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PRE 2010 DOCSVMage ®f Fridley, Bonn. BUHMING PERDUT No 4"72 Office of INSPECTOR OF BUMDINGS it -4 Owner Architect Builder Fridley, LOCATION OF DING No. 00' Street Part of Lot Lot Block Addition or Sub -Division DESCRIPTION OF BUILDING i Front Depth. !1 height �-!- _�) Storie Manner of Construction— To be used as 0,To be completed Estimated Cost Z L 0 Permit Is hereby gFanted to to the building described in the above statement. This permit is granted upon the express c6ndltloit n that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon Jaid 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. Inspector of Buildings. AGREEMENT AI"TD SWORN STATEMENT In consideraiion of the issue and delivery to mle by the Inspector of Bufldings of r, ridley of the above permit, I hereby agree to do the proposed worh in accordance vnth 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 anA sworn to before me at Fridley, Minnesota,is xx day of A.D. 19-1—t . �J �J Village of Fridley, Minn. BUILDING PFAWr N? �48 Office of INSPECTOR OF BUHMINGS II Fridley, LOCATION OF B ING Street Part of Lot, Block M. Addition or sub -Division /1-11[ DimcRipnoN OF BUILDING C lrrontDcpth�,.- �L�' Height- Stories Manner of construction To be used as To be completed Estbnated Coat 4 is Permit is herebyd,to If the building— 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 I around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of FrldleyI, 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. _.'!_-=1aspector of Buildings. li I f AGREEAUMNT 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 jIstated. Subscribed aid sworn to before me at Fridley, Minnesota this 1 1 day of A.D. 19-L-7- s /5-j City of Fridley, Mian.. No 0 i Q 0 BUILDING PERMIT Date: June 12, 1970 Owner: _ Terzy Hes Builder Same Address _ 7600 Van Buren Street Address Same LOCATION OF BUILDING No. 7600 Street Van Buren Street N.E. – Part of Lot Lot R Block 2 Addition or Sub -Division .__ Schafers Subdiv. #1 Corner Lot _ Inside Lot ..._..X Setback —-- Sideyard Sewer Elevation _. Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 20 Depth 22' Height 10, Sq. Ft. 440' Cu. Ft. 4400' Front Depth _ _ Height Sq. Ft. Cu. Ft. Type of Construction Frame Est Cost T $l,_500=0_0__ To be Completed 4 Months Provide Hardsurfaced Driveway Maintain Grade equivalent to existing slope between street and dwelling. In consideration of the issuance to me of a permit to const the proposed work in accordance with the description above set ordinances of the city of Fridley. i I above, I agree to do with all provisions of In consideration of the payment of a fee of $ 9.00 ( , permit 4 hereby granted to Terry Hess 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 violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the condtruction, installation for wiring, phnabing, gas heating, sewer or water. Be sura to as the Building inspector for separafid permits for these hems. APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S //as 5 BUILDER: ,S q M 6— ADDRESS : 7,�( 14A) BUZEA) SF—, ADDRESS: SAM e NO:.. 26 O STREET • V A N Is" LOT: BLOCK: ADDITION:� / CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYARD: 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: ARA6E_ Front • ® Depth: —Height: Square Feet: 11,V O Cubic Feet: Front: Depth: Height• Square Feet; Cubic Feet.- Type eet:Type of Construction: FkA-v?E_ Estimated Cost: $ To Be Completed: �o The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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 plication are true and correct. DATE:' SIGNATURE:— (See Reverse Side For Additional Informati It r N. 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 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 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. City of Fridley, NUmn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 111U"ING PERMIT Owner: Mx !rerr3; Hass Builder Same Address - 7600 Van_8uren_St-reei- N.E. Address Sams - LOCATION OF BUILDING I 7hnn Street an B rAn qt1pet Part of Lot Lot .8 Block - 2 Addition or Sub -Division - Shaffer's Subdivision #1 Corner Lot Inside Lot X Setback —..... Sideyard _ Sewer Elevation Foundation Elevation _ -- DESCRIPTION OF BUILDING To be Used as: Addition Front 9 Depth 10' Height 10' Sq. Ft, 90' Cu. Ft. 900' Front . r Depth Height . Sq. Ft. . Cu. Ft. Type of Construction Frame Est. Cost — 850x-00 To be completed May, 1972 In consideration of the issuance to me of a permit to construct the b escri 6d ove, I agree tq do Abe proposed work in accordance with the description above set fa with all provisions of ordinances of the city of Fridley. . .50 State Su c In consideration of the payment of a fee of $_5.-_00 ,rmit is herkby granted to Terry Hess to construct the building or addition 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 ftdley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings Within e city limits and this permit may be revoked at any time upon violation of any of the provisions of said /f CLARENCE BELSSLE NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to No the Building Inspector for separate permits for these items. V APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: XBUILDER: ADDRESS: ADDRESS: 5� �NOJ. STREET: �/ CJ`) LOT: BLOCK: o? ADDITION:��ttf F/C�� �S� CORNER LOT: INSIDE LOT:%SETBACK: SIDEYARD:rte 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 : Depth: Height: 1j_Gvy—e_ ao- Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: n, 'estimated Cost: $���-� To Be Completed: 7-Z 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 reby declares that all the facts and representations stated tllis�a cation are true and correct. DATE: SIGNATURE: G (See Reverse Side For Additional Information. 9_') --�' ,may rr _r .04 BUILDING PERMIT FE`S 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 azolid i. 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 ® $1.55 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 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 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. do 7- p q 5 Tl ,� 7-0 14 C TO Tle TO. W- 316 Y / / / SUBJECT- P MIT Nrp O. City of Fridley ® 14016 AT THE TOP OF THE TWINS BUILDING PERMIT EC PT NO. COMMUNITY DEVELOPMENT DIV. 1 t PROTECTIVE INSPECTION SEC. t . � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 4/21/77 JOB ADDRESS 7600 Van Buren Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Hess 7600 Van Buren Street N.E. 786-7328 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 1j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 23' x 10' Addition with basement 9 CHANGE OF USE FROM TO STIPULATIONS REQUIRED F#. MIS WARNING SVRAPERMITS ®afore ftft Cd MW a ties HEATIN'�E EATIf�G. PLUMBING AND SiGN�., TELEPHONE - EUCTRIC US Etc. REQUIRED RY LAIN TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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, $4,000 $2.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $24.00 PLAN CHECK FEE TOTALFEE $26.00 SIGN UREO ONTRACTOROR T RIZED T(DATEt HEN PROP RLY VALIDATE THIS IS YOUR PERMIT hLDG INSP DATE " SIGNATURE OF OWNER (I OWNER BUILD R) Y / / / CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: 4F-1 BUILDER: �7 e_-� Address: 7(o d Q V �� �j,�,vti �,,` , Address: Tel. No. No. �(�, o -V Street • LOT: 7r BLOCK: ADDITION: o -i -4 IJi(it.Pr s / CORNER LOT: INSIDE LOT: SETBACK: 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: 3 Depth: 10 Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: /Ll�- �Estimated Cost: $ 27-1 To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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 representatiorg, stated i this application are true and correct. See reverse side for Aditional ormation. DATE: /-7 % SIGNATURE: Stipulations: r 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 $11.75 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 $15.40 jul""Sunjimma•• • 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 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 $7.50 plus $.50 state surcharge. 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 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. 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. rage i OX 4 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: DATE SITE ADDRESS: 6'° '� d l� I fJ PHONE: CONTRACTOR: 06 Determine working square footage of each / 1. Total exposed wall area...... V® 9 , a sq. ft. x .17 2. Toal roof/ceiling area ...... 4:�)sq. ft. x .05 = Total exposed wall area above floor = a. Total wall window area ................................. �® b. Total door.area ............. 3 �° c. Total sliding glass door area d. Total fireplace wall area ............................. e. Total• wall framing area (average 100) .................. f. Total rim joist area .................................. f g. wall area above floor .......................... h. wall area above floor..........................®a i. wall area above floor .......................... j. wall area above floor......... .................. e. X "U" /713 X fluff h. I? X fluff i. X "U" _ j. X "U" s gee = / k. X "U" 1. X "U" 3. Total d 3f tem #3 is the same as, o less than item #1, you ave met the intent of SBC 6006 (c) 2. Total exposed foundation area = 2 14 k. Total foundation window area ........................... �e 1. Total net foundation area above grade ................. Determine "U" value of each wall segment (e.g. window, door, each separate wall section) a. ! X, fluff b. X fluff V �g C. X "U" _ d. X "U" _ e. X "U" /713 X fluff h. I? X fluff i. X "U" _ j. X "U" s gee = / k. X "U" 1. X "U" 3. Total d 3f tem #3 is the same as, o less than item #1, you ave met the intent of SBC 6006 (c) 2. Exterior Envelope Average "U" Computation Total exposed roof/ceiling area = M. Total skylight area ............................ n. Total roof/ceiling framing area (average 10%)... o. Total net insulated roof/ceiling area........... Determine "U" value for each roof/ceiling segment M. X "U" n. X "U" o. X "U" _ 4 ........................... Total = Page 2 of 4 If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006 .(c) 1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2- 1. + 2. 3. + 4. _ WALL SECTIONS NOTE: Use 10% of opaque wall area for frame construction FIG. #1 TOPVIEW OF FRAME WALL talphe a1 7 1 E3G. #3 y % Page 3 of 4 n Construction R -Value V 1. Interior air film 0.68 2. 3. ® 4. . 5. Q 6. Exterjor air film 0.17 Total 1. Interior air film 0.68 2. 3. . 4. S. 6. Exterior air film 0.17 Total 40 -.0 1. Interior air film 0.68 2. 3. -�- 4. - 7) 6. Exterior air film 0.17 Total .- . ��. 1. Interior air film 0.68 v.. 2. 3. 4. 5. 6. Exterior air film 0.17 Total a v, Tit .�„ .• i .. ��.. Fir; #4 !!( t� • • • O r /Il �u Y • /�(= ��/ -• Int f. NOTP.: Indicate type, "R"•value, depth and placement of insulation. - _ .... TIM. cuvw ft UL q ROOF/CEILING Construction R -Value 1. Interior air film 0.61 2. 3* 4. Exterior air film (still) 0.61 VEJJT Total Vented Heat flow up FIG. #5 1. Interior air film 0.61 2 3. 4. Exterior air film (still) 0.61 Total L-J\Iil L-�Zj L-� jj L -U+ Pleat f 101.7 up .•vented •FIG. #6.. 1. Inside air film 0.61 2. 3. tQ 4. 5. Outside air film 0.17 Total Note: Use additional sheets if more space is needed for details and calculations Heat flow up Pxr,. 07 SUBJECT P IT NO. City of Fridley 2 6 7 AT THE TOP OF THE TWINS BUILDING PERMIT r CEIPT NO. COMMUNITY DEVELOPMENT DIV. I L PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/23/98 JOB ADDRESS 7600 Van Buren NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 1 Shaffer's Sub. #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donna Hess 539-0212 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton Johnson Co. 525 Lowry Ave NE Xpls 55419 781-9548 2083 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N0, 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION N REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Shed, and lean-to garage, Reroof house and garage 20 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 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 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 1668 .83 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 PERFORMANC OF CONSTRUCTION. $54.00 Fire SC $1.66 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$61.49 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE®Nyp��PROPS VALIDATED THIS IS�YYOJU"RA/PERMIT a'6/ -1 B DG INSP GATE _ SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW Effective 1/l/97 ADDN [ CITY OF FRIDLEY ALTER [XI SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 7600 Van Buren N. E. 1,6 Legal Description: Owner Name & Address: Donna Hess (same) Tel. # 539-0212 Contractor: mi i ton Johnson Co. MN LICENSE# Address: 525 Lowry Ave. N.E., Mp1s. 55418 Tela# Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IlVIPROVEME\TT 2083 7819548 Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width H Ground Sq. Ft. Roof house, shed, garage, Construction Type: and lean-to on gararagEstimated Cost: $ 0 (Fee Schedule on Back) Driveway Curb Cut .Width .Needed: Ft. + 6 Ft = Ft x $ - — $ 161656 DATE. 223 APPLICANT: Tel. # 7-81-954-8 CITY USE ONLY Permit Fee $ ay0Q Fee Schedule on Reverse Side sire Surcharge $ �, �v .001 of Permit Valuation (1/10th%) State Surcharge $ L2 $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge' $ S-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 �'r11'ULATIO,NS: N BU11,n1NG PEWMIT FEE SCHEM.11.1,. The Chief Building Official sliall, 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 S62.25 for first S2,000 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 $1()0,000 $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.tthe first $500,000 pias $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. f ternate "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 crrnits for construction will be issued a minimum of 24 hours from the time of'application to Off" w for proper :view of' the proposed structure and of the construction site. . e:rtiticate of Survey of the lot, showing the location of"the foundation once it has it has-been constructed h., required bCi()rC Xvith the frtmin- WELL OR BORING LOCATION MINNESOTA DEP TMENT OF HEALTH WELL AND BORING SEALING RECORD Minnesota Well and Boring Mating a unique H--164691 Water Supply Well LJ. Montt. Well ❑ Env, Bore Hole ❑ Other _.. County Name -�- -i-- - -- i Minnesota Statutes. Chapter 1031 Well No. or W -series No. E CASING TYPE(S) - �-- -i-- -;-- iL�UwdtItMiii—) Steel ❑Plastic ❑Tile ❑Other Anoka 1�mife CASING(S) Diameter Depth Set in oversize hole? Annular space initially grouted? Township Name Township No. e No Section No. Fraction Ism. -t. Ig.) Date Sealed Date Well or Boring Constructed Frid1e 30 1274 11 NE N`E N 7-12-00 of perforator ❑ Other Numerical Street Address or Fire Number and City of Well or Boring Location _ 7600 Van Buren NE, Fridley Depth Before Sealing 25 ft. Original Depth ft AOUIFER(S) STATIC WATER LEVEL -St Show exact location of wen'or boring Sketch map of well or boring in section grid with `X-. location, showing property Single Aquifer ❑ Mulhaquifer �, N lines, roads, and buildings. Measured ❑ Estimated WELL/BORING S f note ' PRO ERTY OWN9-P Gonna NAME Hess li Water Supply Well LJ. Montt. Well ❑ Env, Bore Hole ❑ Other _.. � 2 It. N below. ❑ above land surface -�- -i-- - -- i -' . W E CASING TYPE(S) - �-- -i-- -;-- --�-- Steel ❑Plastic ❑Tile ❑Other 1�mife CASING(S) Diameter Depth Set in oversize hole? Annular space initially grouted? I t S f note 11-4 in. from 6 to 2 2 ft. ❑ Yes :j No ❑ Yes ❑ No ❑ Unknown in. from to h. C] Yes ❑ No ❑Yes E] No ❑Unknown in. from to ff..❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ` PRO ERTY OWN9-P Gonna NAME Hess Property owners mailing address if different than well location address indicated above. 3 3 5 S h e r w ood C t Circle Pines, M Ni 55014 SCREEW/OPEN HOLE Screen from 22 to 25 It Open Hole from to ff. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill CKNO Obstruction Type of Obstructions (Describe) Obstructions removed? ❑ Yes ❑ No Describe WELL OWNER'S NAME Wen owner's mailing address if different than property owner's address indicated above. PUMP Type ' ElRemoved [X Not Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO FORMATION If not known, indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: _ o Annular Space Exists ❑ Annular space groutedwith tremie pipe ❑ Casing Perforation/Removal in. from _ to ft. ❑ Perforated ❑ Removed . _ in. from to h. ❑ Perforated ❑ Removed Type of perforator ❑ Other _ GROUTING MATERIAL(S) (One bag of cement = 94 lbs., one bag of bentonite = 50 Ibs.) Grouting Material Nt Cmt from 6 to 25 N yards 1/ 2 bags _ from to ft. yards bags from to ft. yards bags from to-- ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑ Yes X] No How many7 LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or borinn was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is true to the gest of my knowledge. Mork Well Co., Inc. 7 02658 Contras r BusinNarne ® License or Registration Pio. 7-12-00 Authorized Ra esentative Signature Date Ron Danielson (MINN. DEMI: OF HEALTH COPY 11 q Name of Porson Sealing WeN or Boring HE -01434-05 IC# 140-0423 4/99 R CITY OF FRIDLEY PERMIT NO.: 2004-00472 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 04/12/2004 572-3604 FAX: (763) 571-1287 ADDRESS : 7600 VAN BUREN ST NE PIN : 113024110064 LEGAL DESC : SHAFFERS SUB NO 1 : LOT 8 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. MOVE 200 AMP OVERHEAD SERVICE # 101+ AMP CIRCUITS 14 APPLICANT SCANDIA ELECTRIC 17491 OLINDA TRL N MARINE, MN 55047 - OWNER BRIAN & ERIN, BENESCH 7600 VAN BUREN ST 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 worl 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. STATE SURCHARGE, ELEC FLAT 0.50 ELEC AMP SERVICE FEE 30.00 ELEC CIRCUIT FEE (101+ AMPS) 55.00 TOTAL 85.50 PAID WITH CHECK # 2594 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. W Building MECHANICAL P$IlXlkt Inspections RESMENTIAL AP'PLICATTON ReOdved Oy: �:' 763-572-3604 CITY OF FRIDLEY Date R.eeld: l DATE -10 `O6 YOUR EMAIL ADDRLSS __ � �TOT� K MU d! �• CGL% %1�M�1 I SM ADDRESS � 1v � D Mt ft 1nu E% -M 5- ' . i,.3 r t THIS APPLICANT IS: 13 OWNER ONTRACTOR PROPERTY NAME, MI?Af %'.b -- OWNER/ ADDRESS: " 7c too \/An loot -en. Si. me • (.rrY E r•; t} 1�-` 4� _... ,- ^ ^ 3TATG TENANT PHONE; % 6s'3— �7) � — A �� � CONTRACTOR COMPANY NAME: 'eV - ' A& d � c+ clsakrjuq Servms S'URW A COPY O}' It CONTACT PERSON sowam YOURSTATI ____ STATELICENSH#8_*944 . -4. i NNI DATE _.1�]+�1 it +f-OMW) LICENSE WITH! ADDRESS: S 162L For ft r+4w Oy- N) CtTY..�t}�.d STATEAW ZIP=2O APMICATION FAX IPS i ' 0-7 &Solo p, T TYPE .11901.2 FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK; O NEW /P-1PIACFAflWrO ALTERATION/REMODEL ESCRIPTION OF mr- A / c - DETAILED DWORK_ PER MS 16B.665 the permit Ike is a minimum of $15.00 or 51/16 of the total cost up to $500.00, whfohever is grater, for the improvemea. installaticm or mplacament of a residential fixture, excluding dee fixtures. (Thus should reflect only the cost of labor) Labor cost under $300 - $15.00. Labor cost between $300 to SSW s cost of labor x .05 = FOR PROAk7i S WHERE LABOR EXCEEDS $500, TEES ARE BASED ON $10.00 PFA FIX'1 LWE. EXCFYr WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH HEIDV T) Equipmwl Ifs caf o MrQ Flt; ti MODEL: HIANO?5 F1Dr� 1 smawm 7C coo $TU MEG: gel 'i MODEL: AQ K.A 10 SI2F113TU M,acs MFG: MODEL: Size/BTU ,ZAIC $25.00 ,_,,,FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 „_,,,AIR Ta Alit BXCHANCF.FR $15 FIRUPLACE (WOOD) $35.00 NEW OA$ GRILL $10.00 GOILER $35.00 FURNACE $35.00 GAS UNIT TITh $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 _Pani. HEATER $35.00 DUCT WORK $10.00 ..GAS PIPING $10.00 _VENT.ILATOR $15.00 PERMIT FISP. PROJECTS FOR UNDER $S00 PERMIT FW POR PROJECTS OVER $500 Permit Fee $ 'Number of fixtures 1 $10.00 x $10.00 = $ Surcharge $ - _ -_ SO _ Number of ftwes @ $15.00 x 515.00 = S TOTAL DUE 5 � _ Number of fixtares (a 525.00 = x $25.00 = S 'r = Number o€ftewas @ $35.00_ x $35.00 $ State Surcharge - $ SO Total THIS IS AN APPLICATTON FOR A PERMIT -NOT VALID UNTIL PROCE,9SM I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will bs in con&rmance with the ordinances and codes of the City of Fridley and with the Mimmota. Construction Codes; that I wdwitatld this is not a permit but only an application for a peruelt and work is not to start without a pannit; that the worst will be in accordance with the approved plan in the case of al) work w i h rewires re ' vend approval of plans. ` SIGNATURE OF APPLICANT 9 PRINTHAMS 9664 g r i 10 --0 6 PLEASE NOTE: SEPARATE Pgpjv • ARE REOMRW FOR BUILDIN EL••,EC'nWAL AAIB ArlECHAMCAL, WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 Wt/ SZ:Ob:6 6 900Z/6 W:9120 V/ :eBed umouNun :wotj