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PRE 2010 DOCSCity of Fridley SUBJECT P 1322'7 AT THE TOP OF THE TWINS BUILDING PERMIT r RE T NO COMMUNITY DEVELOPMENT DIV. PROTECTIVE LaS 1 INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY �4 /'•�1 CITY HALL FRIDLEY 55432 "•"' �'� 612-560-3450 910-F15 9/26/75 I � JOB ADDRESS 6450. Squire Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Harris Lake Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brickner Builders Inc. 6245 Ben More Driv a N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 - CLASS OF WORK Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 251. x 46' Dwelling and a 20' x 25'. Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. Provide sod in the front and side yards. No floor elevation below 866.0 SEWER LOCATION: (Approx. 8' Deep) 10' South of Manhole (Inv. 881.50) Wye Elevation: 881.45 Top of Footing: 884.45 Minimum WATER LOCATION: 25' North of Hydrant, 25' West of Manhol�LLQ FoF/o `�CrR/C,G Nil, SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. �� 4S410 L SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOA VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 1465 + 500 17,580 + 5,0 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120,DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $21. 00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $42.000 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- $325.00 STRUCTION E PERFORMANC F CONSTRUCTION. $5$.79 J^ � i� PLAN CHECK FEE TOTALFEE , 1 $404.79 C-STGNATURE OF CONTRACTOR O UTHORIZED AGENT (DATE) PROPERLY VALIDATED THIS IS YOUR PERMIT e yWHEN u-,bLa C&,0Lk, / aG d a� BLDG, INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OWNER'S N&ME : OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA BUILDER: X ` ✓� I ��� ��Z S ��C ADDRESS: ADDRESS : G/ t 4�'(— '('f-e'(s R%'e-r NO:. STREET: QVI �r LOT: S BLOCK: ADDITION ; ��� ( /CS CORNER LOT: INSIDE LOT:_ -,/—SETBACK: SIDEYARD: Applicant attach to this .f-orm Two Certificates of Survey of Lot and propose building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front • 76'5—Depth: 4 Height: Square Feet: 1 Cubic Feet: ® Front: ` Depth Height ®02 Square Feet; Cubic Feet: SCO 40 Type of Construction; r ­q A 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 representations stated in this application are true and correct. s DATE: Z- S �.T SIGNATURE:_X41t� (See Reverse Side For Additional Information.) P5 e5p..M PEA. 58.79 V6 A -04+t i'&,gym. "V 11. ® v '74C UAL 404.79 0 BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the averagee height of the roof surface of the main gable of a pitched roof. For repairs or alterations 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 proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: 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 Certified Survey of the lot, showing the location -of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. A- 10 C" S- -quo c roe So IA 3706 city of Fridley Applicesian for Mumbling c-nd Gas G lfi' S it Dept: of Bldgs. Phone 560.3450 DESCRIPTION OF WOi:r. �i r Humber; KL -id and Locrllon of Fixtures Location w N � Z I Z K 7 . W 7 Z Ag NNU 2 7= r N WATER N7R. CAS ure. Barr l 1st 2nd 3rd 4th Futuzo- CannocZi:n Cwninpa e Haw Flxturo. Old Oponings PARTIAL RATE S%°HEDULE So -war Q Ccerpeol City of Fridley.. The undersigned hereby makes application for a .permit for the work here! specified, agreeing to do all work in strict accordance with the City Ordinarcv 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 Owner N- (- Kind of Building - Used 'as - To be completed about - -----_®---- Estimated Cost. S Old --New. Building Permit No. Permit No. LtNI RING FIXTURE RATES: NO. RATS. 'DOTAL Number Fixtures • • • • • • • • • . • + . • . • X $2.00. $ I`0C) Signed ° Future Fixture Opening ........... x $1.50 $ . By 'New Fixture Old Opening....... • .. x 51.50 $_ _. Business Ph -n- Ho Catch Basin • .... • • ............. x $3.25 $ Water Beater 'Up to 99.000 BTU). • • • x M.00 $ •UCS . ROUOx New Ground Run Old Bldg......... x $•3.25 S l:loetrie Sflatar Haatmr.....:........ s $2.00 S iYP7AL II' ZAS 77TTING FEES: NO. RATE TOTAL IsL3Fixtures •••••••••••••••••• _ x $2.00 Additional Fixtures ............... -- x i .75 $ Gas Range to 199.000 BTU......** x $5.00 G 113MPJl1RS & ALTERATIOH3••-Rafer to Codo .50 State Surcharge . Dc;cription ................ i ...................... . TO'T'AL rZE $� ° �', 9"'.rp��s :wia `"' S}+T� �iA�ti•.a�•rp 1�. •� ��� �a n�i yy,^.,+,n^. ^•'"'••�'^ �mrd"'f',� �< �ae''t G4'Rm�a�irs�a ,�'�,'� .�r�.�.�....n�.da. v�c4ti+1 aa. ;v �J Yo"�7 IIaafa wC6".v..t 6i yqq< mm zym. s�t9 G e.,. •...rz o�,gsap�!. wv oaC �!'��p PARTIAL ATE SCKEDVI E GiRAFITT WARM ArA: RAt 1L TOTAL Fumve• Shell & Duct. Work $10.00 $ Replacernent of rurnare 6.00 P.epairc & Alterations— up to 5500.00 600 $ Repairs & Alterations each add. 4,500.00 3W $ Furnace Shell & Duct Wnr'R to 220,000 BTU ..$1000 $ /U each add. 60,000 BTU S.w S -3= z Re�Irce neat of Furnace 6.00 g Repairs & Alt&ataans--up to 5500.00 6.00 S Repairs & Alterations each add. $500.00 3.00 $ STEAM or HOT MATER SYSTEM Pi race Shell & Lines --to 400 sq. ft F.DR Steam. $10.1 3 Furnace Shell & Line ----to 6-40 sq it. EDR )Tot Water 1000 $, Each ;tdd 200 sq. ft Er)k Steam 8 tM $ Each add. 320 sq. ft EDR Hot Water 3.00 $ OIL BURN-ZE—to 3 gal. per :tour 6.00 S. over 3 gal. per hour --See Fee Schedule GAS BVRXI R (up fo 109,= BTU) 5.00 $ Ss 0 over IS`9.000 BTU 3oe Foe Schedule GAZ FITTING FEES: NO RATE TOTAL lit 3 Fixtures ✓ x$ Zoo 3- Additional Fixtures _ x .75 $_—. Gas Range to 199.000 x$ &00 3 AIR C0X s" TIOXIr.G° FAX 2=7150 STBT=f STS ALi iATFG193 & TIZPAlRS .I«opt. of Bidsm. Phorur SM -30M City of Fridley: The undersigned hereby makes application for a permit for the work %ere&. specified agr- ing to de all work in strict accordance with the City Ordnance: and ruling of the Depaitmentoof buildings, and hereby declares that all the fattt and repr-!gentatiuns stated in this application are true and correct. Fridley. Msnn Owner _ Xie/ /I%e /.41e Kind of. Building Used as �__:s/✓�o�G To be completed about 7C Estimated Cost; $ /S Old --New. Building Permit No. _.__ ,_ Permit No. S�`S iiESCRLs'"iION OF WO"3X HE.A77NG or POO ER Fa.A.N 'Sk-,Steam, Not 'Water, 16em No Trade Name F2.�' 4 Lc/G Siwe Ido- C 9d6.Q / Capacity S Zf; 'J/��5q. Ft. £.D.R BTU �p Total Connected L 2d aU `d 9 Kind of t y� BURNER — Trade Name_ Sl:z NO , State Surcharge .50 Cayaacity Sq. Ft. E.D R DW so* F00 s1chadaloU , t • (, • TOT'AL F= S� S l /tel T�,�Fm� UFT • By ?" (,02x0 -os sal HOUSE HEATING TEST RECORD , ADDRESS�� �°�- " • APT.F OR CITY �` BURB OCCUPANT OWNER �®° HEAT LOSS DATEJiTG. II,9T. a00 SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FA HW - STEAM SPACE HTR. UNIT HTR. OTHER OOF E CONVERSION MAKE MAKE OF BURNER Model Model Serial 7 3'7® Max. BTU Rating INPUT jeu '®®® MAKE OF FURNACE CONTROLS THERMOSTAT �` Heat Plug Volvo Model i' oe Vent Size KIND OF LINER SIZE NONE Limit Draft Hood Regularor Limit Setting e� Filters Size umber Fan Setting � ` Chimney Location Inside a Outside Pilot Type a Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. - Pressure Percent CO2 Date Tested Input CFH Percent 02 Company Testing, Stack Temp. Percent CO Name of Tester Form 235 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAX: (763)571-1287 ADDRESS : 6450 SQUIRE DR NE PIN : 133024410059 LEGAL DESC : HARRIS LAKE ESTATES : LOT 5 BLOCK 4 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01752 DATE ISSUED: 10/06/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114- PEHOSKI PATRICIA A 6450 SQUIRE DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date. ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 118132 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.