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PRE 2010 DOCSCity of Fridley, Minn. BU11DING PERMIT Date: _-�— Owner: Builder Address _ _ _ Address -- _ --. } O TI N O IL NG No. Part of t Lot _ _ Block _ Addition or Sub -Division Corner Lot _.__„_ Inside Lot _."' Setback,.,� Aideyard s Sewer Elevation _ .__ _ _ Foundation Elevation DESCRIPTION OF BUILDING To Used Front 7 Depth Height 91(2 Sq, Ft/A-4-411' cu. Ft'V_ , FrontDepth _ _ t Height _._.: Sq. Ft _ _ Cu. Ft ..` Type of Construction •` �',e: Est.. st, _ --- To be Completed 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. In consideration of the payment of a fee of $ , 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 yvlthin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said Ordinances. r1 S w I, Building Inspector NOTICE: Me permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDIEY, MINNESOTA Owner's NameLt � �-S. 4 e s Te. r �t-s T�Bui.lder Address ) % y `/- -3 ? 7 a,,6 , 3 -�' - Address LOCATION OF BUILDING No. e.? //- Street �i� Z i G H 7 ,9411,C Part of LotPL� /— Lot Block Addition or Subdivision Corner Lot Inside LotSetback 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: aF51dew c'a Front L FeV Depth Sq. Ft. Cu. Ft. f &-e ., Front Depth Height Sq. Ft. Cu. Ft. Type of Construction � /"l Estimated Cost / To be Completed %/ A14 6 f? 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. 1-:2 DATE (91,1f /(� / (A Schedule of Fee Costs can be found on the Reverse Side.) MIMING IPMMIT FEE SCHED= Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of &hy building or structure, or for any addition to so existing build- ing.or structui-e, or for any alterations or repairs to.any existing, building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit for the erection of any fire -proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire- proof addition, for similar occupancy, to any existing building.shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such oubical contents. 2.2. For any such permit for the erection of any fireproof garage, warehouse, factory or grain elevator, or for the erection of any fireproof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for` -Ma -erettion--of =any -non fireproof-bur114-ing- other ----- than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building. Permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any nor -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, for similar occupancy, to any existing building or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00., For the purpose of computing fees for building permits the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 for each Five Hundred Dollars ($500.00), or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. City of Fridley Application for Plumbing and Gas Pitting PenWtt Dept. of Bldgs. Phone SU 4-1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures y. i Z�O y YO Z Z w NU' ? L b WATER HTR. ELEC. ?j R N GAS Bas g) t 1st C 2nd _ 3rd _ 4th • Future Connection Openings Connected with Sewer p New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $_13 �c� �® Future Fixture Opening ................-- x 1.20 $_ _as -_z__0 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ...........$ TOTAL FEE $ — City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do an 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. Owner Kind of Building Used as �+ To be completed about Estimated Cost, $ Old New. uilding Permit No Permit No ®� Ca U Signe By Business Phone No. ROUGH / � —a 61 aj FINAL a2 2M 7-89 p C9 Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 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 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 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 $ e 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 GAS BURNER (up to 400,000 BTU) ....................... 5.00 $\:::� ' ® d 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 ROUGH FINAL 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_ Z_ , 19 — Owner Kind of Buildin a -� Used as To be completed about Estimated Cost, $ Permit No.�' �,:� Permit No. 17� DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Wate Warm � No Trade Name s Size No 6 363 0 Capacity Sq. Ft. E.D.R ' �' BTU H.P. Total Connected Load- 624;14f Aipii' &a,Ag Kind of Fuel /G/' /_'. BURNER — Trade Name 6 ? ids �� 4Size No Capacity 42 5, _- ®g Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe By r 4M D(� Phone No__ Lester P. Thorstad K=HEAD'' LOSS CALCULATIONS DEPARTMENT OF BUILDINGS ST. PAUL, MINN. WEATHERSTRIPS A.S.H.V.E.TYPE Guide Reference 19 OF CONSTRUCTION INSULATION r—Winc9a�ora ... IIY16- No . oors Out. Wall Wall Ceipng Roof moor Kind Ceiling Wall ( No Frame weUing I I I 3 n I 3 n 1 FI. � L Room Length Width 13 Hbight g I FI. FaMjjX Room I Length 12 Width 9 Height WINDOWS and DOORS — CRACKAGE and AREA WINDOWS and DOORS - CRACKAGE and AREA No. Width Height No. of of paneof pane lights Lineal ft. of crack Area sq. ft. Width Height No. of pane of pane No. of Lineal ft. Ilghh of crack Area sq. ft. 1 31 6t n1 dofl 2 48 32 24 5h 2 61 41 Coef. Btu. Coef. Btu. lefiltratioe Windows Doors Infiltration Windows Doors 10 IRM Exp. Wall 240 Exp. Wan 168 Glass Glace 32 50 1600 Net Exp. Wall 1 1 Net Exp. Wall 136 9 1224 Inf. hili— Fireplace 1500 Int. Wall CeliNg or Meet-- 22 10 2210 Ceiling or flow— 1 108 10 1080 Total Btu. 11589 Total Btu. 14836 Required sq. ft. E. D. R. or sq. ins. W.A. Leader area I Required sq. ft. E. D. R. or sq. ins. W.A. Leader area 1 FL I Kitchen Room I Length12Width 9 Height 8 WINDOWS and DOORS — CRACKAGE and AREA Width Height No. of Lineal ft. Area No. of pane of pane lights of crack I sq. ft. 2 1 FL I &t 17 Room T Length 11 Width Height 8 WINDOWS and DOORS — CRACKAGE and AREA Width Height No. of Linea ft. Area No. of pane of pane lights of crack sq. ft. t 61811 1 doo 20 20 1 28 22 1 8 4 Coef. I Btu. Coef. Windows Infiltration Windws -4 Infiltration Doorso J§07�— Exp. Wall 96 Exp. Wall $$ Glass 00 Glass 24 50 1200 Not Exp. Wall 82 9 1738 Net Exp. Wan 64 9 576 Int. Wall Int. Wall Ceiling or -Flyer 1108 10 1080 Ceiling or flees- 155 10 550 Total Btu. 2936E Total Btu. 427$ Required sq. ft. E. D. R. or sq. ins. W.A. Leader area I Required sq. ff. E. D. R. or sq. ins. W.A. Leader area 1 FL I Bedr. Room I Length Width 15 Height a 1FL IBedr.Room Length 12 Width 12 Height 8 WINDOWS and DOORS— CRACKAGE and AREA WINDOWS and DOORS — CRACKAGE and AREA No. idth of pane Height No. of Lineal ft. of pane lights of crack Area sq. ft. Width Height. No. of pane of pane No. of Lineal ft. lights of crack Area sq. ft. 3 40 .22 0 26 0 22 2 0 26 Coef. Btu. Coef. Btu. WindowsWindows Infiltration Doors Infiltration Doors 48 57U Exp. Wail 216 Exp. Wall 192 Glass 2 Glaze 26 5Q 13on Net Exp. Wall 190 9 1710 Net Exp. Wall 166 9 1494_ Int. Wall Int. Wall Ceiling or Rees.— 180 1 10 1800 Coiling or Floor Total Btu. 5380 Total Btu. 4804 Required sq. ft E. D. R. or sq. Ins. W.A. Leader area Required sq. ft. E. D. R. or sq. ins. W.A. Leader area D-56 10M 8-68 8 GRAND TOTAL Lester P. Thorstad A HAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS ST. PAUL, MINN. WEATHERSTRIPS A.S.H.Y.E. Guide Marengo 19--.. TYPE OF CONSTRUCTION INSULATION yytndarsI pooh k-No—No� Out. Wall Imo. Wall Celpng I Roof Floor I Kind ( iling I 3 Wall 11 " ( Yo:—IN-o— Frame We Ag 1 FL I Bed Room I Length 11. Width 101-Ibight 8 1 FL I Bath Room I Length 7 Width 11 Height WINDOWS and DOORS — CRACKAGE and AREA WINDOWS and DOORS — CRACKAGE and AREA No. W Fth of pane Height of pane No. o lights Lineal ft. of crack Area sq. ft. Width Height No. of pane of pane No. of lights Linea ft. of crack Area sq. ft. 3 40 22 2 30 26 Coef. Btu. Windows Infiltrefion Doors Infiltration Windows Doors 320 Exp. Wall -- Etp. Wall Glass 26 50 100 Glau Not Exp. Wall 94 9 846 Net Exp. Wall int. Wall Int. Wall Ceiling orT9eor 110 110 1100 Coiling or Floor 77 10 770 Total Btu. Total Btu. 1 770 Required aq. ft. E. D. R. or sq. Tns. W.A. Leader area Required sq. ft. L D. R. or sq. ins. W. A. Leader area B FL I Rea, Room Length 27 Width 13 Height 716" B FL I Laundry Room Length 23 width9 Height7 r G it WINDOWS and DOORS — CRACKAGE and AREA Lineal ft. Area of crack sq. ft. WINDOWS and DOORS — CRACKAGE and AREA Width No. of pane Height of pane No. of lights Width Height No. I of pane of pane No. of Lineal ft. It his of crack Area sq. ft. Coef. Btu. Coef. Btu. Infiltration Doors nows Infiltrafton Dean-- Exp. Wall Wall Glasse° Fireplace 2000 Glass Net Exp. Wall Above Ground 40 150 2000 Net Exp. watt Above Ground 32 150 1600 ,lot. Wall Below 11 260 9 23LO Inf. Wall Below " 176 9 1584 evilhM or Floor 351 7 2457 eeiKng or Floor 207 7 1449 Total Btu. 8797 Total Btu. 4633 Required sq. ft E. D. R. or sq. Ins. W. A. Leader area Required sq. ft ED. R. or sq. ins. W.A. Leader area B FL IBath Room I Length 7 Width 8 Height 7161, B FL I utility Room I Length 12 .Width 13 Height716" WINDOWS and DOORS — CRACKAGE and AREA WINDOWS and DOORS — CRACKAGE and AREA dth Height No. of pane of pane No: of Lineal ft. lights of crack Area sq. ft. Width Height. No. of.pane of pane No. of lights L neat ft. of crack Area sq. ft. Coef. Btu. Coef. Btu. Windows Infilteafion_ Doom Windows Infiltretion Doors Exp. Wall Exp. Wall Glass Glaze Not Exp. Wall Above Ground 7 50 350 Net Exp. wail Above Ground 25 50 1250 _ Lat. Well BelowatLL6 1 9 W. Well Below " 138 9 1242 Coiling or Floor 56 7 392 Selling or Floor 156 7 1092 Total Btu. 1156 Total Btu. 3584 Required sq. ft E. D. R. or sq. ins. W.A. Leader area I Required sq. ft. L D. R. or sq. ins. W.A. Leader area D -ss 10M 3.58 s GRAND TOTAL— `AHEA1 LOSS CALCULATIONS DEPARTMENT OF BUILDINGS ST. PAUL, MINN. WEATHERSTRIPS A.S.H.V.E. Guido Reference 19 TYPE OF CONSTRUCTION INSULATION Windows Out. Wall Int. We" Gaiting Roof Floor Kind I Ceiling I Wall Yes — No IDoors Yes — No I B FI. IBSMt. Room Length Width Height WINDOWS and DOORS — CRACKAGE and AREA Width Height No. of Lineal ft. Area No. of pang of pane lightsof crack sq. ft. Fl. I Room I Length Width WINDOWS and DOORS — CRACKAGE and AREA Height Width Height No* of pane of pane No. of lights ' L nes ft. of crack Area sq. ft. Coef. Btu. Coef. Btu. infiltration Windows Doors Infiltration Windows Doors Esp. Wall Esp. Wall Glen Glass Net Esp. Wall Above Ground 32 Not Exp. Wall -Fnft-Wall Below it Int. Wall 150[!1600 g -or Floor Coiling or Floor Total Btu. 5201 Total Btu. Required sq. ft. E. D. R. or sq. ins. W. A. Leader area Required sq. ft ED. R. or sq. ins. W.A. Leader area Fl. I Room I Length Width Height Fl. I Room I Length Width Height WINDOWS and DOORS — CRACKAGE and AREA WINDOWS and DOORS — CRACKAGE and AREA Width Height No. of Lineal ft. No. of pane of pans lights of crack Area sq. ft. Width Height No. of pane of pane No. of lights Lineal ft. of crack Area sq. ft. Coef. Btu. Coef. Btu. Windows Infiltration ows Infiltration cors Exp. Well Esp. Wall Glen Glass Not Exp. Well Not Exp. Wall Int. Wall Int. Wall Ceiling or Floor Ceiling or Floor Total Btu. Total Btu. Required sq. ft. ED. R. or sq. ins. W.A. Leader area Required sq. ft. E. D. R. or sq. ins. W. A. Leader area FL I Room I Length Width Height FL I Room I Length Width Height WINDOWS and DOORS — CRACKAGE and AREA WiNDOWS and DOORS — CRACKAGE and AREA No. Width of pane Height of pane No. of Lineal ft. lights of crack Area sq. ft. No. Width of pane Height. of pane No. lights Lineal ft. of crack Area sq. ft. Coef. Btu. Coef. Btu. Infiltration Windows Doors Infiltration Windows Doors Exp, Wall Esp. Wall Glen Glen Not Esp. Wall Net Esp. Well _ Int. Wall Int. Wall Ceiling or Floor Coiling or Floor Total Btu. Total Btu. Required sq. ft ED. R. or sq. ins. W.A. Leader area Required sq. ft. E. D. R. or sq. ins. W.A. Leader area D-66 cont; a -ss s GRAND TOTAL 52-84-S915-51 City of Fridley Applicaflon for Plumbing and Cres Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK 6211 Starlite Blvd Number, Kind and Location of Fixtures Location I W F$-ff S Z Z} Z Z ah O Z Z • • WATER HTR. ® j3 �F� uZi 3� o� <Cj OLL� u <3 �d �Sn �O F N GAS ELEC. Base IrBtall jGa D7 7e 1st 2nd 3rd 4th • Future Connection Openings Connected with I New Fixture. Old OpeningsSewer Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ NO. RATE TOTAL x $1.50 $ _ x 1.20 $ x 1.00 $ x 3.25 $ x 2.00 $ x 3.25 $ 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 $ Gas Dryer 1 2.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 2.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn. -9`676 19— Owner Lester horstad Kind of Building frame Used as res To be completed about 9-71-66 Estimated Cost, $ 10.00 �� Old—New. Building Permit No Permit No. �� /" Sign 0 By Business Phone N ROUGH FINAL sue�Ecr PERM I City of Fridley 2110.5' AT THE TOP OF THE TWINS BUILDING PERMIT f ' O COMMUNITY DEVELOPMENT DIV. r o PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571--3450 910-F15 10/8/91 / JOB ADDRESS 6211 Starlite Blvd NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 8 3 Sylvan Hills Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb Thorstad 6211 Starlite Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Northern Circle Systems 1155 Old Hwy 8, New Brighton, MN 55112 633-4541 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Foundation Repair to North.& 15t of West wall 9 CHANGE OF USE FROM TO STIPULATIONS Follow recommendations of Professional Engineering Consultant's report dated 6/5/91. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2 , 000 $1.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $45.00 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $4220 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEt Q WHEN P RLY AL E T ISI OUR PERMIT . 3 awl SIGNATURE OF OWNER OF OWNER BUILDER$ IDATEI BL G $NSP OAT NEW [ 1 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: r_, 2-1 / r // /,,, 8 l L) d Legal Description: Lo 7- , &LoC.e 3, E:t lLy Owner Name & Address: Contractor: Address: Effective 1/1/91 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: — N l:r(jAa- e /(�-' od= 'e 2'C L cc iL?i)A� 0p-) /04'�)r-?T( Corner Lot [ ] Inside Lot t(] Ft. Yd Setback _ Type of Construction: S4r g i t2c4 eye l'r- Approx. Completion Date: h ®L I I 1 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ ?®nn 06 Ft x $ coca m art) DATE: Qct 9 - 9 1 APPLICANT: tt Je, f) ft k 1 Tel. #.6 3-3 '(5 � J Permit Fee Fire Surcharge $ c 6" State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $15 (Minimum Fee is $15 plus surcharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. P.01 1 Mrs. Datb Thorstad 701 LITTI.G CANADA ROAD RRPORTEA To 0211 3LarliLe silv(l. 5 v f 290 Fridley, MN 55432 .IIAINT PAtli. . 611Yt; L'7117n Sl1T • TEL: 0�) dQ1,9?(. f, 93e rax. n�2,eo0.! ' Residence .. ! PROJECT 6211 Starllte Blvd. ,/OFESSIONAI, FNGINEEKING CONSUI; CANTS Fridley, MN INCORPOWATF.0 June 5, 1991 DATE. Work Order #7641 INTRODUCTION This report concerns our recent investigation of foundation wall distress at the Thorstad residence in Fridley, Minnesota. it is our understanding from Mrs. Thorstad that the major distress condition in the north and west foundation wall construction occurred appzoxlttaately two months ago. This was ac=%)anied by a loud sound emanating from the basement region of the home. Our firm was requested by Mrs. Thorstad to investigate the basement wall construction and any related construction or site areas. We were directed to identify the problem condition and ,its causes. We were further requested to provide recommendations for the correction of the condition. COW-LDSIONS Based ,on our visual observations at the hane and our engineering experience, we have developed the following conclusions; 1. The north and west foundation walls of the basement construction have experienced inward deflection and accompanying separations of mortar joints. The majority of the north wall has been affected. The north approximately 16' of the west foundation wall is in a distressed condition. 2_ In addition to distress of these two walls, the north port -ton of the east foundation wall has hairline separation at a horizontal bed joint. However, this distress was not observed to be as severe as the other two walls. 3_ The basement walls have experienced deflection and bed joint separation, together with some step -cracking at joints as a result of excessive lateral pryauras; frm the exterior backfill region of the foundation construction. The past approxirately four years have seen drought conditions throughout this geographic area. Local shrinkage of cohesive soils has occurred on many properties in the Fridley area. It is our opinion that the backfill soils have experienced shrinkage away from the Foundation construction, allowing direct surface water drainage to occur downward along the foundation wall construction. This condition, coupled with poor surface grades in the side yard to the north of the horns, has allowed water entry into the backfill region and excessive lateral watQr prprruria ;u7a.l;wt tlx:� 'black n=txuation. 4. It was our observation that both the framing construction and the masonry construction at this home were in excellent condition. In addition, timber frame walls in the brie mant =gion aro offering lateral asaistanoa to the ncarth and west walla. Thcrfarar we do not anticipate any collapse or failure of this construction, but do recoamnd that: the foundation be repaired in the near future. "age Teo RECOMMMATIONS P.02 we have proviaad tho following rQ ndations for Correction of the foundation construction. These recommendations are relatively straight -forward and can be executed by most smaller independent contractors with a minimum amount of your supervision. 1. Using a verX smrill kaaokhoo attsohniQnt, ac i1a MountQd An a Bobcat or small skid -steer, carefully excavate 2' to 3' out from the entire north foundation wall construction and from the north 16' of the west foundation wall construction, removing the existing backfill materials down to approximately top of footing. At this point, it; is anticipated that the north ar4d wQnt: walla will res -:assumes a plumb condition And the separated bed joints will close. 2. Provide a 4" to 6" hole access in either the interior or exterior face shell of the top r,.ap black of tht=e walla and grout tho wall recti=. This vcartical grouting should be performed on a 48" to 56" frequency around the excavated wall construction. In addition, the north approximately 14' of the east wall should be similarly grouted. 3. Any bed joints cry atop cracks whi.oh have not fully olosad shoul J be chippOd taut and re -pointed, using a Portland cement -lime -sand mortar. A concrete mortax or grout using Portland cement should be used for all grouting work. In addition, the vertical grouted cells should be reinforced with 6' long pieces of reinforcing steel (3/8" di. ter) . The fare: shells should t=hen be repaired with the Game mcg: t,.ar mat orial . 4. The wood stud walls which presently abut the north and west masonry walls should receive additional vertical woad filler which would be glued and nailed in place and extend at least 1' out. fr = the ma.aonry. rurthera►raN�!, at least one side of soh of these walls should receive one sheet of treated 1/2" plywood which would be glued and nailed to the stud wall construction. 5_ The a xC dvated baickfill areess should be rcfillcd with u free -draining sand nrat;crlml and should be capped off with 12" of cohesive soil at the top of the backfill zone. the backfill grade should be set at approximately 6" below bottom of siding and should slope anot=her 8" to 12" downward at: a point 8' to 10' out from the wall construction. This will require a small amount or retaining wall construction a1=9 the north property line in order to achieve positive surface drainage away from the Thorstad hone, while protecting the existing grades of the neighboring property. 6. The north side yard should slope downward from east to west along the full 28' depth of house wall construction_ Since there will be a problem in the front, yard with maintaining this slope toward ,the street, we recommend that a small 4" or 6" perforated tile be run from near the house northwest corner to daylight in the front yard out near the street curb c onstruct;Lon. 7. It is important to establish an impermeable ground cover for the closest 3' against; the subject foundation walls. This coves can, in turn, be covered by a decorative landscape gravel material. OBSERVATIONS On Tune 4, 1991, our firm visited the Thorstad horse and reviewed the foundation construction with Mrs. Thorstad and her son-in-law. AT this time, she provided construction history information, and we took certain measurements of the construction. The house was constructed. approximately 30 years ago by Mr. Thorstad. We noted that the carpentry framing work in the basement region of the home was standard deck frAMJ n9. However, we did note that no sole plate was used for the first floor framing joists. Howyer, all joists were positioned on the 12" block wall construction, with mortar fire stopping. P. 03 Rage Three The masonry foundation walls for the basement construction consisted of full S" high by 12" wide ctsexn block laid in a running bond pattern. we noted that eleven courses had been laid for the wall constxuction, with 10 1/2' courses extending above the basement floor slab (89 1/2" high), We observed two smaller windows in the north foundation wall construction and a smaller window in the east wall over a laundry area. We observed a hairline separation of one of the bed joints in the east wall at a point three joints down from trap of wall. This wall did not have any readily apparent deflection, and access for measureanent was limited. The north foundation wall had a pronounced joint separation of approximately 1/4" at the third bed joint down from the top of wall. This separation was accompanied by approximately 1 3/4" inward deflection of the wall. Most of the distress in the wall was positioned between two windows and concerned the middle approximately 20' of wall section in the 28' length, The mortar materials in the wall appeared sound, aside from the separation noted. scams a.cccmvanying sten-cracking ' was noted beyond the window construction, extending toward both the northwest and northeast corners of the house. The west.foundation wall construction extending from the northwest corner to approximately the water sarvica 161 to the south had an inward daflection of approximately 2". This wall had two bed joint separations at the third and fourth bed joints down from top of wall. Both separations were approximately 1/8" opening. NQither the north or wast walls had any pilaot e r oonmtruotion ext,®nding into tho b=amant region or backfill region. However, both walls did have interior stud walls framing into thein. The stud wall framing into the north foundation wall was slightly east of its center position and consisted of 2 by 6 -framing with no wall covering material. The west wall had a4" at•ud wall framing .into it at about 18' mouth of the northwost, build ng corner. This wall had a south surface wall covering which appeared to be shetrock material. Both stud walls would be considered as valid interior bracing for the existing foundation wall construction. However, both walls would require additional internal blooking in order to oatisfy lateral eaupport roguiromontz for t.,he maaonxy wall$. DISCUSSION The damage in both, ftwr4cLt ion walls would appear to to aerivus to an observer. ttow+ever, both the north and west walls were in a stable condition at the time of our observations. Mrs. Thorstad has indicated that she will soon be selling the home. Therefore, it would be prudent to perform the necessary repairs to the foundation wall construction and =duct the exterior grading work, in order to onrxeGt the cxmaitian. PROFESSIONAL ENGINEERING CONSULTANTS, INC. Brian R. Dobie, P.E. President , BRD/fm i a� 203 LITTLE CANADA ROAD SUITE 280 SAINT PAUL MINNESOTA 5 51 17 ® FAX: 612.490.9265 IKT T®DR A IE9 /PROFESSIONAL ENGINEERING CONSULTANTS INCORPORATED February 4, 1992 Barb Thorstad 6211 Starlite Blvd Fridley, MN 55432 Subj: Residence - 6211 Starlite Blvd Fridley, MN Dear Mrs. Thorstad: This letter pertains to our observations at your residence during foundation repair activities. You requested that we provide a letter concerning the repair completion, with a copy of such letter to the City Building Official in Fridley, Minnesota. The concrete block masonry foundation construction had experienced distress as a result of exterior backfill loading against the construction. Our report of June 5, 1991, outlined the problems with the foundation wall and backfill conditions. During the Fall of 1991, you contracted to have the construction corrected. Our observations at the site indicated that the recommendations noted in our letter had been followed, and the wall construction straightened, reinforced, and repaired. The reinforcement .included grouting of the wall construction with steel reinforcement of the block cells. Based on our observations of the masonry and the completed exterior backfilling, it is our opinion that the repairs have successfully been completed. The foundation construction should now be considered as repaired and stronger then original typical masonry construction. You indicated that seeding or sodding of the backfill would be performed. The grass cover materials used to the north of the structure should reflect a tolerance for shade. Respectfully, Professional Engineering Consultants, Inc. /Brian'R. Dobie, P.E. President BRD/fm cc: Mr. Darryl Clark City of Fridley . CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY Signed By ��.��.2� Tel No. Approved By Rough —In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS RALE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correct. (Side Vent -- Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 $ __1994 OWNER-«� Gas Range $ 10.00 $ BUILDING USED AS -� Gas Dryer $ 10.00 $ /0-0,0 ESTIMATED COST r PERMIT NO. /1/6� *Air Conditioning — All Sizes $ 10.00 $ DESCRIPTION OF FURNACE ANDD go BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/industrial BTU HP EDR 1 % of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE $ / "o MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY Signed By ��.��.2� Tel No. Approved By Rough —In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace, Remarks: HEATING CO: Signed By: Date: CHIMNEY ALIO STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes. ( ) No . (. ) b Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: HEATING CO: Signed By: Date: SUBJECT PE City of Fridley° 8 AT THE TOP OF THE TWINS ?'RECEIPT BUILDING PERMIT NO. Ir - DEVELOPMENT DIV ------COMMUNITY r v PROTECTIVE INSPECTION SEC I �S NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/20/97 JOB ADDRESS 6211 STARLITE BLVD NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Sylvan Hills Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barbara Thorstad 6211 Starlite Blvd NE 571-3438 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install soffit/fascia/trim 9 CHANGE OF USE FROM TO STIPULATIONS Install ventilation to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED 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 1 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 $500 $ .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- $21.00 Fire SC $.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE T,,VfAL FEE $22.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N Fro VALIDA ED THIS IS YOUR PERMIT 44,CGII-ATURM1011OWNENIIF OWNER BUILDERI IDATEI B G INSP DATE NEW [ ] Effective 1 / 1 /97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 3 -S -:- BUILDING PERMIT APPLICATION ConstructionAddress: _ RZWJ. Legal Description: p to y . ,ru ®t®®1� �Y®� �►a Ln .� Owner Name & Address: Contractor: Address: I —Tel. MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ® e +7'®.m Construction Type: him ® Estimated Cost: $ ,� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:®. APPLICANT: Tel. # ®• f �„� 60 STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ K � $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Plan Review Park Fee $ Fee Determined. by Engineering Sewer- Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE' The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, .or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by°lthe applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit - TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for fust $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for 'first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $1()0,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof,.to and including $500,000 $500,001 to $1,000,000 $2887.25 for the fust $500,000 plus $4:25 for each additional $1,000 or fraction thereof, "`to"and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each. additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only- Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application.to allow for proper 7•cview of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been construc.*:: Fill he required hc;fore proccedin<o with the framin<g. City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P *2672 0 r tr _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. a i CITY HALL FRIDLEY 55432 '•j 612-571-3450 T NO. q� 43 file NUMBER 910-F15 REV DATE 7/21/98' PAGE OF APPROVED BY JOB ADDRESS 6211 Starlite Blvd 1 LEGAL DESCR. LOT NO. 8 BLOCK 3 TRACT OR ADDITION 1 Sylvan Hills, Plat 3 SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bruce Thorstad 571-3438 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Const. 4208 83rd Ave N Brooklyn Park, MN 55443 566-5225 20077950 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO - 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASSOFWORK ❑ NEW ❑ ADDITION ❑ ALTERATION CI REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 24 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with statebuilding 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 1 STALLS GARAGES 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 VALUATION $tF-,6jDt' $2,001 SURTAX $1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE ZgVXVM SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCT OR THE PERFORMA E ONSTRUCTION. )*'�-License $]l{ , ]5 ire SC $2.00 PLAN CHECK FEE TOTAL FEE SC $5.00 $82.75 GNATUREO ONTRACTOR OR AUTHORIZED AGENT IDATEI SIGNATURE OF OWNER dF OWNER SUILDERi IDATEI HEN PROPERLY VV BLDG bSP TED THIS IS YOUR PERMIT OATS C''iTY 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 Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) 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 JOB ADDR Effective On January 1, 2001 OWNER_ 7 J2Z_, /� Rate TOTAL BUILDING USED AS $ 30.00 ESTIMATED COST L4 CrJ : PERMIT NO. e � $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $10.00 $ No. of Heating U its Circle One (Steam) (Hot Water,}A arm A' $ 10.00 $ Trade Name_ Size No. fa/! BTU 1, 16nC) HP EDR $ 25.00 $ Fuel_ Xl::f - Total Connected Load Burner Trade Name Size No. $ BTU _HP EDR State Surcharge TOTAL FEE 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. $ .50 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. ROYALTON HEATING & dUNPI HEATING CO 4120 - 56th AVENUE NO BROOKLYN Signed PHONE 424-8333 TEL # s �J Approved By Rough -In Date Final Date BACK SIDE MUST BE`'FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION 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 (4 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 (9) 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 Verit 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) ROYALTON HEATING & COOLING 4120 - 85th AVENUE NO ' HEATING CO: BROOKI XW RA214 MW 555442 Signed By: PHONE 424-8333 Date : -CM 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 (D 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 (V) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (�Q 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 (U,) 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 (4 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 (9) 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 Verit 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) ROYALTON HEATING & COOLING 4120 - 85th AVENUE NO ' HEATING CO: BROOKI XW RA214 MW 555442 Signed By: PHONE 424-8333 Date : -CM 4 -f HOUSE HEATING TEST RECORD A6 D R E S S nz 1,/ 4 t L APT: — FLOOR Cl TYSUBURB OCCUPANT Ecli + yn OWNER HEAT LOSS DATE H TG. INST. SOLD BY INSTALLED BY Electrical Work* By Gas Line By TYPE OF HEAT GA FA HW'—STEAM SPACE HTR. —UNIT HTR- —OTHER GAS DESIGN CONVERSION MAKE --,MAKE OF BURNER Model r– A Model Serial f r 1 _115_ - Max. BTU Rating INPUT Or) MAKE OF FURNACE Model CONTROLS THERMOSTAT Heat Plug Vent Size _791E Valve SIZ KIND OF I LINER— NONE Limit Draft Hood — Regulawor Limit Setting Filters Size U11_2141 slumber I Fan Setting Chimney Location Inal d. -14 Pilot Type Chimney Construction r OUtSideL Pilot Make Pilot Made[ Smoke BombWiring Pilot Timing Draft _f6:_ 1 To Test Tog L.W. Cut Off l Door Pressure Lighting Inst. Percent CIO DaT Pressure Date Tested L' Input CFH Percent 02 Company Tettinn i -I n Stock Temp. Percent CO -Name of Tester Form .235 FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 29, 2002 Ms. Barb Thorstad 6211 Starlite Blvd NE Fridley, MN 55432 Re: Final Inspection at 6211 Starlite Blvd NE Contractor: Royalton Heating & Cooling Dear Ms. Thorstad: A mechanical permit was issued on May 25, 2001 to install a furnace at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Coles. 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 mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/tnh CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) 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 $ $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION EFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr Effective On May 10, 1999 JOB ADDRESS 6 �?-/( J��-/r `�'"�- _31V4 OWNER_2,=,� BUILDING USED AS �,j- ESTIMATED COST-LIJ PERMIT NO. JS DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name � .v- /�, /47-_.S e No. �-'-� BTU exp HP EDR $_ Fuel_ ,V,_� Total Connected Load Burner Trade Name Size No. $ RTU 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. HEATING CO Signed *Air Conditioners can not be placed in a side yard without Approved written permission from adjoining property owner o // FILL OUT BACK C'. DATE Ca —.,-x t 2�ZZ Rough -In Date Final Date 7"�- D 1 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CELL ;[�i TEY AND STACK VERIFICATION The undersigned hereby verifies that the existing: chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rust�.or.<deterioration :. Yes O No ( } 3. Has no foreign :objects lodged -within Yes O No ( ) 4. Is securely supported Yes O No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes O No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY PERMIT NO.: 2004-02049 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/15/2004 572-3604 FAX: (763) 571-1287 ADDRESS : 6211 STARLITE BLVD NE PIN : 153024440080 LEGAL DESC : SYLVAN HILLS PLAT 3 : LOT 8 BLOCK 3 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 8,780.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 8 WINDOWS - H.O. 763-571-3438 STATE LICENSED CONTRACTOR 1 APPLICANT RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C ROSEVILLE, MN 55113- (763) 502-4777 [I�:•/�I X1:7 THORSTAD BARBARA L 6211 STARLITE BLVD 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 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 BUILDING PERMIT FEE 167.25 FIRE SURCHARGE 8.78 STATE SURCHARGE, VALUE 4.39 LICENSE SURCHARGE 5.00 TOTAL 185.42 PAID WITH CHECK # 37873 SEPARATE PhRM TS REQUIRED FOR WORK OTHER THAN DESUKIBED ABOVE. Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE- . YOUR E-MAIL ADDRESS PA -lag oOln . "0 ^ SrM ADDRESS 21 < o Z L V T HIS APPLICANT IS: ❑ OWNER JJCONTRACTOR PROPERTY OWNER/ NAME: lbom OL"®' TENANT ADDRESS: l CITY STATE_ZIP PHONE: IO a . I '3q? CONTRACTOR NAME:_ The Home Depot A.H.S. Inc. SUBMIT A COPY OF STATE LIC 3200 Cobb Galleria Pkwy. YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHONE 763-542-8826 ❑ SINGLE License #20268257. :E PROPERTY TYPE ❑ TWO FA _ .ORIES PERMIT TYPE QADDITION ❑ GARAGE(SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWRVIMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE-riLvp `G` U I LAJ) i IGHT Sq. Ft. 3IZE OF IMPROVEMENT LENGTH WIDTH 200FTNG ❑ HOUSE ONLY 4UM 3ER OF SQUARES 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT• 3ARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 'ROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan 'ROPOSED HEIGHT: 3. List of structural members to be used MDING FOR NEW CONSTRUCTION INCLUDING DECKS, 3 vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: 3 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 3 Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans N EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS 3. Energy Calculations >R FOR NEW OPENINGS -DESCRIBE SIZE OF >PENING CHANGES & 'YPE 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 $ 1- ,01 '1�0 OCCUPANCY TYPE 'ermit Fee 'Ian Review surcharge 'ire Surcharge ,icense Surcharge AC Charge :urb Cut Escrow ;rosion Control ark Fee ewer Main Charge 'otal Due See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation —Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in )nformance with the ordinanand codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a srmit but only an applicai for apermit d ork is not to start without a permit; that the work will be in accordance with the approved an in the case of all workTkch9%Ire s�r and approval of plans. I/ TMI W1 '1W Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or - .structure, or for any addition to any existing building or structure, or for -any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) - $501 to $2,000 $23,50 for 1-4 $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69,25 for 1' $2;000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $39125 for l' $25,000 phis $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1" $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for ls` $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1 $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1"` $1,000,000 phis $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977