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PRE 2010 DOCSCity of Fridley, Nihm. BUILDING PERMIT N® 4 5 5 6 ' � Date: .. _ . °.:..........._? _ _.. ..._......._...._..._._...._.. Owner: ................ Builder ......................... _._ - - -- - _. _.-...-.. _._.._.. _. _. Address .' _.._ e Address ... d! ......... ____ .......... ........ _....... TION OF B`G NoStet art. Lo ... .............. ......... _.._ _.. p Lot ....._............... Block ....._........: _............. _............._.. Addition or Sub -Division �*� _ ..... CornerLot .................................... Inside Lot ...... ............... Setback f ::.........._........ Sidey .... ................... _........................... ._........... Sewer Elevation .. ................................... __.................... ............ ... _................... Foundation Elevation DESCRIPTION OF BUILDING lbe. Used as a...... Front .- --.. Depth .. :.. Height ... Sq. Ft..: ... Cu. Ft. .... -.............. _.............. ....... _............. . Front ...... Depth Height Sq. Ft. ...... ......... ...._.. Cu. Ft......................... Type of Construction . ._^ ..: . Est Cost. ...... ........ To be Completed .............................................. THIS PERMIT DOES NOT AUTHORIZE VIOLAT- ION OF ANY Pid 4AYE LAND COVENANTS AND BUILDING RESTRICTIONS. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. .r In consideration of the payment of a fee of $ _.._.._......, permit is hereby granted to. ...................................... ......._.......-- ..... __........ ........... ............... ...................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violationjof any of the provisions of said ordinances. 11+ A Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Nems. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. 773 Stree Part of Lot Lot___, Block Addition or Sub,Div. Corner Lot Inside Lot_Set Back Side -Yard SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Z,j -a,-- V Front DI Sq. Ft. __.- Y: _� Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of To be 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 representa- tions stated in thi application are true and corre t. DATE - �� _ �' SIGNATURE (A Schedule'of Fee costs can be found on the Rierse Side.) 9 BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit' for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit for the erection of any fire -proof building, -other than a garage, warehouse, factory or grain elevator, or for the erection of any fireproof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any fireproof garage, ware- house, factory or grain elevator, or for the erection of any fireproof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building other than a garage, warehouse, factory or grain elevator, or any non - fireproof addition, for similar occupancy, to any existing building. Permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non - fireproof addition, for similar occupancy, to any existing building or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00. For the purpose of computing fees for building permits the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six.(6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 for each Five Hundred Dollars ($500.00), or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4..00. 01 ly. . SUBJECT PERM O. City of Fridley ® 14'792 AT THE TOP OF THE TWINS BUILDING PERMIT r I RECEI • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 991"V t t DATE PAGE OF APPROVED BY tl ! /"'1 CITY HALL FRIDLEY 55432 i----' ,'j 612-560-3450 INUMBERREV. 910-F15 6/30/78 JOB ADDRESS 7171 Van Ritran qf 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2� 4 Shaffers Sub. #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHON John P. Derence same / 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Woodland Heights Builders Inc. 350.N.E.84.14-7,105 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PI -TONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING House 7 CLASS OF WORK DA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a Dwelling, 9 CHANGE OF USE FROM TO STIPULATIONS 1.. Provide Combustion Air to The Furnace Area 5. Provide a hard surface drive 2. Provide exhaust fan in basement laundry area 3. Provide verifying survey by July 31. 4. Provide sod in front and side yard WATER:10' N. of sewer service Driveway depression cost: N7A SEWER :(Approx. ll' deep in street) 79' N. of M.M. (N. Inv. 875.92) Wye elev. 876.54. Top of footing 879®54(min) W/35' setback? SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 60AYS AUTHORIZD IS NOTSTRUCON OR IFO1120 ES 2— SUSP NCED DED ORAABANDONED FORWITHIN OR WORK A PERIOD OF, DAYS AT Jag .3 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 $2.7.44 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 TOTALFEE 29 $612.68 SIGNATURE OFCONTRACTOR ORAUTHORIZED - E - (DATE) ALIDATED THIS IS YOUR PERMIT ',�--WHEN/PV0PVLY 36 BLDG.'.MSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 01 ly. . CITY 01= FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER;dl —; Address: No. '229 LOT: _ 21 CORNER LOT: BUILDER: r&A6 vl'� Address:��� Tel. No. 3 U v •� T Street: BLOCK: � ADDITION: INSIDE TAT: /--------SETBACK: y S TBACY.: 3 ,5 SIDEYARDS : Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: �4q Depth: Square Feet: 1234— C Co-Av Front: & IS / IA)6 Depth: • P Height: 0 � bic Feet: A Height: Square Feet: Cubic Feet: Type of Construction: ` v�X�CQ_ ��� i Y� Estimated Cost: $ To Be Completed: 1710 ��® Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned herebl, 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. See reverse side for additional information. DATE: SIGNATURE: '2 1. /0 ,S ��•ev 8 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: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $14.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x $17.20 Was)- inw, 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 average 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 tier 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 $7.50 plus $.50 state surcharge. NOTE: Permits for construction will be.issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. _CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten'(10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. r civil municipal planning environmental land surveying soil exploration Denotes Iron Monument O Scale ��2 0' • r CIP F®rAIIIIIIIIIIIIII JOHN P. &RENCE Lor 2/ - ,BLour `f' SHAFFFR S SUBA/V/J1oN NUMBER I AJV0XA COUNTY, f 1"EsOrA 3S I 4J U4 —18032— Q) -/80.92-- 180.70 s3 1,Dgy 'ss j4oy Gll " r- 1, 3 7/ ,CCURAC-y O� IiiT r LOCATIONS AND ELEVATIC t1,,' -d, THIS DATA IS FOR INFORMATION PURPOSES ONLY AN.-, n,RSONS USING IT SHOULD VERIFY THE INEOI W(ION L/riurr EASVIENT se%tt. We hereby certify that this is a true and correct representation of a survey of the boundaries of the land described above and of the location of all buildings thereon, and all visible encroachments, if any, from or on said land, that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of'the State of Minnesota. As surveyed by me this 29� day of t/uNe , 19l$._. COrwfflrg t gne'e1"S p.o. box j. osseo, minnesota 55369 ❑ (612) 425-2181 ldi� Slfied by hc. E 5'098 File No. Book 64:70 Page Minnesota Registration No. _ 7 51 (1;7;7 �� $P-zt-f Ir i civil municipal planning environmental land surveying soil exploration . i. Denotes Iron Mgnument O Scale 1'-501 Certificate For JOHN P. PERENCE LOT 21 - Bi-octr f SHAFFER S SUBD1v1jIaH NUMBER I ANOKA COUNTY fM1,YNESOTA ?3 7/ - � 1-51 Uriurr EarfMEar We hereby certify that this is a true and correct representation of a survey of the boundaries of the land described above and of the location of all buildings thereon, and all visible encroachments, if any, from or on said land, that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. As surveyed by me this 29day of Jens , 19-. Consuffing engreers p.o. box j. osseo, minnesota 55369 0 (612) 425-2181 dl /e ified by - f=ile No. .5� g Book tW Page l� Minnesota Registration No. -ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000) It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIG14 CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: OWNER/CONTRACTOR: ADDRESS: t� �� ® PHONE: ,� � ' 3 0 A. Determine the Total Exposed Wall Area as follows: 1. Total wall ��rea 2. Total qqx� .rea ` 3. Total sliding glass door area 4. Total fireplace wall area a 2--- 5. Total wall framing area (average .10%) 6. Total net wall area above floor(average 90%) 7. Total rim joist arealow Q Subtotal: Total exposed wall area above floor e "' ra 8. Total foundation window area 9. Total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA_ ��7.- ` Item I C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area /1.51 Zr GRAND TOTAL EXPOSED ROOF/CEILING AREA D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X05 = Item II (_ E. Determine the "U" value of each segment (1-9) and multiply by the area as , follows: 1. X fluff /56 - 2. X "U" 3. X "U" 4. X "U" _ 5. g fluff _ r 7. X "U" 8. X "U" _ 9. X "U" _ ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III F. Determine the "U" value of each segment_(10-12) and multiply by the area as follows: 10. X "U" _ 11. X "U" _ 12. X "U" _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I + Item II = J. Add Item III + Item IV = K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By DATE: C J^ xy.M July 5, 1978 6431 UNIVERSITY AVENUE N.E., FRI®LEY, MINNESOTA 66432 TELEPHONE ( 812)571-3450 Mr. Peter 0. Weikleenget Woodland Heights Builders Inc. 3350 N.E. 183rd Avenue Wyoming, MN 55092 Re: Building Permit Stipulations for 7371 Van Buren Street N.E. Dear Mr. Weikleenget: I'm writing to inform you of an additional stipulation which should have been added to your building permit .but was overlooked. A hard surface driveway is required for all new residences in Fridley. We've added the stipulation to the permit and enclosed a xerox copy for your records. We apologize for this oversight and inconvenience. Sincerely, RON HOLDEN Building Inspector RH/mh CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Job Address / 3 A Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: ' The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ facts and ropresg tations stated in this application are true and correct. Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 7.00 4.00 $ $ / Fridley, Minn. &z-, /Z . 19 STEAM OR HOT WATER SYSTEM: OWNS Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING each addn. 50,000 BTU 4.00 S Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT OIL BURNER- to 3 gal. per hour $10.00 $ 7 r� each add. 3 gal. per hour 10.00 $ ESTIMATED COST GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ VM - NEW BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 a $ 3 -00 . , DESCRIPTION OF FURNACE/BURNER Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ BEATING or POWER P Warm Air- No. AIR CONDITIONING �� $ ko-0Trade Name Size No.A /f re ` f' FAN HEATING SYSTEMS $ ) See Fee Schedule VENTILATING SYSTEMS $ Capacity Sq. Ft. EDR BTU Are, AHP ALTERATIONS & REPAIRSJ $ � State Surcharge $ .50 Total Connected Wad //A i ® � Kind of Fuel TOTAL FEE $� BURNER - Trade Name Size No. ROUGH INSP. REINSPECTION FEE Capacity Sq, Ft. EDR TU HP Date ($10.00) FINAL INSP. /8 ,,,,,� Company�; Date Signed By APPROVAL FOR PERMIT Tel. No. 544!�__34 �4 `-3�, ��� MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE r"'.r�r�s^e�s���Te�r�av��v:•e�x*.�a.::�n�A�4,��('%fi'i..gi"�.%"�`�^�w3'�+1�'+t..*''�:�a3�``.Ytx.��'Yar' '??. .sr rz' t;.r-.'t-9+3.��S',2�. v...t �,... x,J.e�eact� HFAT LOSS CALCI TI4°}N3 ' f AIY OF BUIL. a.. ��ttd�litr9lfi a .a a.rv.tJ.�. �rscetl®eeaa'a _._ „�...... Chicle f, lrandawa' Doors e��afefsriae iJs�t.laail lilt. a. Ceilisi�. Hoof Floor Kind i�'pg'is°.g 19 -Vt �� �F,1a. Pcoo Lac,�th '<ei�.`t� ety NeiQht �-ts jv FI.I y WO' at 1W� Windows and ova—C(msksz* asv4 Area W;t,dowa avid Do•oras,�fsa:haia and Area �� al Writ kv,w W1W1 /0 0( L,na@l .4 Age& Wldtk ¢,$ht No of InOel it: Aro® ' of PeAA mQ r@ae 14ah1@ of rPceti a ft too wf ®mno of @8N° uBht@ wA vvo¢tr ft 1 4� ®csor 19 @0 t�v,lf. Dt� 1w�aiteatioaa-- t o b Irs�,trstioii S'cra IGl�ae a Q ��oaa + 'too dap: wall H� ESP. wall tIla Pitt �s. vl1i fc exp: wall o 0 2 iitt. aPall Int. wail .. Catal�nti 1�a ceilinga lflj2,iv ca Floor Total Ehu. -'Total a",ttu. Required sq, tt. E•E.D.R.or 80. Ins. %7I.A. I,. rider &rOA Required seg., ft. E.D R. of BQ. ins. W.A. ipg ,CAdgr area lacom f Un-th PM odic°th t i12i,-ht -o g }i.) . {� Fm to I I n tla «j :?Jtelth g t I a^i:qht 0--b 11'inotoiea and and AM Windovn arj eve—Cfaehare and Area - 64 idsh. flrlc Atas ¢f l.tne¢i t6 1 Afaa6Y 18th H►i8/+t ?d o. mi - t.tarm( ttfa Afr@ 1 O_�' 0f P.0 v10, Of $ON9 ItglatA y Or crath D P'D a't. /�.. FBo. 6( Bl@n@ of p8n4 113x110 or tr@ett sq ft -7 10 _ C-04 Viamf. ! tta . I(►altVi+tioei ' Mc atr infiltratibta �o n. Dao ti�afi a v �.-� 6'0 . Glass r" r Exp. wdi 4 t o'I Exp. wall '1id� iks;p •,'a�a+ll. '2449 ►o.a p Net exp. wall °� � �o yavb Int. w0l Cell,cs��°i 3 Ceiling a a� 10 70 f lir`. Floor 1 o Total Mu.., a�eaored Sq. It, E.D.R. or sq. ins. VI.A. areae Rect-uimd so. ft. ED -11. of sq. iris. W.A. l.srsc°er aare� llsTRoom 'L en ;t&1 N--,. t'i :$1 /d/ Hnt $_Fi.j .6��ta 1 T'.11.sasali /6t6 1a i~deitrht g -o °,• ` ialelaaas land uni At= !_,ir,�kse� aw.d I�;vs rac f.e ,arab �rera [ `' 6't•lth M¢lem ra O. 64 ft. Arra id idth io,gRi Poa vi Llweml t/ Area r PDm of �4o ao' of Pan® llp At¢ er rrcet r'7 4t. iV®; ar tamm of 9amo t4alltm 'at eraet, 4cq tr 4. • \ 1 9, —t7 to $ 1W, 7 a0 O a i. 'Yb 1 X10 GN Loaf. 1L'tai C" to (n�itr$t'last ;�o ga Infiltration - �a0 ywfs �alaidb0 ao Uago s Faip. wain.:,- 1 ii 1 0 Esp. wall `1 g `'';•• "ouispr %poll 1 Net eszp. mall o p w, wall". int-wali . eilag1 (A.�® Ceiling{ W IQ d w . f ltror' _ Fluor mit Tau. o u srs 'a h. E.[? R. Of Aq. ins. 'V.A., l a � tar aia® �s�,t:c�;l act. It. F -D.21 tsi �. isizf3 � t P�: I c^aa�► mrm�' . 4 7�5.Pf�iF�'��`tsd°3�wi�,,a :,"",t}/��. n�"9 i� ;;a i3ti... - ,. '+�.:: ;$�-,i,;.,}k4�,, u�,r�'�. ?�,c `>'. t.a'..�'',aht��^rr..Pix'�4✓'•'ta't�:a,}.�.;2�'S�`�%casS.^J�'r6e4r�+'.SS ..y�'�; Yu. rr ei�:l„+dar' HFAT UM CALCULATION6 N Q �a;arlherstrl s a'a.�.a�. .$,r p. -Guide Con:¢irsociioti N Qidtndaara " l:�nnrs I?kde�aegc¢ Clat: ��all ' Iait: ala?l Ceilii�}g ST FI 4Y1: i3 p $343irb (Ler: ►g,' `eii 9% %S Height' Windows and r®--Cr3_chv%e arty A a NIJIh M"Iam iia at I Lanoat.t., 7-z—vva_- rfa of Dana" so game - wInto of awed • ,� �f o � ..: ,9 to 2'7 1 b CM. f,.tat Infiltration ado 'td4 ! b Desi o2'i ,So. t�/3s Net ecp. will Int. %t911 Caalan� • � z -i o � ro zoo Floor Total Diu. Required sq. ft. E.t� R- or' scl. Ins. WI .A. Leader `rarest aND F1.1 A f,, w b Room i b -w th ' Apt Vi8th m n FI-2swEst c,—'— W1 indows-and a_'- 41indows`and l:f�m—CrACL,'"ad and Aron ., Na. W1121h of pane- drolg Rt ida cf of ran% IlQttt® Linoal Pt. at trach Arca a•a ft.- V1:alftows and (loom- Crsa.Eia is a6od Area c, a s - Ea blt4 D10 la Pt NO DB a.igaat It, � '- Me nP Dana of Fan. IlpPfa nP free4 eq to - e , _ Cw..L !Slid ' lnbltr4tia3a `8 to 19ao' Irsgitr:dti6,� r S�s� Net esp. wall' Casa aPa �Q i F—!SP. %wall tor, t' Int. wall Nd rap. -all ica Asa o Ceiling Floor Cedlrin =1 Total Btu. aa8o . Required iq. ft. C.D.R. or* aq. e -is. W.A. Le r.'mr area URI Bect'*3...R?6orfl I Lett oh :eq6 tdt,_:ah `. ta,. 14TC-11A 9--c' WinJows and. ts-Crtci� r" and, Area 96't.11h Nalgat N%" ' Lit -eat ft: best of Dana of Dane .3hto of crack. t7 It. - C.tsel. h'tit Id,€Ileraei6� �laia E&P. Wall 3 4�a��,. � 1101 Cap, wail.1® to Int. c�alF CeihnQ t Rla�a Tam &U. O . est�efe i t. E.D.Rt or im.'Lit. t"d. A. I...:r, saa a1.2 r Insulation� wa o. Flood Kind I44�v Appld« 1 iicl—i LentW a V1:alftows and (loom- Crsa.Eia is a6od Area c, a s - Ea blt4 D10 la Pt NO DB a.igaat It, � '- Me nP Dana of Fan. IlpPfa nP free4 eq to - e , I Irsgitr:dti6,� r S�s� ,Y Casa aPa �Q i F—!SP. %wall tor, t' Nd rap. -all ica Asa o Iasi. wail Cedlrin =1 Rear Total Diu. fty`t t;n1 E V aterred sq. ft. D R. or to. ?1'�.J�. I,.:en&r area a F1 .1 1 Una Ih Width im L'Jirdowfa And and Area ' \` 4th. Molaht lNA Ol Mneei ft Area ' Mei - of Pana of Dane 1 IIT.1ta of frofti eq ft 1 F3 ted. lstts Infiltrations-� ' Exp'. wall 46 fLt,.oWIAfl P�Iet elp., wall 8e Int: will Ceding _ Floor ` mal Heti. t 6A i'1tr4°I'taimcl tq. ft. EI.). a. or m ins. `II.Q. Lmc!er aPea Viral% wrs aril and Area 7idtA da3ftht ria. 9d i,tnnat dt Aro® r!f Imiea of ga+eo - tic.Ata oP efaett aq rf f, i 611.E;t� lnfiltratiota Cdee;i . ESP. %grill Ides cup. wall 9 Int. wall Ceiling Flts6r ictal 04rs. :...� )k 'm=m, •, ..: ..� ..r. ..xv r.u., CITY OF FRIDLEY • APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures X ro, a Future Fixture Opening x $2.00 :0 New Fixture, Old Opening 4�N • 0.Ny $ Water Heater m°N s 6 Catch Basin 1 $5.00 $ «4 M t 0 W 14 x $10.00 $ Water Softener x $7.00 0 New Ground Run old Building x $5.00 $ X111 x $5.00 uto GAS FITTING FEES: v "$3.00 $ C 0 $1.00 $ Gas Range to 199,000 BTU x $10.00 E p iN aV t7 t� O as lec 1st 2nd 3rd 4 to (R) - Future Connection Opening Connected with Sewer (•) m New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures X $3.00 $ ,y? Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTC x $5.00 $ S •C��? 1000000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x "$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS 4 ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 S State Surcharge $ //.50 FE TOTAL E $ ".S• REINSPECTION FEE (520.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. . o?� , 19 128, OWNER I 1 KIND OF USED AS TO BE COMPLETED ABOUTy ESTIMATED COST OLD - W BU LDING PERMIT NO. PERMIT NO. Company Signed By ' Tel. No. ROUGH INSP. Date FINAL INSP. j Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT I3 $7.50 PLUS $.50 STATE SURCHARGE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 October 17, 1978 Mr. Peter Weikleenget Woodland Heights Builders Inc. 3350 - 183rd Avenue N.E. Wyoming, M 55092 Re: 7371 Van Buren Street N.E. Dear Mr. Weikleenget: On October 17, 1978 the City made a final inspection of the house now being completed at 7371 Van Buren Street N.E. There are three items of concern to us; l.' We need a verifying survey indicating the actual location of the house on the lot. 2. The combustion air duct to the furnace area must be extended downward to within 12 inches of the floor or connected to the cold air side of the furnace. 3. The two rooms now finished in the basement can not be used ,for sleeping purposes. Please ccmplete items 1 and 2 by November 13, 1978. If you have any questions on these items, please contact me at 571-3450. Sincerely, DARREL G. CUa Community Development Administrator DGC/mh CC: Mr. John P. Derence CITY OF FRIDLEY APPLICATION FOR PLUMBING AND .GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 U .New Fixture, Old Opening x a $ Water .ei+ Catch Basin y $5.00 $ cs e A y b S+ ��, w $ Water Softener Heater $7.00 $ to x C $ Electric water Heater � $5.00 $ GAS FITTING FEES: COs 1st 3 fixtures x '$3.00 $ Additional Fixtures 0 j 0 $ Gas Range to 199,000 BTU UI .0 C. N REPAIRS $ ALTERATIONS O p G u d� • N y N N each add. $100.00 or fraction m el U D w w 3 Q w° W w d' U w a r c� c� O as. lec H Ist 2nd 3rd 4 th (R) - Future Connection Opening Connected with Sewer (;) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ .New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE (S10.00) Job Address /3 7/l Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. ® -�f �--- , l9 OWNER \ id�- KIND OFUI ING USED AS TO BE COMPLETED ABOUT _ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. 6 Company Signed By Tel. No. _� f e� ROUGH INSP. Date e ' FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT 25 $7.50 PLUS $.SO STATE SQICML%= CITY OF FRIOLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 January 25, 1979 Mr. Darius Anderson .` D & D Anderson Heating & Plumbing Route #2, Box 754 Cambridge, MN 55008 Re: 7371 Van Buren Street N.E., Fridley, Minnesota Dear Mr. Anderson: Registered Mail #508086 We were called to inspect the heating system which your company installed at the above address. We did note that the system needs to be balanced. We have tried to contact you by telephone but have been unable to reach you. Would you please contact me at 571-3450 between the hours of 8:OOam and 10:00am; 12:30pm and 1:OOpm; or 4:OOpm and 4:30pm, to discuss the problems with this system. We would appreciate your prompt attention to this matter. Sincerely, WILLIAM H. SANDIN Plumbing -Heating Inspector WHS/mh CC: Mr. John Derence 7371 Van Buren Street N.E. City of Fridley SUBJECT PERMI G 9 7992 AT THE TOP OF THE TWINS P, D' III D I � I i� D [ D � A I T r DV L Ivv rLR'vt I R"OTNO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC._[ CITY HALL FRIDLEY 55432 NUMBER Wi7 DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/21/85 JOB ADDRESS 7371 Van Buren Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 21 4 Shaffer's Sub. #1 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE William Woytasek 7371 Sian Buren Street N.E. 786-•9.188 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Ej ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 22' x 141 Garage Addition 9 CHANGE QF USE FROM TO STIPULATIONS SEPAPATe P ER�1TS WIRING, �E RE lIl ,► '"�rd � "EA PLS P®i� 4 B'NG � ANI) SIGN S 4fl 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 Z, QNING 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 $3 754 $1,88 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- $44, 50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. AN CHECK FEE TOTAL FEE $46.38 SIGNATUe`RE NT�RACTORORAUTHORIZED AGENT tDATE) WHEN PROPER LI DATED THIS IS YOUR P RMIT BLDG INSP DATIr iGNATURE OF OWNER (IF OWNER B ERI (DATE) NEW [ ] City of Fridley Effective 4/1/84 ADDN._ [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address Legal Description 13"Pt'g e 'tz' Owner Name & Address: L L `� Tel. # 265"- flAg Contractor: �^ Tel. # Address: 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. o DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [KI Ft. Yd. Setback Side Yard Setback Type of Construction:ti�r�-� Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ ft32:� Z Alt. A Alt B See Back Page for Explanation DATE: '�� 0' �� APPLICANT: Tel. # 79C ' �'/2� CITY USE ONLY Permit Fee $ '7'y,S� Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ U $•50/$1,000 Valuation SAC Charge $ $425 per SAC Unit v Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by 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. . civil municipal planning environmental land surveying soil exploration For. Denotes Iron Monument O Scale 1* -50' i f Q) UcL n 6� u,,,� Certificate 0, JOHN P PERENCE Lo -r 21 — BLock `f' WIN SHAFFER S YU8,01 wil oN NUMBER C ANOKA COUNTY MINNESOTA INNESOTA / V I -- '-- 1 t4 R ti ,, r4� ♦J Lt3. z �3 v ♦ W � ;h s. /o 213 2 -- 6�•3 �`� -33.9 , t � • 1 UT/,.,Tr Ij'� EiufneNr We hereby certify that this is a true and correct representation of a survey of the boundaries of the land described above nd of the location of all buildings thereon, and all visible encroachments, if any, from or on said land, that this survey was Prepared by me or under my direct supervision and that I am a_duly Registered Land Surveyor under the laws of the State of Minnesota. As surveyed by me this __ 291"' -- - day of %luxe ____ _, 19-78 .. f/ovsE LacA7-ioq/, 09*f&sr LS, /97? ;" ,1 �7 a' ! 9 p.o. box j. osseo, minnesota 55369 (612) 425-2181 "9 G F'Je No � "•� U - /. Book---5��_?— Z by Page_._ —ZA0 Minnesota Registration No F-ete, P - DOS -2722 (9-85) PZ -02722-02 l'� _/P -Y4 STATE OF MINNESOTA DEPARTMENT OF HUMAN SERVICES 444 LAFAYETTE ROAD ST. PAUL. MINNESOTA 55101 r®_8.86 Date City of Fridley Zoning Authority 6431 University AVe. N.E. Street Address Fridley, MN 55432 City State Zip Code RE: ZONING NOTIFICAT-I�O/N OF APPLICATION FOR LICENSURE Subject: �Y N&ffie ofa Car Home Applicant ;7 Street Address City a State Zip Code Type of License: Family Day Care Group Family Day Care Licensed Capacity (� Phone No. 7s%-- 17/4f This is to inform you that we are in receipt of an application for licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of this license is subject to compliance with the provisions of Minnesota Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as the Public Welfare Licensing Act and the rules of the Department of Human Services. You should note that under Minnesota Statutes, Section 245.812, Subvision 3, a licensed day care facility serving 12 or fewer persons shall be considered a permitted single family residential use of property for the purposes of zoning. Subdivision 4 of the same section indicates that a licensed day care facility serving from 13 through 16 persons shall be considered a permitted multi -family residential use of property for purposes of zoning. If we do not hear from you within will consider the above-mentioned your local zoning code. Sincerely, Licensing Workdr Street Address 30 days after receipt of this letter, we day care home to be in compliance with COMMUNITY HEALTH & SOCIAL SERVICES DEPARTMENT COUNTY OF ANOKA COURTHOUSE, FOURTH FLOOR Name o A ency Organization City State Zip Code AN EQUAL OPPORTUNITY EMPLOYER suaJEcr PERMI City of Fraley 2 515 2 AT THE TOP OF THE TWINS BUILDING PERMIT • COMMUNITY DEVELOPMENT DIV. >r ----- �PROTECTIVE INSPECTION SEC. q, r � NUM9EN REv DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 10/8/98 JOB ADDRESS 7371 Van Buren Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 4 ISchaffer's Sub. #1 SHEET 2 PROPERTY OWNER MAIL ADORES* ZIP PHONE William & JUdy Wo tasek 8 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO American Bldg Contr. Inc. 12233 Nicollet- 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 0 ADDITION ❑ ALTERATION Qx REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 33 S Tear -off 9 CHANGEOFUSEFROM 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT $2828 $1.41 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 $74.75. Fire/SC C 2.83 PLAN CHECK FE TOTA FEE Lice 8C 5. 8 .99 SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT (DATE, EN R P 9L INSP VALIDAT HIS IS YOUR PERMIT / r,ATE S-GNATURE OF OWNER SIF OWNER BUILDER, (DATE, AUG -25-1998 09:16 FROM CITY OF FRIDLEY TO �L J ADDN [ ] CITY OF FMLEY ALM[ l SINGLE FAMILY AND DUPLEXES R-1 ANDIt 2)qDn BUMDING PERMIT APPLICATION ConstntctionAddress: Legal Description: - Owner Name Addre: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 7079925 P.01/02 hrrectave 1/1/98 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP'T'ION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: /2e7-120o1=Estimated Cost: (Fee Schedule on Back) 3, Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:APPLICANT: U T / O Tel. STIPULATIONS: CITY USE ONLY Permit Fee $ O • Fee Schedule on Reverse Side Fire Surcharge $ '9-5 .001 of Permit Valuation (1/10th%,) State Surcharge $ f $.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 - TOTAL ,.131 $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2000 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 ADDRESS "23_11 �+ RATE SCHEDULE_ OWNER �� l J u �� �'i�Sc�_�,�� Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ , (Side Vent - Fill Out Back) ESTIMATED COST L4sco PERMIT NO.� Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade NameCFX P- /97-:5 Size No. BTU HP EDR Air Conditioning - All Sizes $ 25.00 $ Fuel 0 o Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1%Q of Value of Appliance or Work BTU HP EDR Commercial/Industrial 1.25°J of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all'work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and repr stated in this application are true and correct. TOTAL FEE $ dll& Fbu g CM Lunt #Z0 ou DATE 9 - 0J 2700 IL NNIM k& MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEA�� REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed O"s TEL # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date written permission from adjoining property owner. 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 existing 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 At_trrt Appliance #2 Type BTU Input Fan A '#°�rt Appliance #3 Type BTU Input FanA foet a t Total Appliances Total Btu Input 423 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 CQ Signed By: Date Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da O DATE O l� V YOUR E-MAIL ADDRESS 1�50.'d@ a ennlr De • Ccm� SITE ADDRESS $ DO $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: O OWNER kaCONTRACTOR $1550 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: _XU93-S4 WN ft + 6 ft = ft x $21 = $ ADDRESS: CITY STATE ZIP TENANT Park Fee PHONE:? -La 3 ° d / NAME: Renewal By Andersen Fee Determined by Engineering CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West Total Due YOUR STATE LICENSE ADDRESS: Roseville, N IN 55113 j STATE ZIP WITH APPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/NEI 651-264-47.77 PROPERTY TYPE ❑ TWO FAMILY/NEW G ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING O OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: p�0,-(•� [ CA rt\) i1 I l SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES O ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: O DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, O Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structure Cl Other O Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1W U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S 1-6 Sy — OCCUPANCY TYPE Permit Fee $ 5D 19 See Back Page for Fee Schedule Plan Review $_ 65% of Building Permit Fee Fire Surcharge $ `� .001 times the total job valuation Surcharge $ V6 .0005 x Permit Valuation Minimum $.50 License Surcharge $ DO $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be it conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not . permit but only an application f a permit and ork is not to start without a permit; that the work will be in accordance with the approves plan in the case of all work whic r res revi and approval of p S. SIGNATURE OF APPLICANT R AME&dat �y�'Sc� tf�7 DATE r1� v I&