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PRE 2010 DOCSCity_ of Fridley sueJEcr PER 13381 AT THE TOP OF THE TWINS P, BUILDING PERMIT Ir CEIPT No. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . , CITY HALL FRIDLEY 55432 j NUMBER REV. DATE 2/19/76 PAGE OF APPROVED BY -'-' 612-560-3450 910-F15 JOB ADDRESS 5660 Vest Danube Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 3 .I Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John N. Nelson 3096 Cleveland AvenueN. Roseville Mn 55113 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 Q, NEW ❑ ADDITION ❑ ALTERATION El REPAIR ❑ MOVE El REMOVE A 8 DESCRIBE WORK Construct 38 x 38 house with 24 x 24 garage NOTIFY THE FRIDLE 9 CHANGE OF USE FROM TO PIVISION REGARDING CURB REMOVAL AND RE STIPULATIONS Sewer: (approx. 9' deepi Y OPENINGS, 54' S of M.H. (S, INV. 942026) 1. Provide a hard surface Drive Wye Elev. 943.57 2. Provide a verification survey after capping Top of footing 946.97 3. Provide section through (minimum) and truss design (if applicable) WATER 71.5' S.W. of SAN. M.H. 65' N.W. of SAN M.H. Note: The City does not guarantee the accuracy of utility location. WANIAMV 6EPERATE PERMITS REQUIRED FOR WIRING; Before dieing Call focal utiliffei HEATING, PLUMBING AND SIGNS. TELEPHONE.ELECTRIC - GAS Etc. REQUIRED B LAW 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. 25012 CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 284XIN 9 209720 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET lit I -- 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, $35,350 17.68 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 PROVIS NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 48.99 350.00 THE PERFORMANCE OF CONSTRUCTION. STRU I NOFIFTH PLAN CHECK FEE TOTAL FEE ® $416.67 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN P PERL (DATED THIS IS YOUR PERMIT BLDG )NSP - DATE SIGNATURE OF OWNER (IF OWNER BUILDER)(DATE) 01 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : do %��6.5e BUILDER: ADDRESS ADDRESS: i'! r�5'/!� NO:. �b ® STREET: �DdA)e LOT:: BLOCK: ADDITION:�sh�.vc�' GARNER LOT: INSIDE LOT: SETBACK: 3✓ SIDEYARD: �✓��/%� Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: /�� °��r�r rz # Front: Depth: 30 Height: �® Square Feet: of 2— Cubic Feet: 26 ® % Z �. Front o2 -"y o7-' Height: lD / Square Feet; -5-79 Cubic Feet: �, Type of Constructio n-�e°m� Estimated Cost: To Be Completed:2,: 4 The undersigned hereby makes application for a pex-mit for the work herein specified, agree-ing to do all work in st-kict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: /7 SIGNATURE: (See Reverse Side For Additional Information.) b fo"i 9 ,Lr slz q (-� Ant J W a O$ 51 GN �� F ✓,�r®. -0- • d1a , 7 GEOTECHNICAL ENGINEERING CORPORATION 1925 Oakcrest Avenue Roseville, Minnesota 55113 (612) 36-7744 REPORT OF DENSITY TESTS OF FILL PROJECT: RESIDENCE ON WEST DANUBE" NORTH OF INNSBROOK NORTH FRIDLEY, MINNESOTA REPORTED TO: MR. JOHN SCHULZE JOHN SCHULZE EXCAVATING 2925 166th LANE NE ANOKA, MINNESOTA 55303 GEC JOB NO. 1022 DATE: MARCH 11, 1976 TEST NO. 1 2 FIELD DENSITY Test Method: Sand Cone, ASTM D 1556, (-#4 sieve basis) DEPTH DATE BELOW FIELD MOISTURE PROCTOR TESTED LOCATION FINISHED DENSITY CONTENT NUMBER GRADE _ {lb/cu.ft)Oercent) 2/26/76 SE Corner 1' 111.0 5.8 1 of Excavation 2/26/76 SW Corner 1' 114.8 4.4 of Excavation Test Method: Standard Proctor, PROCTOR SOIL NUMBER TYPE 1 Sand, medium brown (SP) Report Prepared By: Robert E. Pendergast, P.E. Minn. Reg. No. 8450 1 RELATIVE DENSITY (% Compaction 100 103 P ( R1R TOR) (-#4 sieve basis) MAXIMUM DRY DENSITY, lb/cu.ft) 111.0 OPTIMUM MOISTURE CONTENT, Percent 13.0 HYDROLOGY • SOIL AND FOUNDATION ENGINEERING • TEST BORINGS MATERIALS TESTING • PERCOLATION TESTING 9 ENGINEERING GEOLOGY • CONSTRUCTION INSPECTION CHI -y of PI°•sdIoy .- ------ Deprt. of B1dgz. Phone 5;*•3450 DEgCBIPTI01i O: Wor.r. Numbar. Kid ar.d Lotrlkn Of Fixt•-res TB4N •{Tj` TOTAL I I .. -. - x 52.00. Future Fixture Opening ........... - S .New Fixture Old Opening..... e • • • wAT[q wT,3. rAs [uG< x $3.25 $ NVater Iieater 'Up to 99,000 BTU).... x $3.40 $--- New Ground Run Old Bldg....:.... El•ctr'.e Water H&atar.....:........ �;,S FITTING FEES: NO. R;oTE TOOTA,,LL Ist 3 Fixtures ............ • • • • • • —+— x $2.00 $,_2 _4 Additicnal Fixtures ............... x $ .75 $ Gas R.z Ee to 199.000 Bail ........... :[ 55.40 b 3:d LLIS:h _ LL �,. • Fut'.:.-o C:.:r.a:::.'n Gp::nlr� vn�.Tor s 2tbv Fi_:u:n. Old 074=1r:cs Cc ;:.pool PARTIAL RATE 5vHEDULE LUMBING FIXTURE RATES: NO. RATE TOTAL $—.Z.1 - 1 'Future Nwr,ber Fixtures ........... ... .. -. - x 52.00. Future Fixture Opening ........... x SI.50 S .New Fixture Old Opening..... e • • • x SI -50 Catch Basin ..... ............... x $3.25 $ NVater Iieater 'Up to 99,000 BTU).... x $3.40 $--- New Ground Run Old Bldg....:.... El•ctr'.e Water H&atar.....:........ �;,S FITTING FEES: NO. R;oTE TOOTA,,LL Ist 3 Fixtures ............ • • • • • • —+— x $2.00 $,_2 _4 Additicnal Fixtures ............... x $ .75 $ Gas R.z Ee to 199.000 Bail ........... :[ 55.40 b N� 6 ee City of Fridley... The undersigned hereby makes application for a permit for the mork herel specified, agreeing to do all wOrdinance work In strict accordance with the Cit? and ruling of the Department of Build;ngs; and hereby declares that all L'u fad and representations stated in this application are true and correct' Fridley, Minn 3 —2�3 1��• Owners Kind of Building Used as 40 To be completed about Estimated Cost, $ AMC) Old --New. Building Permit bio. P+rmit No. Signed _+ By --- - BusinuK.s Phone No1-�/...,1-- ROUGH FINAL 2- P.:.'??►:qS t; ALTEF.ATIONs—Rafer to, Coda .so state s=cha--ge .De;criyL'on •..•..........•>•.......•..... •..«....►..� ^ ., v _ A _ g•.�14:t',. �r;n-�!•a Gx.+... ^� t•.�+a r' ^^..,!yam /T �!L[ Igo �^...,- .�.-,.�•} p/�/'� Z'�, •.. �..� !s•, �c•�.n .,..r .en �.1 rr •-. C,^........,A Y:.� t+w� s•`'u� a. d7'OsW IC.v 9'S i`.+.'� A�ei Cb'4tii 4e .--o ca• tii:ii•-•tl ¢a...E��•.r �� `ba�W�o-3•l:•�Q irl.o:' r�.:.G �a_+asg �s��•�v.64.5�� cs�'-t.0 yJP»�^�M .....�Z....� KDn�•Awn.T I.!^AR. .�.. A•' -•fir, 4n.+ Gro�F3 �v:•em.s�:.aat+,��_iaK, s$BTJ6C.atc.:+ as..34H .v..:b•b�::.0 - PARTIAL RATE SCHEDULE t;RATITi WAP -14 AM: RP% 47 TOTAL 71=1ce SlxlI & D -art Wort 110.00 Rep'.b.�emcnt o; a sraare 6.00 A;;c at.ons-- up to S-500.00 600 S Re -pa: --s & :fit•^ra:ions each add. 5500.00 30c1 $ F1:: -ice Shcll & Dert Worm to 12.0,00.0 BTU e -,-ch zdv. £0.C7J BTU Pep's-c-n�mt of a um:ce 6.00 S Rmpair-s & Alrte-atiorz—up to 5500.00 6.00 $ F; --sirs It Altertiotis each add. 800.00 3.00 a 3T.AM or HOT WATTR £YSTi Id r -rnace S`:e:l & L mes-_to 400 sq. tt F'.DR Ste= V0.00 a Furnace Shell & Line ---to 640 :q A. EDR 1?ot Water 1000 S. Each add *) sq. ft EDR Steam S on '7z& add. 320 Sq. ft EDR Hot iRafe: 3.00 S OIL BUPNc:c:—to 3 gal. per hour 6.00 S. over 3 gal. per hour—See Tee Schedule &--ev GAS BUIRKiri (up to L"•9.000 ETU) 8.0.0 3Q...— r TCM C{0 BTU S" rte schQd l e GAZ FITTING 210" RATE TOTAL 1st 3 Fixtures xm 200 S' CJ i) Additional nt rtums x .78 S_—• -- Gas Range =a LIP _= x$ 8.00 S A.M CC=,-iO4SI.'Car AL:..iF:9'ivi+$ «� I'_EP3i:Y'L3 State Surcharge .50 Sze rCQ Schodmlo TOTAL 1 n,pt. of MoLI _--V.M City of FridFey: fi The underslgncd hereby makes application for a permit for the work herrir specified agrc-ving to do all work ,n strict accordance with the City Ord:::,- ev and rt>>ing.of the Department of Buildings. and hereby dccl :es L'iat all the fad and reur.rsentatiuns stated in this applfration are true and cc re•ct.. Owre Kind Used To be completed about Estima?ed Cost; S Old—New. Building Permit No. -•-- --- Perffiit 130._ OF W Sax R ATING os FOWd'R ' s.PiNTz5---Stra_n, Frt Fats, Warm Air --No Trade Names- Size CapacityD4 — Sq.�F'L. I;.D.R B'4 UU Total Connected Lid XL -4 of r`t= BURNER — Trs4e Nome Size No c2pocity SCI. 1I4. Z.D R II'%il g-aeaatzs Dual it'd YO. 560-3450 Cit of i7riallecy ANOKA COUNTY 6431 UNIVERSITY AVENUE NE August 9, 1976 FRIDLEY, MINNESOTA 55432 Kletschka Electric & Sons, Inc. 1201 Cannon Circle Fairbault, Mn. 55021 Re: Electrical Corrections at 5660 West Danube Road N.E., Fridley Dear Sirs: An inspection of the above address noted that there was no G.F.I. Protection provided nor is there an outside receptacle provided as required by Code. We will expect these corrections to be completed by September 1 and a reinspection called for. If you have any questions on this matter, please feel free to call on me at 571-3450. Sincerely, LEONARD'EICHMILLER Electrical Inspector LE/mh CC: John Nelson CITY OF FRIDLEY APPLICATION FOR PW14BING AND GAS FLTTm PERMIT +1 ~ Nb s7 • O .a t 1a i0+ c .0C 1 pec 0 O M. a e OM v w x C U .ui A y 6v 3 ,� .� t! mit d' 0 S R U Y Mater Heater, Suer Dispenser - leC 4.00 i® slow off Basin = 5.00 ; Catch sarin t 5.00 : Rale water Leader i 5.00 =�_® Hydraulic valve �— s 5.00 1st Kamp or Receiving 'tiaik 1-5-00 Mater Treating tppliwnoe $ 7.00 Not Mater heater - S.00 Gas Range $ 10.00 a hni $ 10.00 g ALL OTHERS A06/02 MWAIRB AND ALTERATIONS Is of value of ristere.or Appliance g U® State surcharge Rainspaction tee 8 $ O (,415.00j TOTAL PER S 3rd 4th IR1 - Future Connection Opening I°I . New Fixture, Old qpsaing amiectsd with Serer Mater RATE SCIIEDULE PLUNBING FIXTURE RATES: NO. RATE TOTAL Now Flateret _00 rotor* Pi:tures a 3.50 Old Opening, Row Fixture _ 1. So ; Suer Dispenser - $ 4.00 i® slow off Basin = 5.00 ; Catch sarin t 5.00 : Rale water Leader i 5.00 =�_® Hydraulic valve �— s 5.00 ; Kamp or Receiving 'tiaik 1-5-00 Mater Treating tppliwnoe $ 7.00 Not Mater heater - S.00 Gas Range $ 10.00 a Cas Dryer $ 10.00 g ALL OTHERS A06/02 MWAIRB AND ALTERATIONS Is of value of ristere.or Appliance g U® State surcharge Rainspaction tee 8 $ O (,415.00j TOTAL PER S MtODUVO aY#.. 1, 1-991 Job Address Department of Buildings City of Pridley } Tel. #571-3450 The undersigned hereby makes application for a permit for the rash herein . specified agreeing to do all fork in strict acootdance with the city codes >- and rulings of the Departomn,,of Bu--ldings. and hereby declares that all the facts and representations stated in this application are true and correct` idley, M. • 19 0=R -V KIND OF BUILDING WED AS a IM BE CONPIR ED Apart ESTINA"M COST OLD -NEM sU:LDING PEIINI2 ■o.Le raw" No.. l0� °742 RIMNE AIBP. I s 1--jCl CU -ll �' Bate rum nap. Date APPROVAL. FOR PERMIT MINIMUM PER FOR ANY PUMBIk PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARM SUBJECT PER City ®f Fridley `2 219 5 AT THE TOP OF THE TWINS BUILDING PERMIT r r No ' • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 3 [�7 oq CITY HALL FRIDLEY 55432 NUMBER REY. DATE PAGE OF APPROVED BV 612-571-3450 910-F15 10/19/93 JOB ADDRESS 5660 West Danube Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 3 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brad/Mary Carlson 5660 West Danube Road NE_ 574-9570 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 ❑ ADDITION Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK New kitchen cabinets and countertop 9 CHANGE OF USE FROM TO STIPULATIONS provide smoke detectors as per UBS 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,000 $1.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $45.00 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $48.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHE ER ALIDATED THIS IS YOUR PERMIT "BLDG INS DATE SiGNATURE OF OWNER IIF OWNER BUILDER) IDATEI Prepaid Plan Check $ Estimated Cost $ Receipt # 376{ Y.. i_ -_"-_%j Z •: It Effective 5/26/93 TYPE OF WORK { ] New f] AdditionAiteratian -Dasa ibe i 4c cam,.. - � Applicant Signature # S74- 4 s7 o Date `O - l _q- g 3 Length Width Height Sq. Ft. # of Stories OFC. AREA: iaangth Width Height sq. Ft. WHSE ARFA: Iax th Width Height __._ Sq. Ft. OMM AREA: %wgth Width Height sq. Ft. tATIMITM x $ Cost/8q. Ft. = Valuation $ ) sq. Ft. x $ Cost/Sq. Ft. = Valuation Sq. Ft. x $ Cost/Sq. Ft. = Valuatim $ ) TUML VALUE Ara i l di ng use Construction Type Occupancy GrOUp Air CmWticniM []Yes []No Fixe Protection Provided []Yes []No Performance Bond Amount $ See Reverse for Schedule R®oeived [ ]Yes [ ]No ppb Permit Fee $ 45, See Fee Sc he&de on Reverse Side Plan talc Park Fee Spec. Asees.�n�ents $ Dri'vewa`y Escrow $ � TOTAL In M cess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $•50/$1,000 Valuation (See schea. for > $1 Million) $750per SAC Unit (Plans to 1NC7C for determination) $450.00 Corwervatic n Plan Review feet x $13.50/foot CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICESI�I� �� ® ��v ��2 JOB ADDRESS y� �.IJ) , RATE SCHEDULE ..;,The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work In strict accordance with the City Codes and Furnace Shell and Duct Work, Bumer - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $20.00 S'20,00 representations stated In this application are try and correct. (Side Vent - Fill Out Back) o 7 Gas Piping (Needed with new furnace) $10.00 $ OWNER 6fn � � � �� . ISO Gas Range $10.00 $ a BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST ,��®®� PERMIT NO.� *A1r Conditioning - All Sizes $10.00 $ All Others/Repairs & Atterations (UST ON BACK) 1% of Value of Appliance or Work $ DESCIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) arm Alr Trade Name Size No. Commerckrl/Industrial . BTU ?4 c3 HP EDR 1% of Value of Appliance or Work $ Fuel, (2at V Total Connected Load State Surcharge X60 Bumer Trade Name /,_�O Size No. TOTAL FEE � BTU HP EDR �` HEATING COMPANY e m s P 4 e MINIMUM FEE FOR ANY HEATING/COOLtNGNENTILATION RE.F IG9RTtONIAIR CONDITIONING PERMIT IS $15,00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Condidoners can not be placed in a side yard without written permission from adjoining property owner. Signed No. /�6 � 0 v - Approved Rough -in Date Final Date V-1717— FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes (�}�j No ( } 4. Is securely supported Yes ( No ( ) 5. Meets all current Code requirements for size and Notal BTU's connected YesNo ( } 6 Has total heating BTU's of ` o 000 All other BTU's TOTAL BTU's , U. 7. Has a liner been provided for water heater Yes No { } S. Has combustion air been provided for water heater Yes No ( ) Remarks: List ALTERAEM DS . DQM HEATING CO: Signed By: Date: SUBJECT P RIV - City ®f Fridley 25399 2 3 9 9 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT COMMUNITY DEVELOPMENT DIV. r 1 ~ PROTECTIVE INSPECTION SEC. NUMBER REV DATE 8/20/97 PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 �----A-If �'' 612-571-3450 910-F15 JOB ADDRESS 5660 West Danube Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 3 Innsbruck North . SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bradley Carlson 5660 West Danube Road NE 574-9570 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 ❑ ADDITION ❑ ALTERATION Ek REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) Tear-off 9 CHANGE OF USE FROM 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 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 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 $085 2 @1.04 `Y WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W 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- $74.75 Fire SC $2.08 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $77.87 SIGNATURE OF CONTR TOR OR H RIZED AGENT IOATE) WHEN PROPERLY V DATED THIS IS YOUR PERMIT BLDGF INSP f1ATE SIGNATURE OF OWNER OFOWNER BUILDER) IDATEI NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 18 P `+ a5:3-9�7 BUILDING PERMIT APPLICATION ConstructionAddress: 5" �-O UJ • �>allt t4lae PX t J i5- �� t P Legal Description: Owner Name & Address: P `�j oi. CM -"PS -w" Tel. # (& iz-) 974-- q 57 O Contractor: —__Ie I -F MN LICENSE # Address: N Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground _ OTHER: 12� mu� 2-5 s9P01Au-e. Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Sq. Ft. Sq. Ft. Sq. Ft. 4c G17 _ Estimated Cost:.$��%� (Fee Schedule on Back) _Ft 'x $ _ $ DATE: '/2,6 A 7 APPLICANT: Tel. # 5-74-4.5 STIPULATIONS: CITY USE ONLY Permit Fee $ �%�, Fee Schedule on Reverse Side Fire Surcharge $ c< 6) r-) .001 of Permit Valuation (1/10th%) State Surcharge $ /< D `q $.50/$1,000 Valuation SAC Charge $ $950 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 $—!22. 6 STIPULATIONS: Building Inspections 7.63-572-3604 DATE SITE -� ADDRESS_; THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER COMPANY NAME:_ CONTACT PERSON: STATE LICENSE #_ PHONE SINGLE FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK M YOUR E-MAIL ADDRESS ❑ TWO FAMILY EXP DATE FAX 76 LUL-* ❑ TOWNHOUSE ❑ ALTERATION/REMODEL Permit No.: Received By: Date Rec'd: lb Q PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) I MODEL: CL d SIZE/BTU � Equipment Installed MFG: � N SIZEIBTU MFG: MODEL: SIZEBTU MFG: MODEL: _FIREPLACE ( )(AIC $25.00 (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GASNEW GAS GRILL 0.0$10 00 _BOILER $35.00 _FURNACE $35.00 _GAS HE HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER 154..1S35 00 DUCT WORK $10.00 GAS PIPING $10.00 —VENTILATOR $1500 �?� _ .,,,. �,1C F ' iC+iCtL� ''.. k.Jil �7�;, i✓a�acjPpaarur,+�v�a: �� Svc ..�.� c�.sr . � r, �,..._ :.�,�� , x_ - _ __ Permit Fee $ • e>lp Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $•. Number of fixtures @ $25.00 _� x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 in conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case o all wor requires revie and approval of pl s. SIGNATURE OF APPLICANT PRINT NAME SO.J DATE City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel TMC Chapter 7 with MN Amendments b. Natural Gas or PropaneffGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances TFCC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction TMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACOA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations