PRE 2010 DOCSSUBJECT
P fi NO. 1
City of Fridley
21215,z
AT THE TOP OF THE TWINS
BUILDING PERMIT
P
IW_CEIPT
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
Av..30;
r I ,
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
2/27/92
JOB ADDRESS 6127 Woody Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
Moore 'Lake Hills. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clevia Rydberg 6127 Woody Lane NE 571'8234
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Custom Remodelers inc. 8729 Central Ave,`Blaine MN 55434 784^2646 1748
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
Construct a 16"' x 1V Deck
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan.
Mom diggi call dor
811 utility laca;,ioos
454-0002
REY"'UHRED BY LAW
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
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
$1(,452
$•.73
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
P S OF AN STATE OR LOCAL LAW REGULATING CON-'
S�TRUCTION,O TH ER�-OR ANCE OF CONSTRUCTION.
i'
$35.00
Fire SC $1,45
PLAN CHECK FEE
TOTAL FEE
o Z Z7
$37.18
IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
E HIS IS YOUR PERMIT
F;]WRrANA
SIGNATURE OF OWNER i IF OWNER BUILDERI IDATEI
GATE
NEW [ ]
ADDN
ALTER ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
l/l/92
Legal Description: (-(-)7- -�</t� L �y d � OO P- f A Kir G�--
owner Name & Address: C l evR446 Sn� Tel. # !`�-7 / VZ 3 y
Contractor: 9,-(--oaeA—"s xmc- MN LICENSE # CMO pJyX
Address:
eq--,A� L-
S�My�
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
/9d
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
61 Width /;2' Hgt/Ground ad"
.'st �- '/ .5-�2
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _
Type of Construction: i
Approx. Completion Date:
Driveway Curb Cut Width Needed:
DATE: -1-23 4,&
Sq. Ft.
Sq. Ft.
Sq. Ft.
Side Yard Setbacks
Estimated Cost: $ / �
(Can an %*)
Ft. + 6 Ft = Ft x $
= S
APPLICANT: ,. oa— Tel. # X134- ST) 3.
CITY USE ONLY
Permit Fee $ �'1~ee Schedule on Reverse Side
Fire Surcharge$ /, �/S ��001 of Permit Valuation (1/10th %)
State Surcharge $ , 73 .50/$1,000 Valuation
SAC Charge $ "— $700 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ — Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
-3
�t
TnTAI
CUSTOM REMODELERS INC.
HOME IMPROVEMENTS
6729 CENTRAL AVENUE N.E.
BLAINE. MN 55434
(612)784-2646
rnurOer_r A
Mr. Wk.
Mrs. Wk.
11 �s!'�t AS
�+ ` 4r MMMOVE -/
In
CONTRACTOR GUARANTEES WORKMANSHIP FOR ONE YEAR but will not be liable for the cost and expense of making necessary repairs of damages resulting Irom the inherent
defect in premises on which work is to be done. nor loom act of God, civil commotion, lire. strike& accidents. storms. severe weather conditions or from other causes beyond the
reasonable control of the contractor. NOTICE TO OWNER REGARDING LIEN RIGHTS
(a) Persons or companles furnishing labor or materials for the improvement of real property may enforce a lien upon the improved
land if they are not paid for their contributions. even It the parties have no direct contractual relationship with the owner
r��_..,......,,.e.,.r.....,,I1eJh.AWnarJ& rtthhnld.lrwnhts.cantradarasmuch.Gtlhe.contraclnrice.asmay.be_necessarvtomeetthe
�' M
N ` WITNESS BY:
DATE
RD ilN4 APPRAI C D ,,
Z-"I/t/ e, YEAR -BUILT CLASS YEAR BUILT _ CLASS
:ONDITION EFFECTIVE AGE ATTACHED ✓ DET. BASM'T FRONT SIDE BACK
a [1 -
r NO. STORIES FOUNDATION FLOOR OPEN SCREENED GLAZED
BY BY EXTERIOR FOUNDATION FLOOR-
ROOF EXTERIOR
brrrie
INTERIOR ROOF
I O.H. DOORS f INTERIOR i r
ELECTRICITY /
YARD IMPRbVEMEIT$;,.'
YEAR BUILT CLASS DRIVEWAY ` 4p
FOUNDATION FLOOR D d D 9= 3
EXTERIOR
ROOF i lY Ty
INTERIORAL
ao
. P
_,4_5,X,5;a = 69 x 06- x =
X e2S = /oma x = x =
X = ' x d0
X =, x x a s=SSD
X = X = X =
x ►p5g55a x x x = +
BUILT INS i ' , r t/
RANGE -OVEN S ��S €.... EqL D % �R Sir !�✓t 1�y $A5/6����^[[
HOOD -FAN
DISHWASHER C
3
GARBAGE DISP.
FIREPLACES
D o o /oa � I
3 - FIXTURE BATH 1S"DO
?
H
.FIXTURE BATH DJ' i h/e VS e, a✓ _ -
CERAMIC TILE
VANITY
j.._. " F.. I ' 3
i
CARPET - YARDS
7 /
INTERCO r
AIR CONDITIONER Wl ,.. _ i r
WALKOUT
• ' a S / 0 .2z e-15-5 353.0
----FJ-T�l
7
SUBJECT
P
City of Fridley04
6
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
TiiiiTIT-NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
060
r
i A �r���,•� CITY HALL FRIDLEY 55132
NUMBER
REV
DATE
PAGE OF
APPROVED BY
----
l J` 612-571-3450
910-F15
11/5/99
JOB ADDRESS 6127 Woody Lane
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1 4, 20' 3
3
1 Moore Lake Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Keith Davidson
3 CONTRACTOR. MAIL ADDRESS
ZIP PHONE LICENSE NO
Mike Lunemann Const. 11617 Zane Circle Ch lin 55316 421-7726 20045212
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 X® REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage 26 S Tear -of
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 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
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
2272
] 14
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
$83.25
Fixe SC $2.27
PLAN CHECK FEE
TOTA EE
SIGNATURE OF CON'RACTOR Op AUTHORijEO AGEN IDATI:I
Licens . C
VI; nal
-66
EN eROP
Y AL OA HIS IS YOUR PE IT
SIGNATURE OF OWNER,IF OWNER BUILDER, (DATE.
BLD -NSP
■,Aft
7
� q
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:—(,,13-7 LA
Legal Description: q
Owner Name & Address: 16011(-L -1-DQTel. #
Contractor: ���' r✓ ,a„vvF �, [0`v� C MN LICENSE # 2c-;,® 2,
Address: j % 1p 1 "� 2 c�,.� (,� i' (� In �,,Tel. # �j Z/ 7
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: (.0 5A " n-'" ":Y-4'. 8- M-P::r-
Construction Type: 4t o V`@ 6� Estimated. Cost: $
r
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:/! 0
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ j r -Z -5
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , j t --j
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ ; CC)
$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:
NEW []
ADDN []
ALTI"-R [ ]
Construction Address:
Legal Description:
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Owner Name & Address:
Contractor. `
Add
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. # IWO '-
MN LICENSE #
Tel. # _
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.
Construction Type: U Uatas estimated Cost: $ I �tSJ
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: �c APPLICANT: Tel. #.
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
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
TOTAL $ 915-3 STIPULATIONS:
c' O of o o
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
gm ONVENT. ANT CONNECT® AND S Si7®N R VjRIU &TI„Ohf
When re
jjWj!jg-anMi1NGQr , 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 IK)
A/0',
No( )
The venting system is plastfclPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination_ Yes ()
No (�
The undersigned abo verifies that the replacement unit Is a listed assembly
and meets the current codes and manufacturer's specifications, This does
include AGA-GAIIAA Category I Central Furnace Venting
Tables for fan
assisted and natural draft appliances. Yes
(Of'
No( )
The VAlptina comb�i. t pn air Is sized and installed to meet the current codes
and manufacturer's Specifications.
Yes (t-r
No ( 7
When required to jagall a,a2w combo airJ.it wilt be sized and installed
to meet the current codes and manufacturer's
specifications. Yes (v)-
No( '1
When Lq a ne V$n#9g #ern the undersigned hereby verifies that
it 18 >c fisted assembly and meets the current Codes
and manufacturer's
specifiCations. This does include AGA-LAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft
appliances. YeS {yr
No ( p
Is the common vent and vent connectors sited and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current c o&s.
Yes (Vy
No( )
ian2g Tvoe acid Eize/C no®n Vim.,: crit:! Vent Ccsranaatctr In atidn
Appliance #1 Type ®01..,, BTU Input ®ate Fan Assisted or flat & -r
Appliance Type BTU Input
3 Fan Assisted or Not , —
Ap Totals p Type BTU Input Fan Assisted or Nat
Total Appliances
—� Taal Btu Input
Common Vent Type Vent Height _.Diameter,� inches
Appliance !#1 Vent Connector Height4 (ft Length � r ft Diameter _�K in Tye
Appliance ##2 Vent Connector Height ft Length =it Diameter
--..Y__,in Type
Appliance #3 Vent Connector Height —ft Length _,,,_,_,_ft Dameter in Type _
L Y B; c
'501 �o Aa-4 g— ,b/ut
HEATING CO:
,signed 8y: _ ®ate
t10/20Id ATIG I NA An , -LID £5 :9t GOOF-St-6UW
FROM : QUEHL.
OVEt
Ceo M4Nr,-S=
FAX NO. :6514547007 Aug. 23 2005 06:59AM P4
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