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PRE 2010 DOCSCity of Fridley SUBJECT PERM 1440- 14819 AT THE TOP OF THE TWINS BUILDING PERM IT i. RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 7/25/78 JOB ADDRESS 7558 - 4th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 25 2 Osborne Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland D. Evans 7558 - 4th Street N.E. 784-1572 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 X ADDITION ❑ ALTERATION [IREPAIR ❑ MOVE 11REMOVE 8 DESCRIBE WORK Construct a 21' x 12` Addition to House 9 CHANGE QF USE FROM TO STIPULATIONS Provide smoke detector. WON di(;ittt ria lasi#t. utilittts TELEPH04E - EtEC?RtC I GI Etc. i REQUIRED BY LAW SEPW 'PE;RMIT$ REQUIRED FOR WIRING, HEATING, PLUM. N©' Ahb Mift ° SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 252 5040 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 Z 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 $7,721 $3.86 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- $20.16 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 5.04 $29.06 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PtN PROPERLY VALI ED THIS IS YOUR PERMIT 5 t �` � BLDG INSP /yd if 2� %O a e DATE S GNATURE OF OWNER IIF OWNER BUILDER) I (DATEP • CITY OF FRIDLEY ' APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) d OWNER: 4 ,r% C--tJ' .4 BUILDER: /4 G y Address : Address: Tel. No. 2—. No.: Zs s fj Street: LOT: CORNER LOT: BLOCK: ADDITION: INSIDE IAT: SETBACK: SIDEYARDS: 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: 1(Pt#�j %L-� AJC Front: �� ` Depth: �— Height: Square Feet V Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Con struc tion : F61-4 M C " LV0 ,j To Be Completed: .%P " / - 7F Estimated Cost: $ e?7a 1, 7d Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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 of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side f r additional information, DATE: SIGNATURE: Stipulations: a fnv� /�• 11Jliytti.6/� � i %f0 a9, .06 a -ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION , PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: o�� 17 ',Z -//A! OWNER/CONTRACTOR : /Lp Al -i p -P, I::--- CJ'l A JS ADDRESS: �� /if (��! PHONE: A. Determine the Total Exposed Wall Area as follows: Q 1. Total wall ndow rea 2. Total door area C) 3. Total sliding glass door area �,'i�z c7 4. Total fireplace wall area A/ Ev 5. Total wall framing area (average 10%) 6. Total net wall area above floor(average 900) 7. Total rim joist area Subtotal: Total exposed wall area above floor 8. Total foundation window area 9. Total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area GRAND TOTAL EXPOSED ROOF/CEILING AREA D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II K4 11 E. Determine the "U" value of each segment (1-9) and multiply by the area as , follows: 1. X "U" _ 2. X "U" _ 3. X "U" _ 4. X "U" 5. X "U" _ 6. X "U" 8. X "U" _ 9. X "U" _ ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. X "U" _ 11. X "U" _ 12. X "U" _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I + Item II = J. Add Item III + Item IV = K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: DATE: 9 AGREEMENT z owner of the property Te -- located at G L `-/ T._f _��. , have no o j tion to the City allowing the construction of a to be located at ��, without the required certificate of survey that the City ordinarily requires for all new construction. l Signature Witn s V 1 t 7.S - Address ��- -7k Date CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT m .,1 Y !�A n m J O U b O 'ypfr'I�flyy OJ Op a N 3 a� aao+ •.i�' m W t O 14l! o O W 9: N U fA u 14 4)a 1J N a .�% a yq l7 A w u N a+ qtly! (7 14 O water Heater 3as kec x $5.00 Water Heater - to 99,000 BTU x $5.00 100,000 BTU to 199,000 BTO x $10.00 Water Softener x $7.00 New Ground Run Old Building x $5.00 Electric Water Heater x $5.00 1st 2nd 3rd 4th (R) - Future Connection Opening M - New Fixture, old Opening Connected with Sewer Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE 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 BTO x $10.00 Water Softener x $7.00 New Ground Run Old Building x $5.00 Electric Water Heater x $5.00 GAS FITTING FEES: 1st 3 fixtures x '$3.00 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 TOTAL FEE REINSPECTION FEE f 510.00 ) TOTAL Job Address 9,r5 $ 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. - `t , 19 - OWNER KIND OF BUILDINGS� USED AS w� TO BE COMPLETED ABOUT ESTIMATED COST OLD - W BUILDING PERMIT NO. PERMIT NO. Company %/ c Signed By i `�Jiern L�Zt �.o Tel. No. '181- i5�a ROUGH INSP. Date FINAL INSP. A Date APPROVAL FOR PERMIT -f'- " MINIMUM FEE FOR ANY PLUMBING PERMIT I3 $7.50 pyUS $.SO STATE SURGE CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE C GRAVITY WARM WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ city of Fridley Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 each add. 50,000 BTU 4.00 Replacement of Furnace 7.00 Repairs & Alterations -u to $500.00 7.00 Repairs & Alterations each 03.7f5_00.00 4.00 STEAM OR -HOT KkTER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 each addn. 50,000 BTU 4.00 Boiler only up to 100,000 BTU 7.00 each addn. 50,000 BTU 6.00 OIL BURNER- to 3 gal. per hour $10.00 each add. 3 gal. per hour 10.00 GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x $10.00• AIR CONDITIONING FAN HEATING SYSTEMS see Fee Schedule VENTILATING SYSTEMS ALTERATIONS & REPAIRS State Surcharge TOTAL FEE ROUGH INSP. FINAL INSP. Date APPROVAL FOR PERMITJ/ REINSPECTION FEE ($10.00) S $ $ k MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 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, Minn_ , 19:E TO BE COMPLETED ABOUT ESTIMATED COST BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER BEATING or POWER PLANTS, Steam, Bot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR Company BTU HP Signed By \4n.r F) U131, Tel. No. i — s l k SUBJECT City of Fridley pi 17 610 AT THE TOP OF THE TWINS BUILDING PERMIT ` REC • ------- COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 � NUMBER REV. DATE PAGE OF APPROVED BY i -'-1 CITY HALL FRIDLEY 55432 t'"-"' ,•� 612-571-3450 910-F15 7/1/84 / JOB ADDRESS 7558 - 4th. Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 Osborne Manor SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Roland Evans 7558 - 4th Street N.E. 784-1572 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION El REPAIR ❑ MOVE El REMOVE X 8 DESCRIBE WORK Construct a 28' x 26' Detached Garage and remove ciaracre door from existi.ncr tuck under garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Agreement sighed by neighbor adjacent to detached garage. WARNING SEPERATE PERMITS REQUIRED FOR W1011V digging call local utilities (; Before TEtEMONE-ELECTRIC-GAS Etc. HEATING, PLUMBING ANO SIGN. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 728 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 $$ 160.88 $4.08 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVI ONS OF , NY OTHER STATE OR LOCAL LAW REGULATING GON- $74.50 ION O THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ✓'� X L/ $78.58 SIGNATURE FCON CTOR OR AUTHORIZED AGENT IDATEI N PROPERLY VALIDATED THIS IS YOUR P RMIT BLDG INS �/J DA E SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI AGREEMENT owner of the property located at -713-P , have no objection to the City allowing the construction of a to be located at 7� f without the required certificate of survey that the City ordinarily requires for all new construction. - Signature WTO Address 7/7 - Date G NEW ADDN. [ ] ALTER. [ ] Construction Address Legal Description:_ Owner Name & Contractor:_ Address:_ LIVING AREA: GARAGE AREA: DECK AREA: OTHER: City of Fridley �R-1 AND R-2 Building Permits Application Effective 4/1/84 ` Tel. #�— r 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 cZ Width c2 rz, Height l� Sq. Ft. 22:f— Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback -;r_-"x-- Type of Construction: Estimated Cost: Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ __t. A $ fee Back Page for Explanation DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ t2 S� Plan Check $ State Surcharge $ X�, ®'q SAC Charge $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: 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 [ ] I V ST1 STATE OF MINNESOTA DEPARTMENT OR HUMAN SERVICES 444 LAFAYETTE ROAD ST. PAUL. MINNESOTA 55101 Date City of Fridley Zoning Authority 6431 University AVe. N.E. Street Address Fridley, MN 55432 City State Zip Code DHS -2722 (9-85) PZ -02722-02 RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE Subject: �- Type of License: Name of Day Care Home Applicant Family Day Care Street Address Group Family Day Care _2�W x-_432 Licensed Capacity City 0 State Zip Code Phone No. This is to inform you that we are in receipt of an application for licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of this license is subject to compliance with the provisions of Minnesota Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as the Public Welfare Licensing Act and the rules of the Department of Human Services. You should note that under Minnesota Statutes, Section 245.812, Subvision 3, a licensed day care facility serving 12 or fewer persons shall be considered a permitted single family residential use of property for the purposes of zoning. Subdivision 4 of the same section indicates that a licensed day care facility serving from 13 through 16 persons shall be considered a permitted multi -family residential use of property for purposes of zoning. If we do not hear from you within will consider the above-mentioned your local zoning code. Sincerely, Licefising Worke Street Address 30 days after receipt of this letter, we day care home to be in compliance with COMMUNITY HEALTH & SOCIAL SERVICES DEPARTMENT COUNTY OF ANOKA COURTHOUSE, FOURTH FLOOR Name o A ency Organization City State Zip Code AN EQUAL OPPORTUNITY EMPLOYER CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDEIiTIAL RATE TOTAL Job Address Furnace Shell and..Duct Work, Burner (Also replacement furnace) $ 20.00 S -Building Inspection Div. 6431 University Ave NE FridleyMN 55432 P y Tel. No. 572-3604 Gas piping $ 10.00 $ (piping needed with now furnace) $ 10.00 $ The undersigned hereby makes application for a permit for the work herein Gas Range specified agreeing to do all work in strict accordance with the City Codes Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application &90 true and correct. Air Conditioning (all sizes) $ 10.00 S'1 All Others/Repairs and Alterations OWNER It of Value of Appliance or Work S KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS 4P° 11 of Value of Appliance or Work S y TD BE COMPLETED ABOUT ESTIMATED COST State Surcharge S .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. TOTAL. !EE S REINSPECTION FEE $30.00. S `•�� DESCRIPTION OF FURNACE/BURNER Rough Insp. HEATING or POWER PLANTS. Steam, Not Water, War' Air No. 0 �� Date Trade Name Size No.a Final Insp. Date Capacity ®ate Sq. Ft. EDR BTU NP Approval for Permit Total Connected Load % Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. FAR BTU HP MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT Company IS $15.00 PLUS THE $.50 STATE SURCHARGE Signed By Tel No. •Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Fill out back sine for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. Has been carefully examined Yes ( No ( ) 2. Is free from rust or deterioration Yes (Y) No ( ) 3. Has no foreign objects lodged within Yes ( ) No () 4. Is securely supported Yes (XJ No 5. Meets all current Code requirements for size and total BTU connected Yes) No 6. Has Total heating BTU's of 2-5-.�, All other BTU's 2 TOTAL J-1 -7 Remark s CITY OF FRIDLEY Effective Date January 1, 1991 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 TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 S All Others/Repairs and Alterations li of Value of Appliance or Work COMMERCIAL/INDUSTRIAL li of Value of Appliance or Work REINSPECTION FEE $30.00% Rough Insp. Date Final Insp. l% l Date Approval for Permit $ 10.00 $ State Surcharge TOTAL FEE S MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address 9,L4 UPx ST. , N , , Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 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. CT 10 . 1� OWNER R n L A W) F� a� s KIND OF BUI((LDDIING -FR A M r, USED ASy �i ��(� Li N G 1 TO BE COMPLETED ABOUT �® GT I 1 ICA 01 1 ESTIMATED COST ® 011_ OLD - NEW BUILDING PERMIT NO. PERMIT NO. / C 'qC' / DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel SUP14ER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company/, (-,AS �► Signed By Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes (-A No ( ) 3. Has no foreign objects lodged within Yes (i) No (�) 4. Is securely supported Yes) No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes No ( ) 6. Has Total heating BTU's of 0 00 All other BTU's ® ®® TOTAL ! 6. O� Rema rk s iWES, 4162 SUBJECT P City of Fridley 29354 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. `V __���_ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 9LI-14 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 4/29/99 JOB ADDRESS 7558 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 2 1 Osborne Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roland Evans 7558 4 Street NE 784-1572 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Thurs Construction 5717 113 AVe N, Champlin MN 55316 424-5624 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 O NEW O ADDITION O ALTERATION? REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (26 Sq) Tear -Doff 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 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 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 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 $2,228 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHAqf3E PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $74.75 Fir C $2.23 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FE TOT EE Li a SC $5 0 $83.94 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI r - ENL THIS IS S,GNATURE OF OWNER,IF OWNER BUILDER, [DATE, B'• G INS TIATE NEW [ ] Effective l/ 1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Role, r -ej r jQ 1, S Tel. # 7 �y /7 Contractor: 7r—% �o 7`' MN LICENSE # 1 C/)6 Address:. S1 /'7 — f I :�6' , r }fin , Lnnl,Tel. i1�a� s-6a�� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 6r, ^c,5 ,e Construction Type: oo r, o � Estimated Cost: $ A lP `-9 & 'x9 S' - d C) (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ Sad6 Park Fee $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Sewer Main Charge $ . Agreement Necessary [ ] Not Necessary [ ] TOTAL $-r-131 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 7, e� JOB ADDRESS 't/ RATE SCHEDULE OWNER /r Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $� (Side Vent - Fill Out Back) Gas Piping (N aurnace, $ 10.00 G ESTIMATED COST PERMIT N0. �A,, DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE representations stated in this application are true and correct. $21-5 7 %% DATE 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. HEATING CO Rough -In Date Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verges 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 Ventir.,g Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installina a new 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 ( ) Appliance Type and Size/Common Vent and Vent Connector Information 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 ALTERATIONS: (Describe) HEATING CO: Signed By: _ Date: Building $ BUILDING .Plan Review Permit No:. -61,9fy Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ Date Rec'd: 1 DATE n '02� O% YOUR E-MAIL ADDRESS $1550 per SAC Unit (Plans to MWCC for determination) SITE ADDRESS 7S58 41AX :Cr Nt F DCE,i , "A.J 5Sy.3e.• $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: $ TENANT 'EGL9VT -4 ST Al,I� ITY Fid / STAT O/WIP �03� ADDRES : 7S5849-4 $ PHONE (7C3/%W— IS%'�- Total Due CONTRACTOR NAME: /nl8"i•vr��-oN O.J��/D�S STATE LICENSE # r /10W EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:39,3Ir vOGJ CITY S% . L1,I Al' STATZ�eell? °� WITH APPLICATION PHONE C9tL ) CU? - l0 3'40 FAX9,� y3-? — /4"03 PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED)ffWINDOWS 13BASEMENT FINISH ❑ ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: NEW B/2y �) %✓OO SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S . Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGSYes [No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -D SCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLEDAN INSTALLLW14AOO NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ S S 9 `? OCCUPANCY TYPE Permit Fee $ ,j See Back Page for Fee Schedule .Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) / SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21=$ $Erosion Erosion Control $ - $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ o Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 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; that the work will be in accordance with the approved plan in the case of all work whic)lquires r�vige�isrt� jproval of plans. SIGNATURE OF APPLICANT