PRE 2010 DOCSDate
Owner .
BUILDING
Village of Fri
�.:. ...............................
Address.......J.................................
P ;, RMIT
il6y, Minn.
N° 2258
ss.........................................
LOCATION OF B�ILDING
.. 0,
No. .... j�.... .. Street .....!..�: !. ....1. .... J Part of Lot
q�
Lot ... i
Block .. .......... Addition or Sub- vislon .........
Corner Lot .. .... Inside Lot .... Setback.40
... .............
r, Side
DESCRIPTION OF BUILDING
To be Used as:
..:..... Front . ?i: .. Depth Jr't-Height , ! . .. Sq. Ft......... Cu. Ft. ........
.................. Front ........ Depth ........ Height ...... Sq. Ft......... Cu. Ft.........
Type of Constructi n ! ... Est. Cost ...... t.... ... ...... To be Completed ..............
In consideratio i 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 vllage of Fridley.
i,
In on ' er of the payment of a fee of $. ':'.. permit is .hereby granted to . .... .
• . • ....... ... to construct the building or addition described above. This permit is anted upon
the express conditi n that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around an upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, m intenance, repair and moving of buildings with-
in the village lima and this permit may be revoked at any tim pon violation of any of the provisions of said
ordinances.
..1 .. Building Inspector
I
NOTICE
T
his permit does not cover the construction, Installation o� alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
i
•
0 •
City of Fridley, Minn.
BUILDING PERMIT N® 6682
Date:
Owner: Builder
" 2
Address Address
ONO BU WING
No. 4-�040— Street 0 C.Z-t,&A g— Part of Lot
Lot —__ Block Addition or Su - on
Corner Lot — Inside Lot __ s� ,Sttback Sideyard—��
Sewer Elevation Foy dation Elevation
DESCRIPTION OF BUILDING
TO.
Front Depth Height Sq. Ft. Cu. Ft.
Fro, _ _.....__ Depth ght Sq. Ft. Cu. Ft.
Type oT
tio Est. 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 Incomfiance with all provisions of
ordinances of the city of Fridley. / % X P /� - -
UM
In consideration of the payment of a fee of �i ., 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 permit may be revoked at any upnon violation of any of the provisionsprovisionsof said
/ ii � l
ordinances.
Building Inspector
NOTICE:
This porn* does not cover the construction, installation for wiring, phnnbing, gas heating, sewer or water. Be are to as
the BulMing Ingw for for separate permits for these *era.
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LOT N 6611-ou ori 1- SIZE X0 X
BLOC � _ADDRESS /(' - 7 �9 � e. A VALUATION
ADD. ,f"fc,/TYPE
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�+/ ��°.^Sf�7�/ �Q' X ��' U.��iC S�i1✓v Wr�%2 /,'l�S� e+?S S�nw/!.
�+� ����►�C� ,L at. ���nJ.or� ,i c•r7i' �c��ks��P! S�rJ�S �y.s� /J/c��/
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SUBJECT
PERMIT NO
City of Fridley
15 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
rp
RECEIPT NO.
u ____ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 � �
CITY HALL FRIDLEY 55432
NUMBER
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
TREV.
10/1/80
JOB ADDRESS 510 - 57t1i Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
T RACT OR ADDITION SEE ATTACHED
DESCR.
20
10
Donna 's Lakeview Manor SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
David & Margaret Engstrom 510 - 57th Avenue N.E. 571-4187
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
8 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQU1R �l + I ,
HEATING, PLUMBING AND SIGNS.
wQRNWS
sebs dk^V
all
kC-QUMEDsy L4W
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
384
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
$14,300
$7.15
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-
$87.00
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$21.75
$115.90
SIGNATURE OF CONTRACTOR 0) AurHORIZEDAGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
zi,
/6/_/A4d
BLDG INS11 BATE
SIG T REOFOWN RIIFOWNE UILDERI IDATEI
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alferations, Additions, or Repairs)
LIJ(-STIoal BUILDER: �i►a � ►�1�a�C�►�a�i t kOa1
ADDRESS • 5 ICS Aq Ci\iuE N ADDRESS: t® 51+17) A*c, .N S-
TEL NO: TEL NO: 5-71
Construction Location
STREET NO: LC) STREET: �`�A_i-N �y �1��� (_
LOT:
BLOCK: ADDITION:
Corner Lot: v*" Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIO14 OF CONSTRUCTION
_ Jf� Front: C r
T6 Square. Feet:
Front:
Depth:
Cubic Feet:
(o 1
Height: C_c)
Depth: Height:
Square - Feet: Cubic feet:
Type of Construction: U_bU'L JA::�'
To Be Completed: r�S
Proposed Driveway Width If New Opening Is Desired:
1 � 130u
Estimated Cost: $� -a-
Alt. A Alt. B
SEE REVERSE SIDE OF SHEET
7.7he undersigned hereby makes application for a permit for the work*herei.n 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 applicatio re jrue;and correct.
DATE: fz , SIGNATURE:
Stipulations: :W( jC 3'i ? 1(f, 3Q'(
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SUBJECTPE
O.
City of Fridley
19 0 35
AT THE TOP OF THE TWINS
BUILDING PERMIT
RE
�
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
��I�
r PROTECTIVE
�
i1 `
fir---;•� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
----�
L 612-571-3450
910-F15
6/25/87
JOB ADDRESS 510 - 57th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
20
10
Donnay' s T-akview Manor Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Michael Cheurette 510 - 57th Avenue N.E. 771-8405
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sane
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
Install outside handicap ramp and deck: & bathroom remodel
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOA
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
.,
VENTILATING OR AIR CONDITIONING.t
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT. t
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
$1, X00
$ r0O
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
A A_ 6A
$18.00
1 Roc T nl o R UT oRIZE A I (DATE)
WHEN PROPERLY LIDATED/T�HIS IS YOUR PERMIT
Iy� 01f ,
SI NATURE OF OWNER IIF OVOkM BUILD IDATEI
BLDG INSP nATE
01
NEW [ ]
City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. I ] Building Permit Application
Construction Address: sl o s- % AJ Lj
Legal Description: lkT . :10�01
� �p '
Tel. #
Owner Name & Address:
Contractor: Tel. $
Address: JV
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Corner Lot [ ]
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. _
/
'?W4 -T(, aa4-,
kvA O 0
Inside Lot [
] Ft. Yd. Setback
Side
Yard
Setback
Type of Construction: LU0Y-fo C&A��
Approx. Completion Date:
Estimated Cost: $ LQ2r6
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: ek P for Explanation
DATE: ' APPLICANT:
Tel. 7 Y'q&5
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
/00G,00
X00
SUBJECT
City of Fridley
1Z
25431
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir
• ______ COMMUNITY DEVELOPMENT DIV.
v
r PROTECTIVE INSPECTION SEC.
t�
1 . �
NUMBER
REV
DATE
8/26/97
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 510 57 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
UEATTACHED
DESCR.
20
10
Donnays Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Jan/Mike Chevrette 510 57 Avenue NE
571-5830
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
L J Roofing 10151 Foley Blvd NW, Coon Rapids MN 55448
767-1587 9036
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
Reroof House & Garage (27 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$2,251
$1.13
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-
$74.75
Fire SC $2.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$83.13
SIGNAT F CONTRACTOR OR AUTHORIZED AGENT IDATEI,
PROPERLY VA
TED THIS IS YOUR PERMIT
&W4EN
BLDG INISP
GATE
SIGNATURE OF OWNERoF OWNER BUILDERI IOATEI
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 510 0
Legal Description:
Owner Name & Address: 14 Tel. #
Contractor: L-1 40v �^ MN LICENSE #
Address: l o (Sl
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
GARAGE AREA: Length Width Height
DECK AREA: Len Width Hgt/Ground
OTHER: . � �n A le o�
_r 71- J77 0
°103
Tel. # 7b 7- IfT7
_ Sq. Ft. _
_ Sq. Ft.
_ Sq. Ft.
� v
Construction Type: tar '9-ff t- re /'oa T Estimated Cost: $ xs-/
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ $
DATE: �2 APPLICANT: Tel. # 7� 7- If -P7
STIPULATIONS:
CITY USE ONLY
Permit Fee
'rr
$ �1, FJ�'
Fee Schedule on Reverse Side
Fire Surcharge
$ . �S'
.001 of Permit Valuation (1 / 10th % )
State Surcharge
$ /,/.3
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$ S-,00
$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
$ P- . I
STIPULATIONS:
sue�EtT
EMITO
City of Fridley
343 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC,
i 1 CITY HALL FRIDLEY 55432
�''
I ,
NUMBER
REV
DATE
PAGE OF
A VE0 By
612-571-3450
910 -FIS
10/2/00
JOB ADDRESS 510 57 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
20
10
Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRES$
ZIP PHONE
Mike/Jan MR Chevrette 510 57 Avenue NE
571-0875
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Design Renovations Inc 1128 W 7 St, St Paul, MN 55102 651-227-7044 20078966
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 j] ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Construct a 49' x 40' House Addition; a 28' x 26' Garage Addition; and a 12' x 12'
Dec
8 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS
REQUIRED FOR:
WIRING, HEATING
MR a
PLUMBING AND MGM
Before digging call for
all utility location
4540002
REQUIRE® BY LAW
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
MOT
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
$180,000
$90.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF Aq& OTHER STATE OR LOCAL LAW REGU TING CON-
Fire SC $180.00
STR TIO OR E PERF OF UCTI
$1,441.75
PLAN CHECK E
TWOT FEE
Lice C $5.
0
,716.75
SI ATUREOFCON'RACTOAORAUTNORIZEDAGENT IDATEi
H PR P
ALIO Eff THIS I YOUR RMI b
I
S-GNATURE OF OWNER.iF OWNER BUILDER, IDATEI
I
BL INSF'
r)AIt
NEW [ ] Effective 1/12000
ADDN ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: V—/1w
Legal Description:
Owner Name & Address: Tel. #
Contractor: r ?k- MN LICENSE
Address: /o�T 4/ Tel.� ap
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 44Q Height Se q. Ft
GARAGE AREA: Length_ Width Height Sq. Ft
DECK AREA: Length Width IZ— Hgt/Ground_&-/-r Sq. Ft
OTHER:
Construction Type: �, ,r,� i�� Estimated Cost: /82 0062
Driveway Curb Cut Width Needed: Ft. + t = Ft x $ _ $ 465r
f®�/-
DATE: APPLICANT• Tel. #�s�'�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ �7Jr Fee Schedule on Reverse Side
Fire Surcharge $ /�, 00 .001 of Permit Valuation (1/10th%)
State Surcharge $ 90.49 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
111911111
STIPULATIONS:
$1100 per SAC Unit
$ .57 40 $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 [ ]
$ /;7/4 - ?-'5- -"'
(—'-']E R T T F T C A T E O F
FOR MICHAEL CHEVRETTE
510 57th Ave. NE
Fridley, MN,
Legal Description: 'I
Lot 20, Block 10, DONNAYS'S LAK
1t---�-- x x
CC,v4°n/ linn� fE.riGE
i
I
Scale: 1'j = 20'
o Denotes iron monument
Bearings are assumed
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Lf /
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' 6- i �v�u
S U RVEY
r
I
JIIEW MANOR ADDITION.
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• _ 7�A� - 5�9'o5y-� Nye _
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I hereby certify that this is a true and correct representation
of a survey of the boundaries of the above described land and.of
the location of all buildings, if any, thereon, and all visible
encroachments, if any, from gr on said land.
As surveyed by me this 23rd/day of A gust, 2000.
Herb F. emire R S
Minnesota Reg. No. 13349
4416 Abbott Ave. N. f
Robbinsdale; MN 55422
Phone: 763/531-0497
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440.610
srve y
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L, or' Zo
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i 24 /,a wog 6"xi'I
• _ 7�A� - 5�9'o5y-� Nye _
1 i
I hereby certify that this is a true and correct representation
of a survey of the boundaries of the above described land and.of
the location of all buildings, if any, thereon, and all visible
encroachments, if any, from gr on said land.
As surveyed by me this 23rd/day of A gust, 2000.
Herb F. emire R S
Minnesota Reg. No. 13349
4416 Abbott Ave. N. f
Robbinsdale; MN 55422
Phone: 763/531-0497
fCo Aka: hh4"w
R�r4."e"r/6 wart
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Neck MM HE
R4asesats Energy Code
P49check Sftm Version 10
YIYLE: dike and Jan Chevrette
MEMO:
510 Ft Ave I
Fridley 1.
COf Moog'.
Design 8enooations,lm.
1128 R SePesth St.
St Pool., DD, 55102
851-M-1044
Required 2 = 329
Yoor On = 2F
21.11 Better Yhas CA
I I
I I
I PemDit # I
I I
I I
I Chekd byl�te I
I I
Area or M4 Cast. Glaainqu
Perimeter R-Valoe R Valae 0-Yalse 2
MM: Raiff Yross 1888 44.0 44.0 21
mm: Rood Fray, IF O.C. OF 19.0 2.0 81
BE oz. 7.81 ht18.5' 011.8' dssol 1018 10.0 0.0 10
MM, 84sdows or Doors, Aleve Grade 2R 0.350 89
DJC 41 0.350 H
CB4BL: Concrete IF ht192° 0110, issol. 0 11.0 D
MC MP>4uRY: Furnace, 92.0 M
CGRPIIBRCE SSI: the proposed bsildieq dmp d here is
cossisteat with the bd# plass, s*imtioos, and other calalat ons
sniffed with the pit applicatioo. 2e proposed bsildisg has b w;s
desigod to at the *remests,�the knoesota Doery Cade, j
All 1,7717w! 1101 P��M&a mvpmpffl�— =
(--,41 . E R Ir T IF T CA Ir IE OF
FOR MICHAEL CHEVRETTE
510 57th Ave. NE
Fridley, MN, A --:-- ---
6 7 �i7 lqaewaa IVIE
Legal Description:
Lot 20, Block 10, DONNAYS'S LAK Vf
Ic
S cale: 1 20'
o.Denot' el iron monument
Bearings are assumed .
MANOR ADDITION.
M -A
440- 6'1D
owe
03.3 -21
2.7
All
2-6
'V -a ------7
L
/2'x
or 20
A"A a A0, **25 1
WA
I hereby certify that this is a true and correct representation
of a survey of the boundaries of the above des'cribed*land and -of
the location of all buildings, if any, thereon, and all visible
encroachments, if any, from r on said land.
As surveyed by me this 23rd ay of Augt, 2000.
Herb F,Itemire RLS"— —
Minnesota Reg. No. 13349
4416 Abbott Avd4 N,"
Robbinsdale, MN 55422
Phone: 763/53,7-0497,
_,,COWAVIe, MAW '
00, W444
Is
CITY OF FRID4EY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas*`
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () Nc
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
CO -
JOB ADDRESS 510-S-7 44 1 vP- N, C FA I'd Le
Y
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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner /k' IZ . 1,Y7 Ike— G A 'e ✓'-e. 7f -Ac
//—/7— ,200c'
Imo ' Building Used As Ai; !
Estimated Cost :57, y U 0 , UIT— PERMIT NO.
PLUMBING COMPANY L/( Tv
SIGNED BY d,.'Y 0
Approved By f LS// Rough -In Date
TEL N0. 6jr/- x -17-/V3 Z
Final Date ;7 -,26 -(f l
State Surcharge $ .50
MINIMUM FEE 4-R ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $ •S� PLUS THE S.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existina furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is 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 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 manufacturers specifications. Yes () No ( )
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 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) C
HEATING CO: /� �/LeG�.✓c
.
Signed By:
Date: //-/7— z �� c>
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
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 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.
Effective On January 1, 2000
JOB ADDRESS (0 Ak L
OWNER AIR. AV/C Ci�eU'ef{�
TOTAL //
BUILDING USED AS
$ 3d� #'571 ,3cr�
ESTIMATED COST 7-,y0 • PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_L_ Circle One (Steam) (Hot Water) arm Air
$ Trade Name /fit Z- Size No.
�r BTU_ Ooo HP EDR
Fuel 01S Total Connected Load 100,OOo
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$,�
DATE
HEATING CO L -
Signed TEL # Z -7 - N 3
—Z
Approved By Rough -In Date Final Date o� '-2-8-0/
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes (vf No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
es No( )
The undersigned also verifies that the replacement unit is a listed assembly
Appliance #3 Type
and meets the current codes and manufacturer's specifications. This does
Total Appliances
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
es ) No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
es No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
No ( )
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 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)
U
HEATING CO: (/ ` T-'' 14e -c`14. yr ,,* L �
Signed By: Date: //-/7 - 00
HOUSE HEATING TEST RECORDNumber
Street Name St,Ave,Blvd,etc. N,S,E,Vd
Address
-10—S -7
S -MI 4LA-- No
3s
Occupant Suite/Apt # Floor #
Property Owner`
�i c L if /Ae city —
Ime-
`720
Sold Bylle M�G�jq-�/< �j��, Installed
by /
Electrical Work By Gas Line Work by
leoT6 c®��L✓G`
HEAT Date Heating Type o
LOSS Installed �— /— �� Heat
orced A Hot Water L Steam
Space Heater Lj Unit Heater ❑ Other
�L GAS DESIGN
Make 0044 F0x4' ,,tA'Ke< Input _ C"0
CONVERSION
Make of Burner Model
Model &W,< (.)0 N16 Serial# L00yy-3(�
Max. BTU Rating
CONTROLS
THERMOSTAT Heat Plug
Make of Furnace Model
vent Size a� p o c, z ar
Valve
Kind of Liner Size None
Draft Hood Regulator
LimitA1
bre Li it Setting (eQ -Sec—
Fan Setting /3()//S-0
Filters: Size Number /-
-Pilot Type 1 '
Chimney Location: Inside Outside
Pilot Makei 1 S �Q
Chimney Construction
Pilot Model . ileCTw�1C . T� Pilot Timing S� J
Spillage
L.W. Cut Off A//AL-
Smoke Bomb Wiring Aj oqcc�k
Pressure �� Percent CO2 : 076
Draft c)✓vP+ Test TagglA4S /
Door
Input CFH l G(, 00Percent O2 C70
Pressure Lighting Inst lq� of
Temno- V1any %O �!% �4ri1vtE4 L -/bloc TDate
ested I -2(-®
Stack Temp. `� Percent CO
®�
Name of , P CofC
Tes er Number /oZA70
C1(7j.
,j
SUBJECT
City of Fridley
d7215
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
6
r
00
E
NUMBER
REV
DATE
PAGE OF
APPROVED BY
_
E /"'1 CITY HALL FRIDLEV 55132
j 763-571-3450
910 -FIS
10/28/02
10B ADDRESS 510 57 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
20
10
Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Cheverette 510 57 Avenue NE
763-571-0875
J CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Roger Heine Contracting 10000 Abbott So, Bloomington, MN 55431 612-812-0328
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20106910
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Install basement egress window within existing opening
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.
Caulk and flash all
exterior openings.
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 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
$1,400
$.70
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION NY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION 0 T E P RFORMANCE OF CONSTRUCTION
$50.95
Fire SC $1.40
PLAN CHECK FEE
TOTAL FEE
Lic se SC $5.00
$58.05
SIG NATUR OF N• ACTORO ED AGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YO R PERRM,
T
�('
SIGNATURE OF OWNERIIF OWNER BUILDER, IDATEI
lOG INSF'
FlATE
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN (j 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: % t�� )qy E
Legal Description:
Owner Nari
Contractor.
Address: I Lj U v v H .S 1. n v V ED ( UQ M r ei. #[y/ /
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 Wdth Hgt/Ground Sq. Ft
OTHER:
Construction Type: ice s. -e Vv JO 1,J Estimated Cost: $ 1 14 o o
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$
DATE: 1® d ;Lr . ° --APPLICANT. _ Tel. #41; 1r,2 03 24 --
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residerital Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by*Engineedng
Agreement Necessary [ ] Not Necessary [
TOTAL $ a . ®s-- STIPULATIONS: