PRE 2010 DOCSCity of Fridley
SUBJECT
® 1463
THE TOP OF THE TWINS
PERM
Ip,AT
r
BUILDING
RECEIPT NO.
RE
`L _ _ COMMUNITY DEVELOPMENT DIV.
PROTECT VE
r VE INSPECTION SEC.
1 CITY HALL FRIDLEY 55432
'%j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612660-3450
910-F15
4/14/78
JOB ADDRESS 1470 Rice Creek Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
2
Heather Hills 3rd SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Commercial Erectors 814 - 9th Street South 332-7343/571-8865
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS THE CITY OF FRiDLEYZIP PHONE LICENSE NO.
�f7L� N.OT dUARArWEE
�► KA THE
IW[O , LICENSE NO.
5 ENGINEER MAIL ADDRESS,;�
'THIS pAT15 FOR INFORMATION PURPOSES OMiY
PERSONS � AND
6 USE OF BUILDING ON TIDE SITE.ATI®N
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION [IREPAIR ElMOVE 11REMOVE
X❑
8 DESCRIBE WORK
Construct a 48' x 26'4" Dwellin and a 24' x 2614" Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide sod in the ,f`q(A front and side
yards. Provide a verifying survey before capping. Maintain 27' setback to
foundation wall due to 3' overhang. Provide combustion air to furnace. Provide
truss design by May 20, 1978. Variance granted 2/14/78.
SEWER LOCATION: (Approx. 9' Deep In Street) 23.5' E. of Manhole (INV. 920.0.5)
WYE ELEV: 919.35 TOP OF FOOTING: 922.35 Minimum
WATER LOCATION: 8.2' W. of Sewer Service, 49.1' S.E. of Manhole, 35.5' N.W. of
14" Cottonwood
DRIVEWAY DEPRESSION COST: N/A
WARM
SEEPIERATIE PERMITS REQUIRED POR WIRING. 80f0re digging call local utilities
HEATING, PLt9I BfNG AND SIGNS. r�lrE�Ho�� ®���c��cc - ��s �Ir.
RMI n
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPAN (7cU0OAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
$42,955
$21.45
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 O LOCAL LAW REGULATING CON,
$104.48
$400.00
SUIONTHE PFRFORMIj�CE CONSTRUCTION.PLAN
CHECK FEE
TOTALFEE
Is$
l
$552.07
E OF CONTRACTOR -0 AUTHORIZED AGENT (DATE)
WH P E Y ALIDATED THIS IS YOUR PERMIT
BLDG. INS15 IATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
01,
10
Address-
ddress2.
2.
Legal d i
3.
Zoning
4.
Lot Width
5.
Building Width Ile
6..
Front Setback ?p '1
7.
Total Use 4 C-
8.
Lot ,Coverage
9.
Easements
14.
11.
Variance
Soil �.
' 12.
Contractor ,
j 13 . '
Phone 896 45-
,. 14.
Architect
15. Dom'' nage
'
-rte
Energy Ashrae . t�'�
17.
Utility Locations
18..Specials
19.
AooO"- ..
Driveway
�
opening. I
Truss Design_-
]..
Combustion Air
22.
23.
..
24.,-
4.:25.
25.
r i
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OW14ER: (�fY7/I D�'p°� Ca Q ✓fig � BUILDER:
Address: 14 Address:
Tel. No.: P '� �rJ / - aa�.S
No. "V-90 Street: �G� £ /' beld<cc
LOT: ._'< BLOCK: ADDITION: 3?
CORNER LOT: INSIDE LOT: b"I SETBACK: � � SIDEYARDS: /0 '°%
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: �� Depth: 'V Height: 'Qo
Square Feet: Cubic Feet.
Front: _ =�/ 1 Depth: .24'-� "/ Height:
Square Feet: 2,9 Cubic Feet: 7
Type of Construction: Estimated Cost: $
To Be Completed: A J Alt. Alt. B
Proposed 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 ,4� is application
are true and correct. See reverse side for additional. -,in,& ation.
DATE: �;,? — / %--7 9 SIGNATURE:
Stipulations:
Is
m -'/' y8
'. - - A
0
Surveyors Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mpls., Minn. 55432, 784-9346
Lot 3, Block 2, Mr. Mike O'Bannon
Heather Hills Third Addition 5209 Fillmore Street NE
Fridley, Minnesota Minneapolis, Minnesota 55421
.: ��
3 CREEA� DRIVE
At
q a s8.a , --Z'1Ao'eryrou7d allAly eammerW z
�� yD
tI T i—�
. i dmalnoye easemer71
i3I. 00
0
(,'..r'�R�
r°t ® a� r
ERVDLEY
BOARD OF APPEALS
MEETING DATE
LEGAL DESCRIPTION:
Lot 3, Block 2, Heather Hills; Third Addition, Anoka County, Minnesota.
SCALE: /" = SO' 9t�G
o denotes lrgfl Before dig9ii;27 r.,2'91 local util"
TELEPHONEm EI^ET?yG e GAS Etc:
I hereby certify that this survey, plan or report was prepared by me or i r �, BY
`�'
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota. _
361.3
Reg. No. Date Job No.
al Z,,(J fQ� rf2Es�ro.v C)G 5 �
0
0
G-
ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
PLANNING AND INSPECTION DEPARTMENT
CITY OF FRIDLEY, MINNESOTA
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFICIAL can determine that submitted plans comply with the'ENERGY CONSERVATION
DESIGN CRITERIA of the STATE.BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure construction is per approved plans.
JOB LOCATION:
OWNER/CONTRACTOR:
• ADDRESS :�`�
A. Determine the Total Exposed Wall Area as follows:
1. Total wall window area
2. Total door area
3. Total sliding glass door area
4. Total fireplace wall area
5. Total wall framing area(average 10%)
6. Total net wall area above floor(average 90%)
7. Total rim joist area
Subtotal: Total exposed wall area above floor.
8. Total foundation window area
9. Total net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
PHONE:
r
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17
C. Determine the Total Exposed Roof/Ceiling Area as follows:
10. Total skylight area
11. Total roof/ceiling framing area (10%)
12. Total net insulated roof/ceiling area
GRAND TOTAL EXPOSED ROOF/CEILING AREA
�.tit
D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = &I,, tem II
Item I
13X
'E. j)etermine the "U" value of each segment (1-9) and multiply by the area as
follows:
i x "U" _
2.f/ 45 5� x "U" I'
3 ✓ ._� Jr� x fluff
4.� x Ifull lk�
5. x „Ufa
7. ✓ x %full
s._ x fluff _
9, ✓� x ••U° Ob 9 =
r=
ADD 1-9 FOR TOTAL WALL SEGMENTS =/� ITEM III _
•F. Determine the "U" value of each segment (10-12) and multiply by the area as
follows: / 3 ` q
10. Ido 9, x "U" ' °y _ `C6 . ? of
11. �.��� x fluff
12.yL(2- x f -U -f
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV " S
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State Building Code 6006 (c) 1.
I. Add Item I 02173. / + Item II �/e
J. Add Item III + Item IV— C4
K. If the sum of Items III and IV are less than.Items I and II, you have met the
intent of the Code for total envelope system.
ti
The undersigned, as applicant for a building permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate; and hereby
presents the information with required plans in support of the building permit
application.
By: DATE: X? .
v
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
Number Fixtures
>.
$3.00
Future Fixture Opening
-_ x
$2.00
U
x
k
m
x
Water
d
t°�
0
.y'i
100,000 BTU to 199,000 BTU
n
$10.00
H
*11
m
AQ
x
ro sa
a
w
$5.00
Heater
xC
Cmy
yy
u
W
3
o
w
3
o
as
lec
Wri
aea
w°
u�i
Uoa
f
`a�
1st
2nd
3rd
4th
(R) m Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
Number Fixtures
q 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
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: r
1st 3 fixtures j_� x '$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
TOTAL FEE
REINSPECTION FEE
($10.00)
TOTAL
$
$ T7
$ —3-0®
A
Job Address
Department of Buildings
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 application are true and correct
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - UILDING PERMIT NO. J/PERMIT NO.
100
e
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT degO
MINIMUM FEE FOR ANY PLUMBING PERMIT Is $7.50 PLUS $.50 STATE SSE
/
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
.AIR
CONDITIONING SYSTEMS AND DEVICES.
PARTIAL RATE SCHEDULE
1470
GRAVITY WARM AIR:
RATE
TOTAL
Job Address , Q A. -_k - 6`-L - L
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
'7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$ ®'
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$_''
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
Fridley, Minn.
STEAM OR HOT WATER SYSTEM:
OWNER
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING div e
each addn. 50,000 BTU
4.00
Boiler only up to 100,000 BTU
7.00
$
USED AS
each addn. 50,000 BTU
6.00
$
�� � ��
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
f-,
each add. 3 gal, per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$
OLD NEW BUILDING PERMIT NO. PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00•
$
o.
HEATING or POWER PLANTS, Steam, Hot Wat r=WA=Air�
AIR CONDITIONING
$
<
Trade Name C�°+d22�"�' Size No. /�
FAN HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS
$
Capacity Sq. Ft. EDR BTU HP
ALTERATIONS $ REPAIRS
$
State Surcharge
$ .50
Total Connected Load Kind of Fuel
TOTAL FEE
"
BURNER - Trade Name d°z' Size No.
ROUGH INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Data 010.00)
FINAL INSP.
C►PanY ,�-"���a',t ..��
Date
Signed By
APPROVAL FOR PERMIT
Tel. NO. � V s
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
643.1 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
TELEPHONE ( 812)571-3450
t >
October 17, 1978
11
Mr. Mike O'Bannon
Commercial Erectors Inc.
5298 Fillmore Street N.E.
Fridley, MN 55421
Re: Final Inspections at 1411 Kerry Circle, 6170 Kerry Lane, and
1470 Rice Creek Drive N.E.
Dear Mr. O'Bannon:
Final reinspections were made on the above addresses on October 16, 1978
and the following items were noted to be incomplete;
1411 Kerry Circle
1. Provide handrails to lower level.
2. Provide a verifying survey.
3. Install joist hangers on deck.
4. Adjust deck rail to 9 inch maximum spacing.
5. Plumbing work has not been finaled out.
6170 Kerrv. Lane
1. Provide verifying survey.
2. Replace insulation under windows in lower level as they still leak.
3. Lower window wells at east side of house.
4. Reduce deck rail to 9 inch maximum spacing.
5. Provide joist hangers on deck.
6. Protection needed for air combustion intake on fireplace.
1470 Rice Creek Drive
1. Firerock garage header.
2. Provide vapor barrier in basement.
3. Call for plumbing final to get water meter sealed.
We will expect all of the above items to be completed by October 31, 1978
when reinspections will again be made to determine compliance. If you have
any questions on these items, please contact me at 571-3450.
Since ,
RON HOLDEN
Building Inspector
Iii/mh
141 �o � e�
Surveyors Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mpls., Minn. 55432, 784-9346
SURVEY FOR SURVEY OF
Mike O'Bannon >- Li Lot 3, Block 2, Heather .Hills
5209 Fillmore St. DTE 2 Third Addition, Anoka Co., kin.
Minneapolis, M. 55421 W Q
Y .J
Ll RlC'E C°RFEK DR.
550.00
80
D
Ao� };�it
cb y--t-
�
N ��
Ni 8-
.h 3.3 `r
. ^p• .N N
v �
v �
•d Q V
i sv
� � r
tj
• N
13
tv
R= 364t.%3'
L-- 3.38'
•d^
i
LEGAL- DrESCRL?TION
Lot 3, Block.. 2, Heather Hills,Third Addition, Anoka County, Minnesota.
SCALE: 1" = 50'
® Denotes iron monument found
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.
10832 ,Tune 5, 1978 4010
Reg. No. Date Job No.
OF
01
SUBJECT '
P IT NO.
City of Fridley
28594
AT THE TOP OF THE TWINS
g U I L D I N G
P E R M I T
� `
RECEI�NO
` COMMUNITY DEVELOPMENT DIV.
y _ _
INSPECTION SEC.
4
r PROTECTIVE
I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I CITY HALL FRIDLEY 55432
612-571-3450
910-F15
11/16/98
10B ADDRESS 1470 Rice Creek Drive NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR.
3
2
Heather Hills 3rd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kevin Rosenblum
502-0395
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
All American Roofing & Rem. 4112 97th Ln NE Blaine 55434 86-
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 R REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (20 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 CONSTRUCTIONZONING
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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1714
.86
DOES N07 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHAR E
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
56.75
Fire S $1.71
a
PLAN CHECK FEE
TOTA F
�1-14-qf
e
2
I NATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
N P OP
9LoCfsNsP of-
OA IS IS YO PER /I
DATE
S-GNATURE Of OWNERof OWNERBUILOERI IOATEI
OF
01
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: I L4-1 0 R i c e c v e e c{ D R 0
Legal Description:
Owner Name & Address: Ie' -c u ,v, 1R o s "-- " bls vy4 Tel. # 50-z- 03 `(5
Contractor: AL,tr MN LICENSE # S i t, o
Address: 41 1 a q n t,, L ri Tel. # "1* c -4?(,-7(o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF DIPROVEMENT
LIVING AREA:
Length
Width
Height
Sq. Ft.
GARAGE AREA:
Length
Width
Height
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground Sq. Ft.
OTHER:
`Tf l 2 -® F F
1r•e w o o q
je) �i -7�X,
Construction Type:
Estimated Cost: $
4 ® as , oo
(Fee Schedule
on Back)
Driveway Curb Cut Width Needed: Ft.
+ 6 Ft =
Ft x $
= $
DATE: 1 I- l 1,- q I' APPLICANT: g —Tel. #- r7 g L- d.& 7 4
CITY USE ONLY
Permit Fee $ f`�
Fire Surcharge
$ P
State Surcharge
$�
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ �/r�z
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
01
su6JECT
N O.
City of Fridley
32576
AT THE TOP OF THE TWINS
?
BUILDING
P C D AAI T
r
�
C"'v 1
RECEIPT NO.
: • COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
f PROTECTIVE
1
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612_571-3450
910415
5/9/02
JOB ADDRESS 1470 Rice Creek Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
2
Heather Hills 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ann & Mike Martin 1470 Rice Creek Drive NE 763-502-9492
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Shaffer Home Improvements 2714 Arthur St
NE, Minneapolis, MN 55418 612-385-4654
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20222243
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW J2 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 16° Addition to Dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
SEPARATEERIyR
EGUIRE FOR..
Before digging
WIRING, H
®nom
a, 4, ® a ®r�
UMRI
p�EW
SEPARATE PERMITS ARE REOUIRED 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 ABANDONEO 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[{,530.56
$7.27
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 -
TR
TR
Fire SC $14.53
TI HE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE.
TOTAL FEE
J
Licens C $,5 0
$,V8.05
SIGN E OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
EN ROP Y ALIDATED HIS Is YLPR PEWIT
�—
SIGNATURE OF OWNER OF OWNER BUILOERI IDATEI
�A�BLD INSP - raAit
01
6, ji't(
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: 1170 Rick CizizqIC, b 2tvF
Legal Description: In&Crk Z; P94 h4us SCI katmo,u , A—c:W4 Cv. -/Lim
Owner Name & Address: AAA) xM'a Ner.0 IY70 &-,PCe*Ck-'i)A kOtgq M.0 Tel. # 1(03• Svc - T/9 -2 -
Contractor S1Wslp1=FR XrXC&=d1&jrS MN LICENSE # ,,1oaAa2 y�
Address: k)y AeWN2 S7 NC �'1 ARz,s�� sSY�B Tel. # W-s8S"-y(v*`i
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LPANG AREA: Length / (P Width l9 Height S 13' Sq. Ft.
GARAGE AREA: Length Width Height Sq. FL
DECK AREA: Length Width Hgt(Ground Sq. Ft.
OTHER:
Construction Type: Ue)of�!, Peg&tt Estimated Cost: $
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$
DATE: APPLICANT:5-RAF-F4HP2ca,4rus�urS Tel.#1.2-385=yG��f
&5'1.2s7 - lS1161
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
s
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:
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763.572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential Rate
Furnace Shell ad -Duct Work, urner -
Also Replacemen $ 30.00
-- Skie.Vent - Fill Out Back)
Gas Pipin (Needed with new furnace, it $ 10.00
but not replacement)
Gas Range $ 10.00
Gas Dryer $ 10.00
*Air Conditioning - All Sizes $ 25.00
Ali Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
IC61IF,1111112:11
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2001
JOB ADDRESS 44-70 191 k 01 eek rl ✓c
OWNER
TOTAL ,
BUILDING USED AS
$ 3_®.
ESTIMATED COST ® PERMIT.NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ 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
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
1..1�k83 �C1�D DATE
HEATING CO n r
Signed
TEL # 76 "Y,3i�'77
Approved By Rough -In Date Final Dat
BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing 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 manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes ( ) No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () No ( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
Appliance #2 Type
Appliance #3 Type
Total Appliances
— BTU Input
_ BTU Input
_ BTU Input
Total Btu Input
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
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:
—4R–�ftj. '7� � Signed By: Date
SUBJECT
City of Fr
33650 �
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
� �• ______ COMMUNITY DEVELOPMENT DIV.
r L PROTECTIVE INSPECTION SEC.
� p J
REV
DATE
PAGE OF
APPROVED BY-
CITY HALL FRIDLEY 55432NUMBER
""""� 763-571-3450
910-F15
6/27/03
/ /
JOB ADDRESS 1470 Rice Creek Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
2
Heather Hills 3rd SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Michael Martin 1470 Rice Creek Drive
NE 763-502-9492
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 Ij ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 12' x 14' Deck
9 CHANGE OF USE
FROM
TO
STIPULATIONS
See rotations on plan..
FARMING
Before
digging call for
EMARATE PERMITS
allIty
REQUIRED FOR:
®cations
02
NG AND
EQ
AVS
PLUMBIINd SIGNS
SEPARATE PERMITE
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 Nor
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 SAMEM
TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES
3OVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT
$2,086.56
$1.04
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
STRUCTION OR THE
PERFORMANCE OF CONSTRUCTION
$83.25
SC $2.09
PLAN CHECK FEE
1
TOTALFEE
TRAC;TO AUTHORIZED AGENT IDATEr
$86.38
SIGNAT RE OF
yyH PR
PERLY VALIDATED THIS IS YC(VR PERMIT
j
OAtE
'S.fdATURE OF O�,MER,.1114bWNER
BUILDER, IDATEr
BLDG rN5
NEW
ADDN
ALTER
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 11116 F l c -C
ppwvc . rP-i>7y,F-,t
Effective 1/1/2003
(763) 572-3604 Bldg Insp
(763) 5714287 Fax
Lou
Legal Descdp 'on: r S Ag'47-rNfA�� ug 3Ro r Tion
Owner Name& Address: M rc_ /1q7o picL c,egiK oge. Tel. #(74 91 1a z-129 -2�
Contractor: MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREJ
DECK AREA:
OTHER:
Construction T
Driveway Curb
DATE:
Call (763) 572-31
call you for card
Permit Fee
Fire Surchan,
State Surche
SAC Charge
License Surc
Curb Cut Es
Erosion Coni
Park Fee
Sewer Main
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height .9 Sq. Ft.
Length %• Width rT- Hgt/Ground �Le f� Sq. Ft. to S F
'+
Estimated Cost: $ —_S-�
Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
® 03 APPLICANT: 111 r c Wi4-✓_Tr7^► Tel. # 760 S -a z '9 `/92-
)4 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
number.
TOTAL $ ��
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]