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PRE 2010 DOCSr City of Fridley SUBJECT P ?7013 AT THE TOP OF THE TWINS P� PERMIT__ Ir I BUILDING RECEIPfiNO. _ __ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. /'--1 CITY HALL FRIDLEY 55432 �---- �'� NUMBER, DATE . 8/12/75 PAGE OF APPROVED BY 612-660-3450 .910-F15 JOB ADDRESS 6201 Rice Creek Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 1 Rice Creek Estates 2nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Pine Tree Builders 8514 Center Drive 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 p, NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR C] MOVE ❑ REMOVE 1� 8 DESCRIBE WORK House and garaqe 26 x 43 + 26 x 24 garage 9 CHANGE OF USE FROM TO STIPULATIONS 1. House cannot be occupied until sewer and water are in operation 2. Provide a hard surface driveway 3. Provide a verification survey 4. Sodi front and rear yard Foi{ �` d SIRED S EPERATE PE N® SIGNS - S A j3j . Pt��'�B►NG ,AE AT1NG, Before d1g ng call loaf i llifti TELEPHONE - L�: CTRIC B �S E SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANC RMUIRE I� O !!�� VENTILATING OR AIR CONDITIONING. wood frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT 8 CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 554 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 $36,050 .18.03 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 52.73 325.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 395.87 SI aN TUAEOF N OR OR AUTHORIZED AGENT (DATE) EN PROPERLY VALIDATED THIS IS YOUR PERMIT,/ % J cy�I y y _ is SIGNATURE OF OWNER (IF OWNfj B ILDER) (DATE) BLDG )NSP b17ATE .APPLICATION FOR RL'SI'DL'NTIAL., ALTL'RATION, ' OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY,-NIINNESOTA OWNER'S Nion rte WQS BUILDER: Yiva fot.L�l��I� • ADDRESS : ADDRESS : 94 t � e 0e 4J , NO;, STREET: i I.OT : - BLOCK :o ADDITION : CORNER LOT: INSIDE LOT -i�SETBACK: 1;IDEYARD: • E Applicant attach to this fora. lVo Certificates. �f Survey . of Lnt and..proposed building location drawn on these Certificates. . i DESCRIPTION OF BUILDING i To Be Used As: �" y �4 Front: Depth: `t Height: Square Feet: 71k Cubic.Feet: • !Z Front: ', Depth •Height • i Square Feet;. L -1-S Cubic Feet: Type of Construction: W006 Estimated Cost: $ -_ To -Be Completed: AV Soev A -S PO r J . 3�e ®•S� The undersigned hereby makes application fora 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 representat'ons stated in this application are true and correct. •DATE• 1 �'� SIGNATURE:. (See Reverse Side For Additional Information.)' , CERTIFICATE OF SURVEY FOR: Pine Tree Builders, Inc. Z 0 I � I a •• I Q I 10 I I C I a 4 1 (920.?) I J 1 Ljj V ��,--- — -- -----—o--L'------� � 03. ._ LP 12.26 •• 13 92o.01 BRIARDALE RD. NE (919,2); 0 De -notes Iron Monument (920.0) Denotes Proposed Gro -de Description: Lot 3, Block 2, RICE CREEK ESTATES 2ND ADDITION, Anoka County, Minn. IJOWfI & CO"Ittr I hereby certify that this is a tru6 and correct representation of a survey of Job No. the boundaries of the above described land and of the location of all buildings, 235 if any, thereon, and all visible encroachments, if any, from or on said land. �urver�or� Book — page . Land Surveying • Site Planning As surveYed by me this day of ALAI , —1915— Civil 1915Civil Engineering 8816 70th Av. N. (1-94 at Boone Av. N.) '� "r'i`d �` v,/ � Scale Brooklyn Park, MIFF 55428 1` � 411 = 40, Phone: 533-7340 Minn. Reg. No, '� :r.-.v��'i n .�� .� �.. � �.^e `.. t;. "+1...._.,_w �..a.. ._� �fl',,. _�^°.-^•�'j, e'�`r*...;.f9 .. ?ry � Te`�. "...,� rn ,�A.R,..,, ... ...--^�Aa..O �� 3z 4l- .... lw ..a.av•� tG. Adti.>.� `4t L .r.v.....✓s7� ,�.-�..ay._d'•w:::: L• "id �, e• 7W"'`"^J .M �U Wti.ri:1 .c. �..vn:uEv%..t.:r�(+�". or �GrJaC.16Z � Q:rio" 6:v S.: v= PARTIAL RATE SCS "EDULE Wit. of r?11--3. Phi GIUVITY WAZI! AM WET TOTIM rurnsce Shell & Duct Work ... .... ..... .. $10.00 s Replacement of JNzrnace 6.00 $ Repairs & Alterations ---up to $500.00 6.00 $ Repairs & Alterations each add. 5300.00 300 $ MECEL WAr-M Amt furnace Shell & Duct 'Work to 1$3,000 BTU er.ch add. 60,000 BTU . ......... n *;Trent of Furnace Sc Alterations --up to $500.00 it-aAirs & Alterations each add. $500.00 s'7iFANI or MOT VI,' 1M R Y3T_7-_1 ..51000 $ City of Y*e.dley: The undersigned hereby makes application fora permit for the work hereur• specified. agrecing to do all work in strict accordance with the City 0rdi�eef and ruling of the Department of Buildings, and hereby decls:es that an tiee facts and representations stated in this application arra true and correct. 3. tri $ Owner 6.00 $ Kind of 6.003.00 $ Used as Furnace Shell & Lines -to 400 sq. ft. FDR Steam Q10.00 $ Furnace Shall & Lane, -to C40 sq. ft. tDR Not Water 10.00 Each add 200 sq. ft. EDD Steam 3.th'1 $ Each add. 320 sq. ft. EDR Hot Water 3.00 $ SOIL BUB MER -to 3 gal. per hour 6.00 over 3 gal. per hour -See Fee Schedule � Gies BUiinER (up to I.rc3,030 BTU) 6.03 S . vver 190,000 BTU See Fee Sch,cduls GAS FITTING : ZZZ: N0 RATE TOTAL Ist 3 Fixtures x$ 200 $ Additional Mrtures _ ss .78 Gas Range to 10,= 5.00 $ FAX ice., a ��30$'i"c'i ALT MU4 ON -3 Cc REPM State Surcharge .50 �3 €3= Foca To be completed about Estimated Cost $ Ot --Ne Widing Permit No: or VTOZZ HF-1kTING or Pa'ia PLAMMS -Sham, Hot W , Warm Aur o 4 Trade Name size NO. � Capracity_....._._ . — Sq. Yt E-D.R BTU � R.P Total Connected Load Kind of :fie . BURNER — Trssde IlaSize hio Capaci sq. Ft. ED R BTU SUBURBAN RIR CO Myrad RAID MiINNEAP 01 is, 441AIRIN _ DRtVR 1_A 55432 2L �� city of F-rial Apphcotion for -PDI ;ng and Gas ►ng Permit J�aF'4. o¢ $td;;a. ?honor x..3450 VISCWTIOM Of WORK I&MI)MI-Kind Osd 14--sMarr of Frxtawf ffi ?Corer ii.•h:re. O!d 07,oairm, sevar. COUP0 l City of Fridley: The undersi;ncd hereby makes application for a permit for Lye° Bork here specified, a:ree:ng to do as wcrk in strict accordance loth the CltY C7:' -I:=--( and ruling of the ":par ::cert of BU!e;-- s, and hereby declzres L'sei all L':e 1: and representations statai.Ln this applicatim are t/r;e =d co%rect 7 / ef !® Owner - I. Kind of Building Used as To be completed about • d C t S PARTIAL RATE SCHEDULE. Z'S tims.r: ps . .. _ N P fit Nd. pLt?IKBING FIgLTtiR]E RATES,. WATtR Wyk TOTAL.' : 1-2 U ° ; < !I 7 < 7 " a m w meas ELM ° Fvture Fixture Opening .... • • • • • ••• r-- x 51.50 S� .� �% �-- • By ep7, Businvzs P12vne NO —�-- :Cew Fixture Old OpPrnirg......'.... �— x 5i."' 3 _ .. __ --.. , Catch Basin ........ '........... . x $3.25 S K atcr Hea:cr 'Up to rs9.G30 BTUs x 53.60 S n -• • ::err Crcund Run Old Bldg....:..:. x $3.25 S - %J e l t•c:riz iter F."ter...........T. . GAS FZTTINC FUSS NO. RnTE TOTAL • . . Bare $,__ a•o0 ° Ist3Fixtures••••••••••••••'••' ----"— . Adda:onal Fixtures. .............. _._ _-- x $ .75 $ - Gas Range to I99.00.0BTU .......... « _---- x S5.04 ' S ' .50 State ' a �L•T� �t4 �� We. •Surcharge ISM ::d I ffi ?Corer ii.•h:re. O!d 07,oairm, sevar. COUP0 l City of Fridley: The undersi;ncd hereby makes application for a permit for Lye° Bork here specified, a:ree:ng to do as wcrk in strict accordance loth the CltY C7:' -I:=--( and ruling of the ":par ::cert of BU!e;-- s, and hereby declzres L'sei all L':e 1: and representations statai.Ln this applicatim are t/r;e =d co%rect 7 / ef !® Owner - I. Kind of Building Used as To be completed about • d C t S PARTIAL RATE SCHEDULE. Z'S tims.r: ps . .. _ Old—New. Building Permit No. P fit Nd. pLt?IKBING FIgLTtiR]E RATES,. NO. RATE TOTAL.' : x SZCA S � • � O • Sign Number Fixtures . • • • • • • • • • • . • • • • ._...� ° Fvture Fixture Opening .... • • • • • ••• r-- x 51.50 S� .� �% �-- • By ep7, Businvzs P12vne NO —�-- :Cew Fixture Old OpPrnirg......'.... �— x 5i."' 3 _ .. __ --.. , Catch Basin ........ '........... . x $3.25 S K atcr Hea:cr 'Up to rs9.G30 BTUs x 53.60 S n -• • ::err Crcund Run Old Bldg....:..:. x $3.25 S - %J e l t•c:riz iter F."ter...........T. . GAS FZTTINC FUSS NO. RnTE TOTAL • . . / % 52.00 $,__ a•o0 ° Ist3Fixtures••••••••••••••'••' ----"— . Adda:onal Fixtures. .............. _._ _-- x $ .75 $ - Gas Range to I99.00.0BTU .......... « _---- x S5.04 ' S ' .50 State ' a �L•T� �t4 �� We. •Surcharge • 53-84-915o5�, a7�s' 0� r-ridloy k'�pplitr.�d�olan for 8 lurs—t•�:' g W �n.7'a�.f �J Ott dt r Bldgs, Mona WO.345(1 DESCRIPTION OF WWI= �,c:a4�ox '6201 Aica Crack Drive -- Humb.-r. KLtd &.nd Loer.fcn 6f TIMbs.es. . t view Fimturo. Old 0-,,sm1n9% PARTIAL RATE SCHEDULE ,:war Ccrapcol City of Fridley,.. Ino undersigned hereby makes application for a permit for the- work herei snecifiod, a� eeing to do all stork in strict accordance with the Cit;j Ort!4=:9 and ruling of the Depa.tment of Build!nzs, and hereby declares that all Lie fart and represt-r:tations stated ita this application are true and correct' r�idley, biinrra 4-21-76 1S Owner .. Loo fnTrospir . Kind of Building frgM Used as res. To be completed about 4-28-76 Estirr:ated Eost, $ Parait Old- Duilding Permit NO.— LD:rii1I?tC FI:CTJ; z 2�ATES: NO. RATE TOTAL • Signed Nurr.er Fixtures .............. • , b � ° u Future 1lxture Opening• , , . , .. a .. a .�..---- x 51.511 $ wAl[a WTu. - � By w Businrss PhJrr bio - ew Old Openingx 1Fixture s ew e6 x $3.25 S u Y ® d MC. • I.OUGH New Ground Run 41d B:d g. r ---- T-1oetek V4,ar Hoatsr..... o ... , .... x , 2.0 5 - FINAL �� ' ;Z4 —?7— ;6S FITTING FEES: 230° k1:1Z'2; TOTAL o Ist3Fixtures x$2.08 $ — - kd. coal Fixtures ...............--------- x $ .75 $ 0 L R^-^r6e to 13.000 BTU .:.., ...... -. x $5.08 ,'$--------- - 5,00 $3SL State SurCharSe - 4 .50 .1Zecrl;.tion.'.....::.......:....................... - TOTAL FTs. 3 ---- St 13 gT ill 3:d t view Fimturo. Old 0-,,sm1n9% PARTIAL RATE SCHEDULE ,:war Ccrapcol City of Fridley,.. Ino undersigned hereby makes application for a permit for the- work herei snecifiod, a� eeing to do all stork in strict accordance with the Cit;j Ort!4=:9 and ruling of the Depa.tment of Build!nzs, and hereby declares that all Lie fart and represt-r:tations stated ita this application are true and correct' r�idley, biinrra 4-21-76 1S Owner .. Loo fnTrospir . Kind of Building frgM Used as res. To be completed about 4-28-76 Estirr:ated Eost, $ Parait Old- Duilding Permit NO.— LD:rii1I?tC FI:CTJ; z 2�ATES: NO. RATE TOTAL • Signed Nurr.er Fixtures .............. • , b � Future 1lxture Opening• , , . , .. a .. a .�..---- x 51.511 $ -. - � By Businrss PhJrr bio - ew Old Openingx 1Fixture S 1.50 S •�.-•.:. -. - Catch Basin . o ............ . ... m . x $3.25 S Water Beater'L'p to 03,000 BTU). x $3.00 • I.OUGH New Ground Run 41d B:d g. r ---- T-1oetek V4,ar Hoatsr..... o ... , .... x , 2.0 5 - FINAL �� ' ;Z4 —?7— ;6S FITTING FEES: 230° k1:1Z'2; TOTAL o Ist3Fixtures x$2.08 $ — - kd. coal Fixtures ...............--------- x $ .75 $ 0 L R^-^r6e to 13.000 BTU .:.., ...... -. x $5.08 ,'$--------- - 5,00 - State SurCharSe - PeL A:H3 to ALTERATIONS--P.afe�r !o Coda .50 .1Zecrl;.tion.'.....::.......:....................... - TOTAL FTs. 3 Ul �Le 0 13 Ll f- ;Q Cx �Le 0 <'. 13 f- ;Q <'. City of Fridley SUBJECT PE ATTHE TOP OF THE TWINS BUILDING PERMIT _�44 r RECE COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 ;in 1 CITY HALL FRIDLEY 55432 NUMBER REV. le thtr 10-0 1 PAGE OF APPROVED BY 612-571-3450 910-F15 �ZXZQ JOB ADDRESS 6201 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK. 2 TRACT OR ADDITION SEE ATTACHED DESCR. Lot 3 Rice Creek Estates 2nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE M Lee Wraspir 6201 Rice Creek DRive N.E. 3 CONTRACTOR MAILADDRESS -tatk , ZIP PHONE LICENSE NO. North Star Services 688 Kai= Avenue St. Paul 55104 227-7061 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Kitchen addition and remodeling and deck residential 7 CLASS OF WORK �7 ElNEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE n 8 DESCRIBE WORK 6 foot kitchen addition, remodeling of kitchen and deck 9 CHANGE OF USE FROM TO STIPULATIONS XXXXX Variance granted 10/13/81 REQu1RED P��`T� PER�AITS AND oas* � 1� r getaCe tila,�o �,, 9��' M� SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. And f ramp 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 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 7,400 3.70 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- 8 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. = PLAN CHECK FEE 17.13 TOTALFEE 89.33 - ®a 6 'dIGNATURITbFrTRA&fORO AUTHORIZED AGENT (DATE) HEN PROPERLY VALIDATED THIS IS YYOVR PERMIT SIGNATURE OF OWNER (IF OWNER BUILDER) IDATEI BLDG )NSP DATE CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PEW41TS (New. Alterations, Additions, or Repairs) OW14ER: Wf a -JF BUILDER: e, -V- rte& ADDRESS: ADDRESS: 6 S �y� 14-e- , S-t-PaµJ N, -IS-1 CJ V i TEL NO: TEL NO: Construction Location C - STREET NO: d STREET: c e- e, -e e Ac ,- o s� `i�,•yi� BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey t -and proposed building location drawn on certificates to e. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: -6& Estimated Cost: �m400 Tb Be Cbripleted: Alt. A 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 %..ork-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: �� / � � �� SIGNATURE: Stipulations: T Country W I �13 C A 7 E C)F S. U, RV E Y LLJ > Q F: LIJ 113" LAJ .�-Lr (0 Ln. Iron Momtjr-rt(,Xjt To 15't I Q),.v U.j-,6cr- Cotj5tr. ol: 1Y Joh No, rioo, P,j,T 'Ad CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas*` Gas Range** NO. RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No XType 1 1 %,20/i} $15.00 Re p�"ee7. 0/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance TOTAL JOB ADDRESS 6z01 /E I C f OP -£UG Z) %Z / 6 State Surcharge $ .50 TOTAL FEE $ 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. f!l`�sP C7 ,20� Owner Building Used As Ll W C 10' ',( Estimated Cost PERMIT NO. PLUMBING SIGNED BY Approved By rzc� TEL N0. 7k. 67/ Rough -In Date Final Date C� 0 NY PLUMBING/GAS PERMILDS $20.00 , E SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existina 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 manufacturers specifications. Yes () No When installing a new ventina system, the undersigned hereby verifies that it 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 ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : City of Fridley SUBJECT P 3 3 OJ61 AT THE TOP OF THE TWINS P, B U I L ®I N G P E R M I T Ir E RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r E PROTECTIVE INSPECTION SEC. 5 E Ci NUMBER REV DATE" OF APPROVED By CITY HALL FRIDLEY 55432 763-571-3450 910-F15 9/10/02 JOB ADDRESS 6201 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 2 Rice Creek Estates 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Leighton 6201 Rice Creek Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO B & B Remodeling 6760 Madison St NE, Fridley, MN 55432 763-443-1694 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 9042 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 (27 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 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 $2,894 $1'45 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 Y OTHER STATE OR LOCAL LAW REGULATING CON- $83 25 Fie SC $2.89 STRUCTION E PERFOR NCE FCO RUCTION PLAN CHECK FEE TOTY FEE License $5.0 $92.59 S.ATURE OF COIV7RACTOR OR AUTHORIZED i tonrE, N ALIDA 1 THIS S�RU _1011 BLDG S _ S,GNATURE OF OWNERoF OWNER BWLDERI .DATE, NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDIS! [ ] 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: (OZO ( f Le Legal Description: Owner Name & Address: ['1 w� Le o� �.�� Tel. # Contractor. Z (� MN LICENSE #� ,d_ �ceit.�r Tel.# 763- VV3-/09 / Address: �%G� � sem.._ 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: Lend /— �Wid Hgt/Ground Sq. Ft OTHER: Construction Type: Estimated Cost: $� C5 9Z Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: �LT -'V�. APPLICANT. S7 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 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 [ J Q -:2 TOTAL $ Q. T STIPULATIONS: Building $ BUILDING Plan Review Permit No.•oZ005'-0299, Inspections Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Rec'd: DATE YOUR E-MAIL DRESS SAC Charge SITE ADDRESS $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME: 7 ' Park Fee ADDRESS: ! Z C�'¢'�6 CITY ��+��'1 STATZIP�� TENANT $ PHONE: Total Due CONTRACTOR NAME: C2 STATE LICENSE # ' .ter EXP DATE / COPY OF SUBMIT A YOUR STATE LICENSE ADDRESS: CITYA-2�� S TATS ZiP-1-azIr WITH APPLICATION PHONE -76 Z FAX 2-:5' '50 4� PROPERTY TYPE X SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ BASEMENT FINISH ❑ ROOF ❑ WINDOWS ❑ DRAM TILE , Z_ ❑ DECK ❑ SIDING PI OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR 0 REMODELING - DESCRIBE WORK BEING DONE: SIZE OF RaROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY SUBMTf NUMBER OF SQUARES 11 HOUSE & GARAGE BASEMENTisting DELING I • Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan Propose PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS. ❑ Vinyl ❑ Aluminum ❑Soffit ❑ Trim ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Epergy Calculations M EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING ' 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ �,�,ZS� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ 2. yp (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ X20 .001 x Permit Valuation (I/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due _$ hecks payable to: City of Fridley Attach Stipulations THIS ISPPLICAT N FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permi 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 of all work which requires review and approval of plans. - SIGNATURE OF APPLICANJ.,�- fes... PRINT NAMF1 /17-; -VW,A 4 Z a DATE Buil -ding Permit Fee BUILDING p ?j _ See Back Page for Fee Schedule Plan Review Permit No.:*'(n I oz Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Surcharge Received By:A AAA 763-572-3604 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow CITY OF FRIDLEY ft + 6 ft = ft x $24 = $ Erosion Control Date Recd: 763-502-4977 FAX $ Fee Determined by Engineering 09 201 $ Agreement necessary ( ) Non Necessary ( ) EFFECTIVE 1-1-2010 $ i(i C1 Make checks payable to: City of Fridley Attach Stipulations EM // DATE dU i o� %� ®O ® ® YOUR E-MAIL. ADDRESS J/�� rti /esti Sd �e s °� t/ h®ice zebra SITE ADDRESS (o,2 0 O > s4�. ` r�ek v A45- b� THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME:�e��ye TENANT �r ADDRESS: 4 a p / e 8— � LT e'41Zr' _ rere Ci l e STATEMJ IP PHONE: 7J.3 v S2•2 - -22 7 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE O%INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION 0 GARAGE/SHEDDOWS 13 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 0 SIDING ❑ OTHER 0 SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 1ff MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: MSOFT SIZE OF IMPROVEMENT LENGTH WIDTH HE HT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2., Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl OSoffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum 0 Trim 1. Site Plan/Survey showing the existing structures ❑ Other 0 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED Vi / NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ -� 4 °" / . , `r OCCUPANCY TYPE Permit Fee $ p ?j _ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $(�k .001 times the total job valuation Surcharge $ 0 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ i(i C1 Make checks payable to: City of Fridley Attach Stipulations 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 on site; that the work will be in accordance with the approved plan in the cas of all work which r wire review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 'dr "VATE -7 oZo r e FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER I, s ® � sOunderstand that the State of Minnesota requires th all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at ,e� �� p11�l ty IX , Fridley, am exempt from the state licensing req iru ement only if I am not building or improving t this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. ' I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Building Permit Fee BUILDING See Back Page for Fee Schedule Permit No.-gb 1& -bJ Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $ 10 a Regi[ - e Mi 763-572-3604 $ CITY OF FRIDLEY License Surcharge Date Rec'd: 763-502-4977 FAX SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 1-1-2010 Erosion Control $ DATE % g z t " E-MAIL ADDRESS e— .IJ' O td / C �Zf� "I . SITE ADDRESS �YOUR $ THIS APPLICANT IS: ❑ OWNER V. CONTRACTOR $ `, `� PROPERTY OWNER/ NAME: J ADDREss: 61 ` r� L,ep-4 CITY I'st-� STATF_ZIP I& TENANT PHONE: & 2, 00 - 7-7m CONTRACTOR NAME: 3 EXP DATE STATE LICENSE # QC) 6 3gn SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: 1 039 L rte(, 4 , &J� CITY0 , p s STATE/`° IP t�3 INSURANCE PHONE Gt --kk - 7-1-5 FAX -71-6J PROPERTY TYPE PUINGLE FAMILY/NEW CONSTRUCTION SIZE ,, fl -1 I— ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE JA,DECK ❑ SIDING ❑ OTHER ii ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION AADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Ath tW . � Z SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT ROOFING Q HOUSE ONLY BASEMENT REMODELING SUBMIT• NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GA GE a 3. List of structural members to be used �jc-f NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl .M � � 4 ❑Soffit --70J-Ic �G : = FOR ADDITIONS, & PORCHES SUBMIT: E3 Aluminum 13 Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia i o' �,��® and proposed project. 1 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: G 7 U.B.0 E .�C DULE) TOTAL JOB VALUATION $ C _ ��'J" OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ ( 65% of Building Permit Fee Fire Surcharge $ 10 a .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ `, `� Make checks payable to: City of Fridley Attach Stipulations 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 on site; that the work will be in accordance with the approved plan in the case of all w hich re qu" ew and approval of plans yy �j �'� k SIGNATURE OF APPLICANT4 PRINT NAMEY"L r." '" �I DATE Go t y CERTIFICATE OF SURVEY i FOR: Pine Tree Builders, Inc. ti w I >ti3g 9 • - - ' Q. I 243 ��= � ,� p 2s t Ip 1sa i r LLJ i Foun&iiop- 00 I Ali I I I . _ . (920.2 Ise V i6t 10 �_ _ aJ .... z�4 132.26 C BRIARDAI.E RD. %'E- 0 EO Denotes Iron Monumerit Revised 8-28-15 To Show " Foundo.-}ion Under Constr. Description: Lot 3, Block 2, RICE CREEK ESTATES 2ND ADDITION, Anoka County, Minn. F,Own pC� � /'OuntrI hereby certify that this is a true and correct representation of a survey of Job No. C l t�U the boundaries of the above described land and of the location of all buildings, 235 lsurueyor.4if any, .thereon, and all visible encroachments, if any, from or on said land. Book —Page Land Surveying • Site Planning As surveyed by me this day of %AtAq . _ '1915— Civil 19 75.Civil Engineering 8816 70th Av. N. (1 94 at Boone Av. N.) — ' 4 �GcS�iet.c�L Scale Brooklyn Park, MN 55428 `�= 40i Phone: 5337340 Minn. Reg, No. X0944