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PRE 2010 DOCSr Date: July 23, 1968 City of Fridley, Mnm BUILDING PERMIT Owner: Dalberg Blders . Builder Same ,Address 1121 80th Ave. N. E. address Same LOCATION OF BUILDING N9 No.. �7418 Street _.._ S t ins on B 1vd Part of Lot Lot_ 7 Block 2 Addition or Sub -Division .____ Dalberg terrace Corner Lot . Inside Lot X Setback 35Sideyard — _10_' Sewer Elevation _ _ 894.11 Y _ 897.11 Toa of Footing DESCRIPTION OF BUILDING .,.1'3 5S -45" 984 To be Used as: Dwelling Front _.._..40' Depth 24' Height _ . 8' Sq. Ft ._.25..0_ Cu. Ft _1 200. Garage Front 20' Depth 22' Height 81 Sq. Ft _440 cu, Ft 4400 Type of Construction Frame Est Cost __$l 5 , 5 00 __ To be Completed Oct. 1, 1968 Sewer Location _ 166' North of Manhole Water is in'the street ( not stubbed in) 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 fo and yin compliance wja�l provisions of ordinances of the city of Fridley. L J In consideration of the payment of a fee of $ 35.00 , permit is hereby granted to Dalberg Blders . 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 regardin$ location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector Clarence Be ale AtlS NOTICE This permit does not cover the construction, Installation hr wiring, Plumbing, gas beams, saver or water. Be sire to as the Building Inspector for separate permits for these hams. F_ APPLICATION FOR BUILDING PERMAIT CITY OF FRCDLEY, MUMESOTA OWNER'S NAhE. " ,BUILDER: ADDRESS ADDRESS . 1OCATION OF; BUILDING NO. STREET_ LOT -� BLOCK '"r ADISITIOrI OR f6UBDIVISION `° _ CORVER. LOT INSIDE LOT SETBACK ��_SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant .attach• to..thi$ '.fostis Tu►o Certificates `.df lSur, edY-df:-16t and-.propo#eid building .location drawn.'on' these Certificates. DEidlilii& OF BUILxIP*'k .. 4 .s + ". :i•- r To Be Used As: : } Front : Deptb: a � HAightL_ _rt Square feet a Cubic Feet Height_; / square feet Cubic Feet° Type of Construction Estimated Cost To Be Completed �. The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and represents o state in thi applu ion are true and correct. ,y "I DATE SIGNATi- (Schedule of Fee Costs can be found on the Reverse Side). ,,,•' •" *� 7' .r' R +,e'' �a' _.. �` s .` / a— rim � ° W SECTION 2.. The Inspector of...Buildings shall, before issuing permits for the erection of any building or structure, or.. -for any.,add,ition.to any existing structure or building, or for any.alteration.or repairs to any existing bV41ding or.structure,. upon application fIcrefore,.require the the payment by the•applicant for such permit of fees to the amount herein below set forth and in the manner herin-provided to -wit: Uniform luildina•Codes Type*l,.•2,­& 4- $1.75 for each -one --thousand cubic feet, or..fraction thereof, is such. cubical contenVs: •Type--' 3 ' & 5 ' $1.50 for each one theusand cubic feet;, F For the purpose of computing fees for building 'permits,..-. ifis, cubical contents of any building or Addition tea uviform height throughout,by multiplying the ground ezea covered fram $point siu (6) inches below the floc. line fihe- basement- or the cellar 'tri the average height of the upper surface or to the average height of the roof surface•of the main gable of a. pitched roof. For.'repAirs-or-alterations.to"au existing structure, the fee shall be at the rate of $3.90 per each five hundred dollars,,($500.00) or fraction thereof in.the coet;• Of At! proposed. _work. In ,no case shall th'e "fee ',charged for asiy permit as set forth. in -Section 2 be less than $5.00. NSSSA Cenneetipu Chanes based .on Location-,: Area 1 -*,:or 2 Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR �O Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell &'Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ U OIL BURNER—to 3 gal. per hour ........ ................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2A0 $ v Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule $ TOTAL FEE Dept. of Bldge. Phone 560-3450 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. Owner Kind or, Used a: To be completed about Estimated Cost, $� E' Ol New Building Permit No. ! 14// Permit No. DESCRIPTION OF WORK a, HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No /y ! Trade Name �� Size No� Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuet BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed ....,Anntri( ` ®ND� � O. By. WS CENTER DR1VE.� — �l1NN'E:AP®i: 42 Business Phone No D-56 ,-42 a z HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide Windows Doors Reference Out. Wall lint.Wall I Ceiling I Roof Floor I Kind Yes—No I Yes—No 19_ f FI.I AQ.!, -Room I Lenstth / -a— Width --Tf Heiaht 4P'° Windows and Doors—Crackage and Area rackage and Area 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 pane lights of crack sq. ft. ( ° k r '� v(�' e j�P Coef. Btu Infiltration Coef. Glass Coef. Btu Infiltration Net exp. wall Glass Int. wall ��- Ceiling !�® Glass Floor Int. wall �-4 3 ¢S— '33S-1, Exp. wall ® Int. wall - 7 Net exp. wall Floor ® as - Floor O's -r- Int. wall Ceiling G �� Floor 1 otal Litz. i cs Required sq. ft. E.D.R. or sq. ins. W.A. Leader area J FI.I Room I Length /`/ Width /v Heiaht A Windows and Doors--Crackage and Area rackage and Area 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 pane lights of crack eq. ft. gg /3• 7 Coef. Btu Infiltration Coef. Glass Infiltration Exp. wall Infiltration Net exp. wall Glass Int. wall ��- Ceiling !�® Exp. wall Floor ! otal btu. ® —j - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 0 FI.I /411R 77 Room I Length % -Width! Heiah► Windows and Doors—Crackage and Area rackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. gg /3• 7 d �' Coef. Coef. Btu Infiltration Btu Infiltration 5- Glass ;Z01, ��- c-3- 9, Exp. wall Exp. wall Net exp. wall Int. wall Net exp. wall 3 ¢S— '33S-1, Exp. Exp. wall ® Int. wall Ceiling Ceiling Floor ® O Floor Int, wall 1 btal situ. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area rZ FRIDLEY, MINN. Insulation How Applied / I Ll o Room I Length -// Width/ Windows and Doors—Crackage and Area rackage and Area Width Height No. of Lineal it. Area No. of pane of pane lights of cracksq. ft. gg /3• 7 d �' Coef. / F• % �G Coef. Btu Infiltration e c-3- 9, Glass Exp. wall Net exp. wall Int. wall Ss- 3 ¢S— '33S-1, Exp. Exp. wall ® �' Ceiling Net exp. wall Floor Int, wall Ceiling n Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l ,RAdmld.enath / -,�i- Width Height P - Windows and D rackage and Area 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 pane lighta of crack sq. ft. /3• 7 Coef. Btu Coef. Btu Infiltration Glass Glass 4 7 Net exp. wall Exp. wall Net exp. wall Int. wall Int. wall Ceiling ® �' Ceiling Floor Total 13tu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area I / F1.I Room I Length I -Al Width // Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration a 6 % .- Glass Exp. wall Net exp. wall Int. wall Ceiling ® �' Floor i otas ntu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area � City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORKS/� Number, Kind and Location of Fixtures Location— q m 3 Number Fixtures ...... .............. — 2 x $2.00 y� Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 �JZ p u.�7 x $3.25 w UN' 0- ? O t R • N WATER HTR. GAS ELEC. Base x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... % $ 012° Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... .............. — 2 x $2.00 $--a - 610 Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ......—� x $3.00 $ , 6-n New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... / x $2.00 $ 012° Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE $ CR ° 6 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 f�e —, 19 Owner Kind of Used as To be completed about v Estimated Cost, $ Ol New uilding Permit No. % �� Permit No. All Signed By��.K'�y Business Phone No 7e ROUGH FINAL - a 01 SUBJECT . City of Fridley r219325 11 AT THE TOP OF THE TWINS BUILDING PERMIT r i � R • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. "�.� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 2/17/88 JOB ADDRESS 7418 R= Stinson Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 2 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Beverly Orton 7418 Stinson Blvd. -`N. E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Franzen .Construction Co. 4250 - 5th. Street N.E., Co.. Hgts. 788-4071 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 141 x 16'• addition and a 14' x 1116" .Deck Addition 9 CHANGEOFUSEFROM TO STIPULATIONS See plans for notations SEPARATE PERMITS REQUIRED FOR A N I IEWI ING, PLUMBING AND SIGNS. O'elare diSgun.call focal utilities TI I.EPHONE -ELECTRIC' CAS Etr:` REQUIpf-D BY LAW 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 ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $12,000 $6.00 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 PR 10VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $92.50 S RUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ��- $3.13 $121.63 SIGNATURE OF ONTRACTOROR,1 ORIZED AGENT IDATEI WHEN PROPERLY I AFED T IS IS YOUR PER IT BLDG INSP ATE SiGNATURE OF OWNER OF OWNER BUILDERI IDATEI 01 NEW [ ] City of Fridley Effective 14/1/86 ADDN. R-1 AND R-2 ALTER. L ' Building Permit Application �' Construction Address:_„( � � ipjs6pj v2 Legal Description:d - Owner Name & Address: �PtJPV� RTC �� �ti5o V e Tel. Contractor: AD �o Tel. # 7A Tel. Address: ' a 50 —5--4k-S� /U.i;- 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 J GARAGE AREA: Length h4 ---- DECK -- DECK AREA: Length OTHER: , Corner Lot L ] Inside Lot [)C] Ft. Yd. Setback Side Lard Setba k Q_!'-'S-�— I11 06 N Type of Construction: PccJ %�'QA Estimated Cost: $ Width AP Height g / Sq. Ft. Width �r Height Sq. Ft. Width— Hgt/Ground Sq. Ft. Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: Tel.��� CITY QE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ *54 per SAC Unit 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 e'alluation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,OOO or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 m 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 been constructed will be required before proceeding with the framing. Land PJoronrry % /V % W75 Yyhm� KS AT Land my SmrskjMy ENGINEERING, INC. cm/ b Munkral SUijd 4 0" to;?ff rrry Irl y 'r?eer s f Sur ve o s --- certificate of survei jro: alba r builders Inc. f NORTH Q L� O o Qeno7�es Iron APe —' ——�tno�es U><Ji'�� ¢ Div1,7o9z EosaJrlert� LOT & OCII 2 17AL. BERG TE'KWACE �NOflA CocJNTY J/,&Tby ced#3q rpt J60-1 n a bw d d mrrrcf rrprrSentatbrr Ord ,.tswq ON hmv *rrts i',* err a(wy6isd �d,m� )rh laco ri gl'a!I 1,#Id ys , *rrw' ed rwhle axyvarh-wenfi . ;t's y . f�rr or wv said Arid. As sw veyed 6y me lh4 - °ij SU6 UPS" ENG/NEERINa ._ INC CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997. 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS65iA `j. RATE 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 $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) 1997 Gas Piping (Needed with new furnace) $ 10.00 $ T OWNER 7C,- A.) Gas Range $ 10.00 $ BUILDING USED AS� Gas Dryer $ 10.00 $ _ ESTIMATED COST ����� PERMIT N0.c J it Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR 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 1.25% of Value of Appliance or Work $ _ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE $ �S..�C� BTU HP EDR HEATING COM ANY S���� MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed Tel No.-57d—"� PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Approved By Rough—In Date Final Dat -1v FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE Remarks: CIH1 MY 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 () 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 ( ) 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 ( ) No { ) Remarks: 01) SUBJECT P 0• ' City of Fridley 27792 AT THE TOP OF THE TWINS BUILDING PERMIT 1 , pT NO. COMMUNITY DEVELOPMENT DIV. ____ _ e 1 ~ e PROTECTIVE INSPECTION SEC. ®� 1 � 1 NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/15/98 JOB ADDRESS 7418 Stinson Blvd T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 1 Dalberg Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bev Orton 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Tabor & Sons Roofing Inc 1805 Polk St NE Minneal2olis 55418 789-1902 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 O NEW ❑ ADDITION ❑ ALTERATION Ca REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof house & garage (26SQ) 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,228.00 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- $74.75 Fire SC $2.23 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL EE !� L ce e SC $ . 00 $83.09 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN OP ALI DATE& 114R P R IT "V BLD INSP nATE SIGNATURE OF OWNER OF OWNER BUILOERI (DATE) 01) NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Effective 1/1/98 v Owner Name & Address: Tel. # Contractor: a MN LICENSE # 2 nol !�2v&� Address: Tel. # 7f ci— i "/o .-t Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: /e . „ a� �' �o ,��_e. �, � _ �`G' / 1 1� f I Construction Type:.L o Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: % - /9- i APPLICANT: d-� zTel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge 11101 ITA 0 STIPULATIONS: CITY USE ONLY $ i Fee Schedule on Reverse Side $ 23 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] 6, � BUILDING PERAM 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 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $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 first $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 $100,000 $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 first $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 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. .0 1 r :,ITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NIIMRFR OF FIXTI IRFR Tn RF IPICTAI I Fn nAl Fero M nnQ Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _-54NIF *ts du' o IZ / a(5 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser M M � $ 7.00 IT, F FIR 5 Catch Basin M ORTON, BEVERLY 1 Rain Water Leader $ 7.00 7418 STINSON BOULEVARD L /-,7 20 Tank $ 7.00 , FRIDSump/Receiving (763) 7 6 85 55432 (763)786-8855 Water Treating Appliance $10.00 Owner. Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range`* Gas Dryer** $10.00 $10.00 oa Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY (� �� )l� �Z„() jVj�jJA) Cz Reinspection Fee $47.00/Hr SIGNED BY TEL NO.&F-8�-'�� ALL OTHERS ANDIOR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance ,Approved By Rough -In Date Final Date li'1� State Surcharge $ .50 TOTAL FEE $1M.550 MINIMUM EEE ANY PLUMBINGIGAS PERMIT IS $20-00 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _-54NIF *ts du' o IZ / a(5 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct Catch Basin $ 7.00 ORTON, BEVERLY 1 Rain Water Leader $ 7.00 7418 STINSON BOULEVARD L /-,7 20 Tank $ 7.00 , FRIDSump/Receiving (763) 7 6 85 55432 (763)786-8855 Water Treating Appliance $10.00 Owner. Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range`* Gas Dryer** $10.00 $10.00 oa Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY (� �� )l� �Z„() jVj�jJA) Cz Reinspection Fee $47.00/Hr SIGNED BY TEL NO.&F-8�-'�� ALL OTHERS ANDIOR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance ,Approved By Rough -In Date Final Date li'1� State Surcharge $ .50 TOTAL FEE $1M.550 MINIMUM EEE ANY PLUMBINGIGAS PERMIT IS $20-00 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No The venting: system is plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes () No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( Is the common vent and vent connectors sized and installed correctly after an appliance'has been removed from the common vent and vented separately as -:per current codes. Yes( ) No ( Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat' Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date Building Inspections 763-572-3604 DATE 0 91TE ADDRESS 2L THIS APPLICANT IS. PROPERTY OWNER/ TENANT CONT- CTOR SUBMIT A COPY OF YOUR STATE LICENSE `WM-I APPLICA?tON PERM>L'Jt' TYPE From: 9528814491 Page: 2/5 Date: 5/4/200710:00:52 AM MECHANICAL hermit No.; REST DENTL4,L APPLICATION Received 8 CITY OF FR.IDLEY nate Rel YOUR E-MAIL ADDRESS © OWNER ',CONTRACTOR PRONE: 7(S - COMPANY NAME; SEDWIVICI( K CONTACT PERSON:._. 89,, STATE LICENSE 0 Minr PHONE FAMILY 13 TWO FAMILY TYPE, OF WORD: 1 o NEW AR'GPLACEMENT DETAILED DESCRIPTION OF WORK FAX O TOWNHO17SE Q ALTERATION/RSMODEL ATE Zlp PER IVIS 16B.665 the permit fee is a tnfaimum of $I5.00 or 5% of the total cost up to $500.00, whichever is greater, for tho Improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROMM WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FWTLRLE, EXCEPT WHERE NOTED. FIXTURES: (TNDTCATE TOTAL NUMBER OF EACH BELOW) P.quipmgwthiststicd MFG; U kjn0 )c MOD1!L:0U VS 19 &L) SmMTU 90.11Z0000 M%G: .� © MODE1.4 SrzVBTU •SON. i A/C MFG: MODEL: SMEMTU Y7REPLACE (OAS) $15.00 GAS RANGYWOVEN $10.00 AIR TTO G AIR SXOFIAN(iBER $15 FIREPLACE (WOOD) $35.00 ,_NEW GAS GRILT•. $10.00 BCiII N Y LIN t—FURNACF, $35,00 _GAS UNIT FrrR $10.00 CkII7 WO LINEA, $10.00 GAS DitYER $10.00 POOL HEATER $35,00 DUCT WflT.K $16.00 CAS PIPING $10.00 VENTILATOR $15.00 aPER T 1. b"- MOC. TS Gid!' .33.00 Permit Fee $ Number offixtures Q $10.00 _ x $10.00 - $ Surcharge _.50 Number of fixtures @ $15.00 x $15.00 — $ TOTAL DUE $ Number of fixtures @ $25.00 I x $25.00 = $ Z . oa Number of fixtures @ $35.00 _1 x $35.00 — $-3 5.0 0 State Surcharge = $ASO Total = S-6 S a THIS IS AN APPLICATION FOR A PERPM-NOT VALID UNTIL FROCESS.F,D I hereby apply :for a building permit and 1 acknowledge that the information above is complete and accurate, that the work will be in conformance With the ordinances and codes of the City of Fridley and with the Minnesota Construction Codcs; that T understand this is not a permit but only an application fora permwork is not to start without a permit; that the work will be in accordance with the approved plan to the case Work which r it =me'w approval ofplans. AlAd SIGNATURE OF APPLICANT PIUNT NAA r3LkkE C+ • tAJl' t. -%JF-�z -A— DATE •J 3 b'7 City of Fridley Building bspettions Department 6431 University Avenue NE, Pridley, MN 55432 763-572-3604 FAX 763-502-4977 200% From: 9528814491 Page: 3/5 Date: 5/4/200710:00:52 AM City of Fridley Residential Mechanical ,Application Page 2 REQUMD INFORMATION NEEDET] TO PROCESS PERMIT RESWENTtA,L PERMIT APPLICATION HVAC ❑ NEW HOMES/A.DDITIONS � MSTING HOME ❑ MAKE-UP AIR 99QU_WD FOR NEW/E.XI 'TING HOMES I . Combustions Air (See note below) a. 011 or solid fuel IMC Chapter 7 with iVW Amendments b. Natural Gas or Propane/lFOC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a, Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel. other than gas IMC Chapter S with MN Amendments BEMUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1,346.0603.2 a. ACCA Manual D NO'T'E: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and makeup air calculation& �LIFV 007 Inspektions 763-572-3604 SITE ADDRESS THIS APPLICANT IS: 11:44 �52-935-9E,441 MINNESOTA RUSCO J� U J.LlJ tIN Cr RESIDENTIAL APPLICATION CITY, OF FRIDLEY YOM E$ ]7 S 0A6EG 02102 X G11ILLL 1114U.: — " : QrW l'LL,51e.0 - 0_ 4D r -y -ti PROPERTY OWNEW -- TENANT NAND. ADDRESS' 'J.. _ CITY STATE ZIP NUMBIRZ OF SQUAM 13 HQUSE & GARAGE _ g CONTRACTOR NACRE. � SU$1VJY'I' A COPY OF STATS LiceNSE cA 17- V" DATE -�+� J � ._. YOUR STATELICENSI~ ADDR$S5: SSS, j}2 LA' CITY •-�%Y)�'�Gt��,SrAiEf� J����11� — WrM APPLICAT[ON PHONi 992. 9-34: - 8009 PAX asz • 9.35. g6Y.,f n SINGLE FAM ILYft-WW CON I isTRu :TION . SUE PROPERTY TYPE A gC,=.$.SLn3mrr. L Sim PlanfSmviy s[spwuig the czt#iseg ssuctcvGS El TWO #AMILYINEW CDNSTRUCTION ST{?RtFS P IT TYPE Q ADDMI ON 17riA ORIS W5 -- Two sirs ofoon*ucdon plans 3, EntraCai.iA26= rJ SASB�ENT MNISH © ROOF DRAIN TILE 17 UECIC D'tstffy iG © OTIMlt. © a:W0i 040 POOL TYPE OF WORM�aDD17MO a ANCEIREF AIR O REMODP1LXNZ-- _ ' DESCME WO= BMIG L 0 - SIZE OF RI eROVEMENT LENGTH WIDTH —110U-36 ILEI j ]r �� ��g. Ft. T9�ry Rdt�F�i7 I2 ci4r iy NUMBIRZ OF SQUAM 13 HQUSE & GARAGE BASB MNT 1t�1490IrE2.IPJG SiIB1yi1T -- � Li ATTAR GARAGE 1. Exissng F1nur Pian PROPOSED sm Ci DETACFTEC GARAGE floor 3 PROPOSEDi$IGHi: 5d Members in be used a Vinyl G Soft FOR NEW CONSTRUC iON INCLM11NO DECICS, G Ah>ttlk= C Dim A gC,=.$.SLn3mrr. L Sim PlanfSmviy s[spwuig the czt#iseg ssuctcvGS O Odter ❑ pmai$ and prapo=l projam WEND $ 12. iNWMTING3OPENINGS Two sirs ofoon*ucdon plans 3, EntraCai.iA26= a513No LdC;pi1'1t! OR FOR NEW OPENVOS-DESCRIBE SIZE OF QFEIVIAICti ,TGES do T"'--- TYPE OF V/200W TO BE INSTALLED _ NLIl+tl3i�t OF VAI, D(YWS 48 ALL FEES An BASED ON VALU.FI170N, INCLUDING THE COST OF LABOR AND MATER ALS: (USI1 G TEE 1997 U.B.0 FEE SCHEDULE) TnT,i I. JnP. VAT.TTAIrTrW C A '?A/rs - 09 CW—e RT!'l A T&T*' %Y Pian Raview Fire Surcharge S=bwge License Sarchmge SAC Charge Curb Cut Escrow Erasion Control Park Fee Sewer Matz Charge See Sark Page for Fee Schedule --- 65% of Building Permit Fee .001 times the total job valuation .0005x Permit Valuation Minimum $.50 55.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Pians to MWCC for determiwgtion) ft+58= Rx$21 =z -S $450 Conswvation Pharr Review :Fee Determined by Engineering .Agreement necessary { ) bion Nemspry ( ) Make cheeks payable to; City of P'ridlev Attie TM IS AN APPLICATION .FOR A PERMIT -NOT VALID UNTIL, PROCE!>MED I hereby apply for a building permit and I aelclowledge fat the information above is coruplete and aacmie; that the work wil:. be in confoslaance with they urdinances and codes of th,: City of Fridley and with the Minnesota Construction Cedes; feat J understand this is not a permit but only an application for a permit and vork is .not tp start without a permit; that the work will be in accordance with the approved plan in the case of all work whi rc"s Mdew QW1 of plants. Voki.AV- ;� ¢}� '7SICrNAIURE OF APPLICANT r PRIM' NAME . PIL.�C) J/L/ ; l