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AF - 35520, _ �.- _ �,a � � _ i , , �, , _x "k, , � � ' . ` Gi#� c�f Fridley;:: �� P,R 1?�1�. .;; ._ AS THE"fA'SP QF TME TW�MS B��`��-ER�M I�T� �. , _ ,� , .z >_. ; �, �_= e�ti�r nevelcm�ror oiv EIPT N + � `.-: b��'i� IN�Pk�N19D! 8EC _ : . .. � � �� '� ' OITY HIt1.L FHJDLEV ' SSM42 , . �euueEn , �: nnce o� AlMioveo pr . �' s,z� '.' 9�o-Fis 7/�2173 / / _' ;;� Atio�sa ��b434. �htQa �Y�nu� �.8� ` , : +. ` . - �- . .;, . . � E�� i ir � $tOGK TRACTORAUOITIOH � � �� SEEATTACHED , ;�_�� I�7�., . � k2 � � $€i�le,�.;Per}� &�itis� . ;� � � � sN�Er ' - ' - -� MA7LkD�HES6 �.� - . '�;IP . -. PHONE � t�c_�Y8 �?�h'��t $��t6h QVYp4ti$ .2L.8 • �� - . . � ' MRIkAB$AESS :ZIP .:. � .. PHONE �.�. klCEP1aEN0. . � x '` * ':• � ` � {��lS�P .. MAILADDABSB - : ., ZN � '. PFIONE ��.. tICEN#�NO. : ..`: ��- �� , -� °� ° <� : MAIIRORR668 > ' ' ' ' .2tR '� PHONE � LICENSENa - e _; p� � a . _-.� ., . . . ^ � ,. ,, ._. _ . . �. . -. .. - �. 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FF n: '� � '- -�61�3 r NEED W71�N TION .- �- _ � ' � ; 4b A9ANIICY(I� _ ��y3 AT i � . - 'b ' ... �Y;: i�ISNR� 1S CQMM�H� ,• ' . � .„. r'"F n LG: �Nf . : ��- OFFSTFEET PhRIf1M(� " � WERfgY_�' 1": tNAT I IiAVE R6A� �46TINED�4FIf8�lipDllC�"FiiSN_�; s _$i�41,S �� GqRAG�S ��'. ��# -, �$�Af�illBE�tFE+�S4S0 T.$.tLPFOVi810NSbPEAWS' � {� ; .3-' SVR7A% -�#:.YENNItJ§'?(!1#R�iY��fYYFppK WILl. BE�.COMPUED. t�,, ` �' �� W ': �i#: � fkQ 31�F6�N `4N Xi67. 'fT�j['@pAlkitry8 6F A PEHMR . - �+��w!4.� . St% � _ r : k�� 0 311t�^ AW�'FfiQR}iJ'TQ V�D4i4.S$ OR CANGEL THE P Tg�E-.' 9AGCMfiRGE � � -�6iA'f�;,i��f.�A4"}xN�'iYESikl6AflNQ CON- - ..; � `�taoaitM��E rS�:+�sN�)�ron. �5.�; . = ' ' #°^, . � ,� �. �� BLFN T�TAL EE� : � u -c.—..�.G_ �� . �C v�s»� �A YB Y QR�� @P�4EtlT ��. (UATFI � . ` . y + � _ ., ,- �. � . AL TED T�13J3 Y011 � p1YT � �. _ , ' . . , -�. ., . .. , ' � � . »-.v ': `,' _ . ,.:: • s. 4. , � . ,. ;r .. � �� P Al r.�' .. c` �` <.. �. , ' �. . n i m .:vt' `y ' .-F. .. .. .. .. � . . 'y. . �, . . _ � . . - �, . , � .. . . �-�. . . . _ ' .' ApPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME'�� S BUILDER: �u/ N P i^ ADDRESS: �Yy� S ON ve. ,. f;d�e ADDRESS: NO•. STR$ET• �T:11- ( 2-�_BLOCK: I Z. ADDITION; F �AR �� R �IU<fiY CORNER ypT; INSIDE LOT:�_gETBACK: SIDEYARD: Applicant attach to thia form ltao Certificates of Survev of Lot and proposed building location drawn on these Certificates, �ESCRIPTION OF BUILDING To Be Ueed As; l� >c� Front: c�'19 � Depth: �2 �� I Height Square Feet• Cubic Feet S}}rD Front • 72 `� Depth:_ � 2_,� ___Height Square Feet; Cubic Feet: Type of Conatxuction; _��.pC� Estimated Cost;_� ��/j�j �� p�CK To �e Completed; _ �c,� � � y-�-3 � 0 U S(c}�D_ . � The uadezsigned hereby makes application for a permit for the work herein apecified, agreeing to do all work in ettict accordance with the City of Fridley p;dix�ncea and rulinga of the Department of Buildinga, and hereby deolarea that all the facte a=td representationa atated 1n thia application are true and coxrect, L1ATE • _i —29 _ '�'i SIGNATURE • �` I 1/ '- '„��// �1' i,,,��f'7-D...� (See Re�•erae Side For Additional Infoxv�ation.) . ' –� \ _ "" `� J �' ' i � �y � � � ��> �) ' � / : �--' --- , . i_ (' ,��, . � � , BUILDTNG PERMfT rEE SCHEDUL� SECTION 2. The Inepector of Buildings shall, before issuing pexmits for the erectian of any building or atructure, or for any addition to any existing building or etructure, or for any alteration or repairs to any existing building or atructure� upon application therefore� require the payment by the applicant for auch pexmit of fees to the amount herein below set forth and in the manner herein prwided to-wit: UNLFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feeC, or fraction thereof� in such cubical contents. 1�pe 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORb1ATI0N For the Qurpoee of computing fees for huilding permita� the cubical contents of any building or addition, ie determined by multiplying the ground area covered from a point six (6j inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average heigh,t of the roof surface o£ the main gable of a pitched roo£. For repaire or alterationa to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500,00) or fraction thereof in the cost of all propoaed work. In no case shall the fee charged for any perniit as set forth in Section 2 be leas than $5.�. VBRIFICATION OF FOUNDATION NOTEt Pexmita fvr eonatruction will be isaued a mini�uum of 24 houre frrna the time of applicatlon, to allow for proper revfew of the proposed structure and of t11e construction aite. A Certifiad Survey of the lot, showing the location of the foundatlon, once it has heen conetructed, will be required be€ore proceeding with the fxaming. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be ipade ten (10) days prior to the uae ox occupancy of any structure for Which a building permit has been 3asued; and eaid aCructure shall not be used or occuPled until a Certificate of Occupancy haa been ieeued. s �, 0 I' '``�/,'�iOn/ Xi o � , owner of the property located at (� ��' �'J,�",�,,,,,�n„� have no objection to the City «� allawing the construction of a��,k E gt��ed to be located at -��°�'y �/f"n�0_�i%GP without the required certificate of survey that the City ordinarily requires for all new construction. � �-� Witness - (� � �, . , _ . ._ ,.:. - f,��;_. � �- . .�. - I .'- �- � �- - � i� � ." ;yg. ^ . <�E +�d`� i �- F A � ��_ �� F � � E' . hG ItA4ti ERl1N. fdeo 3e�o Q � -: Ati4iE � ' ! w, ...,_.-.:. .,��p.y . - ... =. . . . . . . - - . . .. .,r�, ,.. . ,.... , . . _. . ,... , . - . .� sue.�ccr �� - ' .. �� RMIT - > `- . » ' . . `: La ..' �� +� '�«S y` �i. =: BUfI[�� PERAi1IT , ` . �� a�. � � a�e��o � �:� �-sEO. t -> ;, E�^,-�. 9�432 : NUMBER . � REV. �� DAN4 . P!�6� Of �.�. .dYMPDVEQ BV .�, �� - 910-F15 ;: .1�2a7/�4 �..- � - �< :MC70RADOtTiON� � SEEATTA�HE� - SHEE7 h�y R9pktE8B. . . .'�. i,.� iP . MiONE .,., �� A' N.fit'. _' � . ' '." :IEP � . PNPNE. - IICENSENO. � �� , _ 21P. _ .� PFIONR� �� LICEii5EM1l0 td��8 - 'YfP �.:� PNONE � � ttC&NSEHO. - 40WTION ❑ ALTEMTION •;' El` :�ly�t _G1 MOVE .O REMOVE ,� „ ' � 2fi`. Garaqe ;� ; f a.. : ' - �� . � - � � ; ; _ '. _. _ - ra - � ,� . _ „ n �.. ,: ;� � Gti$ti: � � � • . � �, �� _�face drivp�p, Muqt �i��.s3e a 5 fcacr� sepaiatiott `' - . � , '' ; . 2r�itx�� Siblas or a 1 hour ,�i��i�t. � � _ � � � _,.� � r'��, -. . , � e- �. ; � � i r � t �� + � _ �� _ � �� _ ' �. � = f .� a .- �` ��r�':��at�rs RE��a� � ��, Y� ,,�; = MFA�'{NC. PLttN4$!NG AhtD S�tS. _ �.-� : � .= , _ ,�. .;: � �_ . .� �:t '. . . - . � ° � ' . . a�N''�TttlG.�: � ',� ;��- OCCUPAN _� £16Gk1VA1'tCV6C+tB ' _ CTIUN. :?ONINB � 80_€T. .F7 ' ��-1��8AYff�AT. ; c-,t �,�,. . t° ,�"£ : �N9 E)YPj.6.';..� - OFKS7REET� PARKJMG . I�O TNl$-APPt]GATt{)J�1�� ], - .•'s, BT�iLS faA(tAf�ES . � -PRC3V1$A�ISAFlAW$ ,VAI AX , - s 'K :W{Ll BE �OQIc�k1Ep: . - P�:�. . ��QE R'PERMIT - - �,�, �•` •°` = t�7kNCEC FHE � PERMITi�; . • �— . .,. i+:t�t �IPEt�4lAiltlq �CUN. . !CTf�A. _ loar�f�+' . _� :. ��/ ... _.`�.j�iEF'_� -....r gL . , i-• � �N: ;;: -, �,.:;. _ � APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: /�'P.NNG.'FY1 T7(�a{rfl�_BUILDER: �iWy�Qy. ADDRESS : d �t �en iv�E - ADDRESS : ,S n� Lo NO•. $q vye STREET: LOT: Il- /�a-/3 BLOCK: I eZ ADDITTON;_ �r.; d,Ie�( Par / / CORNER.LOT: INSIDE LOT:�_SETBACK: G I SIDEYARD: S Applicant attach to this form 7iao Certificates of Survev of Lot and proposed building location drawn on these Certificates. UESCRIPTION OF BUILDING " To Be Used As: . �qra�� Front• �� Depth• o� 6 Height• � St'or� .--r Square Feet: Cubic Feet: Front• Depth• Height• Square Feet; Cubic Feet: 1j*pe of Construction: �ra v,�e Estimated Cost: $ �%$(�. �U To Be Completed: �%0 O�Ayt The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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: �aHe �i /`l7f/ SLGNATURE:_ �,Q,�.t� Y�n �• J� (See Reverse Side FQr Additional Infoxmation.) ��✓Lvti � f ��,OCi f � � �-� �� 5.��c 1. 3'� `C�cr,�L $f l . 3'7 Y_ ■• Y n z P � b � %�o k � r M �p � P Gzi �" � N w � O n W w O m Y M C � Ei ta � � � A b] � m Y O r 7 w k qy f^ N v � m vi r � 4 � � x M N 'd $ m `. y N y o 'tl o �y O �� z M 'D n `�C � n O 'A � � � e�-na� " m-ziz� a, «, x n �n .a>az° y �^'"� wyp, m � . .T22,•.j m W rt % Vl ... L� Iti W L7 � 'D (� W �KK�+ � � Y � �'A IA [/� 7 m w%� m 'V1�.^.Cy.1� rt ~ C � Y33 ��m .h1 � � �p rt y IVi � �o F �/Y� o m O m �m m m m � m m o � w o G G �M C O Y S p �a m � f IJY a � m� M A z tn �� D M � "o� Eyf C h� O m O a A o �n °o D tD � C �s a H� �p. � � m � H C 0 .. r m C z m m �, " a ° w� tO Y 1-' ro p n n Q �„ n a � Y• W N 1� � n m a .nT � � P cp�� w a 'i ��f � W VI O N�U O O U O O O O 0 0 0 o- o N C � y o � C O m � X % X N N N N N N O I � W � � � O O O O�J1a N O O O O O O O O O O � � � a � S broro � w n r m w °ryry] w m F F ] � � � Y rt W I-� rr rto ar� 2 N M • rt �f C O � v Y M O O J o n 5 7 Oi O R m m � o £ �ro � X, S � s a a� r 0 0 0 0 N • in o 0 00 0 0 0 o m o «� N Y A J �I ip N 0 0 0 0 0 C O O O O � t� a z «. n a r a'�1 3 9 A n s � ro�ro� =3 � �.w w '� m u�i �ry3 m � P ¢� 0 N � b Y R m R rt O Y � f] N M �"� H M m 'A w w �ry rt rt F (J l� Y ry C � � w n w m n i m 8 n b x �s �� 0 0 N tn o 0 0 °o N �F' p J J N y 000o tn O O O O h0lNNN NM C1N NN NNNN NNNNN IYINNN � �i I I �'$ t! I I o( I I I I I i�� I � I I I a � C f� � `� [+�i rt ro w b � � o m � � � � 3 O � o m K m � E Z a �� T � a � � � � N ng ��a' � y R � Z M rt � p N C n �m n (� Of � � \ m m my o � °9y O h G � b FI • ,� µ p � I 9 Y Z O M Y 0 h O � � M ~y� M Ol Dy O M ty.l O � W "�9 £ ° ro c m n � I � � v°+ K o � y ° 3 � � g r S y � �� M N N n a m y�y' 'A b �t In+ N w r � � 5 Y� N awam �t W N K �� M M � � Z � �w a Z � n �°o o`� nry P K O �< m � d m N F� �T 7 N �% W rt m r °�Mx"-ro `�C 3 G Y. N � r 7 N � n r n sam a 5 w� � n w 7 W Y O N m n � b m w o w 7 n n n a n a �• m a ro , �.--.y m � 10 i N K N � N o. E tt �M1 n n o G N J' M�} � 2 7 ? a w m m p �} a 'J Y � O r�i �C � X n w � x � n r W n rr m r, � N ta O K N �" K 'tl � m x O � �rn� J N � n rt �ao V i Y M �� c Y � W N t 0 C � 0 m _ \ b � ➢ r � � r7 S m O C m ,.. �<.a. .� a � � � � a .�_. O z a .T1 O E � i0 a v .Zl > 2 2") -1 o �, 17 D � a D 2 +-� D � � a � � K � fA � n 3 O y � D '� O � t7 < m m � 1 n m 7"' N D --�1 � m T Z1 G1 m b r O Z D Z L1 •�-. �--I � 0 'tt T � C7 m K 0 CITY OF FRIDLEY APPLfCATION FOR HEATlN� REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION (O�Z� �,�f{TOr�+ AdE h1L DATE Jtn.�y ,3_ 19%9 OWNER � /U � L`-T/-I �Ic%G/�iG-"c ADDRE55 �� {7-eu �uc N � � `� a The undersigned hereby verifies that the existing chimney or stack: t. Has been carefully examined �',C� � � 2. Is free from rust or deterioration �iiM �� 7� ,(,t �ns��w� 3. No foreign objects are lodaed within �K �_ o--� 4.' That it is securely supported I� H_ � 5. That it meets alt current Code requirements for size and totat BTU connected � �-�. v�. 6. Total Heating BTU Qd b All Other BTU REMARKS HEATIN6 PERMIT � - Eifl't rZ TOTAL SIGNED /�, �__ � censee by Address�¢L4 l�su�.L Y�„� N� Telephone 5�G - ¢� r Fridley City License � ,�: ; � -,. > �. � �;, :: . - ��., .- { 4 ' � . . . . SUBJECi . � ; City of Eridley ` � AT.THE TOP OF THE TWINS gU ILD1t�� P��f�RM IT. �� ., � � � � COMMUN#�Y DEVEL6G.fi]ENT QIV. - � y .1.Y"••�••� PRGiEG71VE INSPECTlON�SEC. �� .. . . r � , �� "'1 ��C�TY FAIL FRLDLE� �� 55132 HUYBER nEV � osTE�>� �� veGe ov • �'� 612-571-3450 9to-Ft5 SJ5/87 / / ' �bb ndortFSS 6424 Ashton Avenue N,E. A '� ��u. LOTNO. � BLOCK � 'TRACTORADDITION - . � � o¢scq; 11,12 y 13 12 Fridley Park � �� . .. �_. TIfAYlNER � � . � MA�L AOQRHSS� � . � .. _ ZIP `ICOti"IQ34hss 6424 Ashtqu ilvenue N.E. � 3 ..i..:.� TOR . . � � MAICPO ... . 21P ,.,:.: $s7IDE ... . .: . � ... �. <E.-�,pCHITECTOROBBKiNER. MAIi�A@ORES6 � Z�P � 'S ENOIN R' .. . . � � � MAILADDRE9S � - � � .ZIP � 9 USEOf��9U1kDI,N6 � - .. .. � � SEEATTACHED SHEE7 HONE 574-1891 l PMONE LICEMSE NO. R28.1dEliL],81 . . . . : T B�OF WORK � � �: .. , O` NEW �l ADDITION � ALTERATiON ° ❑ AEPAIR O MOVE ❑ REMOVE � �� 8 - BE WONK �. . • � . , � . .. . . �"" �ist,ruct a 24' x 20� C,a�cage Addi.tion � 9 CMMAQE OF USE f ROM � � - . � . � � � � TO � � � � � Sr��r�t;a�Ns L�ovid@ � fisxd surfaae dri.vec¢ay. � : � . `p':. , . .. . � . . . . .. ' 7Y OF CON$P. ' OCCUP/ ,- $SPAkATE PEPMITSMRB REOUIRED POR ELECTRICAL, PWMBING, HEA7ING, ,. VENT14;671NQ OR /Elq CpNDIT10NING. �" '�iHIS_PERMI; BECOME$ NULL�AND j/OID 1F YMORK.OR�CONSTRUCTION ZpNINd-�� SO.FT. �r" ` A37T1M4Rf$�D IS NOT COMMENCED WI7NtN 80 GAY6,�Oj{ IF CONSTRUCTION ��. � t. .Ofl WONIk-�� Stl3P{ypEO OR ABANDOFY��Y-DA �l::P@9�OD OF 120 DAYS .iT � - ' AIP} tIME!AFYER �OBK IS COMM¢NCE,0. � � NO OWLG.`UM 5q.. : �� 1 HEAEQY�.CPRTIFY TNpi 1 MAye RiAD ANO E%AMINED THIS APPLICATION 1 STALLS . ANDKNQ:WPME�SAMETO@ETiUdEANQ.CORRECT:ALLPROVIS10N50FLAW3 yp��pT�� AND.OHDINANCE$.60VERNING iHIS-TYPE OF WORK WILL BE COMPUEO � � - WITM WHE7NER SPEGFiEO HEAEAM OR NOT. THE GPANIING OF A PERMIT +GZ i ��Q � �� DbHS NQI,pAf�SUM� YO GIYE AUFNORiTV TO VIOLATE OR CANCEL TNE PEflMRfEE� ?�.�RQYI310N5 6f A11i' C:NER STqTE OR LOCAL LAW REGULATINQ CON- � � . ..� -$YRt1CFION,OR=7HE PEpFOfiMANCE:OP CONSTRUCTION: S3Z_.SQ � �� .. . � � . � LAN E K iEH e... E .,, .. .. . ,., ,-?,. „n rc. : . . . ..� �.:�SG�IXtUREOF�ONTRqLT�ROR�UTHORREDRGENt �_ i�PiE� WH :' R� V/� _ .._. V ... .. . ......-..-,.. OCCUPANCV $1,�0 $33,50 Nsri I I ADDN. � pLTER. I 7 ConstruCtion Addreas Legal Description:_ City of Fridleq Effective 4/t/85 R-t AND R-2 Building Permit Appliaation �-Z� �,�l.rl�� h�� ,UL-r Owner Name & Address: �''� Tel. #�-'/ � 16 7[ Contractorz -- Tel. # dddresa• LI9IqG ARHd: Rp� caxa��s a� e: A43 DECB A1t8A: OTHBH: Attaeh to this application, a Certificate of Survey of the lot, xith the proposed conatruction drawn oa it to scale. DHSCRIPTION OF IMPROYBMSNT Length Length �_ Length ilidth W�.dth z.v Aidth Height Height Hgt/Ground _ Sq. Ft. Sq. Ft. /(� Un Sq. FL. Corner Lot [] Inaide Lot �] Ft. Yd. Setback � Side Yard Setbaek Sf Type of Construction: �� Estimated Cost: $��,) Approz. Completion D,ate; S m�*�-• Alt. A Alt B Propoaed Drivexay Width If Nea Opening Ia Desired: � S_ See Baek Page for Explanation DATE: a 6 p APPLICANT: �N � Tel. e S 7� �8 �( CITY OSE OM.Y Permit Fee Plap Cheok State Sureharge SAC Charge Park Fee Sexer Flaia Charge ��.t. STIPULATION3• Q�,L.� �:.4.1% a 32� a-�— E ��? i —' � ^ � .�� 3•50 t�.�ro-�.�5. Fee Sehedule on Reverse Side 25x of Building Permit Fee E•50/$1,000 Valuation f 525 Per SAC Unit Fee Determined by Engineering Agreement Necesaary [ J Not Necessary [] _, � � , � • � �. :,�x�^ � . f '+M$ s# u. k 1 � � . . �- � 3� -. .. : { , � � ` � , � � SURVEY FOR: Kenneth Nughes �� .; 6424 Ashton Avenue N. E., - . . Fn�idley, Minnesota 55432�`' :'. _ l�.a ' -- -. _ - : _ c• . _-�� ', " ' � , � . ^, � . � � •0 4 � � p � � . . ��v' �O! _� � � � � �� .,,��rr•�. . . " .. � �� po°r" � (_L3r . �. . `( -I-_'---.•._ - - -..,0�' -- .. � �� . i .. .O n' . . w�� . � .� , � ,O � . �' . � � � • . .�0 'N ti � � : � O ��: �> � . � �, L oT I 2 : ,� , � ,L �.. > s" ..., . ,G.9 � . 1 + �. ; v� � ' I`— �,-------=�—�-- — --- � � I .. � . � � - �� LOT �13 _ �. � . ,. . � , ` � ' ��'- ; '-. - - 15�f,0' - --SSA:C F /'=30 � . � G s l.POrY /�OrYUc+1�f1�1' I hereby certTfy that this ts a#rue and wrrect representation of a survey of ihe 6oundaries of Lots 11. 12,.13 and the east 1/2 of the vacated alley adjacent thereto. 81ock 12, FRIDLEY PARK, Moka County, Minnesota, as surveyed by me the tst day of Juoe. 1974. �= F. � . : . : � ;. t � /� , . 1 _ � _ �. _. _ �..___ 1..�fi��'";'� _. �.. O �v__.._ _ 'panss� uaaq seq ICouedn3ap ;o aas��3T3.safl 8 Z'F3nn pa�dno�o so pasn a4 ��Zi�ls asn�onz�s PFes pus :panss� uaaq as� ��mxad Bu�PT'Fn4 B��R� =o;:aa�ions�s eCus ;o l�uadn��o =o asn aq� oa xo�{sd eiC�p i0I) �� aP� a9 Ti�ls d��dnoa0 ;o a3saF3�73a� a zrc rt =.,�; ;��ddF; . _ ...rr�..:. ` ;� , � � � � � SUBJECt . - City of Fridley ATTHETQPOFTHETWINS BUILDING� PER�MIT ;y _ � �� COMMUNITY DEVELOPMENT DIV. + � �' �� PROTECTIYE INSPECTION SEC. i � � � � � /"'1 � CITY NALL �FRIDLEY 65�32 NUMeER p �.•..�' '•' 612-571-3450 910.f15 108 ADDRE55 6424 Ashtan AVenue N.E, 1 LEGAL �OT NO. BIOCK � TRACi ON ADDITION �sca. 12,13 12 Eridley Park Y PHOPERTY OWNER MAILADORES$ Ken Hughes 6424 Ashton Avenue N.E, � CONTRACTOH MAILADORESS Tmperial 8idinq & Remodeling Co. 111Q Adams � ARCHITECTOH�DESIGNER MAILAODRE68 USE OF DATE PA ];1/1{40 / OF / 1 " .. � ! i � SEEATTACHED SNEET � � � IIP� PNONE 574-1891 � ZIP � PHONE LICENSE! ZIP• ZIP LICENSE 7 CUSSOiWORK ❑� NEW .❑ AODITION O ALTERATIOM .�� REPAIR ❑ MOVE ❑ REM V 8 DESCRIBE WORK � � . � � � � Reside, so£fits, £asciap add aluminum window & daart X'eroo!', a Roofing can Fae 2nd layer but not 3rd, On ali new roais or tear�otfs and repiace:nent roofs, State Code requires fhat 2 layers ef 15 I.�. fe�t, mopped together, be instalied to a pcist 2a inehes uD from extenor wall line, or the use of vther a�rovrd underlayment membrane. SEPARATE PENMITS ARE REQUIRED fOR ELECTRICAL, PIUMBIN�, HEATING. -� � � �. VENTILATING OR AIR GONDITIONING. � THIS PERMI� 9ECOMES NULL AND VOID IF WORK�OR CONSTRUCTION Zpry�N6 �� AUTMOfiIZED IS�NOT�COMMENCEO WITMIN 80 DAVS��. OR IF CONSTRUCTION ON WORK IS SUSPEHDED OR ABANDONED FOR R PEAK10 OF 120 DAYS A� ANY TIME AFTER� WORK IS COMMENCEO... � � NO. DWLG. UN17 1 HEREBV GERTIFV THAT I HAVE READ ANO E%AMINED TH15 APPLICATION 1 AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PPOVISIONS OF IAWS yALUATION ANQ ORDINANCES GOVERN�NG THIS TYPE OF WORK WIIL BE COMPLIED $BrQQO,, . WITB WHE7HER SPEC�FIEQ HEREIN OR NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE AUTHOHITY TO VIOLATE OR GANCEL TME pEfiMITiEE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- $44�OQ STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. �WTEi StAlLS $4.�Q SAC CFIARGE Fire SC $8.QQ fpTALFEE /�111,00. LOAD I�S�1 [ ] Effective 8/16/90 ADII�T [ ] R-1 ArID I�2 ALTER �Q a,;i�;.� Permit Appli�tian �� : �5!� y .�s,s�a�v �r„�. N, �, Iegal nesc¢�ipti�: owrar x�oe & ,,,�.�._....., �t-.t� �fV��s �"i�i � 7�e1. # ��/-/'� 9/ Zz�_/37 � o��: ��%�l�/f%C S/D/d� D�/p�'/�D�'Ll/t� co��.�y �. # 3�8-a�s� �s: ; _///O f��-�j 4 5 i ; �v, f , /d1P�s, �rv� SS�//3 Attach to this application, a Oertifiaate of SUxvey of the lot, with the proposed oa�trvcticez drawn an it to scate. � � e � v.-,n - . 71 � '� r' �+� - . >« •, �., - . �•�:�• Width Width Width 0 iieigtst FIeic�lt _ Sq. F't. _ ScI. Ft. _ Sq. Ft. Oar'ner Iat [] Inside Int [ j F't. Yd Setback Side Yaz[i Setlaacks Zj+pe of Constnicti�: �1r/��PlaR .c°E.�fL Estimated Cxst: � R7o °'�' Appr�c. oompletion Date: ^/? - /S-9b Proposed D�iveway Width If New Openirig Is Desired: r�t. S S �C'��_ A,>�� Width + 6' See Back Page DATE: / %O APPI,ICANP: � a,y� Te1.. � ��i13��— �exmit Fee S 9. D D Fire Stlxrhatge $____= 8; pU State Stu�ange $ /� D U SAC Q�aiSe $ Driveway Fscmw $ Park Fee $ Sewer Main Q�arge $ . �� F-YP�.ili:4Y-..� `��'�i $ // / Ub �� • O C� wyy �ct' •.,� � Fee Sd'�P a[i Revetse Side .001 x Pexmit Valt]dtiodl (1/10th $) $.50/$l,00o valuatiaa� $600 per SAC Unit Alt. "A° oz' Alt. "B" AbovE Fee L1Pt'sar�nirwri vY �iil�p,rjlYj � �Y [ ] � �il' [ ] �C�JS� � - 0 0 O N N � R 3 c m � C � > U � W Z Oy � W � V ~ W Z O > C � Z Za J N � C.1 N Z y rz wZ = O p 1= ti' Z G s Q pZ N UF- l�' Z �. 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UNDERLAYMENT MUST COMPLY WITH Tf� STATE CODE. STATE LICENSED CONTRACTOR 1 APPLICANT IIviPERIAL SIDING & REMODELING 140 HUDSON AAVE N BIG LAKE, MN 55309 OWNER HUGHES KENNETH D& CAROL A 6424 ASHTON AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or constrvction 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 cettify that I have read and examined this application and Imow the same to be ave and correct. All provisions of laws and ordinances governing this type of wor} will be camplied with whether specified herein or not. The ganting of a petmit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating constryetjogto�e perjprmance of construction. Bldg BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE LICENSESURCHARGE TOTAL PAID WITH CHECK # 13503 SEPARATE PERMITS REQiYIRED FOR WORK OTHEIi THAN DESCRIBED ABOVE. 9725 3.47 1.74 5.00 107.46 NE1N [ ] CITY OF FRIDLEY �# a� 3 Effective 41112004 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp q��R [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION � /��/ a�� Construction Address: �/�r /�S�T� f��-�' — Legal Description: Ovrner Name & Address: Contrador: LMNG AREA: C��L S�O��- d—/�i'�o�"U� � ,9ri�'. N ,�iL-G�9v Tel. MN LICENSE # �� ss�aq T�. # �� a�3 -�� Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scaie. DESCRIPTION OF IMPROVEMENT Length Widih Height Sq. Ft GARAGE AREA: Length DECK AREA: �THER: Width Height _ HgUGround Sq. Ft Sq. Ft p v /.� ,„�� /� �� Estimated Cost: S � � / �:.1 Construction Type: f Driveway Curb Cut Width Needed: _Ft + 6 Ft =_Ft x$ _ DATE: �=3- O� APPLICANT: fZl/�'F{11�L 1�Io,Q�'�� Tel. #�o �oI-36 %-S 3S� Call (763) 572-3604 for Pertnit Fees ff mailing in application. Fax to 763-571-7287 if using credit card and we will call you for card number. CITY USE ONLY - Permft Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control $--- 9`% �S" Fee Schedule on Reverse Side $ 65% of Permit Fee $ 001 of Permit Valuation (1/10th%) $ , $.50/$1,000 Valuation $� $ $1350 per SAC Und $5.00 (State Licensed Residential Contractors) Alt. "A" or Ak. "B" Above $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] i TOTAL $ � STIPULATIONS: �, - � n O � � C "'� O Z D � � � W m v 0 < v m v v m � C � � � rn � 0 z w 0 a .�. D a O D m r m � D � oi � c O � � n' � � T m m � (� d � D � r ._ r �� mc� m C� � � D a m Z W o, o v+ ?i O o c� °o mmi � D v A v � — D �o � m n � 0 2 � a °a �. m 0 � � � m° m N � z 0 < � � � °o 'D c � � z � O 3 D { co�c's�� 'm"o� wwoz �� m w d d 3� 3��° o� �n '. s�2 �' xxlz�ao�o-o � m °i m �t °" � f � d d � � .� � � � � � N f��D � �: � � q � � y � � � m � m rc m Z � N � 'O � m f � m v d � -n ,� �� .� A � � x � � c n � m °IIIIIIIIIIII �� i �/.i �Ii �I.i � � � i �i � 000,cncn0000000 p$° o° o° o° o° o° o° o° o° o° o IIIIII II m 0 � � N � � m 0 c� 0 � 11� O lg �o m � 3 1 N � "\� C � o Z � p c � o T N � � !� � � 7 3 w � a a � c� m 2 �; c a N w v � � � � � �� a m � a � � 7 � � C. O i m a a Q ar° m � o = °• o °'�' < D � a �. w m y � � � a � q �. �a c„� a; .. ? d o � m o � d � � � � 2 �'g� � � F � n o' � � $ � � � �� 3 m o m . � � � � � � N � O � � b C � � � � 1 C A m D � m � z O .. �. �� 0 D r 0 � � � � �� C ITi � �� rn� �n � � s � o,_c cO w Z m � �� A �1 N C � � Zm � m '{ w Z � � m � n V � O z v < a v � r a � O Z �7 0 � � C W Z � D 2 v � a N � � Z 4: � m � � � � W 'o J � O 1�. A V_� FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS 1, COMMON VENT. VENT CONNEGTOR AND COMBUSTION AIR VERIFICATION When reolacina an existlr� fumace, 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 plasticiPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and tertnination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufadurer's specifications. This dces include AGA-GAMA Category, i Central Furnace Venting Tables for fan assisted and naturai draft appliances. The existina combustion air is sized and installed to meet the current codes and manufacturers spec�cations. When required to instali a new combustion air, it wil� be sized and installed to meet the current codes and manu#acturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installinst a new ventina svstem, the undersigned hereby verifies that it is a listed assembiy and meets the current codes and manuFacturers specifications. This dces include AGA-GAMA Category I Centrai Fumace Verrting Tabfes for fan assisted and natural draft appliances. Yes () 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. No ( ) Yes ( ) No ( ) Appliance Tvae and Size/Common Vent and Vent Connector Information Appliance #1 Type _ Appliance #2 Type _ Appliance #3 Type _ Total Appiiances BTU Input BTU Input BTU input Tatal Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Common Vent Type VeM Height Diameter inches Appiiance #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: (Describel HEATING CO: Signed By: Date : CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE PERMIT O.: 2004-00932 FRIDLEY, MN 55432 DATE ISSIIED: 06/17/2004 (763 572-3604 FAX: 763 571-1287 ADDRESS : 6424 ASHTON AVE NE PIN : 153024410005 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : PLLJMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 300.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A FEBCO 765 BACK FLOW PREVENTER. # ELEC WATER HEATERS 0 VALUE OF FIX'I'URE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 15.00 CEDAR PLUMBING PLBG FIXTURES (NEW OPEI�iINGS) 0.00 2445 VIKING BLVD NW PLBG FIXTURES (EXIST OPENINGS) 0.00 CEDAR, MN 55011 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00, GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 HUGHES KENNETH D& CAROL A PLBG REPAIR/ALTERATIONS 0.00 6424 ASHTON AVE NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 15.50 PAID WITH CHECK # 12058 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 a8er work is commenced. I hereby certify that I have read and examined this applica6on and lmow the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula ' constru rion or the performance of construction. Appli ant Date Bldg Insp Da � Z1�► SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building Inspections 763-572-3604 763-502-4977 FAX DATE !Vltq SITE ADDRESS � TFDS APPLICAM IS: TENANT SUBMIT A COPY OF YOUR STATE LICENSE AND CERI7FICATE OF INSURANCE �'��] 7�:Y�7;7 ;ii DESCRIBE WOAK BEING ROOFWG MJMBER OF SQUARES GARAGFS PROPOSED SIZE: PROPOSED F�IGHT: � O V'vryl 0 Alumimim ❑ OtAer BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY E-MAIL STATE EXP DATE Permit Received By:, ADDRFSS: CITY STATE_ZIP_ �SINGLE FAMILYA�dCTf91d TWO FAMILYMEW CONSTRUC770N ❑ BASEtdEM FIMSH O ROOF ❑ DECK ❑ SIDING � HOME CONS7RUCTION ❑ ADDI110N 0 REMODELING p HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit ❑ Trim O Fascia WINDOWS INEXISIINGOPENINGS es �No L0�A TIONOFj.VINDOWS ORFORNEWOPENINGS- ESCRIBESIZEOF l._YdSfl�vy.i OPENWGCHANGES& �� _, ,_ „ ALL FEES ARE BASED ON Plan Review Fire Suroharge Surc6arge License Suroharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge 0 DRAIN TILE ❑ OTHER a��,{$ING THE 1997 U.B.0 FEE SCHEDULE) U "✓ OCCUP, FT BASFMENT 2F.MODELING SUBMIT: 1. EzistingFlaorPlan 2. Proposed flow plan 3. List of slrucNral members w be used FOR NEW CONS7RUCTION INCLUDING DECKS, ADDIT[ONS & PORCHES SUBMIT� I. SifePlan/Surveyshowingtheexis[ingsWttures and proposed pmject. � 2. Two sets of conswc[ion plens 3. Energy Calculations FOR WINDOWS — PROVIDE U-VALUE AND MANUFACNRE STICKER ON WINDOW. MATERIALS: �t?� 5(7 See Back Page for Fee Schedule ' 65%ofBuildingPermitFce �b .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed ResidertYiai ConVactors) $2100 per SAC Unit (Plans to MWCC for detertnination) ft+6ft= ftx$24=5 $450 Conservation Plan Review Fee Detertnined by Engineering Agreement necessary ( ) Non Necessary ( ) THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I heroby apply for a building permit and I aclrnowledge that the information above is complete and accurate; thaz the work will be in wnformance with the ordinances and codes of the City of Fridley and with tt�e Minnesota Consduction Codes; that I wderstand this is not a permit but only an application for a permit and work is not to start without a pemiit on site; that the work will be in accordance with the approved plan in the case of all wo wh' h requires review and approval of p�l/an�s. j[ SIGNA7UREOFAPPLICANT�;� PRINTNAME hCK nu�'{ES DATE �b//�/I� Page 2- Building Residential Application BUILDING PERMLT 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 shvcture, 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 be(ow set forth and in the manner herein provided to-wit: 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 Oniv City of Fridley Building Inspections Department � 6431 University Avenue NE Fridley, MN 55432 763-572-3604 F�: 763-502-4977