PRE 2010 DOCS777-
City ®f Fridley, Mium..
BUILDING PERMIT
Date: December 16,, 1970
Owner: ..... K. F. Hammer Builder
Sussel Company
N 10919
Address 871 West Moore Lake Drive Address 1850 Como Avenues St. Paul
No. 871 _Street
Lot 11 Block
LOCATION OF BUILDING
West Moore Lake Drive
3
Corner Lot ._ Inside Lot
Sewer Elevation
Part of Lot _—
Addition or Sub -Division Shorewood Addition
Setback _ Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Remodel Basement Front _ Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft:
Type of Construction Fst. Cost — 2Q9 r _..__ To be Completed Jana 16, 19 71
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compli ce with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 15.00 permit is hereby granted to Sussel Company
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 anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, constructio
Min, alteration, maintenance, repair andmoving 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.
awiding Inspector
IETANK MUNICH
NOTICE:
TW penult does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be ane to we
the Building Inspector for separate permits for them Items.
171
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: t�
. �-
/1, M QI
E -Q- BUILDER:
(S UJ�_
C
ADDRESS :- c3' -I 1 -
\�\I• !NA
no V_ L�
- QV ADDRESS:
Y�; So
_ Q -o boe „ STT VAO L
NO:. �(� STREET •
LOT: BLOCK: ADDITION•
F
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
{ o �w" Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $
�t�C��00
To Be Completed: -f A N q� -. ri1 i
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 application
are true and correct.
DATE:* SIGNATURE: PA ZL _:� 6yNC
r
(See Reverse Side For Additional Information.)
GRAVTTT WAM4 AM:
RATE TOTAL
Pinner Shell &Duct Work ... ...
..... .. $10.00
Replacement of Furnace
6.00 �
Repairs do Alterations ---up to 9300.00
6 00
Repairs &a Alterations each add. 9500.00
300 �
CSE. WARN AM.
Furriace Smell &i Duct Work to 220,000 BTU
each add. 60,000 BTU ......
Replacement of Furnace
Resmirs &c Alterations --up to y500.00
Repairs &c Alterations each add. $500.00
.410.00 $
3.110 S
6.00 !
6.00 $
3.00 $
Furnace Shell & Lines—to 400 sq. ft. FMR Stearn $20.40 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 S.
Each add 200 sq. ft. EDR Steam a.00
Each add. 320 sq. ft. EDR Hot Water 3.00 $
®IL BURPTER—to 3 gaL per hour 6.00
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to M,000 BTU) 5.00
over imm um see roe Schodulo
'Y-zJ='7%
inn:• :. i e�L1-77'j,'.�.XY
MAN MAWNW1
City of Ridley:
The undersigned hereby makes application for a permit for the work herd
specified, agreeing to do all work in strict accordance with the City Q
and ruling of the Department of Buildings, and hereby declares that an the fad
and representations stated in this application are true and. correct.
Kind of Building
Used as
- r
To be completed about,
00
Estimated Cost;
6Z)New. Building Permit No. Permit No._ A>__'�
u` ;,��,ss A'0
IMA77NG or POWER PLANTS--Stemn, Not Water, Warm Air—No �
Trade Name g i1✓ Sft. R?o �✓ %�
Capacity—__. ____ Sq. Ft E.D.R BTU In
Total Connected Lwd 4--b�®yKind of puel q-0,41___
BURNER -- Tri No size iso
rt.>
"
BEAT ,OSS CALCULATIONS;, DEPARTMENT OF INSPECTION : N1N•
Weatherstrips
A
Construction No.:
Insulation
Vindowa Doors
Reference
Out. Wall Int. Wall Ce' `
Roof Floor
Kind Haw ,
A
Yea— o Y;;=—Wo
19.....
"
F I Room Length ' ' Width Z -H
F1.1 Room Lengch . Width Helght
Windows and Doors-�Crackage and Area
Windows and Doors--Cracage and ArcN,,O A
Width Height No, of Lineal ft. 'ree
No. of pao0 of pane . lights of crack sq. ft.
W kith Height No. of uncal fo.
No.: of pane of pane li hte' pf.-amok :
Coef. Btu.44F�p
bs tw
,
Infiltration P 00
Infiltration l� s� r'ILI
Class
Glass
Exp. wall
Net exp, f 4. c
Nec exp: wall
lat. wall 4 . ,. j x r< f . d .
Int" wan
i�
CeilingFloor
,4 • .Ceiling • r u '¶ i ° r a: r
Total lata t,
Total Bta
Regilired'aq k. E:D.It or:64. m�: W.A; Ljeader area
Required pq: ft. D.R..or's4. ias�'W.A.`.Lea►der'fisea ",
^e+ight
FI ooa+ � en�th" idth I-leigbc' :
`.
Room I eflgth'' Width 6:
Wj dawat', nd Doors-Cracks e:and;Atea ~.
Win and•Doora---Craclta atl Area v'
,'It
wrote ;; >Keta t No:'ot l.tne�l t ° a►Te,.r w: 3
No.. of pstee of fight " lights 'of crack s$ ft. {� "Y fY�
vanv
Width. " Hetght No. o Linee M. :' a
�#t,.
No of pend of ne lights oY crack ets ft r
Coef ° B4ri "
Infiltra�fi nr� �f
9q�■ '
��F
IIIrrr�W�tlraU®n' t r.• j'
pCpAJ-'
Wa�e 'A70
iMp�wan R' .w W, 4 F8
��:r: 'rrY.p.'wan 4 F:.i. .h F:
Net exp. wall' �' 1
Net exti. wall+"
int: wall, > +d..
Int. roan
Ceiling . r
r.
Ceiling
iCI.QOf k D M.
Floor t .
'Pat�1..�,
Total Btu., �� `♦ ,,1' r 4 M,;
�,�]µ�
R¢ tii k. IG.46vY5 . ai; ?w W. A.4aa�r aVd
��y -
";,"'Height
Fi. Room Length Width
Fl, ROOM1Ixr> i. Yidth r,•..MeaBht '
WindowiF rind Doortr-- rackagot.and Area :'. `„
inddwe"rtad Doo�a�-Crackoga ago J4�ea
4th Height.; No. bf neat ft 'reg
Na of pane of pane tights of amok . f wEeol
!Arlt Hetg t No. of Lineal ft
Na t paDe of pane 1! hts• of crac
.
e
In6lttal3oa:, ¢,. .A ..
n6ltratioa
^,
us
Gla�a ,,
rp. •.,
�
• `P w�1�
&P.Man
u
Net 4M. wall
ov.. wail
ipp
P Ax
'4
Int.��t►n
iN_et
Int. wall ...y Y l:.
G•. ",.c :F.
�.
Ceiling; ;
Ceiling
�.
A. y
clor
Flowr
Total Btw .r t`
a4
`T®tel Btu.:
ltl. It. E.D.R. of 04.^inL W.A. L.11i ntroa K ,
Required a¢ k• E.D R. or • trlt. W A Lreader
'�•�.e••f .t}r �,t 1 4 a 1� ,� fry.: {.t,�. a;t y,�' C ;4' 1
P 4x! �`
k..p' a 4 1 d1Yt n'fj ,.;.t 47 ,'s �` 111i� �� , ..
n �N"14, ".,'op,`� A
"'v , , t f•_ �; y;.,n 41r: Y 1
rr >dq' f.•, 8 r �' x'F
CITY OF FRIDLEY
97-84-116051 APPLICATION FOR PLUMBING AND GAS PITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00 *
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
a [
x
$10.00
$
Water Softener
x
$7.00
a+
New Ground Pun OldBuilding
Water
$5.00
$
11 e
1
$5.00
$
N
-A h
a
H
m W
w
w
Additional Fixtures
x
Heater
+4
d
x
$10.00
G
REPAIRS $ ALTERATIONS
,� sj
$4
.0 rC
o d
R
each add. $100.00 or fraction
Sa
$
State Surcharge
O
O
TOTAL FEE
N
6911
q
N
.�i 0
3t
O
O
N
S N
N
m
m
v"i
' v
14
m
-f
a w°
w
croi m
Q 3
c
o
as
lec
1st
2nd
3rd
4 t -h
(R) - Future Connection Opening
Connected with Sewer
(*) - New Fixture, Old opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00 *
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Pun OldBuilding
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
43.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
Job Address 871
West Moore Lake Drive
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the Work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 6-13-78 , 19
OWNER Hamtt pr
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 6-20-78
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. RMMIITT NO.
Company MINHEEmsea
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT-�
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.SO STATE SUS
63781-X16051 CITY OF FRIDLEY
APPLICATION FOR PLAMBING AND uAS FIT -i I`,NG PERMIT
PARTIAL RATE SCHEDULE
e
PLUMBING FIXTURE RATES: r0.
>1
c
*:.:-.3er Fixtures
x
$3.00
oo
cflst-:re Fixture. Opening
x
$2.00
S
Water
e
m
ai
Catch Basin
x
W
e
rd
m
a
$
4i
b $4
a
W
w
$
water Softener
Heater
a
41
.-a
19
t,
$
Ey
4
u
$
m
lst 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Cas Range to 199,000 BTU
x
$10.00
3
O
0
v
C
o c
v
U
H
rJ
-.i
Z
•3� O
.0
M
�d �7
7 �3
b
.0
v`
uu`�
a
o
as
Iec
iIs_
!2 d
,
l
4 a
(R) - Future Connection Opening
Connected with Sewer
t") = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: r0.
RATE
TOTAL
*:.:-.3er Fixtures
x
$3.00
$
cflst-:re Fixture. Opening
x
$2.00
S
New :fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Nater :ewer - to 99,000 BTU
x
$5.00
$
-03,000 B.J to 199,000 BTU
x
$10.00
$
water Softener
x
$7.00
$
New Ground Itin Old 'Building
x
$5.00
$
Iectric.Water Heater
x
$5.00
$
GAS FITTING FEES:
lst 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Cas Range to 199,000 BTU
x
$10.00
$
REEPAIRS & ALTERATIONS
First $100.00 $5.00 $-
ea h add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE $
REINSPECTION FEE
cw14.o�y
Job Address 871 West Moore Lake Driv
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for ti:e 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 ocrrect
Fridley, Mn. 1-19-81 19
O'aNER HAMMER
KIND OF BUILDING Frame
USED AS res.
TO BE COMPLETED ABOUT 1-26-81
ESTIMATED COST 50.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO. gs-C�
Company l l
Signed By
Tel., NO.
ROUGH INSP.
Date
FINAL INSP. 1/^
Date
APPROVAL FOR PER:.IT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURMMRGE
SUBJECT
E
City of Fridley
26902
AT THE TOP OF THE TWINS
BUILDING
PERMIT
O
COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
�
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910415
7/29/98
JOB ADDRESS 871 A W Moore Lk Dr
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
3
1 Shorewood
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Josephine Hammer
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Affordable Homes 12301 Central Ave Blaine 55434
754-2202
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 19 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REOUIREO 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
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
$1584
.79
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 P5RFORMANSE OF CONSTRUCTION.
$51.25
Fire SC $1.58
CPLAN
CHECK FEE
TOTAL FEE
7-2f '-?d-
LIcense S5.00
$58 2
NA URE OFC OIAUTHO ZED AGENT (DATEI
P90PERLY V DATED TPft IS YOUR PERMIT
r BppG SP
s �y
DATE
S,GNATURE OF OWNER,IF OWNER BUILDERI (DATE)
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (�
BUILDING PERMIT APPLICATION' I�
ConstructionAddress: S 7 Piz i d ICY
Legal Description:
Owner Name & Address: 3k P6 NF_ f 4MM L -P Tel. #
Contractor: %6Fo2Di9�%e�5, 1� o�e�' (7ZA- L MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF U"ROVEMENT
LIVING AREA:
Length
Width
Height
Sq. Ft.
GARAGE AREA:
Length
Width
Height
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
•REiZCr_>P
%
/ 'S d ohm
Construction Type:
$450.00 Conservation Plan Review
Park Fee
Estimated Cost:
v
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft.
+ 6 Ft =
Ft x $
_ $
DATE: Z9 ^- 71�r
APPLICANT:
Tel.
CITY USE ONLY
Permit Fee
$ , �� ��
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 72
$.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
STIPULATIONS:
$'.
3uilding
BUILDING
Permit No -:b
Inspections
RESIDENTIAL APPLICATION
Received By: ;
763-572-3604
CITY OF FRIDLEY
vat d:
763-502-4977 FAX
EFFECTIVE 1-1-08
f�
)ATE lbO k
YOUR E-MAIL ADDRESS
c) y�
'ITE ADDRESS �J -7) We MOO& 1V `/ _ '01
PHIS APPLICANT IS: PLOWNER OCONTRACTOR
PROPERTY OWNER/
NAME: %YliM Ga Lfi
_
ADDRESS: V7) W, Moo,, W a r' , CITY Fo `t �2
_
STATE m7 ZIP 156 2
TENANT
PHONE: �I �) g go y q
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
rkSINGLE FAMILYNEW CONSTRUCTION SIZE
0 TWO FAMILYNEW CONSTRUCTION STORIES
PERMIT TYPE
0 ADDITION 0 GARAGE/SHED 0 WINDOWS
0 BASEMENT FINISH O ROOF 0 DRAIN TILE
0 DECK ;KSIDING 0 OTHER
0 SWIMMING POOL
TYPE OF WORK:
0 NEW HOME CONSTRUCTION 0 ADDITION
MAINTENANCE/REPAIR 0 REMODELING
DESCRIBE WORK BEING DONE: Si i'1
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
0 HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
0 HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
0 ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
0 DETACHED GARAGE
3. List of structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS_ & PORCHES SUBMIT:
0 Vinyl
OSoffit
1. Site Plan/Survey showing the existing structures
0 Aluminum
Other Jo r» a
0 Trim
❑Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ SOL OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee &��'
.001 times the total job valuation At
.0005 x Permit Valuation Minimum $.50 0
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary
$ Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
Attach Sti
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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. f 'S � _
SIGNATURE O I ANT l PRINT NAME_ Il�,ng� (�gl DATE A
DATE
APPROVED BY _____