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PRE 2010 DOCSN0 23 No./z, —/ - � / Village of Fridley, Mum. Office of INSPECTOR OF BUEL DINGS Fridley, Minn., LOCATION OF BUILDING Block „ Addition or Sub -Division of DESCRIPTION SOF BUILDING v? Depth Height ' Stories —Manner of Construction— Front a s w To be used as �� Cdr g 14 To be completed 'U = t Estimated Cost ` R�r�' •�°�/x,��''� €v 5 f'l 'yy n Permit is hereby granted to the building—described in the above statement. This permit is granted upon the express coA41tion that the p rson to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon aid building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., 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. r _Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In cohsideraton of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permits I hereby agree to do the proposed work in accordance with the description above set forth a d according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby sate and say that the facts stated by me and contained in the above permit are true as therein stated, pft� Subscribed and I! �sworn to before me at Fridley, Minnesota, :-this Y ofE ,� PERMIT for Power Plants and. Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Aeating Plants to be installed—altered—repaired Make , Size Oil fired—,- Coal fired—, Gas fired ; Gas Authorization No Remarks d Approved Final Inspection Date , 19._ , Inspector Permit N° T 4536 Fee $ o Office of the Inspector of Buildings City of Owner Locatic Kind o City of Fridley How Occupied LeL-e Work to be Commenced ,19_ To be Completed—, 19— Estimated Cost, $ 9C7. 0--h Old -New, Building Permit No. Permission is hereby granted to C L L'V ^ 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 whom 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 mentioned 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, and to the specifica ' ns set forth in the approved application for this permit on file in the office of the Inspector of Buildings. � = Inspector of Buildings .11�42 2M11-wv SUBJECT P IT NO. City ®f Fridley 26935 AT THE TOP OF THE TWINS ry BUILDING PERMIT r ` v PT NO. i v �___�_' COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��� 6 r 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 �'� L 612-571-3450 910-F15 7/31/98 JOB ADDRESS 7514 Van Buren St 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 2 1 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Deann & Michael Glomski 7514 Van Buren St780-3985 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION) REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 24 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 80 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$2001 81-00 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 F -75 SIGNA RE OF CON7RAC ORA T O IZED AGENT IOATEI ROPE ALIDATE IS IS U PE M �- R9.SP SIGNATURE OF OWNER Q ER SUILOERI IDATEI TE NEW [ ] ADDN [ l ALTER ConstructionAddress : Legal Description: Owner Name & Ad Contractor: MN LICENSE # Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 a� BUILDING PERMIT APPLICATION �� Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. # DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE -AREA: Length Width Height Sq. Ft. DECK AREA: Le gth Width Hgt/Ground Sq. Ft. f �— OTHER: �� ,�� `r i c? 1-1 �� I - -o Construction Type: ����ttima"ed Cost: $ f '(Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:I ^ APPLICANT: l�'U �, L Tel. #T- �� 0 STIPULATIONS: CITY USE ONLY Permit Fee $ �'? Fee Schedule on Reverse Side Fire Surcharge $ 0 0 .001 of Permit Valuation (1/10th%) State Surcharge $ j. r% $.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 $ 0 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 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. CITY OF FR1DLEy INSPECTION DIVi510N 0 '6431 University Ave NE `1 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 - REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCIiEDi1LE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *,Air Conditioning • All Sues All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial./Industrial 1.25% of V@Iue of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State SUrc:harge TOTAL. FEZ 1 INtWM FEE FOR ANY HEAVING/CQOIN/VC-N 1 1 N REFRIGERATi N/AIR CQNDIT'IONING PERMIT IS5?5,00 FLUS THE 5.50 STATS SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, Effective On May 10, 1999 JOB ADDRESS,�`In t iJcGn b un 6 -1 -- TOTAL -TOTAL BUILDING USED AS ESTIMATED COST -LU PERMIT IVO. L d .pE� RIPTIfl ® F�RIYACE Ably OR BURS $ No. of Heating Units Circle One (Stearn) (Hot Water) i $ Trade Name 9 Size No. BTU_ ,� HP Fuel___. ____ Total Connected Load Burner Tracie Name— - _ Size No. $� BTU--- HP EDR _ $ ' The undersigned hereby makes application for a permit for the work hercii specified agreeing to do all work in strict accordance with the City Codes z rulings of the Building Division, and hereby declares that all the Yaf t:� and representations stat€ d Ira tills application are tale and correct, �I MMY AM STACK VERMCATION yes (-Y No ( } The undersigned hereby vermes that the existing chimney or snack: Yes (,j No 1. Has been carefully examined Yes (.-�'No ( ) 2. Is free from rust or deterioration Yes No ( ) 3, Has no foreign objects ledged within Yes No 4. Is securely supported yea (-f No { } S. 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 bew, provided for water heater yes (-Y No ( } 8. Has combustion air been provided for water heater Yes (,j No ( ) Remarks: List ALTERATIONS Being Dore: HEATING CO: Signed Ey: Date: