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PRE 2010 DOCSENERGY REQUIREMENTS ,This form to be completed and submitted with building g permit applications r EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER ,l%Lnn *A. k-"! N Go S 4 SITE ADDRESS W_ t\1W c) iR CONTRACTOR A DATEAc< Il Iff'VHONE, 5- 21 .35/4 Determine working square footage of each. I. Total exposed wall area ..... sq. ft. x ®l = e o Z LO2. Total roof/ceiling area .... 1760 sq. ft. x �`c = 'e Total exposed wail area above floor a. Total wall window area ........................... 4-- b. Total door area ................................... c. Total sliding glass door area .................... d. Total fireplace wall area ........................ e. Total wall framing area (average 10%) ............. f. Total net wall area above floor .................. 1 -7 g_ Total rim joist area I- Y, 4- 155 -rut;? CA- e Total exposed foundation area = h. Total foundation window area ..................... I. Total net foundation area above grade ............ !%it, Determine "U" value of each wall segment. 1 `J a. X $sun — m b. x "un = C. X e,�n B �� F '6�r ,'�— d. X "Un = e. X "Un = '07 f._L-- X "U" g. X nun h. X "lir a i. X nus � a V 3 ......................................... .Totes If item /3 is the same as, or less than item H. you have met the intent of 2 MCAR 1.6005 (4.3) Total exposed roof/ceiling area = J. Total skylight area ............................. k. Total roof/ceiling framing area (average 10%).... 1. Total net insulated roof/ceiling area ........... , Determine "U" value for each roof/ceiling segment. X "U" - k. X "U" _ 4..........................................Total = e-7 4 - If If total of #4 is the same as, or less than #2, you have met the intent of 2 MCAR 1.6005 (4.3.2.2) Alternate Building Envelope Design To utilize tht total envelope system method, the values established by the sum of items #3 and #4 shalt not be greater than the sum of items #1 and #2. L J a y + 2. a 1 = 3. + 4. _ ell— I IV � e `r � VVI OC40+1 4 Ir. SUBJECT PERMI City of Fridley 18170 AT THE TOP OF THE TWINS BUILDING PERMIT i • COMMUNITY DEVELOPMENT DIV. ?03/ PROTECTIVE INSPECTION SEC. i � I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 8/22/85 JOB ADDRESS 850 West Moore Lake Drive N .E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Shorewood 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delmar Kingsriter 850 West Moore Lake Drive N.E. 571-2427 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Interior Alteration in Dwelling and a 24' x 141 wifNx Addition 9 CHANGE OF USE FROM TO STIPULATIONS Finished lower level is for relative use only -- can never be rented as a separate living unit. 'SEPARATE FFA'117 R70YlRED FOR WIRING, KASI; G, PL MBING AND SIGNS. 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 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 1 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 000 $10.00 $20,000 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- $140.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 3.5.13 $185.63 GN TU OF CONT ACT 0 R A UTLO Rf DAGE NT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT . 3 f . IGNATURE OF O N IIF O ER BUILDER) (DATE BLDG iNSp Df7E TE 16r NEW I [ ] City of Fridley Effective 4/1/84 ADDN. [�` f R-1 AND R-2 ALTER. [14 Building Permit Application Construction Address: M®ORE L DAtI/L AA10L�yl Legal Description: - o Owner Name &Address: ZFJ m om >m6S R1 7'p- 4Q MrJE $ Tel. #,f?0 A VAL % Contractor: SM LX Tel. # Address: -4�r 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 _.L_l� Height ,� Sq. Ft. 6V- 23 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: .0ibl Corner Lot [ ] _zVUi I side [ Ft. Yd. Setback Side Yard Setback /Lot Type of Construction: [4*A1, kM*A Estimated Cost: Approx. Completion Date: %'�'VT Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: (Nr APPLICANT: A A.. Tel. # 3v4 d 44 CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: 71 1 S ��-� �a - 0 J6,S-,6e3 Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] L o v, �N, k i -5 U L b ,L",- T I UA a ASSEMBLIES of GOD P.O. Box 48377 DIVISION OF FOREIGN MISSIONS Nairobi, Kenya Area Representative, Eastern Africa UCAND Rev. Del Kingsriter P.O. Boz 48377 RUANDA Nairobi, Kenya BURUNDI TeL 512231 850 W. Moore Lake Drive Minneapolis, Minnesota 4432 August 20, 1985 Mr. Darryl Clark, Building Inspector Fridley City Council Fridley, Minnesota 55432 Dear Mr. Clark: SUDAN I am leaving two sets of plans for your consideration for the improvements at 850 W. Moore Lake Drive, as we discussed in your office yesterday. 0 SEYCHELLES 0 MAURITIUS Also I am enclosing a photocopy of the survey plan. You will note that there is a 9' 4" span between the corner of the garage and the property line, instead of the normal 10'. My mother-in-law has explained this survey that shows there was an adjustment of additional street footage given to Mr. Hayes, and additional lake frontage given to Mr. Hozempa. This was at the request of Charles Hayes, the resident at 840 W. Moore Lake Drive, enabling him to have a larger cement slab off the road in order to park a second vehicle. The 9.4 feet is at the front of the garage and falls very slightly away toward the lakeshore, as you can see, so that it may come very close to the 10 foot span where the addition is to be placed. You will also note that the 9' 4" span is not between the house but between the garage and the property line; and also that on that side of the addition there are no windows, as both the upper and lowel levels of the addition will be storage. Thank you for your kind consideration of this matter. Very since ely yo rs elmar Kingsriter DK mk Enc. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Oft Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Not Water Heater Gas Range Gas Dryer NO. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance Reinspection Fee $ (S1S.00) RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 S 5.00 $ 5.00 $ 5.00 $ 5.00 S 7.00 S 5.00 $ 10.00 $ 10.00 State Surcharge TOTAL FEE TOTAL ,w - S S .50 $11 .fo Ettective Aug. 1, i9ta Job Address � � . Ma j �� LSCT1 B /'gyp, l ® to d y Department of Buildings (✓ �` t fSs City of Fridley Tel. 0571-3450 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 9 Fridley, Mn. �, B 19 OWNER KIND OF BUILDING _, USED AS TO BE COMPLETED ABOUT v�oo ESTIMATED COST 4sw ♦ ®'Ci 70 OLD OLD BUILDING PERMIT NO. PERMIT NO. /�� • J=1�-._���Zl/L iii % .�►_;. ROUGH INSP. Date FINAL INSP. — jl Date APPROVAL FOR PERMIT !"' MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE A q Ir c b .0 A V a Mater •o a i0 0. w Neater 00,e "� �a( C t C i 8~ U ".Ci .0 R U U s7 m U D o$ a M 9 M O ow b 7 �0 M 9 N ul � U a w U�<s >� o ,as gler lot 1 d a 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (•) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Oft Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Not Water Heater Gas Range Gas Dryer NO. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance Reinspection Fee $ (S1S.00) RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 S 5.00 $ 5.00 $ 5.00 $ 5.00 S 7.00 S 5.00 $ 10.00 $ 10.00 State Surcharge TOTAL FEE TOTAL ,w - S S .50 $11 .fo Ettective Aug. 1, i9ta Job Address � � . Ma j �� LSCT1 B /'gyp, l ® to d y Department of Buildings (✓ �` t fSs City of Fridley Tel. 0571-3450 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 9 Fridley, Mn. �, B 19 OWNER KIND OF BUILDING _, USED AS TO BE COMPLETED ABOUT v�oo ESTIMATED COST 4sw ♦ ®'Ci 70 OLD OLD BUILDING PERMIT NO. PERMIT NO. /�� • J=1�-._���Zl/L iii % .�►_;. ROUGH INSP. Date FINAL INSP. — jl Date APPROVAL FOR PERMIT !"' MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE f CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ' RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer • Air Conditioning (all sizes) RATE $ 20.00 $ 10.00 $ 10.00 S 10.00 $ 10.00 All Others/Repairs and Alterations It of Value of Appliance or Work COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work State Surcharge TOTAL !EE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. 7 Date Approval for Permit ! MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE TOTAL $ ,.b tt 5 S S $ 0.0 S Attach stack verification form with replacement furnace permits *Air Conditioners can not the placed in sid.• yard without written pt•rmission from adjoining neighbor. Effective Aug, 1. 1981 �y Job Address Department of Buildings, 6431 University Ave. N.E., Fridley. MH 55432 City of Fridley Tel. 0571-3450 The undersigned hereby waked 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. OWNER RIND C Fridley., Minn. 'Kd'�")q . l9 USED AS TO BE COMPLETED ABOUT �% /k6 ESTIMATED COST .91200- - OLD - NEW BUILDING PERMIT N0. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Not Water warm Ai No. 7 Trade Name(f size No.�����Ll/®3� Capacity �C;, Sq. Ft. CDR BTU HP Total Connected load Kind of Fuel BURNER - Trade Name Size No. capacity Sq. Ft. EDR BTU HP Company 7 i Signed By Tel I. Na. CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FOR14 MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. I]/ LOCATION I to e � GATE �� "096 OWNER F b Kinns R d ADDRESS C R It The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. No foreign objects are lodoed within 4. Ttat it is securely supported 5. That it meets all current Code requirements for size and total BTU connected 6. Total Heating BTU All Other BTU TOTAL REMARKS n S+ont b II F, CL) L a n HEATING PERMIT ! 0 I SIGNED AL —Z Licensee by Address I3SCcA NVE Telephone 05 77 - to CS Lo Fridley City License CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1,199k( APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS P� C 4) - Residential Rate TOTAL Furnace Shell and Duct Work, Sumer - Also Replacement Furnace $ 20.00 $ (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ Gas Range $10.00 $ Gas Dryer $ 10.00 $ *Air Co ditioning - All Sizes $10.00 $ (-'Li All Ot /Repair & Ae tions ( ST BA K) 1% of lue of Appliance or Wor $_ CommercialJindustrial I% of Value of Appliance or Work State Surcharge TOTAL FEE $x50 MINIMUM FEE FOR ANY HEATING/COOLING)VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15,00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. 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 Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. , /0-� .1994 OWNER 5-71 -3Y41 BUILDING USED AS �j ESTIMATED COST _� yr �_� PERMIT NO. No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Bumer Trade Name Size No. BTU HP EDR HEATING COMPANY WVIWWG Signed Approved By , Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. COY MD STACK YYBRUR A ON The undersigned hereby verifies that the existing chimney or stack: 1. Has been c arefally examined Yes (} No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( } 4. Is securely supported Yes () No ( ) 5. 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 been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: c List ALTERATIM Was Done; HEATING CO: Signed By: Date: SUBJECT PER City of Fridley �e q AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV ______ r L PROTECTIVE INSPECTION SEC. / NUMBER REY DATE PAGE OF APPROVED BY "1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/11/9 JOB ADDRESS 850 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK 1 TRACT OR ADDITION SEE ATTACHED DESCR. /{ 1 Shorewood 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delmar Ringsriter 850 West Moore Lake Drive NE 571-3468 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 p _ ❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Install dividing wall in garage storage area; install door 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 $ 175 $ 50 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. PLAN CHECK FEE TOT FEE 7$21.67 SiG)GNATUREOFCO AGENT IDATEI 0, PA100P VALIDATEjt THIS IS Y PE�i MJj SIGNATURE/E/'Ce/F OW NER UFOWNER BUILDER] IDATEI7 al-09fINSP OU TE NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 41-0-)6 ConstructionAddress: SCS 0 `� RE "�Y t3 Legal Description: Owner Name & Address: ,&r �sz% Tel. # --5' 1 Contractor: JL MN LICENSE # Address: T-50 I k- � � � � , v L r cl, Tel. # _�5: )I LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq, Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. G Construction Type: A *C 0 C 15 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed:.,_ Ft. + 6 Ft = Ft x $ _ $ DATE: 1 APPLICANT-: QC 1_ t -to. Tel. #S %) 3'11-9 CITY USE ONLY Permit Fee $ 07/ 40 Fee Schedule on Reverse Side Fire Surcharge $ • /'7 .001 of Permit Valuation (1/10th%) State Surcharge $ .SO $.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 $ STIPULATIONS: Sketch of proposed improvement to our garage at 850 W. Moore Lk. Dr., Fridley. Please note that the improvement is very minimal and may not even involve a permit. But I want to be safe rather than sorry. When the house and garage were built, we allowed fora storage area as shown in the sketch. Currently we have shelves in the storage area. All we are asking is to reconfigure the storage area with shelving that can be accessed from the garage as well as from the porch. This will be done by a family friend who has helped us with small repair projects in the past. He is not a contractor, but only a family friend and handyman. The cost of this work will be under $200.00. I hope you can understand my sketch. Note that there will be no change to the present structure except to reconfigure the shelving and a door between the present storage and the porch. Proposed change attached. y V ..l" j. - [('T.�4 `' ' t t .+5 t �. \ V -._� 'i'.. '^-_'\`. �"�^`^'-� - :w^_�' Il . 'LV,`. _!- -6a�-w.�-/' .....,"d�..�- •,� � . � a ~ Y \i � f ••� t .. . r � lam_____._•-_ � f \ �� � . ,; ; — 1"! --�_ i7t ' :,_�/ • � _. _ ... __. _.. _ .. . , a,,,a, _ - __ mac: 01 SUBJECT City of Fridley'11466 AT THE TOP OF THE TWINS BUILDING PERMIT r ` R I T NO. `v ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC r PROTECTIVE 1 � 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY "'j 612-571-3450 910-F13 5/14/99 JOB ADDRESS 850 West Moore Lake 1M Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Shorewood - 2nd SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Marlys Kingsriter 571-3468 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 O NEW ❑ ADDITION O ALTERATION G9X REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (25 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 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 $2185 1.09 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 Fire SC $2.19 PLAN CHECK FEE TOT FEE 6.53 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT MATE. PO ID THIS is Y PERM n S,GNATURE OF OWNEROF OWNER BUILDER. I DAATEI 'A� INSo pATE 01 NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Ado BUILDING PERMIT APPLICATION Construction Address:k. 0 Legal Description: Owner Name & Address: Tel. # 6ly Contractor: Ow (r1. -K MN LICENSE # Address: ftim Tel. # 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. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: i& -949F 4 4 G--Lak��J'Estimated Cost: $ c� % �S Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 6-- t q qAPPLICANT: , Tel. # CITY USE ONLY Permit Fee $ 93- o-? -6— Fee Schedule on Reverse Side Fire Surcharge $ aR . /7 .001 of Permit Valuation (1/10th%) State Surcharge $ /-07 $.50/$1,000 Valuation SAC Charge $ $1050 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 [ J Not Necessary [ ] TOTAL $ 6 • �3 STIPULATIONS: SUBjECi City of Fridley 33958 AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. �• COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC 59r UMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV 55432N L J` 763-571-3450 9taF15 10/9/03 JOB ADDRESS 850 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Shorewood 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlys Kingriter 850 West Moore Lake Drive NE 763-571-3468 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D & S Construction of MN Inc 480 206 Ave NW, Cedar, MN 55011 612-369-7077 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 6652 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW O ADDITION O ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 10' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARN11% '"Ors gigging gging call for all Utility locations O02 Ry w 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 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 1 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 $1,735 $.86 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- $69.25 Fire SC $1.74 ORMANCE OF CONSTRUCTION 29z�� PLAN CHECK FEE TOTAL FEE icen a SC $5.00 $76.85 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT (DATE, EN PROPERLY VALIDATED THIS IS YOUR PER IT .NSI BATE S-GNATURE OF OWNER,IF OWNER BUILDER. iOATEi NEW [ ] ADDN [] ALTER [ l -. Construction Address: CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 'So U\-"' Effective 1/1/2003 (763) 572-3604 Bldg Insp '(763) 571.E 1287 Fax Legal Description: Owner Name & Address: i �.i�+ e�ii < �,� ®®�— Tel, Contractor. ,�'� C "'� ti c ° MN LICENSE #_" _-5.2- Address: Address: L -f 6" .•f --L/ rr� �, � � � el. #. .3e9 I o-2-2 Attach 2 - 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. DECK AREA: Length Width 1VO Hgt/Ground Sq. Ft. OTHER: 4 - Construction Type: AL,, 6'i— 9�Estimated Cost: $� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x —,�,_-36�' +r DATE: 3 ? APPLICANT: - — Tel. # ��/� 11 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge, License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering , Agreement Necessary [ ] Not Necessary [ 617. / N I f .V � � y T•io�s` S3LOtt��. 40 21 ti SQL.. °'"T � �� �J is � ,c% oZ� - a\ .Y .1 •1".i�,!�•. ,Za 1017Al ,, ,r a fir' a c r • � � _ •�,_ ob ,� a 94 �•+' 1i �t�; i'5,�"t"`r'1r` 4. ! ptj• .� 'ti�� Q E pr) 1 F ,rr >•�+��!4,�E�. // _ .�J..... -. .� 111 00. 1 '0� ,•'. :r'. .d�� Vii � •Z �% l . ^' t i3. O� � r "' � � ;f. ��� ��;A' ,; p;,. 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