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PRE 2010 DOCSSUBJECT - P MIT NO. City ®f Fridley o 15465' AT THE TOP OF THE TWINS BUILDING PERMIT f i t L' ----- COMMUNITY DEVELOPMENT DIV. P 1 PROTECTIVE INSPECTION SEC. Y& 1 1 ' CITY HALL -FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/18/79 JOB ADDRESS 1460 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 2 Heather Hills 3rd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Al Palmer 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Commercial. Erectors 5298 Fillmore Street N.E. 571-8865 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. LICENSE NO. 5 ENGINEER MAIL ADDRESS SEPER g� iiii�l0 TE PERMITS ZIP _IRED ONE QOR KAND ICRIMM 8 USE OF BUILDING NG ,9 SIGNS. Residential 7 CLASS OF WORK l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 58' x 481 Dwelling and a 34' x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. yvallry Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. WATER LOCATION: 49.3' S.W. of Manhole SEWER LOCATION: 8' to 12' E. of Water Service WMWIG P ER3 LEY 0011%. NOT GUARAt�1T�eE TMIB Ttl� an O D M 119VATIC44- . ke ACCURACY ON UTILITY LOCATIONS AND !Rmm" THIS DATA IS FOR INFORMATION PURPOSES ONLY ANO - W' t"t ' PERSONS USING IT SHOULD VERITY THE INFORMA �k�lk * �� LAW ON THE SITE. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT, CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1472+748 36,554 Tot OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANYTIME 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 $52,900 $26.45 WITH WHETHER SPECIFIED HEREI O NOT. THE GRANTING OF A PERMIT DOES N TPR UME TO GIVE A T RITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVIS S ANY 0TH T R LOCAL LAW REGULATING CON- $146.22 $425.00 STRUC I O THE PE O A F CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 36.55 $634.22 N TUREOfCONTRACTO R UTHORIZEDAGENT (DATE) WHEN PROPERL LIDATED THIS IS YOUR PERMIT U /8 "► BLDG INSP I DA E SIGNATURE OF OWNER OF OWNER BUILDERI (DATE) �► CITY OF FRIDLEY - r' APPLICATION FOR RESIDENTIAL BUILDING PERMITS (flew, Alterations, Additions, or Repairs) r OWNER: ;,� G ADDRESS: aa.� TEL NO: BUILDER: ADDRESS: TEL NO: S -7'/ - Construction //- Construction Location ST + T NO: L STREET: LOT: BLOCK: ADDITION: e7 Corner Lot: Inside Lot: Setback: / Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION us E Front: Squane. Feet: Front: Square' Feet: Depth: Height:Q Cubic Feet: Depth: Height: Cubic Feet: �® Type of Construction: QEstimated Cost: $ To Be ODmpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ "-'-` r $ 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. DATE: � �7 SIGNATURE: Stipulations: PC(LAA ;r' P. e 5t -)r- 144.ZZ 3G -6S 7-6. qS 3�I.2� 11-1 _ _, t y 11-1 _ _, t Surveyor's Certificate COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors 1446 County Road J, Mpls., Minn. 55432, 784-9346 Lot 4, Block 2, Mr. Mike O'Bannon Heather Hills Third Addition 5209 Fillmore Street NE Fridley, Minnesota Minneapolis, MN 55421 4 r R/CE CREEK ;01pjvE o� dretina9e easernen�, a °'. •� �, Q `Qpm �.� A i GU FKIO � DO11.9 AK bIEdAT►C'`l� b I 1 r c140 o ®P r may LOCA pOgtP105ES ONLY ANO O'tit ey T,315 0 Sto R . e Ol1lD os,$08S U drainage easement I ; I x F . Btf — -- — TELEPHONE=m€ T- /74.80 � � ,. �_;, ,�, RE0U� RE B r� LAS v� a LEGAL DESCRIPTION: Lot 4, Block 2, Heather Hills Third Addition, Anoka County, Minnesota. SCALE: /'= So' 0 oel ,nes //on /1 awned I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. 10932 A e 119174 3619 Reg. No. 4ate Job No. r �l� ����-�,QST �i� rill ce a CITY 6F FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $� Future Fixture Opening x $2.00 d New Fixture, Old Opening water $2.00 $ Catch Basin A $5.00 $ Mr46 E -.4 $5.00 i 100,000 BTU to 199,000 BTU 41 w wU Water Softener x Heater $ o 4F CC x $5.00 GAS FITTING FEES: C.4 0 lst 3 fixtures x $3.00 $ 3.00 Additional Fixtures x $1.00 $ -4 x $10.00 $ 11 8 9 . m� each add. $100.00 or fraction y° $ State Surcharge qG $ .50 Or N .1 J �O trip q ,yy as lec to w U MRC 3 (7 C7 0 1st / 2nd 3rd 4 th (R) = Future Connection Opening Connected with Sewer (*j - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $� Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ water Heater - to 99,000 BTU �� x $5.00 $ �•i 100,000 BTU to 199,000 BTU x $10.00 $" Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: lst 3 fixtures x $3.00 $ 3.00 Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ J("!�D - REINSPECTION FEE ($10.00) Job. Address / o P-0 Department of Buildings City of Fridley Tel. #571-3450 The undersigned hezeb ,makes application for a permit for the work herein specified agreeing biY 411 work in strict accordance with the City Codes and rulings of the Departttent of Buildings, and hereby declares that all the facts and roprosontati®ns stated in this application are true and corr6ct Fridley, Ma. /0 m �� , 19 Q OWNER KIND OF BUILDING TO BE COMPLETED ABOUT ESTIMATED COST OLD,EUILDING PERMIT NO. PERMIT NO. • Company Signed By Tel. NO. ROUGH INV. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUs $.SO STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND each addn. 50,000 BTU .AIR CONDITIONING SYSTEKS AND DEVICES PARTIAL. RATE SCHEDULE 7.00 $ each addn. 50,000 BTU GRAVITY WARM AIR: RATE TOTAL Job Address ���� Furnace Shell a Duct Work $12.00 $ $ Replacement of Furnace 7.00 $ (over 199,999 BTU see Fee Schedule) Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterationn each add. $500.00 4.00 $ City of Fridlay Tel. 0571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ 'c !O © . . each add. 50,000 BTU 4.00 $ (5C9 Replacement of Furnace 7.00 $ Repairs & Alterationsa-up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal, per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ C9 aab (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ J• Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ AIR CONDITIONING $ FAV HEATING SYSTEMS Sea Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS & REPAIRS $ State Surcharge $ .50 TOTAL FEE $GG ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. - -13 v'R Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE The undersigned hereby makes application for a germit for the work herein specified agreeing to do all work in strict aFcordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. '1927 OWNER -- KIND OF BUILDING _--LfYi--Lx USED AS Cv TO BE COMPLETED ABOUT p ESTIMATED'COST �s7 �J OLDNEW UILDING PERMIT N0. PERMIT NO. _%• DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Wate WarmAir- o. c% -- IgG%--/0���a C 3 Trade Name �� Size No. 0 D Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name C(� Size No. Capacity Sq. Ft. EDR BTU HP companyZL�i/Vi.® Signed By d Tel. No. 2 rrn .J ,Qu�G.:Ssat JAI � 1 m 'e 6431 UNIVERSITY AVENUE M.E., FRIDLEY, MINNESOTA 66432 TELEPHONE ( 812)571-3450 ,. November 30, 1979 i Mr. Mike O'Bannon Commercial Erectors Inc. 5298 Fillmore Street N.E. Fridley, MN 55421 Re: Final Inspection at 1460 Rice Creek Drive N.E. Dear Mr. O'Bannon: A final inspection was made on November 29, 1979 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Provide sod in the front and side yards by June 15, 1980. 2. Provide a hard surface driveway by June 15, 1980. 3. Post address numbers on structure by December 17, 1979. 4. Provide City.with copy of verifying survey by December 17, 1979. 5. Provide closers on both doors leading from garage to house by December 17, 1979. 6. Provide a guardrail and handrail on stairs leading from garage to lower level of house by December 17, 1979. 7. Provide a handrail on lower level stairway by December 17, 1979. 8. Insulate rim joist by December 17, 1979., 9. Render patio door inoperative until Deck is constructed. We will expect the above items to be completed by the scheduled dates when reinspection will be made to determine compliance. If you have any questions on these items, please contact me at 571-3450. Sincerely, C:: �a DARREL G. CLARK Chief Building Official DGC/mh . CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 65432 TELEPHONE ( 612)571-3450 Mr. Mike O'Bannon Commercial Erectors :Inc. ' 5298 Fillmore Street N.E. Fridley, MN 55421 Re: Final Reinspection at 1460 Rice Creek Drive N.E. Dear Mr. O'Bannon: A final reinspection was made on December 5, 1979 of th.e above address and the construction was approved with the following items to be completed in June of 1980; 1. Install sod in the front and side yards. 2. Provide a hard surface driveway. We will expect the above items to be completed by the scheduled date when a reinspection will again be made to determine compliance. If you have any questions on these items, please contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh l ' - SUBJECT city of Fridley 3 00 0 3 AT THE TOP OF THE TWINS BUILDING PERMIT r IP `L ------COMMUNITY DIV. PROTECTIVE INSPECTIONSEC. vo?'®/ r e CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 7/17/01 JOB ADDRESS 1460 Rice Creek Drive NE I LEGAL LOT NO. BLOCK CT OR ADDITION SEE ATTACHED DESCR. [� 2-7 Heather Hills 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Margaret Lie fried/Stan Mack 1460 Rice Creek Drive NE 763-574-2668 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Jansick Inc 6480 Squire Drive NE Fridley, MN 55432 763-574-9679 8618 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Construct a three season porch addition/closet addition and a deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING SEPARATE REQUIRED PERMIT'S ER F®R: Before digging call for"RING HEA-nNG all utility locations PLUNIRINj AND SIGNS. 4540002 REQUIRE® BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO: DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 09 COMPLIED $95,000 $47.50 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- $958.75 Fire SC $95.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE o — Licens C $5.0P 1,106.25 SIGNATURE CONTRACTOA OR AuTNORIZED AGENT iDATEi - HEN PROPER VAIIDAT D THIS IS YOUR PERMIT G ® Z ltd �„ BL INSP GATE ' SIGNATURE OF OWNER IIF OWNER BUILOERI IDATEI NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: /2-140 ��P OSP Legal Description: Owner Name & Address: 41W60ARt r Li,—,o0Awe4-d 4"O' K, WC -r Tel. # 7G 3 S7'/- .? 6G8 Contractor: dAA1514.r �OcC MN LICENSE # f;(- /9 Address: /,4*& S.04,a?P A4 Tel. # 71.3-S711- ft -7y 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: 3 • se,4 60A.1A&W, Iel user ,W Estimated Cost: $ ,4"4O0. a o " D&-ClC Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: o/ APPLICANT: Tel. # 2L3 Sly- 9679 I V CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ 7 PS"Fee Schedule on Reverse Side $ b .001 of Permit Valuation (1/10th%) $ r"O $.50/$1,000 Valuation $ $1150 per SAC Unit $ �5;: ca $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 [ ] $ OCG.44; ' CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ��� / s' .d® GATE SCHEDULE / OWNER Residential Rate 'Burner TOTAL _ J- Furnace Shell and Duct Work, - BUILDING USED AS �� Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle On� (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name-�a �, ��� /_:s Size No. BTU ,_ c; c c HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel = - Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are'true and correct. TOTAL FEE _ $ ' MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO'°- REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed y ='y DATE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date written permission from adjoining property owner. 7"'?, 1 ` FILL OUT BACK SIDE F STACK VERIFICATION ON REPLACEMENT FURNACE if CHIMNEY AND STACK VERMCATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration 3. 4. 5. Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes O No ( ) Yes () No ( ) Yes O No ( ) Yes ()No() Yes No Yes O No ( ) CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential 0A Effective On January 1, 1998 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ 3Q $10.00 $ LkD -' $10.00 $ $10.00 $ $ 25.00 $ s State Surcharge TOTAL FEE $ .50 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr JOB ADDRESS ) �90O Qj Q!P 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. ) g 7- .p ,1998 OWNER �-N I -N- (-AQ BUILDING USED AS 41,4 SAI, ESTIMATED COST PERMIT NO. 13V4 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) (4- Air Trade Name C �' Size No. -1Soon 6,,J BTU S �O HP EDR Fuel $ CAS Total Connected Load Burner Trade Name \ C jp BTU -rS c 2 c;, HP Size No. -7 d C7 EDR HOME ENERGY CENTER 152M 25TH AV'!'. N. #128 HEATING COMPANY PLYMOUTH, �N 55447 _ C Signed Tel No. Zip /`?-o Approved By4 Rough -In Date Final Date 5� 1k_�;w *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE fes/ RIGHT -J LOAD AND EQUIPMENT SUMMARY File name: default For: Mack 1460 Rice Creek Drive Fridley MN By: Home Energy Center 15200 25th Ave. N. Plymouth WINTER DESIGN CONDITIONS Outside db: -20 Deg F Inside db: 70 Degl? Design TD: 90 Deg F HEATING SUMMARY Bldg. Heat Loss 50246 Btuh Ventilation Air 0 CFM Vent Air Loss 0 Btuh Design Heat Load. 50246 Btuh INFILTRATION Method Simplified Construction Quality Average Fireplaces 0 HEATING COOLING Area (sq.ft.) 1200 1200 Volume (cu.ft.) 14400 14400 Air Changes/Hour 1.0 0.5 Equivalent CFM 240 12 0 HEATING EQUIPMENT SUMMARY Make Model Type Efficiency / HSPF Heating Input Heating Output Heating Temp Rise Actual Heating Fan Htg Air Flow Factor 0.00 95 0 Btuh 0 Btuh 0 Deg F 1010 CFM 0.020 CFM/Btuh MN 55447 Job # Wthr Minneapolis /St ._Paul_AP MN Zone Entire House SUMMER DESIGN CONDITIONS Outside db: 95 Deg F Inside db: 75 Deg F Design TD: 20 Deg F Daily Range M CFM/Btuh Rel. Hum.: 50 % Grains Water 33 gr SENSIBLE COOLING EQUIP LOAD SIZING Structure 21118 Btuh Ventilation 0 Btuh Design Temp. Swing 3.0 Deg F Use Mfg. Data n CFM/Btuh Rate/Swing Mult. 1.00 Total Sens Equip Load 21118 Btuh LATENT COOLING EQUIP LOAD SIZING Internal Gains 1380 Btuh Ventilation 0 Btuh Infiltration 2698 Btuh Tot Latent Equip Load 4078 Btuh Total Equip Load 25196 Btuh COOLING EQUIPMENT SUMMARY Make Model Type COP/EER/SEER Sensible Cooling Latent Cooling Total Cooling Actual Cooling Fan Clg Air Flow Factor 0.00 0 Btuh 0 Btuh 0 Btuh 1010 CFM 0.048 CFM/Btuh Space Thermostat Load Sens Heat Ratio 84 MANUAL J: 7th Ed. RIGHT -J: VI 3.0.17 S/N 11089 Printout certified by ACCA to meet all requirements of Manual Form J default Job# s Zone: Entire House Printout certified by ACCA to meet all requirements of Manual J Form MANUAL J: 7t1i Ed. RIGHT -J: s . U .11- 5IN i l uo N 1 NsmeofRoom Entire House Mack 2 Running Ft. Exposed Wall 140.0 Ft 140.0 Ft. Ft Ft. 3 Room Dimensions, Ft 0.0 t 40.0 x 30.0 Ft x Ft x Ft 4 Caiings, Ft Condit Option 12.0 d 12.0 heat/cool TYPE OF CST HIM Area Btuh Area Btuh Area Btuh Area Btuh E}POSURfi NO. Htg I Clg Length Htg Clg Length Htg I Clg Length Htg Clg Length Htg Clg 5 Gross a 12D 7.2 1.9 1680 **** **** 1690 Exposed b 0.0 0.0 0 ***** 0 Walls and c 0.0 0.0 0 *°*° **** 0 Partitions d 0.0 0.0 0 0 e 0.0 0.0 0 are** anw* 0 aaa** "*** * are** areare areare f 0.0 0.0 0 **** ** 0 **°* * *►tee arer a *p* *area 6 Windows and a 2A 42.8 144 6156 **** 144 6156 Glass Doors b 0.0 ** 0 0 **** 0 0 **** **** **** Heating c 0.0 *" 0 0 **** 0 0 d 0.0 ** 0 0 **** 0 0 e 0.0 ** 0 0°" 0 0 f 0.0 0 0 0 0 **** **** 7 Windows and North 31.0 32 * 992 32 **** 992 Glass Doors NE/NW 0.0 0* 0 0 0 **** M*** Cooling E7W 89.0 48 **** 4272 48 **** 4272 SEJSW 0.0 0 0 0 "* 0 **** **** South 48.0 64 * 3072 64 **** 3072 **** **** Horz 0.0 0 **** 0 0 **** 0 **** ***a 8 Other doors a 10F 28.8 7.6 42 1210 317 42 1210 317 b 0.0 0.0 0 0 0 0 0 0 9 Net a 12D 7.2 1.9 1494 10757 2821 1494 10'757 2821 Exposed b 0.0 0.0 0 0 0 0 0 0 Walls and c 0.0 0.0 0 0 0 0 0 0 Partitions d 0.0 0.0 0 0 0 0 0 0 e 0.0 0.0 0 0 0 0 0 0 f 0.0 0.0 0 0 0 0 0 0 10 Ceilings a 16D 4.8 2.3 1200 5724 2798 12005724 2798 b 0.0 0.0 0 0 0 0 0 0 c 0.0 0.0 0 0 0 0 0 0 11 Floors a 21A 2.2 0.0 1200 2592 0 1200 2592 0 b 0.0 0.0 0 0 0 0 0 0 C 0.0 0.0 0 0 0 0 0 0 12 Infiltration a 128 14.2 186 23808 2645 186 23808 2645 13 Subtot Btuh Loss=6+8..+11+12 **** 50246 **** *** 50246*"** 14 Dud Btuh Loss 0°/ 0 **** 0°/ 0 o/ area+ o/ aoxare 15 Total Btuh Loss = 13+14 **** 50246 50246 16 Int. Gains: People@ 300 6 * 1800 6** 1800 **** **** Appl. @ 1200 2 **** 2400 2 **** 2400 **** **** 17 Subtot RSH Gain -7+8..+12+16 ** **** 21118 *a ** 21118 * * **** **** **** 18 Dud Btuh Gain 0°/ 0 0% * 0 19 Total RSH Gain=(17+18)*PLF 1.00 **** 21118 1.00 21118 20 CFM Air Required **** 1010 1010 **** 1010 1010 **** **** Printout certified by ACCA to meet all requirements of Manual J Form Remarks: List ALTERATIONS Being Done: HOME Dic-,,Po%4 15200 25TH AAI N. u120 PLYMOUTH, i�IN SW7 HEATING CO: Signed By: Date: i r. CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes Sy) 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 0 No ( ) 8. Has combustion air been provided for water heater Yes k)O No ( ) Remarks: List ALTERATIONS Being Done: HOME Dic-,,Po%4 15200 25TH AAI N. u120 PLYMOUTH, i�IN SW7 HEATING CO: Signed By: Date: Arlo UIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 25, 2001 Mr. Stan Mack 1460 Rice Creek Dr NE Fridley, MN 55432 Re: Final Inspection at 1460 Rice Creek Dr NE Contractor: Home Energy Center Dear Mr. Mack: A mechanical permit was issued on October 23, 1998 to install a furnace and air conditioner at your address. According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the mechanical work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Mechanical Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh SUBJECT � - PER City of Frydley 3223 AT THE TOP OF THE TWINS C D B U I L D I N i� PERMIT A A I i , � COMMUNITY DEVELOPMENT DIV. r v PROTECTIVE INSPECTION SEC. L V L'\/v` (� R O. �s 1 . � / NUMBER REV DATE PAGE OF APPROVED BY 0--t CITY HALL FRIDLEY 55432 'j l 612-571-3450 910415 10/12/01 JOB ADDRESS 1460 RICE CREEK DRIVE NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 4 2 Heather Hills 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mack 1460 Rice Creek Drive NE 763-574-2668 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northern Crest Inc 7401 Central Ave NE, Fridley, MN 55432 763-792-9364 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098415 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION C REPAIR O MOVE O 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 OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1.29 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,573 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION c PLAN CHECK Licen SC .00 ZVTOTALFEEFEE $92.11 57GNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi WH N P A DATED THIS ISYUR PERMIT�ERLY011-0 S-GNATURE OF OWNERoF OWNER BUILDER, iDATEj LOG MSP FATE NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY 612-5723604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 1460 Rice Creek Dr. Legal Description: Owner Name & Address: Mack Contractor: Northern Crest, Inc. 11IIPIF.J MN LICENSE# 20098415 Address: 7401 Central Ave. NE Fridley, MN 55432 Tel.# 763-792-9364 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: tear off and re -shingle house and garage- 24 square Construction Type: Estimated Cost: $. 0 0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: 10-12-2001 APPLICANT: Bill Olson Tel.# 792-9364. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (612) 572-3604 for Permit Fees if mailing in application $ Fee Schedule on Reverse Side -�r% 1 .001 of Permit Valuation (1/10th%) $ C-^) 01 $.50/$1,000 Valuation $ $1100 per SAC Unit $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ TOTAL $ 9.2"11 STIPULATIONS: SUB�E& PER . '26 City of Fridley 9 8 AT THE TOP OF THE TWINS BUILDING PEG Av, I T r e � ", 1 RECEINO. PT COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. e e NUMBER REV OATS PAGE OF APPROVED BY ' 1 CITY HALL FRIDLEY $5432 612-571-3450 910-F15 6/14/02 JOB ADDRESS 1460 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 1 Heather Hills 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stan Mack 1460 Rice Creek Drive NE 763-574-2668 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 7CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 25' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERM'S WARNING REQUIRE® FOR: Before digging call for WIRING HEATiAIG all utility locations PLUMGINd AND SIRIS 45"002 RFOUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $3,450 $1.73 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- `V STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $1.43 _ N P P RL LIDAT HIS IS `YOUR PERMIT G/�/✓ s S°G A URE OF COQ CTOp OR AUTHOR°IED AGENT ° TE b�p./_ SGNAiu F+E OF G NEa,,F OWNER 81RD. ° 10 TE° " BLDG SP ' 10,gAtE NEW [ J CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ���Construction Address: A �'t _ � c'kA� Legal Description: Effective 1/1/2002 (763) 572-3604 Bldg Insp V - Owner Name & Address: Tel. # Contractor. MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width �� Hgt/Ground\AA Sq. Ft OTHER: Construction Type. Estimated Cost. Driveway Curb Cut Width Needed:Ft + 6 F = Ft x $ _ $ DATE: APPLICANT: Tel. �SA 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. / �(J� "216 CITY USE ONLY- 0,/.L(/R � '� C'o , Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ 1,23 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 [ ] TOTAL $ l6) -� STIPULATIONS: MAY -12-1998 ®9:00 FROM CITY OF FRILLEY TO 5741330 P.01/0t MINNESOTA VALLEY SURVEYORS & ENGINEERS CORP. 4 1071 EAST CLIFF4%OAO WO NORTHEAST FOURTH STREJ:T SURNSYILLE, MINNESOTA 55337 GRAND RAPIDS, MINNESOTA 5&14 PHONE: 4612) 6ft+0.7750 PHONE: (216) 3268528 a t� � tt House Location Suwsy /o,- :_k7lKE BAN�lOIN . ; 11,. Qk 4j L F'F•K SCALE: /".7 50" • DEN�O� ES tRoN MONUMENT LOT 4,Blwa2 HEATHER HILLS THMD ADOMO1f! ANOKA COUNTY, MIMES= 1 Mereby certify that this is a true ana correct representat+on of s survey of the boundaries of the above oescribud land, and of the Ioottion t)f all buildings, thereon, and all visible encroachments, it any, from or on said lend. As som9yed by me Ih13-91�d—day of_„ Apr# 19F-0 = `r, r ?rr...,r.+r R.LS. TOTAL F.01 uii Y OF rRiDLLYINSPECTION DIV.�, ®✓��V �L! �%� �2. (:(' ,�/J �. Au1�u- �� a'�DI t �'t�� {�t� 1, iuW 6431 University Ave NE 7"D l 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 /410-4 - IZaCC- CeZ99k, bt New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 d,� 20_ Rain Water Leader $ 7.00 , Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner S7 -A^1 IMA CK Water Heater -Electric $ 7.00 Water Heater - Gas** _�_ $10.00 Building Used As 9 Gas Range" $10.00 Estimated Cost 900 '"' PERMIT NO. Gas Dryer"' $10.00 Back Flow Preventer Required ( )Yes ( ) No ��� Type $15.00 PLUMBING COMPANY �=T Reinspection Fee $47.00/Hr SIGNED BY _ TEL N0. W3 ' D ,7j ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �qs Approved By7q��_ Rough -In Date Final Date Z �j State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $__L6 1511 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, VENT CONNFCTOR AND COMRtiSTION AIR VFRIFICATION When mplaninn an exicting furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing emhustinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When required to ins all a new cnmhustinn air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When inc allinn a new venting nystam, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #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 HEATING CO: Signed By: Date : � / CITY OF FRIDLEY PERMI NO.: 2004-01329 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 08/17/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 1460 RICE CREEK DR NE PIN 133024430056 LEGAL DESC HEATHER HILLS 3RD ADD LOT 4 BLOCK 2 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 1,600.00 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. KITCHEN ALTERATIONS. STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 57.05 37.08 JANSICK INC (8618) 6480 SQUIRE DR NE FIRE SURCHARGE 1.60 FRIDLEY, MN 55432-5243 STATE SURCHARGE, VALUE 0.80 (763) 574-9679 LICENSE SURCHARGE 5.00 TOTAL 101.53 OWNER MACK STANLEY II & LIEBFRIED M 1460 RICE CREEK DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of 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 rovisions of any other state or local law regulating co on or the perfo ance of construction. Applicant Date -!? Bldg Insp Da C� U SEPARATE PERMITS REQURED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: s%'fFA! 4ii,4,fC CZE 7-" i224e Tel. # 7103d:S7f�- X210lO Contractor. � HS i c..(c,,3WC. -- MN LICENSE # d & a Tel. # 6 7� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: r' evl Construction Type: "zr Estimated Cost: $ ` �00 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE: D' - 0 APPLICANT: Tel. # 20-52V-4767,9 Call (763) 572-3604 for Permit Fees if mailln n application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ 17, o 8' $ $ f® Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ld / S— STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 r'AX: ( 763) 5 71-128 7 PERMIT NO.: 2004-01577 �6qy DATE ISSUED: 09/13/2004 ADDRESS : 1460 RICE CREEK DR NE PIN : 133024430056 LEGAL DESC : HEATHER HILLS 3RD ADD : LOT 4 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. KITCHEN REMODEL. # INSPECTIONS 2 APPLICANT MELLAS ELECTRIC INC 16901 XYLITE ST NE HAM LAKE, MN 55304 OWNER MACK STANLEY II & LIEBFRIED M 1460 RICE CREEK DR NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 40.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 40.50 PAID WITH CHECK # 28670 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.