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PRE 2010 DOCSCity of Fridley,: i BUIIDING PERMIT N? (6,14e- Date- ;eBuilder�:. Address Address LO 101iF BUILDING No. Lot 81ock Addition or Sub -Divi Corner Lot —_..'Inside Lot _ _ Setback ' _ _ Sideyed Sewer Elevation __ _ Foundation Elevation DESCRIPTION OF BUILDING Tome �Use�i a Depth . + Height • Ft:. ` Cu. Ft. Fro Depth Height _ _ Sq. Ft. _ Cu. Ft. Type of Construction �j _ . Fst. cost _ To be Completed In consideration of the issuance to me of a permit to construct the building described aboveI agree to do the proposed work in accordance with the description above set forth and in compliance with ail provisions of ordinancs3s of the city of Fridley. In consideration of the payment of a fee of $ = ,permit is hereby granted to 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 any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time .upon viola9* of any of the Provisions of said ordinances. , %A A I Building Inspector NOTICE: 'fids pennh does not cover the constwetion, h►stallatlon for whine, phumbtae, ens heatie, sewer or water. Be wn to see the MIA* hopsetor for sopanMe peemhs for these heam I APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY0 MINNESOTA Owner's Name Builder Address Address LOCATION OF BUILDING No. �zz� Street 5, Part of Lot Lot Block Addition or Subdivision ,—, I Corner Lot ------,Inside Lot Setback J Side -Yard SEWER'LLEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING Height Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all.work in strict accordance with the City of Fridley Ordinances and rulings•o£ the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE I > -I,- SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). 52-84-S915-51 City of Fridley Application for Plumbing and Comas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures pp I x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. NN p 6 Q O t{ v! a 6 w W a z u� Z c a (9 O . F ` N WATER HTR. GAS ELEG Base New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater Ime t qas Drver NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 1st Gas Range to 199,000 BTU .............. x $5.00 $ Geyer 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ 2nd TOTAL FEE $ 5.00 3rd 4th • Future Connection Openings >k New Fixture, Old Openings Connected with Sewer I Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Geyer 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 5.00 Location 1,90 X M 4703 N E 22 St City of Fridley: The undersigned hereby .makes application for a permit for the work herel specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn U-21-68 19..— Owner W NOrling Kind of Building fr Used as To be completed about Estimated Cost, $ 10.00 Old—New. Building Permit No Pe it No. a ® P By Business Phone No ROUGH FINAL 5- 3-2Z ! 4'r 01 4 `V o-vN 5-M-15 Minnesota Well and Boring H WELL OR BORING LOCA ON MINNESOTA DEPARTMENT OF HEALTH Sealing No. 67052 County Name WELL AND BORING SEALING RECORD Minnesota Unique No. Minnesota Statutes. Chapter 1031 or W -sen tf Nkn _ (Leave blank d not rownl Anoka. Township Name Township No. Range No. Section No. Fraction (sm. Ig.) Date Sealed ry Approximate Date Well �I S E'A N Ww S 1k� �$-12 -� or Boring Constructed Fridley 3 0 23 26 Numerical Street Address or Fire Number and City of Well orBonnLocation Depth Before Sealing 7 ft. Original Depth 4703 2 2 Street NE, Fridley n - Show exact location of well or boring Sketch map of well or boring Static Water Level Accurate in section grid with -X-. location, showing property lines. roads. and buildings. Approximate N W EMEN ' GAR z>creen rrom OBSTRUCTION/DEBRIS/FILL Obstruction ❑ Debris Fill 1� it U ' p Type of debris/obstruction 521 Obstruction/Debns/Fill removed? X1 Yes ❑ No a & jet - PROPERTY OWNER'SNAME AME LaMere Construction Brad Larson Mailing Address if different than property address indicated above. 714 181 Ave. NE Minneapolis, MN 55418 PUMP Removed ❑Not Present El Other NONE CASING Diameter -Depth 3 in. from 3 to ?oft. in. from to ft. in. from to It. Set in oversize hole? Annular space initially grouted? ❑ Yes N1 No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM BEEN If not known, indicate estimated formation log from nearby well or boring. - BEEN A Single Aquifer ❑ Mullifiquifer 15 ft. - - below above land surface ii CASING TYPE E house c Steel El Plastic -❑Tile ❑Other mite S N— — r mite ' GAR z>creen rrom OBSTRUCTION/DEBRIS/FILL Obstruction ❑ Debris Fill 1� it U ' p Type of debris/obstruction 521 Obstruction/Debns/Fill removed? X1 Yes ❑ No a & jet - PROPERTY OWNER'SNAME AME LaMere Construction Brad Larson Mailing Address if different than property address indicated above. 714 181 Ave. NE Minneapolis, MN 55418 PUMP Removed ❑Not Present El Other CASING Diameter -Depth 3 in. from 3 to ?oft. in. from to ft. in. from to It. Set in oversize hole? Annular space initially grouted? ❑ Yes N1 No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM TO If not known, indicate estimated formation log from nearby well or boring. - METHOD USED TO SEAL ANNULAR SPACE BETWEEN No Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing PerforationtRemoval in. from to in. from to Type 2 CASINGS, If. ft. OR CASING AND BORE HOLE: ❑ Perforated ❑ Removed ❑ Perforated ❑ Removed of perforator q Other GROUTING MATERIAL Grouting material N t Clot from from from from 3 to to to to 1 78 ft. yards 32 bags ft. yards bags ft. yards bags ft. yards bags . REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes ® No LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was seated in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is true to the best of my knowledge. Mork -Well Co. InCA 02133 Contract Name �/j/)fl, License or Registration No. 4-19-95 Authorized Representative Signature Randy D6ni el son Date LUFOR4A`,-ALVEIMTH PROPERT PAKERS-WELL MER COPY H r, 7r Name of Person Sealing Well or Boring HE -01434-01 SUBJECT PE R WT -NO, City of Fridley f2 3 3 0� AT THE TOP OF THE TWINS BUILDING PERMIT' _.. Ir? - RECEIPT NO. COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER __JREV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/21/95 JOB ADDRESS 4703 2 1/2 Street NE 1 LEGAL LOT NO.BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16,17 7 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David/Jean Huss 4703 2 1/2 Street NE 572-8787. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. LaMere Construction 714 18 1/2 Ave NE, M ls, MN 55418 788-7273 3588 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 Miscellaneous repairs per attached bid sheet 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 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 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 $12,700 $6.35 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- STRUCT NOR THE PERFORMANCE OF CONSTRUCTION- 144.00 Fire SC $12.70 PLAN CHECK FEE TOTAL FEE License SC $5.00 $168.05 SIGNATUR F ANTRACTORORAUTHORQEDAGENT IDATEI WHENPROP WY VALIDATED THIS IS YOUR PERMIT 16XII BAG INSP OAT(( SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ADDN (] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:T Legal Description: Effective 1/ 1/95 -j�-4`7 S0 Owner Name & Address: a l') a� iy ��SS Tel. # 7 g 79% Contractor: �a �yi� GJD Y�S'� - MN LICENSE # Address: i Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �A Ev�,CAd ( Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: - CWAA Estimated Cost: $ ( Z- -7 � Approx. Completion Date: Joj q1- 31 1�1 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 t = Ft x $ _ $ DATE: 111-7 APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $850 per SAC Unit Tel. #2z2 -7Z73 $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 [ ] BID SHEET David Huss 4703 - 2 1/2 Street Fridley, MN 55432 572-8787 Page I LaMere Construction Contractor 7/ / - / F- %a. Contractor's Signature /s /11(lo y., S-1 LIVING ROOM . 'br a -k — 7 8:C- $ 625.00 a. Install new steel insulated exterior door, prehung unit, six panel with peephole or nine lite with mid of owner's choice, new threshold, hardware, locking device and weatherstripping. Castlegate or equal. Reuse casing. Key alike to other door and supply owner with two keys. ttclu-�{Opt&n: Install deadbolt in place of locking device. Schlage or equal. $ 40.00 0-2 KITCHEN S 625.00 b. Install new steel insulated exterior door. Refer to spec S-1 a. 1ney, Ax tion: Install deadbolt in place of locking device. Schlage or equal. $ 40.00 S4 OTHER ROOMS USED FOR LIVING AND HALLS Upstairs $ 85.00 a. Repair damaged wall above east window (damaged by dormer roof). Make ready for finishing by owner. S-6 BUILDING EXTERIOR $1375.00 a. Tear off built up roofing material down to bare wood (flat roof). Haul away debris. Replace rotted and damaged boards. Specify separate board replacement cost per sq ft S 2.50 Install 1/2" sheathing with pitch (for drainage away from house) and synthetic rubber membrane, EDPM or equal. Install metal flashing at house and along roof edge. Install roofing so there is no ponding water. $ 225.00 b. Install new storm/screen door for west entry off living room, solid core, baked enamel prefinished aluminum, self -storing inserts, hardware and locking device for complete assembly. Benada or equal. Owner's choice of color. $ 663.00 c. Install new basement windows, vinyl framed, slider type, with self -storing screen and storm inserts, weatherstripping and locking device. Benada or equal. .Owner's choice of color. Total of 3. S-7 HEATING AND PLUMBING $ 185wo a. Replace flexible gas piping to dryer with copper piping. $ 110.00 b. Install anti -siphoned ballcock mechanism in basement water closet. Fluidmaster or equ . $ 725.00 c. Abandon wall per State requirements. 162- 7-5-15 zl $ 200.00 d. Install new exterior faucet with back flow pi eventer and self -draining. $ 89.00 e. Replace water supply line to water closet at shut-off. (l st floor bathroom) �� ASID SHEET / David Huss 4703 2 1/2 Street Fridley, MN 55432 572-8787 Page 2 S-8 GENERAL HEALTH AND SAFETY S 887-00a. Install 1/2" drywall over exposed styrofoam insulation on basement walls. Tape and make ready for finish. Owner is responsible for making walls accessible to do work. n 'Remove styrofoam insulation. Confirm disposal with owner. S 165.00 S 365.00"b.'Install black iron handrail continuously along open side of platform and steps of east concrete stoop. S 589.00 c. Insulate upstairs crawl space. Blow insulation below floor boards and above boards ( where there is no storage) to meet R-38 or as clearance permits. Kneewahs shall be insulated to R- 20. Insulate peal: to meet R-38 or as clearance permits. Seal all thermo by-passes prior to the insulation work. Insulate and weatherstrip access panels. Install roof ventilation to meet State energy code requirements. S 600.00 d. Install glass door enclosure to fireplace. Frame and glass shall be safety tempered and UL listed. Specify manufacturer Thermorite A,��✓ � ��/I��, $ 120-00e. Install combustion air intake for furnace.�;�?,�x��,7'/cY�dS S-9 ELECTRICAL S 60.00 a. Protect wall receptacles within 60" of kitchen sink with GFI. Install 20 amp wall receptacle 100.00 at countertop. S b. Install wall receptacle in bathroom, GFI protected. S 377.00 c. Code wiring in basement. Run wires through joists. Install 20 amp appliance wall receptacle for laundry. Install wall receptacles to eliminate extension cord usage. Specify total 4 4 Ac�-,zts ASL ZZ -DIE -S S 8005.00 TOTAL BID BID GOOD FOR 90 DAYS FROM 1/11/95 *jot, 'Y.3("cro This work write-up describes the rehabilitation work to be performed on the subject property. The contractor will be required to do all work in a trades like manner and in accordance with building code_ and TECHNICAL SPECIFICATIONS. ALTERNATES: ' S SEE SHEM Code plumbing system. Specify all other plumbing code work not listed above and the cost per work item. S 2. Code electrical service. Specify all other electrical code work not listed above and the cost per work item. S• 3. Repair water softener for working order. !' Option: Install water softener, UL listed, sized to hardness of water. Install '.N ith by-pass valve. Owner to supply salt. Plumb. Specify manufacturer Futurmatic Economy, and S 850.00 4703 - 2i Street ALTERNATES TMMRP T(1R PAGE 3 $ 285.00 1) Repair water damage ceiling in south addition room. EXTERIOR $ 225.00 1) New outer door in Kitchen (east side). $ 1286.00 2) Combination windows. Replace fourteen (14) double hung aluminum storms with Benada "Windsor" storm windows in a mill finish. $ 185.00 3) Reframe damaged windows in basement, ie the frame the window rest in attached to the house. PLUMBING --.,,• 850.00¢ P1) $ 136.00 P2) r P3 ) Water Softner: NOTE: Due to age and condition and salt in tank that has become rock hard from being disconnected and not in service, it's not cost effective to repair and put back into service. Supply and install one (1) Futurmatic Economy residential water softener of cabinet design, 24,000 grain capacity with clock regeneration. Floor Drain: Remove broken back water valve and snake drain line to assure proper drainage. Re -install new back water valve and clean out plug to meet code. Water Heater: Remove existing electric water heater. Supply and install one (1) new state 40 gallon natural gas water heater of energy efficient design and replumb water lines as necessary to meet code. Tying vent into furnace flue with a saddle wye and aluminum pipe to meet code. Include one (1) AGA approved gas valve, drip tee and all hardware as necessary for final connections. $ 251.00 P4) Kitchen Faucet: Presently leaking around spout and stems recommend replacing with new. One (1) Delta 400 with spray and all necessary hardware for final connections. $ 845.00 P5) Horizontal Water lines: NOTE: some piping has been changed to copper previously. Recommend replacing the remaining horizontal galvanized water lines with copper to eliminate rust, corrosion and electroysis problems in the future. P6) Basement Bath: Nothing could be ascertained at this time whether permits were pulled and bathroom was installed legally or up to code. NOTE: If the local administrative authority (inspection found 3/4 bath a problem it would be additional and considered an extra. ELECTRICAL BASEMENT $ 644.00 Replace existing 100 amp fuse panel with new 100 amp, 20 circuit square D breaker panel, ground electrical service to code. Replace meter socket, if needed. $ 65.00 Install new laundry receptacle on separate 20 amp circuit, remove existing junction box & Romex wire. $ 33.00 Install furnace on separate circuit. $ 91.00 Install two (2) 3 way switches at basement stairs. L. ` 4703 - 21-2 Street ALTERNATES (CON'T) ELECTRICAL PAGE 4 BASEMENT (CON'T) $ 59.00 Rewire receptacle by water heater to code. $ 33.00 Install one (1) pull chain light by water heater & old well room. �N 11$`l110.00, Replace time clock for water heater. BO� BATHROOM $ 72.00 Refeed old circuits from open fuse disconnect, remove old fuse disconnect•. "Rt r-.7001 Install one (1) GF t receptacle, disconnect receptacle in vanity light. $ 26.00 Ground vanity light. WORK SHOP AREA $ 13.00 Disconnect & remove Romex wire to outside. FIRST FLOOR KITCHEN $ 59.00 Install one (1) 20 amp receptacle, small counter. $ 19.00 Replace receptacle for refrigerator. HALL $ 85.00 Install one1) 110 smoke detec with battery back up. BATHROOM ,$ 91.00 Install one (1) GFI receptacle, disconnect receptacle in light. $ 19.00 Ground vanity light. SECOND BEDROOM - FIRST FLOOR $ 65.00 Replace two (2) open bulb pull chain closet lights with two (2) globe enclosed pull chain lights. SECOND FLOOR $ 6.00 Cap open junction box in closet. $ 58.00 Replace defective ceiling light (pull chain type). GARAGE 4-728 00' Install new electric from house to garage, underground - flih NOTE: To do only when ground is thawed. Install one (1) GFI receptacle. Install one (1) disconnect. Install one (1) porcelain light and install one (1) single pole switch to control. Install one (1) security light and install two (2) 3 way switches to control. Install one (1) outside GFI receptacle with weatherproof cover. 182.00, Install one (1) outside GFI receptacle with weatherproof ° cover at patio. NOTE: Some underground wiring to patio needed. �$ 221.00 Install two (2) outside GFI receptacles with weatherproof \ of covers on west side & east side of house. CITY OF FRIDI EY INSPECTION DIV. Effo6tiv4 On January 1', 1996' 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT-.. 572-3604 pknr\ 1NUIVIDrIn Vr riA I UMCO I U OM 11NO I ALLW UN ItAUH I-LUU PLUMBING FIXTURE RATES: NO. RATE TOTAL Auto. S $7.00 4+0 Old Opening, New Fixture :Washer $4.00 Beer Dispenser E Blow Off Basin $7.00 Catch Basin $7.00 Rain Water Leader $7.00 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Water Heater —Electric $7.00 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $7.00 4+0 Old Opening, New Fixture $4.00 Beer Dispenser $6.00 Blow Off Basin $7.00 Catch Basin $7.00 Rain Water Leader $7.00 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Water Heater —Electric $7.00 Water Heater — Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 .00 Back Flow Preventer Required )Yes N6 Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS I% of Value of F�7 ixtu 9 or Appliance _5�0 sop State Surc rge $ .50 TOTAL FEE $�Q JOB ADDRESS - The undersigned hereby makes application-for.a permit for thc' Work hqrdln*. specified agreeing to do -all work in strict accordance with1he city C006 and rulings of the Building Division, and hereby declares. that* all the facts: and representations stated. In this application, ire'trud And correct 1995 Owner Building Used As 13 Estimated Cost PERMIT NO PLUMBING COMPANY ZA'" A-Y.Lc:vZ SIGNED BY Approved PLUS THE $.50 STATE—*.SURCHARM 01 SUBJECT PE City of Fridley 3 0 317 AT THE TOP OF THE TWINS BUILDING PERMIT f R T NO. ` COMMUNITY DEVELOPMENT DIV. �+ r PROTECTIVE INSPECTION SEC. r(/"J d 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/30/99 JOB ADDRESS 4703 2 1/2 Street -NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16,17 7 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave & Jean Huss 572-8787 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 ❑ NEW ❑ ADDITION ❑ ALTERATION x® REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 16 S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS U derlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 $1398 $.70 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- $50.95 FirA STRUCTION OR THE PERFORMANCE OF CONSTRUCTION SC $1.40 PLAN CHECK FEE TOEE 05 SIG TU LOLiCANTRACTOOORA EDAGENT IDATEI HE P I VALID 5x THIS ISRMIT BubG ,NSP ?R OATS SIGNATURE OF OWNER,IF OWNER BUILDERi ,DATE, 01 NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 II BUILDING PERMIT APPLICATION iJ l Construction Address: `7 ?o N. Legal Description: Owner Name & Address: L,4yL 'C_.' '�6 f, r/ Tel. # Contractor:4 Lr' 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 IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Lengthy Width Hgt/Ground Sq. Ft. OTHER: ✓A v®r— r� // Se '1F_ A/C -U i -F v Construction Type: Estimated Cost: $ 1.3 90 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: f Tel. # �_-7 2 -t7,17 TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ d • S Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ % o $.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 [ ] Not Necessary [ ] TOTAL STIPULATIONS: / H 51 SUBJECT City of Fridleyr? 7,�3�2 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. % _ _ ------ r - PROTECTIVE INSPECTION SEC. ��o 1 � NUMBER -] REV DATE OF APPROVED BV- = CITY HALL FRIDLEY 55432 �"'""� 763-571-3450 910-F15 12/18/02 r;GE / JOB ADDRESS 4703 2 1/2 St NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 16, 17 7 I Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Scott Barsness, 4703 2 1/2 St NE, Fridley, MN 55432 763-572-1400 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Scott Barsness (same as above) 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 11 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Remodel kitchen & dining room; changing stairwell 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on building plans. 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 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 $25,000.00 $12.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE $ACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $391.25 Fire SC $25.00 PLAN CHECK FEETAL FEE 428.75 SIGNA R F CON'RACTOR OR AUTHORIZED AGENT IOATEI E PR , LY VA 0 ED THIS IS YOUR P MIT OWL-Z�lY�2 e/y , 9 �• -- 4TURE O OWNERIIF OWNER BUILDER, IDATE, SL INSPZ Ijif / H 51 NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 7 0 3 /-D- S�- /ye' Legal Description: 5i nk l -j" Owner Name & Address: Tel.# 763-5 -7 vb Contractor. Pym." 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 Width Hgt/Ground Sq. Ft h1 Construction Type: "' & [ Estimated Cost: $ Ov TOP��®,� Driveway Curb Cut Width Needed: Y.- = Ft x $ 4 z vZ_ $ DATE: 12 APPLICANT• Tel. # 763 bre - o77a-1 Call (763) 572.3604 for Permit Fees 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. "A" or Alt. 'B" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary [ ] Not Necessary [ TOTAL $ I-Igoa o Is STIPULATIONS: 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 FAX (763) 571-1287 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 Effective January 1, 2003 JOB ADDRESS '70 3 7— /Z 5,T A/,5 OWNER S C o -/Lr io,>4tr S NCS S Rate TOTAL BUILDING USED $ 30.00 Q 010 Z - / ESTIMATED COST PERMIT NO. / $ 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. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water)arm ' $ Trade Name A/"1 I WA Size No. _G UCA 07D /FX'33 BTU 5 i)do _ HP EDR $ Z.i • 00 Fuel N&= Total Connected Load Burner Trade Name Size No: RC CC 6 3{'A ZA $ BTU 301 coo 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. DATE 1 1114 HEATING CO�l s� %i r�J�' Af_t Signed JA �� TEL # %6� 5 36 —b fvl % FAX # cl Approved By/_,C4_ Rough -In Date Final Date 1`.21-,)3 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED ....r..L VENT Mwll►ICCTilR AND rnMRl ICTI(1N AIR VERIFICATION When rapinninn an axiin0 Mranna, 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 OC► No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (y,) No ( ) The undersigned also verifies that the replacement unit 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 Yes( No ( ) assisted and natural draft appliances. The axinfing come ,_goon air is sized and installed to meet the current codes and manufacturer's specifications. Yes ()o No ( ) When required to Install a new cemeustinn air_ it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( No ( ) When installing a now venting system, 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 ( ) A - nli n Tyne and size/Common Vent and Vent .onnnetnr Infarmation Appliance #1 Type BTU Input _ Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 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 T e� i V " L �r� l` �2 y�i it-e-A� Al T RATIONS- (npccrihel - HEATING CO: 11147t- N - �- Signed By: "P Date: /7/°j- ADDRESS: 4703 - 22 St. NE APT: FLOOR: jc-11Y:Fridley DATE: I OCCUPANT: Scott Barsness OWNER: SAME HEAT LOSS: HEATING INSTALLED BY: Marsh Heating & Air ELECTRICAL WORK BY: N 5 1 GAS LINE BY: Marsh Heating & Air TYPE OF HEAT: GA FAX ROOFTOP SPACE HTR UNIT HTR OTHER GAS DESIGN MANUFACTURER: AMANA MODEL: GUCA070AX30 SERIAL: 0103213672 INPUT: 70,000 BTU CONTROLS THERMOSTAT: VENT SIZE: VALVE: L.0 q 17 E- 12 0 f 6 KIND OF LINER: SIZE NONE LIMIT: i.,:, d 7-% 19 o 157 rs P, DRAFT HOOD: REGULATOR: LIMIT SETTING: �� FILTERS- SIZE: /bK2, `x V NUMBER: / FAN SETTING: �% - 1120 CHIMNEY. INSIDE OUTSIDE PILOT TYPE: 09 F -1c CHIMNEY CONSTRUCTION: v C-1 PILOT MAKE: PILOT MODEL: SMOKE BOMB: WIRING -eve` l0 V PILOT TIMING: j ;, DRAFT: TEST TAG: L.W. CUT OFF: DOOR PRESSURE: LIGHTING INST: PRESSURE: r �G`� % CO2 (DATE TESTED: �-? INPUT CFH: 7!? 0 0 ' % 02 -7s COMPANY TESTING: Al A P 5�Y- STACK TEMP: I% CO f NAME OF TESTER: Led° ®% 14 -2-- CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUNIRFR OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2003 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS ro/ 7 DS 002 Sj_ 'X r� New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby -declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 2 / 203 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner® Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMP Y Reinspection Fee $47.00/Hr SIGNED BY TEL N0. %6 3 o 0 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 % Sb MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 SURCHARGE TOTAL FEE $ c PLUS THE $.50 STATE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r'QMMQN VENTS VFNT r.QNNFrTQR AND COMMUSTION AIR VFRIFICATION When replacing an PAsting,juran _ _, 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 plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit 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 ( ) The axinting cemhLstion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to inettall a new enmhustinn airy it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When installing a n _3u y _nting nystpm, 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 BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 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 HEATING CO: Signed By. Date :