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PRE 2010 DOCSDate: "` IAI Owner: Address City of Fridley, Minn. BUILDING PERMIT N° �194 Address LOC. NOF BUILDING No. Street __ Part of Lot ry Lot Block a2. -- Addition or Sub -Division �- Corner Lot _ Inside Lot +�°� Setbackdeyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used � ;� ' Front Depth Height Sq. Ft. Cu. Ft Front DepthHeight Sq. Ft. Cu. Ft -OA 17 Type of Construction _,AJIA'_ Est_C�; To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. y 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 grantedupon 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 violation of any of the provisions of said ordinances. .n _ /—"� NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sere to see the Building Inspector for separate permits for these Rema APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners. Name !'G�,C `fc Builder `;rllm�/s'%�' S C`� Address Address® LOCATION OF BUILDING Z - No. 3 Street Part of Lot _ Lot Block Addi'tion or Sub.Div. Corner Lot Inside: Lot,Set Back S� Side -Yard SEWER ELEVATION p. FOUNDATION ELEVATION Applicant'.attach to this;.form Certificate of Survey of Lot and.proposed.building location. DESCRIPTION OF BUILDING To be used as: a Front Depth O Height ` Sq. Ft.'.. �� Cu. Ft. / ,3 FrontDepth 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in his application are true and correct DATE L SIGNATURE FA Schedule of Fee costs can be found on the Reverse Side.) • MINI R ENGINEERING CO. INC. ENGINEERS AND SURVEYORS LANG DUQVEYINO CIVIL S& MUNICIPAL ENGINEERING SOILS TESTING LANA PLANNIN® 6418-Sr.TN AVENUE N. MINNEAPOLIS 27. MINN. KE 7- 3637 C A fe 40 f S IN w wfp'i 5URvF-y Fop, Tom SIL`✓IS. -*�' IRON LOT 23 3-11\" L u LANI D ? " �-. r . WE HEREBY CERTIFY THAT THIS 15 A TRUE AND CORRECT REPRESENTATION .OF A SURYEY OF THE 80UNDARIES OF THE LAND ABOVE DE5CRIBED AND OP THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON , AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. GATED THIS pNor r4cv AU 159 MINDER ENGINEERING CO., INC. l ENG1lo4E� `g�� .... D sUj�v6/.R �� ,, // , Q(JS'�" Appfication for Power Punts and Heating. Cooling, Ventilation, AeMgeration end Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. .§.00 $ Repairs & Alterations --up to $500.00 ... :............. 5.00 $ Repairs &Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM 4, Furnace Shell & Lines—to 400 sq. ft. EDR Steam- ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTALFEE $_I $I� ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 Location City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn (A 1i� 1 196L r� Owner ��`l�l � 'f-� ' C� Y"l ��`� 1.�(� C-) k. , Kind of Used as To be completed about Estimated Cost, $ Old— a ding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, W�No Trade Name ) a Size Capacity Sq. Ft. E.D.R BTU A 0Q C )00 H.P. Total Connected Load -?- q PA q G Kind of Fue - c� Wil^ BURNER — Trade Name Size No Capacity. Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signed J Yw- 42 zM 7_59 Business Phone No'! YP. - r -- � -9 � D* a •. . a i6///!`/� SAT LOSS CALCULATIONS DEPARTIIAT BUILDINGS Weatherdr Gula Construction No. n Referenax Out. Wan Int. Wall Ceiling Roof Floor 0 19 -it, 3 E. 11I II htmdation F Room Length .� ° Wirth 16 Height S° j Fl.I g E D Room Windows and Doors-Xrackage and Area Windows and Doon- 4 Width Height No.of Lineal t . I Area width Height 1 No. of pane of pane lights of crack W. It. No. o[ pane of pano 2 Z 32 124 2 24 -2-4 48 4E4 I 1$ 1 9 1 3 g Total Btls. (-L.1 9 Requi ed sq: ft. E.D.R. or sq. ins. W.A. Leader area, l`7.1 .,r h , . t Room Lenirth 1;0A Width I I Q Height A Windows and Doors—Crackage and Area Room I Length '` Width 3 Y elg t No. of Lineal ft. Area No. of pace of pane lights of crack q. ft. ?,c&0 -s. 4 ZO JCoef. Btu Z. ®I I�dtlatlon ZOO 0 Infiltration Class 61150 5050 Glass & I 19 51 Exp. wall Net ev. wall 19 11 IQ 19 10 Net esp. wall Int. wall I Int. wall Ceiling ZZA to Z Z O Ceiling Floor ZZ -9 1 1 159(.1 Floor Total Btls. (-L.1 9 Requi ed sq: ft. E.D.R. or sq. ins. W.A. Leader area, l`7.1 .,r h , . t Room Lenirth 1;0A Width I I Q Height A Windows and Doors—Crackage and Area Room I Length '` Width 3 Y elg t No. of Lineal ft. Area No. of pace of pane lights of crack q. ft. ?,c&0 -s. 4 4 0 2 36 b 4 i 6 I Z. ®I Dar, ej 19 1 a Coef. Btu IfAbration 0 Can SO 50 O Esp. wan CA60 Ceiling Net ozp. wall Floor Total Btu. ' 50, At op is*e•+ltalt,19 FU J Room I Length LW Width $ Ceiling 1 0 19S-1 Nat esp. wall 601 101 1500 Int. wall Ceiling 143 /ol 143p Floor 143 771 1001 Total Btu. 1 8 Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.1 VJMD Room I Length '` Width I 13- Height Z!s Trujows and Doors--Crackage and Area Fl -1 4 4�etoRoom I Length 11 L Width $ Q Width eighto. Llaeal ft. Area srs. of pans of pace ligYts of crack eq. tt. 4 i 6 I CME an Infiltration 4 - Glass 46 Infiltration Z Coef. &n lafdtratpn too 0 Can Net exp. wall A& JOL 50 O Esp. wan Ceiling Net ozp. wall Floor Total Btu. ' 10 Int. wan FU J Room I Length LW Width $ Ceiling 10 Floor Tbto1 Btu. Faired sq. ft. E.D.R. or sq. ins. WA. Leader area ,. 11 z t, Coef.1 Sta 2 A -o 1 Z 9'O NEE Total Btu. - - Required sq. ft. E.D.R. or sq. ins. WA. Leader area 149 Fl -1 4 4�etoRoom I Length 11 L Width $ Q Heigh Windows and Doors--Crackage and Am Width Height No. of Lineal rt. Area No. of pace of pane lights of crack p. tt. -Z4 -z IL 5 1 CME an Infiltration 4 - Glass 46 Infiltration Z Z O Glass ZZ so too Exp. wall 'a Net exp. wall A& JOL Int. wall Ceiling Ago Floor Total Btu. ' Required sq. ft. E.D.R. or sq. las. W.A. L.aader area FU J Room I Length LW Width $ Height 8 Windows and Doom--Crackage and Area a Idt► elg t o- o[ lAn"Ift. Area No. of pans of pane lights of crack so. ft 149 CME an Infiltration 4 - Glass 46 Exp. wall Net exp. wan Int. wan Ceiling Floor Total Btu. OIS Rewired sq. ft. E.D.R. or sq. ins. ®VA. Leader area 0 n U • City of Fridley, Minn.. BUILDING PERMIT 4C. */ -'qY N° .7094 Date: '/', / '� — (' V Owner: Builder - Address Address -_ LC---C�N�OFNG No. Street � o Part of Lot Lot__ Block Addition or Sub -Division . Corner Lot Inside Lot _ _ �� Setback ideyard __�� Sewer Elevation -- Fofindation Elevation DESCRIPTION OF BUILDING T �_ yg Front Depth Height Sq. n,<& Cu. Ft Depth Height Sq. Ft. Cu. Ft. Type of Constructio 2Est. 4//�-Vg� To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. , „ // f '4 U 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinance. --=, A A �1 NOTICE ibb permit does not cover the construction, Insh an for wiring, plumbing, an boating, sewer or water. Be sure to we the Building htgmtor for separate permits for these hens. APP,LICATION FOR BUILDING. PERMIT CITY OF FRIDLEY, MINNESOTA, OWNER'S NAME !,a i 1_ L , Aa , L BUILDER - _-- ADDRESSate-/�,,. ADDRESS LOCATION OF BUILDING No. & 5 % Street Fart of,Lot Lot. Block Addition or, Subdivision_ Corner Lot Inside Lot�Setback 1/ : Sid -Yard SEWER ELEVATION — FOUNDATION ELEVATION Applicant attach to this form Two.Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: cr Front - Depth ight / Sq. Ft. Cu. Ft.��� Front Depth Height Sq. Ft.. Cu. Ft. Type of Construction Estimated Coat .To be Completed The undersigned hereby -makes application for 1. 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. DATE � e l , '� SIGNATURE r 11 (Schedule of Fee Costs can be found on the Reverse Side). 40 0 .. - City of Fridley, Firm.. BUILDING PERMIT • Date: Thomas S. Silvis Address _ x,31 StSt, N. E- Address 6020 Wymmood R. N? '7732 LOCATION OF BUILDING No. 6131 street 5th Street X. E. Fart of Lot ,.at 23 _ Block 2 Addition or Sub -Division . uplands.' 2nd Addition Corner Lot Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft Front Depth Height Sq. Ft Fat cost 5y390.40 _ To be completed • Storm damage Repair Cu. Ft Cu. Ft In consideration of the issuance to me of a permit to construct building described above I agree to do the proposed work in accordance with the description above set fo and in compliance with ajl provisions of ordinaaoes of the city of Fridley. _ "� C — In consideration of the payment of a fee of $10- , permit is hereby granted toThomas Ste- a 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, Minnesotaung location, construction, alteration, maintenance, repair and moving of buildings within cesthe city limits � this permit may be revoked at any time upon violation of any of the provisions of said NOTICE Ob pensb don net sever Nis contrustion, hwhdld on for wh M phmabby, gn hating, sewer or water. Bo sen to ae &S Bulk"no hupomr for separate permits for Nan hmm APPLICATION FW BUILDING PERMIT CITY OF FRIDLEY XtURESOtA - OWNER'S' NAM BUILUE ADDRESS/�`— �5� - %` ADDRESS .e,_ -,2V' 01 LOCATION OF BUILDI G No.street '— Part of Loth__ LOT '2 BLOCK ADDITION OR SUBDIVISION 6 Corner Loth Inside'LOT _Setback 'Side ward__ SEWER ELEVATION. _-_- FOUNDATION'ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. = DESCRIPTION -0F BUILO$1G To be`u4ed as; _ Front Depth Height Sq. Ft, Cu. Ft. .Front Depth Height Sq, Ft. Cu. Ft; Type of Construction Estimated Coo t��� Ta be completed The undersigned hereby makes application fora permit for the'work hetein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of 'thd, Department of'Buildiage,' and- hereby •declarei that all the facts and , represen Ation s stated in this, application are true and correct R ISA SIGMA (Schedule of Fee Costs can be found on the Reverse Side). FROM Thome S. "IdIvis 6020 Wryaiavood FOO join. , Yl=. 55422 Proposal 544-3919 Proposal No. Sheet No. Date I- Proposal Submitted To I Work To Be Performed At I Ia„r (,Lggt City State Date of Plans Telephone Number. We hereby propose to furnish all the materials and perform all the labor necessary for the completion of oarage; rebuild to form a straight square plwb strueturs properly anchored to All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings an s ecifications u �nfitted for above wot an com I d in a substantial workmanlike manner fq�.,j, wum of �e LY101i88.r11'8e hUAdTBQ niAe`Ey A� DA�w - - - - - - - - - -Dollars ($ 5i33`1��. 1 with payments to be made as follows: Total amount due on completion. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessaryinsurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by Respectfully submitted Per Note —This proposal may be withdrawn by us if not accepted within Len days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. F rldle7, Minn.Signature �r _ '-CAJ c ' ' Date Signature �. LITHO IN U. S. A. TOPS FORM 3450 '/ SUBJECT PERMIT NO. City of Fridley _ 218 7� AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i I "q r 1 1 1 NUMBER REV ATE PAGE OF APPROVED BY t CITY HALL FRIDLEY 55432 � 612-571-3450 910-F15 r5/26/93 / JOB ADDRESS 6131 - 5th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED 23 2 Uplands 2nd Addition SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James T. Saefke 6131 - 5th. Street NE 571-4592 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 Ej REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (.22 Squares) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State wilding Code, 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 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 $� 88 $,59 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT f7 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $291 00 Fire SC $1.19 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $30...78 SIGNATURE OF CQALTRACTOR OR AUTMORI ED AGENT IDATEI P RLY V LIDA D THIS IS YOUR PERMIT T/Ue A3 L]41HE T DG 1NSP \ DATE iGNATURE OF OWNER 1 F OWNER LDERI IDATEI '/ NEW [ j Effective 1/1/93 ADDN [ j CITY OF FRIDLEY ALTER[ j SINGLE FAMILY AND DUPLEXES R -I AND R-2 *7 0'3 Building Permit Application Construction Address: (p/ / 3 / S rs / 7 .� 7. Legal Description: O 7- -,,?3 6Z-0 CK �'� oa4�4 Owner Name & Address: _ �S���f« Tel. # -5-.-7 Contractor: MN LICENSE # Address: S /21220- Tel. # S 4_9L�'Yl[= 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. T OTHER: do — r O o -tn A h -Lt eie &' cT Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ / /c3c; Ft x $ (Cost on Back) DATE: APPLICANT: Tel. CITY USE ONLY Permit Fee $ �', ��� Fee Schedule on Reverse Side Fire Surcharge $ A 1c7 .001 of Permit Valuation (1/10th%) State Surcharge $ ��/' $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ j TOTAL $ �3 0 STIPULATIONS: SUBJECT P City of Fridley 2 8 0 8 7 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. 16. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC (03 313 1 � NUMBER REV DATE PAGE OF APPROVED BY = 1 CITY HALL FRIDLEY 55432 ,'� 612-571-3450 910-F15 10/2/98 JOB ADDRESS 6131 5th Street NE I LEGAL LOT NO. BLOCKTRACT OR ADDITION SEE ATTACHED DESCR. 23 2 Uplands, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR Norling Exter's►DORESS ZIP PHONE LICENSE NO zta 341 79th Way NE Fridley M 55432 55432 20098700 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 O ALTERATION 3& REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace storm damaged trim 9 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet 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 SQ. 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 500 $.50 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 $21.00 Fire SC .50 PLAN CHECK FEE TOTAL FEE SIGNATURE OF CON•RACTOR OR AUTHORIZE G T IDATEI WHEN PROPE VA IDATED THIS IS YOUR PERMIT 1 S,GNATUREOfOWNEROFOWNER BUILDER, -,DATE, BVbG INSP TIATE NEW 4 [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (1(-3 Legal Description: Owner Name & Address: Contractor: k PI.— i Address: S'cp e— Tel. # c L ., MN LICENSE # Ld Tel. # 7 8y A-9�3�- 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: Construction Type: r p toe-, fg4, Estimated Cost: $ (Fee Schedule on Back), -5- " Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Permit Fee $ Fire Surcharge $ State Surcharge $ t% SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ 2,7, d'0 STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $ . 00 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning - All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ Commercial/Industrial 1.251y. of Value of Appliance or Work $ 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. $ .50 $_23o -.50 JOB ADDRESS � I3 1 — 9TH' St N E OWNER Ti m SA e -P k BUILDING USED AS lu'f i i9 Co Effective On January 1, 2000 ESTIMATED COST aLfO O • 00 PERMIT NO. 'C /' DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units I Circle One (Steam) (Hot Water Warm Ai Trade Namur , gAi a rU Size No. C1.3 o BTU (o , &;c) HP EDR Fuel ri21At. (oAS 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. River City Sheet Metal, IrMATE l I — da - od 9928 Bluebird St. N.W. HEATING c1g®on Rapids, Ie/N 55433 Signed 754-2199 Fax (612) 754-290 g L # Rough -In Date Final 0131 - 5 i-4qs �_ (1Z COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the Diameter in venting has been examined and is free from rust, deterioration, obstructions, Appliance #2 Vent Connector Height ft and is securely supported and firestopped where required. YesJo ( ) The venting system is plastic/PVC and meets all current codes and manufacturer Appliance #3 Vent Connector Height ft specifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly ALTERATIONS: (Describe)1-5a�%j®AJ 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. YeW No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes F 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/"" -o ( ) When installing 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] Central Furnace Venting Tables for fan assisted and natural draft appliances. Yeses 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. YeA ) No ( ) Appliance #1 Type BTU Input 6'00,,00�D a -Pssist2d)ort& OrNat Appliance #2 Type HSA rt= BTU Input ©VO OFan Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances 2_ Total Btu Input,/Dace-, Common Vent Type' Vent Height t " Diameter inches Appliance #1 Vent Connector Height _-5—ft Length ft Diameter in Type t34<_ Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe)1-5a�%j®AJ HEATING CO: Signed By: Date : N SUBJECT PE City of Fridley 3 0 5 9 AT THE TOP OF THE TWINS BUILDING P E R M I T Ir ` RECEIPT NO. • -------COMMUNITY DEVELOPMENT DIV. SEC 5072, r � � PROTECTIVE INSPECTION 672-3604 1 r CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY L 763-571-3450 910-F15 9/10/02 JOB ADDRESS 6131 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 2 1 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Saefke 6131 5 Street NE 763-571-4592 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Norling Exteriors Inc 341 79 Way NE, Fridley, MN 55432 763-784-8936 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20098700 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARATE PERMITS ARE REQUIRED 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 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 $10,675 $5.34 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- $195.25 Fire SC $10.67 TION OR THE PERFORMANCE OF CONSTRUCTION T PLAN CHECK FEE TOTAL FEE "-.7J•� - Licens C $5.00 $ 6.26 S ATUREOFCONTRACTOR ORAUTHORIZED dWtNT (DATE- ENP PER 'IDATED IS IS YOUR PERMIT SIGNATURE OF ONEPF OWNER BUILDER -DATE PATE N NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: J�.Y, SR�� SR ^^ Tel. # Contractor. b /- /'r I tod .� �MN LICENSE # -.2 d0 92r7 0 Address / 3 �' / % `` w •� �/ 01 tle -f _ Tel. # 61-;)—1 d R 9 LMNG AREA: GARAGE AREA: DECK AREA: OTHER: 2 -0 T- %Y9,- fq-? 6 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 HgtIGround Sq. Ft Construction Type: j,' S +g ��� l �� e w(K d °ter Estimated Cost: $ l �� 67 S• e Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ -=$ DATE; `/o `Da- APPLICANT: Tel. It SSP ��91 Call (763) 572-3604 for Permit Fees If mail ng in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ 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 $ �� (� �� STIPULATIONS: Building BUILDING Permit No.: Zb(ho Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date E,khy IN, 763-502-4977 FAX EFFECTIVE 1-1-2011 1 DATE - 3 / YOUR E-MAIL ADDRESS 'Y' I JC &3Y 4 C K hev i�ue\� eV $ , C� ►"► ,/r SITE ADDRESS 6.1 3 J 5--Ih 57 /V6:-7 V6- THIS THIS APPLICANT IS: ❑ OWNER `CONTRACTOR PROPERTY OWNER/ C NAME: si -�, '13 av b Sc, r- TENANT B ADDRESS: (7 1 3) -r l, % L CITY Ir-rL)l) LL�,/ STATE MAZIP �S V It PHONE: cry 3 - Si i '"q S Ta z / CONTRACTOR NAME: C.\C II-,/ C L C SUBMIT A COPY YOUR STATE LICENSNS E STATE LICENSE # 3 4 y ( LEAD CERT NUMBER AND CERTIFICATE OF _ 1 � / ADDRESS:4a3 O I� Liv y �'5- Al 0 3 CITY F 11 I i Z L-'� STATE/ / `ZIP % INSURANCE PHONEt — FAX 7 S% C PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ FAMILYINEW CONSTRUCTION STORIES PERMIT TYPEADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING OOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION DDITION ❑ MAINTENANCE/REPAIR ❑REMODELING. A (_ % l7 X 1 "� f � L_ C DESCRIBE WORK BEING DONE: 14-Y J H O/) ! % /OI'I/ '- C IZ UU,5 4 -OL -75 � EN ! S I I I✓ SIZE OF IMPROVEMENT LENGTH WIDTH Y HEIGHT SO FT ROOFING)t ❑ HOUSE ONLY NUMBER OF SQUARES❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE ZI U PROPOSED HEIGHT: 3. List of structural members to be used SIDING ��Jqa_ oIFOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. &PORCHES SUBMIT: ❑ Vinyl' f 1. Site Plan/Survey ❑ Aluminumim4` ❑ Tr I a ❑ Other rc3 �[ ❑ Fascia showing the existing structures and proposed project. 2. Two ® sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS -t_Et FOR WINDOWS -PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEFAS ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: WQ1'� SM T MAn FEE SCHEDULE) TOTAL JOB VALUATION $ '-•' t POCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2230 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$25=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of,,all}}''F�'ork� which require$ review and approval of plans. l % SIGNATURE OF APPLICANT 0',.. / --r C3 PRINT NAME (LIC P A fI V 611 I C IC KC V DATE APPROVAL INSPECTOR SIGNATURE of 31 5-1-14 STK �o i �3 o3�oC1C � G(�Ll�e1J� ,;too 4ODlIv.