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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: ........ � 4 Owner: - - •-••- _:._................ -71 Address ----.--_----- ._......... N® 48'74 z Builder Address _.. ._ _:.. d._........ LO 10 F - UILDING No.:.. _:....... Street ....._ _....,�_: ............... Part o Lots .._...... _ ._ _.......... Lot :.......... Block .....- ........ ........... Addition or Sub -Divi on r ... , & . ........ Corner Lot ............... Inside Lot .--- Setback .. _....:.: Sewer Elevation ....._ ..................... ....... ..................... ...................................... _.. Foundation Elevation .................... .............. _............. DESCRIPTION OF BUILDING To bf Used as y � AA . ' - - ✓ . __ Front ..._ _.. Depth ...:. ..:_:. Height -.. Sq. Ft. Cu. ...... Fron Depth ...., Height ... Sq. Ft. _.. Cu. Ft..` �9 „ ... To be Completed -------.........__.........._..... .............. Type o Crnstruction ... ":fir...... Est. Cost..., ,... .. .... .... In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. 00 In consideration of the payment of a fee of %P-4- permit is hereby granted to....._...._. .......... ........ ._......................... _.... ........ .......... _.......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation fi any of the provisions of said ordinances. ' Az? Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, SCAU A Idee,thea to see the Building Inspector for separate permits for these items. ��11 �Y 99V T °�1 IV (1T eLl7unRl7 OLAT- 4 ION OISY PRIVATE LAND COVENANTSS AND "';; BUILDIN"� RESTRICTIONS. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name OF No. �/ ,� / Street - f /L `j to V L1 -U14$1 MrTl ti Lot Block. Addition or Sub.D Corner Lot_ side Lot Set Back AIj Sidel- SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front Depth Height �� Sq. Ft. Cu. Ft. , $4 0 3-0 nt 9-a/ Dept � Height Sq. Ft. Ci Cu. Ft. % 0 Q Type of Construction C' Estimated Cost IA To be completed The undersigned undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and cogpSp. n a ��ON WIA CA. / (A Schedule of Fee costs can be found on the Reverse Side.) T City of Fridley Appaication for Plumbing and Gas Fitfiing Pi Dept. of Bldgsr Phone DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. 2� TOTAL Number Fixtures ...................... x $1.50 $� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. N WATER HTR. GAS EHEC. x 3.25 $ �9 ...... x 2.00 3��. e� x S� U� < 4a O R x $1.50 $ Additional Fixtures .................... 3(j .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd _ 3rd _ 4th ' Future Connection Openings Connected with I Sewer � New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 5k New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................T x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ....:...........................................$ TOTAL FEE $ '4 /d 7U City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this applic on are t e and correct. y, Minn 19 Ownergi�zg: ,— Kind of Building �L Used as To be completed about — Estimated Cost, $ Old—New. Building Permit ROUGH FINAL dz 2M 7-59 By_L.g Business Phone No. �- Application for Power Plants and Heating. Coaling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ® 010 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule CCAS BURNER (up to 400,000 BTU) ....................... 5.00 $ ,-,- 0 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ......................�— x $1.50 $��/ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ REMARKS: Dept. of Bldgs. Phone SII 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn , 195Z-0 Owner LX11 ! . 195— Kind of Building Used as To be completed about Estimated Cost, $ Old- e ' Building Permit No. 195— DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Wate Warm —No- Z e Trade Name A Size No- /0,.-.': Capacity—,S/q. Ft. E/.D.R BTU H.P. Total Connected Load z Kind of Fuel�� "�"� rrLL�� BURNER — Trade Names ', Size No- 12.4f10. ' Capacity Sq. Ft. E.D.R /D 00 d00 0 BTU H.p. SUBURBAN HEATING & SHEET METAL 8419 CENTER DRIVE N. E. Signed MININEARGLIS 21, MIWN o gee 11 POST 1M-12-58 Business Phone No- -5401 � X47ep Ddb az HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS /67 FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall I Ceiling Roof Floor Kind How Applied eNo I No 19--i-0 Zp -f�,f I / Fl.l~ .., _. Ji. Room I LenQth.i ® Width Height 9 II / FLI R I Length /. A / idth / 71 Heisrht,'/ Windows and Doors—Crackage and Area moi' -....0..' do Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2- �® i �- nfiltration l ' ' Coef. Btu Glass Infiltration < SS Exp. wall , -i Exp. wall p Net exp. wall Net exp. wall1v 15, X/0 Int. wall Net exp. wall t:z Ceiling Ceiling S Floor ®� ®® Floor Ceiling ® "notal Btu. 113,1.2-V Required sq. ft. E.D.R. or sq. ins. W.A. Leader are FI m I Length z/ Width /V/ Height / Windo s and M sL--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack I sq. ft. 31Y 2- Zt-/ 2-d 1;?? ® L2/,,o Coef.l Btu Glass Z� Exp. wall Net exp. wall Int. wall Ceiling d' ue 99 Floor" Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I m I 0_L— IT _-L me -2.t , In i _- w,+ ---7— 1---" --- . ...'­ Windows and Doors; Crackage and Area moi' -....0..' do Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack ft. i Net exp. wall 0 Int. wall Coef. Coef.1 Btu Infiltration y , ,�W Glass , -i Exp. wall p 2J Net exp. wall1v Int. wall Net exp. wall _,1'r4z16 Ceiling Int. wall S Floor Total Btu. Required sq. ft. E.D.R.I or sq. ins. W.A. Leader area I -as> Windows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack ft. Esq %/ y / fir✓ Net exp. wall 0 Int. wall Coef. Btu Infiltration , ,�W :?, Glass -i �',$- 2J Exp. wall Net exp. wall Net exp. wall , /® Int. wall Int. wall Ceiling Ceiling S' ® & 0 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leider area FI.I Room I Lenstth %.?_ / Width 41/ Height P/ Windows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Glass Exp. wall Net exp. wall 0 Int. wall Coef. Btu Infiltration 2 . Floor L3 15— ,�W Glass< Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �',$- Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area F1.1 Room I Length / Width / HeightV/ Windows and Doors--Crackaste and Area No. Coef. Btu Infiltration /7 50 Glass Exp. wall Net exp. wall 0 Int. wall Ceiling L2 Floor L3 15— Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /h SUBJECT ®P NO. of Fridley 25080 AT THE TOP OF THE TWINS BUILDING PERMIT Ir?City COMMUNITY DEVELOPMENT DIV ~ r PROTECTIVE INSPECTION SEC% NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/21/97 JOB ADDRESS 497 Rice Creek Terrace NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 4 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Florence Zawislak 497 Rice Creek Terrace NE 571-4460 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement Inc 11773 Magnolia St NW, Coon Rapids MN 55448 4840 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 757-7780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C. REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,062 $1.03 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.06 STRUCT N O THE PERFOR CE OF CONSTRUCTION PLAN CHECK FEE TO AL FEE License S $5. $82.84 SI NATURE OFCONACTOR OR AUTHORIZED AGENT IDATEI p ALIDA EP THIS IS YOUR PERMIT �ILIG 7 DATE SIGNATURE OF OWNER IiF OWNER BUILDERI IDATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: %?46 Effective 111/97 Owner Name & Address: 2EZVX�-e /.��� Tet. # sr` J & 0 Contractor: a Tm rouement, !no _ MN LICENSE # 4840 _ Address: 11723 Maaanal i a Stx'eat NW., Cnnn uani ria r-gA4$ Tel. # 757-7780 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: — Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: '� ' APPLICANT: 0^ Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USX ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1110th%) $.501$1,000 Valuation $950 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 [ I Not Necessary [ ] CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 LICENSE AGREEMENT The undersigned Florence Zawislak being the fee owners of certain property located in Fridley, Minnesota, at 497 Rice Creek Terrace , and legally described as: 14-30-24-21-0056 hereby grant to the City of Fridley, Minnesota, and that the City's employees, a license for the purpose of gaining access across the above-described property to a retaining wall and other structures adjacent to Rice Creek. This license is only for the purpose of allowing the aforementioned persons access for maintenance purposes. This license is intended to last ten (10) years from the date of its execution, and is not transferable or useable by any persons other than those designated herein. By accepting and using this license, licensee hereby agrees to repair any and all damage caused by the City or its employees while using this license on the above-described parcel. Signed: Florence Zawislak Subscribed and sworn to before me this T day of � 998. Notary Public Y ------------------ JOAN M. BUDNICK NOTARY VU81lC - NNOWW too GOOM110011-11-0 --- M A Mor Caaml�m Eimbtar.7t. m00 Building $ j'Z . 2 BUILDING Plan Review Permit No.:.a?616-b Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: MIGLW 763-572-3604y $ Q ly_ CITY OF FRIDLEY rat 763-502-4977 FAX $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 7-I-2010 ft + 6 ft = ft x $24 = $ Erosion Control DATE YOUR E-MAIL ADDRESS Park Fee SITE ADDRESS c Sewer Main Charge THIS APPLICANT IS: ❑ OWNER *_CONTRACTOR Total Due PROPERTY OWNER/ NAME: S' .� TENANT ADDRESS:"I .r;e ewO L;& w CITY � STATEAV2IP_9, PHONE: CONTRACTOR NAUE: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # dG3 '7.2 9 EXP DATE 3 /® AND CERTIFICATE OF �A ADDRESS: M 46 a ils" NE CITY 61 1e —STATE,�ZIP INSURANCE PHONE 111✓SINGLE FAMILYINEW CONSTRUCTION FAX SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_ PERIVIIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH XROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWINIMQdG POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ODELING DESCRIBE WORK BEING DONE: fa O SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT sQ FT 3O ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 3a WHOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES JNiATTACHED 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 ❑Soffit ADDEEIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ 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 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 S Roo& Ar OCCUPANCY TYPE Permit Fee $ j'Z . 2 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ Q ly_ .0005 x Permit Valuation Minimum $5.00 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 $ "'7 C? Make checks navable to: City of Fridlev Attach Stinulations 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 fo aAM—. 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 r h' es review and approval of plat>q bf®®�SIGNATURE OF APPLICANTPRINT NAME .11 !w • A DATE % APPROVAL INSPECTOR SIGN F PLEASE NOTE: $WARATE PERMITS ARE REOUIRED FOR PLUMBING ELECTRICAL AND MECHANICAL WORK