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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PFJLU ' N° 862 Office of INSPECTOR OF BUMDINGS Owner Architect ' Fridley, Minn. 19 Builder, i j, LOCATION( OF BUILDING NO, street letxxA IX -7Y -Q--? art of LO* Lot Block Z Addition or sub -Division DESCRIPTION OF BUILDING Front Depth =� Height Stories fs `= Manner of constructio++�x° T8 be used as To be completed Estimated Cost n Permit is hereby granted to to - � e,, the building _ �_-� - «.r described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Mina., regarding the 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. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and, sworn to before me at Fridley, Minnesota, s thi"` day of A.D. 19 i 11 i I Date: .1 ... +A`.... ' . ................. Owner- ... Address .�c�9. �J. �'r ,�r✓�.<✓d-r?-t�° City of Fridley, Minn. BUELDING PERMIT i �T® 3582 Builder ✓ ..".: s ....�► . . Address............................................. LOCATION OF BUILDING No. �. �... Street d%r�fr4-e:t�.... Part of Lot ............................... Lot ... / ..... Block ......... e........ Addition or Sub -Division ...................... . Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ...................... DESCRIPTION OF BUILDING T; be Used as: . : ,' ..... si Front 197(. � / ' � r / � r Depth ' .`.=� Height ! o : d Sq. Ft. a q Cu. Ft. �. .................... of Construction Type... Front ........ •Depth ........, Height ........ Sq. Ft. ........ 31st. Cost.. /-.q �q .� . �.. . .............. "—'-^.. To be Completed .......... Cu, Ft. ........ - "C -'e - In consideration of the issuance to me of a permit to construct the building desribed 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. i In consideration of the payment of a fee of $.:-:t: ...., permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the empress 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ` .. ,.....e !. ................ Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items SUBJECT ERM City of Fridley 1 18260 AT THE TOP OF THE TWINS BUILDING PERMIT CEIPT NO. V ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 1 PROTECTIVE 1 ; CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPROVED BY 612-571-3450 910-F15 10/23/85 JOB ADDRESS 6101 Sunrise Rive N.E. 1 LEGAL LOT NO. BLOCK TCTOR ADDITION RA SEE ATTACHED DESCR. 10 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tony Lorbeski 6101 Sunrise Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings. Co. 6331 Riverview. Terrace N.E. 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS Can be 2nd layer but not 3rd. Install riged galvanized valleys. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,400 $.70. DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER *STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $23.50 PLAN CHECK FEE TOTALFEE /o/a,3 24.20 SIGNATURE OF CONTRACTOR OR AUTHOR D AGENT 1 ATE) � WHE PROPE LY A A ED THIS IS YOUR PERMIT INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) NEW [ ) City of Fridley Effective 4/1/84 ADDN. [ ] I R-1 AND R-2 j ALTER. [ ) Building Permit Application Construction Address: Legal Description: Owner Name S Address: L®' S r Tel. # '"-T Contractor: 9 c LA A E D Tel. # Address: G33/ &ioE'r-Lte- 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: 46R-oo F Aust --+ 15 AZAR 4:4� Estimated Cost: $ % Approx. Completion Date: 1111411--s Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B See Back Page for Explanation DATE: /& lb ���s APPLICANT: ��'���1/.--Tel. #, Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge f0TAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $425 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 Valuation 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 $1,000 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 - 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. a PERMIT for Power Plants and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. o. Heating Plants to be installed—altered—repaired Make nl& ,Size ' cp_ Oil fired—,- Coal fired—,- Gas fired ; Gas Authorization Remarks Approved by. Final Inspection Date , 19_ Inspector 3 L Pmt N° - 4'748 Fee $ ® a Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. , 19.2Q Owner Location % / 6 Kind of Building How Occupied Lj,_a� Work to be Commenced----L—,19— To ommenced ,19_ To be Completed ,19 Estimated Cost, $_4_a6_d, 0 Old- ew, Building Permit No Permission is hereby granted to t to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to who it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentio d shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, apd to the specificatao set f h in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1. 1991 Fridley. MN 55432 APPLICATION PDR POWER PLANTS AND HEATING, COOLING. VENTILATION. ! ' 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS LP I to ! Ii sc h RATE SCHEDULE Residential Furnace Shell and Duct Work. Bumer - Also Replacement Furnace n ' Gas Pi Needed with new furnace Piping t ) Gas Range Gas Dryer "Air Conditioning - All Sizes The undersigned hereby makes application for a permit for the work Rade TOTAL herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division. and hereby declares S 20.4 $ D LCU that all the facts and representations -stated In this application are true and correct. 13 .1906 510.E 5 OWNER R� 4' LOICb1, a h $10.00 - :10.00_ 010.00 5/C,0C All Others/Repairs & Alterations (LIST ON BACK) 196 of Value of Appliance or Work Commercial/Industrial 1 % of Value of Appliance or Work State Surcharge TOTAL FEE BUILDING USED AS FeSldwac ESTIMATED COST A?iA' Do PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER 5 No. of Heating Units__L Circle One (Steam) (Hot Water) arm Air) Trade Name 5725 C Size No. BTU i _1) HP EDR 5 Fuel Total Connected Load S •50 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONIAIR CONDITIONING PERMIT IS 615.00 PLUS THE 5.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EOR HEATING COMPANY Signed By U r Tel No. 'I Z-�f Z-1 [ U Approved By Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE N F] 5. Meets all current Code requirements for size and total BTU's connected Yes (b() No ( ) 6. Has total heating BTU's of �1 i.�, ODC ) All other BTU's) p� TOTAL BTU's Remarks List Alterations HEATING COMPANY Signed By Date I F$7 W_J 0 Rowl �_ • The undersigned hereby verifies that the exist.in§ chimney or stack: 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes ()Cy No ( ) 3. Has no foreign objects lodged within Yes (Y-) No ( ) 4. Is securely supported Yes (6 No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (b() No ( ) 6. Has total heating BTU's of �1 i.�, ODC ) All other BTU's) p� TOTAL BTU's Remarks List Alterations HEATING COMPANY Signed By Date I F$7 W_J 0 Rowl �_ • CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATIO I,_. REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 (Side Vent Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ Gas Range $ 10.00 $ Gas Dryer $10.00 $ *Air Conditioning - All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE $,32,6-0 MINIMUM FEE FOR'ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 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. /f—,me, 79 Effective On August 1, 1995 JOB ADDRESS / % S .'J ®5 e 'Oe. IL16 The undersigned hereby makes application:for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby :declares that all the facts and representations stated in this application are true and correct ,1995 OWNER 57q- 7S41 BUILDING USED AS ESTIMATED COST / tea 00 PERMIT NO. �� ✓ DESCRIPTION OF FUMA-Ca AND OR BURNER No. of Heating UnitsT Circle One (Steam) (Hot Water) (Warm Air) Trade Name L14XSize No, BTU'' 90� &wJ HP EDR Fuel AW Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY AV -V-/ ly Ave 60141 Tel No. Signed By 6 ®��� Approved By 4 Rough -In Date Final Date FILL OUT BACK SIDE R STACK VERIFICATION ON REPLACEMENT FURNACE' CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (%,,KNo ( ) 2. Is free from rust or deterioration Yes (-,O(No ( ) 3. Has no foreign.objectsI dged.within Yes ( No O 4. Is securely supported Yes (No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (o ( ) 6 Has total heating BTU's of $O 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 (,,J'No ( ) Remarks: �'x 41� List ALTERATIONS Being Done: HEATING CO: Signed By: Date: its VOL- Ak Ir IlausL 19M rVIC TGT ACCOMr) APr. FLOOR CtTK!G " UBUItB :. OCCUPAH�T�c2 �/ Wim /�, OWNER Mkr LQS.r,-DATE Iirc. KIST. - SQ CA BY 1'M 1 �GC!'s h L VIZZ �LLCD BY_ r i nal - - J G.LaL;t:rlc:aJ- bark By. Cas Linc By TYPE OF HEAT: Cil FA 111 STF.l�H ShCC It—ra. UUIT II7I1.• OVIER ' • CAIS DESIGi'i � CO�EVCRSIQ:I I-:i.F:J: � _Ukal.t r� • J�t:t?: OF. IIUR;irZ • a c2rYI Ld a Nn SO Mc d cI S::isl GAG Li 'Js7d? �,� Mcx. Biu Ratinr, vgvu"c ao [� Ail.:' OF FUc:M ACE - I-IaiIcI. •. ' CaUTROLS TIIF KOv , icat PIUS Vczt Sizc Yzlvc Rb"r451,"W I Ifo Or LZIHrit S=zZ' NON-- UmLc tabe'.-41N , Ora -C hood Rcru?acot: - -- LiaiC Scttic? 'c3006 Filtc:s; Si -c x�s Hcrbc: 1 e Fast 5ctti:t2' Chim:tcy Location: 'I:tsidcOutaidc Pilot Typc clow •Chis».cy Ccnstruction c,) Pilo a I{a'-u_ Pilot Mcdcl C=Ckc Bomb Wiriaz pilo c iirtirilT 2coevc4s Draf C Tca t Tar L.ii., Cut QEE Doo: Pracaurc �Li�Ittirir Inst. P:casura t S td c- Pcrcc:zt cc 7�b Datc Tca tcd - Cf - ��• `' Input C:Ft .�Jd. icrcant Q` ` cc:i17m cy T=olls; Stack TCM17. • 3110 Pcrccat CO3-rlo '"�`���a�c of Trs to SUBJECT City ®f Fridley 0 7R_ AT THE TOP OF THE TWINS BUILDING PERMIT r . _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REVGATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/8/98 JOB ADDRESS 6101 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Peggy Wiebusch 6101 Sunrise Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Greg Wills Exteriors 4246 Royce St NE Minneapolis, MN 55421 788-0529 20037840 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK p C3 NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House; Aluminum trim 9 CHANGE OF USE FROM TO STIPULATIONS Call for inspection of building wrap before covering. 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 1 HEREBY CERTIFY THAT I 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 $6,280 $3.14 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- $124.75 Fire SC $6.28 STRUCTION OR IHE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE License $5. 77$139.17 FEE 7--o-YA SIGNATURE OF,CONTRACTOR OR AUTHORIZED AGENT IDATEI NP VALI D THIS IS YOUR • -.PERMIT 4a 40 SIGNATURE OF OWNER IIF OWNER BUILDER) (DA TEIII BLO INSP FATE NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress : Legal Description: Owner Name & Address: Contractor: 6 /� C—'(0 Address:. Z/ 3L,16 k LIVING AREA: GARAGE AREA: DECK AREA: OTHER: r; CITY,.OF FRIDLEY , SINGLE FAMILY -AND DUPLEXES R-1 AND R-2 Ri 1ILDING PERMIT APPLICATION N Effective 1/1/98 Tel: # Vii. O dC MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: 14 /V� S 69 t,t) j —,4&,rV %7Xstimated Cost: $ 96 (Fee Schedule, on Back) Driveway Curb Cut Width. Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel.# '�� — ��19 CITY USE ONLY Permit Fee $ f %S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 3, A $.50/$1,000 Valuation SAC Charge $ $1000 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: - , . r 0 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 $501 to $2,000 $2,001 to $25,000 $2501 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up $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 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for "first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $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. O SUBJECT City of Fridley 27193' AT THE TOP OF THE TWINS B U I L ®I N G P E R M I T rp ` RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r i e 1 � NUMBER DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/14/98 JOB.A.QDliEss 6101 Sunrise Drive NE 1 LEEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Sylvan Sills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Peggy Wiebusch 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Hastings Richard Contr. 6331 Riverview Ter NE Fridley MN 55432-4846 574-9966 4051 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 2k REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Rzi Reroof house and garage (23 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building 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 ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 1 918 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ' $.96 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. _ PLAN CHECK FEE TOTAL E License $5.00 $70.13 SIGNATURE OF ON ACTOR OR AUT VRIZEDAGENT tbATEj N P OPE ALIDAT HIS IS R P 24T 01> SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI BLDG INSP D'TE O e - NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address:_ C��` �� Tel. # Contractor: X e r_ -A a P - A :S_ a`1e6 S MN LICENSE # C' Address: ire Vie/ ' e Tel. # S" ^5756 4' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWPROVEM ENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:% �`/-r—c F -4- K! eva F Estimated Cost: $ < 9 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $, DATE: &Z/ V ? APPLICANT: Tel. # 5 s Z TOTAL STIPULATIONS: CITY USE ONLY Permit Fee 1 $ Fee Schedule on Reverse Side Tire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge _ $ . 00 $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 [ j TOTAL STIPULATIONS: e BUILDING PERMIT FEE SCHEDULE A 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. • ' HOUSE HEATING TEST RECORD ADDRESS r APT. FLOOR CITY SUBURB v OCCUPANT ►�®� �_ GihOWNER HEAT LOSS DATE HTG. INST. p _ SOLD BY &� e- INSTALLED BY Electrical Work By &r'v/k� E-1-11-6, Gas Line By TYPE OF HEAT GA FA --,t-HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE �� MAKE OF BURNER Model /F1-17e7S 0i Model Serial 1 .09' -'U/ k S® it 11100 Max. BTU Rating INPUT 26�:aza MAKE OF FURNACE Model CONTROLS THERMO3'TAT Heat Plug _ S Vent Size Volvo �/-4el KIND OF LINER SIZE NONE Limit 0/- &d ep Draft Hood Regulator Limit Setting 0—w-0 Filters Size.1A4,LS%1l I Number Fan Setting ® © ® Chimney Location Inside Outside Pilot Type m ks fi�te�.� . Chimney Construction Pilot Make A- L/ Pilot Model Smoke Bomb Wiring Pilot Timing WAd f Draft 6" Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure Percent CO2 Date Tested Input CFH %S- Percent 02 Company Testing �t Stock Temp. 4T�� Percent CO 14 Name of Tester Form 235 2 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Water Closet Urinal Bath Tub Shower Sink Wash Drink. Tray Fount. Floor Catch Auto. Gas Drain Basin Washer Appl. Gas Misc. Water Heater Range Fixt. Gas Elec Stories Basemen Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric _ Floor 1 Water Heater - Gas _ $10.00 Gas Range _ $10.00 Ga3 Drya; a t _ --10.00L'30 6 Back Flow Preventer R uired ( )Yes () No Floor 2 Type _ $5.00 Reinspection Fee $30.0? ALL OTHERS AND/OR REPAIRS AND ALTERATION Floor 3 1 % of Value of Fixture or Appliance FF- PLUMBING PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture _ $ 4.00 Beer Dispenser _ $ 5.00 Blow Off Basin $ 7.00 Catch Basin _ $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric _ $ 7.00 Water Heater - Gas _ $10.00 Gas Range _ $10.00 Ga3 Drya; a t _ --10.00L'30 6 Back Flow Preventer R uired ( )Yes () No Type _ $5.00 Reinspection Fee $30.0? ALL OTHERS AND/OR REPAIRS AND ALTERATION 1 % of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE JOB ADDRESS (0 \ b l 'jam d- . s -9- -"�> , �\'j The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Building Used Estimated Cost m cs- o PERMIT N( PLUMBING OMPAN rl ft IQ Z S E611800 Approved B i Rough- n Date 06' 61 .NO.524®7- Final Date MINI -MUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE ,199