pane Height of pane No. of lights Lineal ft. Area of crack sq. ft. L d '7 Coef. Btu Infiltration p /ICoef.1 Glass 6 �' Coef. Exp. wall �va� Coef. Btu Infiltration Int. wall z 6P 6 Glass �+ ✓� Int, wall Exp. wall Net exp. wallLL Ceiling Jyr Net exp. wall Int. wall 7 01 Int. wall ` 1 Ceiling 7 Total Btu. Floor U Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /G Fl. I Z m oo Width --42 it No. Glass Exp., Net e Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / FL IP: r- Room I Length Width 1A Height I,?- . Windows and Dors—Crackage Height, of patine and Area Area sq. ft. _ Width No. of pane Height of pane No. of lights Lineal ft of crack Area sq. ft. d '7 Coef. Btu Infiltration p /ICoef.1 Glass 6 �' Coef. Exp. wall �va� Btu Infiltration Int. wall p Glass V qC' I i i� o Exp. wall Int, wall Total Btu,'�� Net exp. wallLL Ceiling Jyr Int. wall 7 01 Ceiling Total Btu. 1 Floor 7 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 9�F1. I : v Room I Length I Width Height Windows and Doors--Crackage and Area. No. Width Of pane Height, of patine No. of Lineal ft. lights of crack Area sq. ft. cam` d 4o A a �C f �— Coef. Btu Infiltration Glass 6 �' Coef. Exp. wall �va� Net exp. wall e Int. wall Glass Ceiling V qC' I i Floor 7 Int, wall Total Btu,'�� II Required sq. ft. E.D.R. or sq. iris. W.A. leader area Height Room I Length Width Height Windows and Doors--Crackage and Area _ No. IWidth of pane Height No. of of pane lights Lineal ft. of crack Area sq. ft Area sq. ft. a �C f �— Coef. Btu Coef. Btu Infiltration e _ Glass Glass Exp. wall Net exp. wall L-57� Int, wall 3 Ceiling Jyr Floor 01 Total Btu. C 17,6 Windows and Doors-Crackage and Area Width NO.of an el No. of ofpane lights Lineal ft. of crack Area sq. ft. a �C f �— Coef. Btu Inffitration Glass L-57� Exp. wall Net exp. wall Int. Wall 01 Ceiling Floor 7 / - 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. 1eader area 11 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Compliments of North Central Public Service Co., �� HEAT LOSS CALCULATIONS 'gt-.,e DEPARTMENT OF Weatherstrips A.SJLV.E. Construction No. Guide WindowsDoors Reference Out. Wall Int. Wall Ceiling Yee—No I Yes—No 19........ I Fl. 1 ,"� J f,� J, , doom I Length / "-Width / Height Windows and Doors—Crackage and Area No. No. Width of pane Height of pane No. of lights Lineal ft. of crack Area sq. ft. a96l go aq TT o Coef. Btu Infiltration Coef. Coef. Btu Infiltration Infiltration 6 Coef. Btu Infiltration Glass Cd 0 Glass Exp. wall Net exp. wall Glass Exp. wall Net exp, wall Int. wall. Net exp. wall Q 42 2 d0 Int. wall O / Ceiling Floor , , Floor &' L 0 Total Btu. I 73V Required sq. ft. E.D.R. or sq. ins. W.A. Leader area B Fl. a t Room I Length Width Height Windows and Doors—Crackage and Area No. No. Width oY pane Height No of of pane lights Lineal ft. of crack Area sq. ft. Area sq. ft. a96l go aq Coef. Btu Infiltration Coef. Coef. Btu Infiltration Infiltration 6 Coef. (� Glass 1,59-0 Exp. wall Exp. wall Net exp. wall Glass Int. wall Net exp, wall Int. wall. Exp. wall Q 42 2 _ Ceiling O / Ceiling Floor Int. wall Total Btu. Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Ceiling F� -/,A Room I Length CWidth /' Height V' Windows and Doors—Crackage and Area No. No. Width of pane Height of pane No. of lights Lineal ft. of crack Area sq. ft. a96l go aq Coef. Btu Infiltration Coef. Btu Infiltration Btu Infiltration 6 Coef. Btu Infiltration 1,59-0 Exp. wall Glass Int. wall Net exp, wall Exp. wall Q 42 2 Int. wall Ceiling Net exp. wall Floor Ceiling J Int. wall Total Btu. Floor Ceiling Total Btu. Floor Total Btu. sq. ft. E.D.R. or sq. ins. W.A. Leader area Roof I Floor FL I Pa .,_dna o, Room I Length Insulation Width I (I Height Windows and Doors—Crackage and Area _ No. Width Height of pane of pane o. of lights Lineal ft. of crack Area sq. ft. Lineal ft. of crack Area sq. ft. a96l go aq Coef. Btu Infiltration Coef. Btu Infiltration Btu Infiltration 6 -;L®' 0 Glass ' 1,59-0 Exp. wall Int. wall Net exp, wall e Q 42 2 Int. wall Ceiling Floor Ceiling J `� Total Btu. Floor Total Btu. All Required sq. ft. E.D.R. or sq. ins. W.A. Leader area —rFl. �o h -.,,.Room I Length I/ Width J--2 Heigh Windows an Doors--Crackage and Area C' No. No. Width Of pane He of parvo No. of lights Lineal ft. of crack Area sq. ft. a96l Coef. Btu Infiltration Coef. Btu Infiltration / ` ' Glass Int. wall Exp. wall Net exp. wall Int wall e Ceiling Ceiling Floor Floor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FL I Roam I Length _Width Height Windows and Doors—Crackage and Area C' No. WidthHeight of pane No. of Lineal ft. of pane I lights I of crack Area sq. ft. Coef. Btu Infiltration Glass Exp, wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. header area I City of Fridley t Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone 560-3450 b k DESCRIPTION OF WORK I Number, Kind and Location of Fixtures Location 1L pia NO. RATE �Zt Number Fixtures ......................�� x $2.00 12 Future Fixture Opening ................ x $1.50 $ a New Fixture Old Opening .............. x $1.50 $ Z aO • F N WATER HTR. GAS ELEC. 3 Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... W x $2.00 Base Additional Fixtures .................... —x$.75 $ Gas Range to 199,000 BTU .............. x $5.00 $ % 1st 1 - 2nd 3rd 4th • Future Connection Openings Connected with e New Fixture, Old Openings I Sewer Cesspool PARTIAL RATE SCHEDULE . PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ......................�� x $2.00 ��TOTAL rr $� Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ 3 Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... W x $2.00 $ Additional Fixtures .................... —x$.75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...................$ TOTAL FEE $ City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Owner Kind of Used as To be cuiujjimcu auuu6 Est ima st, $ �y o� Old New 'ding Permit No kMVA 17 Permit Signe evBy Business Phone No ROUGH FINAL 42 a Base CNy of FridleY 53-84-s915.51 Applicaftn for Mo6ing and Dept. of Bldgs. Phone 980-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures NEON I NEEIRME1 WATER RM. GAS EC. Sewer Csaspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.26 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water heater .............. : $2.00 $ GAS FITTING FEES{: NO. RATE TOTAL 1st 3 Fixtures .................. 7 x $2.00 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU ................ x $5.00 $ Install (1) Gas Grill $3.00 REPAIRS & ALTERATIONs—Refer to Code I,oea:-_511 Rice Creek TLjg, Bled City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that an the fact and representations stated in this application are true and correct Fridley, & inn 5-22-72 18., Owner Thomas Mikoda Kind of Building Frame Used as Res • To be completed about L-29-72 Estimated Cost, $ 7-0.00 Old—New. Building Permit No. Permit No. Signed . f Byarxe�j�R°C1 -- - Business Phone No ROUGH Z Description .............................................. ; ffm `°A" ►Su'rcharge .5®.¢ TOTAL FEE $ 5.00 SUBJECT P IT NO. City of Fridley 21204 AT THE TOP OF THE TWINS BUILDING PERMIT CEIP COMMUNITY DEVELOPMENT DIV. _ t0 PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 2/7/92 JOB ADDRESS 511 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin Bohman 511 Rice Creek Blvd NE 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 ❑ NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 15t' x 141. 'Three Season Porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, SEPARATE PERMITS REQUIRED FOR ANIILI W G WIRING, HE,_r1-NGS PLUMBING AND SIGNS.. Before digging Mall for Rr r .art • ��a ,,•Lt M . . - �.: . w rs: all utility 100#005 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING 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 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 $4,769 $2,38 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- $72,00 Fire SC $4.77 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTAL FEE IGNATURE OF CONT5AQi6ROR AUTHORIZED AGENT (DATEI W EN P OPE Y IS YOUR PERMIT 1( DA'ATHIS /: i BLDG INS PATE SIGNATURE OF OWI ERI IDA EI NEW ( 1 ADDN ALTER ( ] Construction Address Legal Description: Effective 1/1/92 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Owner Name & Address: N E VIII �5 o h Tel. # Contractor: se /L G MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length `s Width Height Sq. Ft. 2l D Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot Ft. Yd Setback _ Type of Construction: Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ '00 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ J DATE: APPLICANT: Permit Fee $ q"'I' on Fire Surcharge $ , 71 State Surcharge $ 13 0 SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL M* on %*) Tel. # Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: &F- F_(2c (2( .e c R t b -- tt)A A-) / 4)6- Land Planning C87S N. h,, y '�`S •vE. LwdStr►•cYny /Alin ltvls 21, Soils rrshbq ENGINEERING, INC. 9;ir,�;ofa Ctvtl b- AAunkc al $ 9 Stln of 4066 � E ineerr` . ------ Enyl'neers Survery. ors o' -,`fie o - c n-Q.V7- 'a ' � . � • smell - �� � ! ;t •`.'.. I\y 40 v. O\ /hei-eby cerh& /liar' ,'us rs o fi vc &V arred ref;ressnfallon o�'a scc�vety 'i�:e �vvnd©rtcs c 54e c'�v,� s � .Y,`.ud /c:, -a,:4"! ' /an�ian e�'arl burlurilas r 1'l•efronn , vnc all Y15/ble ewvachrncnfs ,!rcr?r�, fan or onsbid land. As st:rveyed f ty Me1, - 4-Y R.D. w: 5U6 UR BA.'V L1-NC11VEERINC7, INC. Cn rnrers 5urreytrs CITY OF FRIDLEY INSPECTION DIV, Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ' ADDRESSADDRESSESS RATE SCHEDULEJOB The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL 'specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated In this application are true and correct. (Side Vent — Fill Out Back) 1996 Gas Piping (Needed with new furnace) $ 10.00 $_ OWNEFItjl Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $, ESTIMATED COST 4 PERMIT NO, *Air Conditioning — All Sizes $ 25.00 $� All Others/Repairs & Alterations (LIST ON BACK) DESCRIPTION OF FURNACE AND OR BURNER 1�%% of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Commercial/ st/ a duA Trade Name Size No. 1.25% of Value of Appliance or Work $ BTUHP EDR Fuel Total Connected Load State Surcharge s .50 Burner Trade Name Size No, BTU _ HP EDR' TOTAL FEE s.b ` HEATING COMPANY �Z � '� c� �"✓L MI.NItA.Q FEE FOR AN•y WEAI!NG(CnOLINLgNENTILAII.QN REFRIGERATION/AIR C9Np1TI0N11VG E_ERMIT 15 25.00 Signed By ' �c%.. ._ Tel No. T ge . 445 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date =Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE R STACK VERIFICATION ON written permission from adjoining property owner,REPLACEMENT FURN CE Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIIVINEY 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 All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No { ) 8. Has combustion air been provided for water heater Yes( No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SUBJECT City of Fridley 15 5 2 0 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. >r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ?v?, I0 4/- 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 9/18/97 10B ADDRESS 511 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Debra Bohman 511 Rice Creek Blvd NE 574-2416 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $29168 $1.08 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- Fire SC $2.17 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 PLAN CHECK FEE TOTALFEE $78.00 SIGN REO CONTRACTOR RAUT ORIZEDAGENT A (DATE (/� WHEN PROPERLY V 1 ATED THIS IS YOUR PERMIT Q17C /� ® /9 BlD )NSP GATE SIG URE OWNEROF OWNER BUILDER) I ATE) NEW f 1 ADDN j J ALTER j ConstructionAddress: Legal Description: Owner Name & Ad Contractor: Address: Effective 1/l/97 CITY OF FRIDLEY '�o SINGLE FAMILY AND DUPLEXES R-1 AND R-2 96 ��j BUILDING PERMIT APPLICATION d MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVE112ENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft, DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �D i/� cr�• /�/v� ��? ��1%/CI�c� c�C cS� Construction Type.: Estimat Cost: $ (Fee Schedule on Back) .Driveway Curb CutWidth Width Needed: Ft. + 6 Ft = Ft x $ $l Co DATE:APPLICANT: �% A /% Tel. #�f! ` a CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ / .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Xiveway 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 >TIPULA"riONS: SUBJEtT PE City of Fridley 32536 AT THE TOP OF THE TWINS BUILDING PERMIT i ♦v -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �� Ir PROTECTIVE I 1 . � NUMBER REV DATE PAGE OF APPROVED BY I 1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/25/02 r JOB ADDRESS 511 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACTORADDITION SEE ATTACHED DESCR. 8 2 Holiday Hills SHEET 5 21P 2 PROPERTY OWNER MAIL ADORES. PHONE Kevin Bohman 511 Rice Creek Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contractor 6331 Riverview Ter NE, Fridley, MN 55432 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 574-9966 4051 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION C REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof House & Garage (24 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 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 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,573 $1.29 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 TOTALFEE S �U.� Licen $5. 0$9 11 SIG N.ORiZED AGENT DATEi N ROP ALIDA THIS IS YOU PERMIT .000/0 tN - gAtE S,GNATUREOfOWNEQnfOWN ERSUILDEA, iDAtEt IBLD NEW [ j CITY OF FRIDLEY Effective 1/1/2002 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �� CK1FjF1c aL�d Legal Description: Owner Name & Address: f;�0 0 ® 'AA 4/ Tel. # Contractor. AA -St IV S MN LICENSE # -2710 S/ Address: 3 3 / E� i U �= D aF P 7cfdz- Tel. # 2 `f - 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: a �4 V Construction Type: 7 F'kk eff d- ki� 1Z 00 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $, DATE:ZS �Z APPLICANT:i 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 CITY USE ONLY - 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: PLUMBING RESIDENTIAL APPLICATION City of Fridley Laos -601'1 Pemfit N her iv y Date Received NO'T'E: IF PROPERTY IS NOT OWNL'RIOCCUPIM A UCENSED CONTRACTOR MUST 013TAIN THE PERMIT. DATE 4V-90 -o YOUR E-MAIL ADDRESS S1T8 ADDRESS �oA o ��c 2� r)cr THE APPLICANT IS. (CIRCLE ONE) OWNER CONTRACTOR NAME— 7- lrne-S. 4- Pe-%ra i -e /® PROPERTY OWNEW ADDRESS _-S 5-1 TENANT CITY STATE ZIP PHONE # 57 - Q c NAME UGENSE # CONTRACTOR ADDRESS 1 VL CITY STATE. M K) _, zip -,55 Y PHONEO.-7 FAX# PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK ❑ NEW REPLACEMENT, FEES ARE t3ASED ON $10.00 PER FIXTTIRE, E)ccEPT v4HERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF BATH SDIK/LAY FLOOR DRAINS SHOWER ----NATER PWM BATHTUB GAS PIPING (weed City License) SV1IMMINQ POOL. WATER SOFTENER (435) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY WATER HTR (SM FOR IRRIGATION WATER METER OTHER Permit Fee $ 3S rt MINIMUM: $18.00 or 5% of cost of the improvement -whichever is Plan Review S greater on work less than $300 Surcharge $ ,5p TOTAL DUE $-50 Make checks payable to: City of Fridley 111116 is AN AFFt„ IGATION FOR A PERMIT - NOT VALID UNTIL PROCESSED I hereby apply for a plumbing pemtit and 1 actmowwedge that the lnfmmatiOn above is ocmplete and accurate: that the warp will be In conformance with the onlinanoas and codes Of the CRY of Fridley and with the Nnnesota Construction Codes: that I undetsland ttUs is not a permit but only an applicatbn for a permit and work is not to start wiftmt as pegr that the work will be in accordance with the approved plan in the case of all worts which requires review and appmVal of plana. j% NAME OF APPLICANT �C DATE � �a-6 Please type or print SIGNATURE OF APPLICANT TOTAL P.H1 Building PLUMBING Pcnnit No.: IT Inspections RESIDENTIAL APPLICATION Received By:=� 763-572-3604CITY OF FRIDLEY Da 'd: DATE YOUR E- IL ADDRESS ` t SITE ADDRESS l 1 L �t Lam Y= THIS APPLICANT IS: 0 OWNER IRONTRACTOR PROPERTY NAME: P1 TENANT y ADDRESS:. ---_k IT_ C` 4_ STAT ZIP_ PHONE (; Q l LD `5 1 LP CONTRACTOR NAME: Ix VLJ STATE LICENI }S # W EXP DATE �� 1 �j SUBMIT A COPY OF YOUR STATE ADDRESS: ' CITY STAT LICENSE WITH PHONE �S 4 LD FAX APPLICATION PERMIT TYPE I3,0NGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK �Z 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER_ WATER PIPING _ _FLOOR _ PIPING (NEED cn-yucaysE) _ SWIMMING POOL T WATER SOFTNER ($35) —BATHTUB —GAS CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _ _ _ DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _ _WATER WATER METER —OTHER y-�O�q f� 1 '�.] . . i..l.:. .. '? dl. �.•-:._,�7.ij. Lt ,W .Y .. i.. ss't :.'.n'.*bi i �. T. .. s �, S.<r ���i °r i3 ,1!.1 JaI�A;LM TOAW$5001 Permit Fee Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ —� TOTAL DUE $ 75b Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case o77""71 qui s review and approval of plans. �j% SIGNATURE OF APPLICANT.PRINT NAb1�_� l,�l 1 , `�W �1��iLDATE n.w,d S.. g <, , .95' 4...,'' CaI� T. ... `. 1�R1�, ' lJ 1. 4T�r'S3 �i III.` l%Jr 1VD1V��:.'. �3t?i3...V1CCLdW•; ": City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.. ' Inspections RESIDENTIAL APPLICATION Received By:, 763-572-3604 616 CITY OF FRIDLE a DATE b YOUR E-MAIL ADDRESS SITE ADDRESS Se.wtc CVS D��.e� Lisa Sorensen THIS APPLICANT IS: ❑ OWNER *ONTRACTOR 511 Rice Creek Boulevard Ne PROPERTY NAME: Fridley, MN 55432 OWNER/ ADDRESS: 7635641651 LATE ZIP TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # Sb S / EXP DATE ADDRESS rfi'C� / CITY ,0 O1l STATE�LIP sfYvp' SUBMIT A COPY OF YOUR STATE , ,' LICENSE WITH PHONE 7— y®; FAX Z — APPLICATION 4 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK % PER MS 16B.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 = ,FORXROJECTS WHERE LABOR EXCEEDS-S300;TEES ARE BASED ON $10.00 PER FDITURE,-EXCEPT EERENOTED :FrKI-I.IRES:.(INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS ----SHOWER - - WATER PIPING _ BATHTUB _ GAS PIPING (NFW aryl MSE) _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _DISHWASHER --LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15,00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ 36.00 State Surcharge = $ Total 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 applic . n for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case 1 o review and approval of plans. Owrp�luires /� q'2ol I SIGNATURE OF APPLICANT PRINT NAME C Or 001 DATE . City of #ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977