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PRE 2010 DOCSSUBJECT PE City of Fridley 0 � 5 2 5 3 AT THE TOP OF THE TWINS BUILDING PERMIT t , RE COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV. DATE PAGE OF .APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/29/91 JOB ADDRESS 5751 West Moore Lake Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 DO -nay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 571-6637 Betty Young 5751 West Moore Lake Drive 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue NE 784-7543 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 O ADDITION ❑ ALTERATION )p REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (15 Squares) 9 CHANGEQFUSEFROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING S0. 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 $ 780 $ .50 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 PROVISI OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $21.00 Fire SC $.78 STRUC ION R THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 22.28 SIGNATURE OF CONTRACTOFTOJR AUTHORIZED AGENT g IDATEI WHT PROP RLYAA111 AT T ISI YOUR PERMIT ' IN e! DAT L G I RI SIGNATURE OF OW NERIIF OWNER BU LDE IDATEI NEW [ ] Effective 8/16/90 ADEN [ ] R-1 AND R-2 ALTER [ ] BuildingPieermit Application Construction Address: , 06 me Ole-21ile Legal Description: Owner Name & Address: � ®� Tel. # Contractor: ���.� 2V Tel. Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVMG AREA: Length Width Height Sq. Ft. GRPJ E AREA: Iongth Width Height Sq. Ft. DBCR AREA: TpTgth Width Hgt/Grwnd Sq. Ft. on=: ,_c�rner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Alole-mi etlex ff&s2k,Estimated Cost: $ Approx. Cappletion Date: —> Is"SrAres Proposed Driveway Width If New Openingjs Desired: Ft. $ $ Fit zo %10 WA Z A W41 MM M60 Permit Fee $ O Fire Surcharge $ -� State Surcharge $ �� SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Marge, $ $ ' `d5 STIPULATIONS: CITY USE OINLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Aunt Necessary [ ] Not Necessary [ ] SUBJECT City of Fridley 316 2 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. rry -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. y `� r PROTECTIVE 1 � � IL� I CITY HALL FRIDLEY 55432 NUMOER REV DATE PAGE OF APPROVED BY ---- L 612-571-3450 910-F15 1/22/01 JOB ADDRESS 5751 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16 1 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gordon Hines 5751 West Moore Lake Drive NE 612-332-6369 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 IR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house; Soffit & Fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. SEPARATE PERMITS ARE REOUIRED 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 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 DWI G. 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 $4,100 $2.05 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- `I' STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO AL FEE 117.40 SIG T OF CO 7R .TOR OR AUTNO Z AGENT (DATE, ROP VALIT D THIS IS OUR P MIT/?DER, k�rWN (DATE, ' GATE NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:z�� Legal Description: Owner Name & Address: ��--�%�/�/ �--�� %' S Tet. #f /•2 r��� Contractor. MN LICENSE # Address: Tel. # 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 A Width Sq.. Ft. i e P 1ifs l"I % q C, v Construction Type: V Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ « . 2 DATE: APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 11 /. eZ Fee Schedule on Reverse Side Fire Surcharge $ V, !0 .001 of Permit Valuation (1/10th%) State Surcharge $ 0,17 $.50/$1,000 Valuation SAC Charge $ $1150 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 $ , -410 STIPULATIONS: IJ SUBJECT P City of Fridley 33308 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. DEVELOPMENT DIV. v -------COMMUNITY r PROTECTIVE INSPECTION SEC. NUMBER REVDATE PAGE OF APPROVED BY /---I � CITY HALL FRIDLEY 55432 763-571-3450 910-F15 I -I 1/3/03 10B ADDRESS 5751 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gordon Hines 3920 Lakeland Ave N 763-533-8710 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dorothy Lohse Contractor 3920 Lakeland Ave N, Robbinsdale, MN 55422 763-533-8710 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20223773 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Rental Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ! ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Finish basement into 3 rooms plus 2 bedrooms and laundry room 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $2.00 STRUCTI R THE PERFORMANCE OF CONSTRUCTION $69.25 PLAN CHECK FEEA$77.25 OTAL FEE i /`c3 ��®y Lic e SC 5.00 SiGN4TURE CON'RACTORORAUTHOR4E AGENT iOATEt W EN PERLY V (DATED THIS IS YOUR PERMIT _ LOG NSP 1-3-D:s riAfE S-GNATURE OF OWNER,IF OWNER SUiLOERi iDATE, IJ NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg insp ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: dol Legal Description: Owner Name & Address: o - Tel. # 76 J Contractor. �^ �� � . �' �� - MN LICENSE # Address: 3 9.2© 4 / XWA. l �� Tel. #- n ,3 ` �� 53� 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:; n�`i�i�'J l°J , ?s l��a � fA/ o I-cp & ^;� lead — Construction Type: Estimated Cost: $ 2 , POlaw Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ � 3 DATE: ey APPLICANT: Tel. A Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "Nor Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary [ ] Not Necessary [ J TOTAL $ 77 .2 S STIPULATIONS: 31 (HeelL rre'a UY Z;42." c1,� M F - q -0-1 Room 1 1. 1 Bedroom, J OW MaIAVO 357 8'9 13'5 wn- SO Room CD L3 A � a r Bedroom \ ` 1 �-x 915 4' 41 4'8 5110 13'5 8'9 13'5 /s 357 �to� • U)/d 'D '0-1 �� 7S/ a/, 44 M� cl-reelL --2XY Z"42— /-- ava-*,�r alW' 4ela-41V , AXI Room 357- 8!9 - i u n =,y—O 9'5 IT5 4' 4'1 48 5'10 8'9 357 13!5 90 Room co fD co —,e,,.m C) DO -BedFUWW 13'5 I 0 S r s• t'1LLE'. i.1vS'>PE..,TION DIV. Effective Or. Jan 1, 2002 6431 University Ave NE Fridley, MN 5 5412APPLICATION FOR PLUMBING AND GAS FITTING PERMIT CS (763) 572-3604 =-7 �D �J °' 5 7 r I F'7�11i- PLUMBING FIXTURE RATES: NO. BATE rck New f=ixtures En Old Opening, New Fixture. • . LBeer Dispenser ti � Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appl ante Water Heater -Electric Water Heater - Gas** ®� Gas Range' LD m Gas Dryer* C Back Flow PraveOter Required ( )Yes ( ) No Type m Reinspection Fed $47.00/Hrda . $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.x0 $10.00 $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5°7c of Value of Fixture orApptiance NState Surcharge .. N N TOTAL FEE TOTAL ... JOB ADDRESs 7 1 Vii . (Ylaore �.r�.ker !� t? i v�, , : d t� ► The undersigned hereby mattes application for a perm!: for the work herein .. speclGed agreeing to do all work in strict accordance with the city codas and rulings of the Building Division, and hereby declares that all tha facts ,and representations stated in this'applicatfon are true and correct `Owner tSydm 4.Y\X':5 Building Used As • .7 0� Estimated Cocst ZOb - PERMIT NO. PWM131NG COMPANY SIGNED BY uJ TELNO. FAX It to 0- l?Z j Approved By Rough -In Date Final Date MI IMUMFEE F R ANY PLUMBINGIGAS PERMIT IS 20.00 PLUS THE $.60 ISTATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER -UMC SECTION 504.A) AND TABLE 6-A. - COMMON VENT INFO ON 13ACK SIDE ' . NIMM NUMUtrt Ur HA i UKI= S:TO BE INSTALLED ON EACH FLOOR .,.<sk=..Stories wash Y < -A Floor ;4j� Auto.Water HeGas ater : ro Urinal Shower Tra •� Drain Washer f Ran E Gas Stec �j gry� y*- '+vr:�4'v3-r."'••'i 13asemen"3 Y a - _n�-.nYe�wK«I.gD- ::• �3f 9rox lfi i'•' Y u d+rlw _tihs.-«•vs: h"si�4 _t.:.4• -•*'Y fik, T<t4h+ WP'- -`• Floor 1 - �•': _ - y CWh iS.<i "vaa+.Fr �xk• -. ^io .ti - � t� �•�'. �y�.�3'"u vrVn .. � � �-0"y�+J�� .�`C�k" A}-+vr'WxAS� .n Floor 2Floor - ._ -+n.�3 v� '' '•� -• - • • - f -:i- .4-Y.Q. x x_au 3 t. 4x�x... a-i� gv r .3 . = L� }y. yy bi'fW�.+�a� '�- - � - va''.� :wink• -`l. 'Y p3. :v •K4.Y ]•� x::" ^FJl\ •'S:= jvhri. %tib' .. �4e_ e a p�:3 � _ ti!4}P- .3 0 `�'w'.� .- PLUMBING FIXTURE RATES: NO. BATE rck New f=ixtures En Old Opening, New Fixture. • . LBeer Dispenser ti � Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appl ante Water Heater -Electric Water Heater - Gas** ®� Gas Range' LD m Gas Dryer* C Back Flow PraveOter Required ( )Yes ( ) No Type m Reinspection Fed $47.00/Hrda . $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.x0 $10.00 $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5°7c of Value of Fixture orApptiance NState Surcharge .. N N TOTAL FEE TOTAL ... JOB ADDRESs 7 1 Vii . (Ylaore �.r�.ker !� t? i v�, , : d t� ► The undersigned hereby mattes application for a perm!: for the work herein .. speclGed agreeing to do all work in strict accordance with the city codas and rulings of the Building Division, and hereby declares that all tha facts ,and representations stated in this'applicatfon are true and correct `Owner tSydm 4.Y\X':5 Building Used As • .7 0� Estimated Cocst ZOb - PERMIT NO. PWM131NG COMPANY SIGNED BY uJ TELNO. FAX It to 0- l?Z j Approved By Rough -In Date Final Date MI IMUMFEE F R ANY PLUMBINGIGAS PERMIT IS 20.00 PLUS THE $.60 ISTATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER -UMC SECTION 504.A) AND TABLE 6-A. - COMMON VENT INFO ON 13ACK SIDE ' . CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $_!,0. () C) $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. G, Effective On January 1, 2002 JOB ADDRESS 5_7S_/ OWNERy BUILDING USED ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Wat ( a m Air) $ Trade Name &—'C Size No. BTU 6GLet'6 HP EDR $ Fuel AA Total Connected Load Burner Trade Name Size No. $ BTU HP EDR 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and ' representations stated in this application are true and correct. $ �� fl DATE HEATING CO C-1� Signed �9' Sri : /f TEL # FAX # — r Approved By Rough -In Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT, VENT GONNFMOR AND COMR1ISTION AIR VFRIFI CATION When _re In acing an exic ila furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting system is plastictPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes*j No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) The pxic_ting combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combiistion air, ,itwill be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new ventingsyc_tem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type Appliance #2 Type Appliance #3 Type Total Appliances BTU Input BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type r HEATING CO: - ��- Signed By: Date: i ��