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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date:.'"° Owner: 4t �,Jder Address Address N° 5'732 NO',. ILDING No.[ Street �E - �._ Part Lot Lot — _ Block A ~tion or Sub - Comer Lot _ Inside Lot __ ` t SetbackSideyard Sewer Elevation __ Foundation Elevation DESCRIPTION OF BUILDING To Used yyrrs� �� ,,,// - Front -.� Depth Height A Sq. Ft & Cu. Ft pAV Front Depth - �,eeiight - Sq. Ft.Cu. Ft. Type of Constructionr Est Cost 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 world in accordance with the description above set forth and m compliance with all provisions of ordinances of the city of Fridley. lot In consideration of the payment of a fee of $Art permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viol n of any of the provisions of said ordinances. '001Nw � ,,.� Building Inspector NOTICE: This permit does not cover the construction, installation for whine, plumbing, gas heating, sewer or water. Be sura to as the Building Inspector for separate permits for thea items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder Address Address LOCATION OF BUILDING No. Street _Part of Lot Lot �� Block Z Addition or Subdivision 9e = .,- 11 Corner Lot � side Lot Setback - side-Yard.Z. SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Denth Heisht /9 Sq. Ft. Cu. Ft. Front.Depth Height Sq. Ft. Cu. Ft. Type of Construotion ,>�',>�. 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 representations stated in this ,application are true and correct. /// j -/W/ 2 - moi/ (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures i NO. ZF� 2 $1.50 Y F ZZ x O <aZ � p�?� j � °d (9 0 Z � • F •N WATER HTR. GAS ELE G 4- 3: � $ 2.00 � � x 3.25 ��- o � NO. RATE TOTAL U < 3 $1.50 $ 1.50 o x .50 $ Gas Range to 200,000 BTU .............. W 2.00 $ Base 1 1 1st 1 1 1 1 I-DjsDosk 2nd _ 3rd _ 4th • Future Connection Openings Connected with Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 2.00 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ 1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ 14.00 Location 111 - 63+-d Way IL F" 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 Feb. 8 1 19A2 Owner Paul Schwartz Const. Co. Kind of Building Frame Used as Dwelling To be completed about 4-1-62 Estimated Cost, $ 800,00 Old—New. Building Permit No. N%t=l ,,? `�ermit No. r -- Signed STANDARD PLUTVTOINS 8' "L CE C By � Basin s Phone No We 8 3589 ROUGH�– FINAL a a 2M 7_59 Application for Power forts and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dep:. of Bldgs. Phone SII 4-7470 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 $ 8.00 each add 60,000 BTU ....................... 2.00 Replacement of Furnace ............................... 5.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM 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 $----5-.00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ lY� Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ 14.50 ALTERATIONS & REPAIRS TOTAL FEE $ REMARKS: x, �, xlj'% Iez • Location 111 - 63rd W&V E. E • 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_ 9-90– , 1962— Kind 962 Kind of Building Fr • 195— Used as Res. To be completed about 3-7n-62 Estimated Cost, $ 450.00 Old—New. Building Permit No.'�� 3 DESCRIPTION OF WORK HEATING or POWER. PLANTS --Steam, Hot Water, Warm Air—No_ Trade Name Westinghouse Size No 100 Capacity. Capacity Sq. Ft. E.D.R BTU—I= H.P. Total Connected Load 459631 Kind of Fuel Gas BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Sign WEB VOW a e By 1 6:30 West Lake St. * WE. 9-6767 1 aosr IM -12-58 Business Phone t, �To osis rarr, Minnesota • • • Ci ®f Fridley, Minn 1 � �6 �' City Y� BUILDING PERMIT N? 61.2 7 Date: Builder Address _ Address �T N FING - No. Street Part of Lot Lot ��__ Block — Additio or Sub -Division Corner Lot , Inside Lot w Setback — _ Sideyard Sewer Elevation __ _____ _ Foundation Elevation DESCRIPTION To be U as: Front Type of Construction BUILDING r Sq. Ft. Sc,. Ft. To be Completed Cu. Ft. Cu. Ft. 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 compliancq with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ AI 41� , 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, and moving of buildings win the city limits and this permit may be revoked at any time upono on f any of the provisions of said Building Inspector NOTICE: lhb permb does not corer the construction, hrstaQarton for whdng, phnubhng, gas heating, sewer or weer. Be sere to as the Building bspe for for separate permit for than hens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME �� BUILDER ADDRESS ADDRESS LOCATION OF/BUILDING No. or Street _ �� e' Part of Lot Lot % Block Addition or Subdivision e6fd",�F,� Corner Lot Inside Lot Setback Side 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. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction_Adf�r�S WV`4 Estimated Cost To be Completed 30 — 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 statod in this application are true and corraqt do S IGNATtME (Schedule of Fee Costs can be found on the Reverse Side). 3,15`0 f City of Fridley, Minn. N° 8608 • BUILDING PERMIT Date: NOVEMBER 17, 1965 • E Owner: CLARENCE W. THTESEN Builder SUSSEL LUMBER Address Ill - 63rd Way N. E. Address 1850 Como Avenue Fridley, Minnesota 55421 St. Paul, Minnesota 55108 LOCATION OF BUILDING No. ill Street 63rd Way N. E. —_ Part of Lot Lot _ _18�__ Block 2 Addition or Sub.Division .—Eva Erickson River Manor Corner Lot , Inside Lot _._. % Setback -- Sideyard Sewer Elevation To be Used as: DET. GARAGE Foundation Elevation DESCRIPTION OF BUILDING Front3 2 Depth 22 Height 10 Sq, Ft 704 Cu. Ft 7,040 Front Depth freight Sq. Ft. Cu. Ft. Type of Construction Frame Fst. Cost _ $ 2, 005 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 21 provisions of ordinances Of the city of Fridley. n _ In consideration of the payment of a fee of 57.00 , permit is hereby granted to SUSSEL LUMBER COMPANY 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 b,11- 41 --within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN NOTICE: rah pwn* does net corse the cend ruetion, habMan for wleh"1, phnAlno, on hedb& ewer or water. Be sure to as the Bsildla8 ingw toe for sepmft , 1- for thea Nana. % % . I -3`•t+ ami�— s 142 0cme;.m. 2� APIZb►.� (3oL-r s Q 45QUAOL E LAJ I -C 44 N ®U S E SEE C�uF-V- RF -MC v E Qu,o �^R1B�.oGAT� k` CATH CS iso" (rP- Rss11 t -e Bo"rN QS Pee. OvioEe Q MESH i coon m e N►rmst4 �J►OPt: �u �" 0 ,J Covo u cr -T0 c � a . 0 P C)Q r 0 NAME SIZE 2.4 Z2 G LOT K atZ. AV az Po 1Z BLOCK ADDRESS VALUE 005 O 1 ADD'N. AREA TYPE �2d1.AE -3`•t+ ami�— s 142 0cme;.m. 2� APIZb►.� (3oL-r s Q 45QUAOL E LAJ I -C 44 N ®U S E SEE C�uF-V- RF -MC v E Qu,o �^R1B�.oGAT� k` CATH CS iso" (rP- Rss11 t -e Bo"rN QS Pee. OvioEe Q MESH i coon m e N►rmst4 �J►OPt: �u �" 0 ,J Covo u cr -T0 c � a . 0 P C)Q r 0 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME (2 /d r e vt e e Led f /y P o s te BUILDER j t'S 5 C-0 ADDRESS_ _ i / / - &34 f ry a., fv � tUDRESS � r3" v C c,..,e /q ce r _. LOCATION OF BUILDING -� Street Part of Lot LOT K ADDITION OR SUBDIVISION Corner Lot Inside LOT Setback Side -Yard SEWER ELEVATION. FOUNDATION ELEVATIOIJ 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; 4®- -say Front _ �Depti� �� geight Sq. — z® S . Ft. Q Cu. Ft. Front Dept Height Sq. Ft. Cu. Ft. Type of Construction �6.e Estimated Cost To be completed ., �✓as, 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. /may & S- SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). CITY' OF ��'�FRIDLEY* � _ -- POLICE DEP4RTMENT Each Report Must -Off6me ',',Report Beer Number '(To Include'Attempts) Number 70-3289 OFFENSE. DATE .OF THIS REPORT 10-15-70 Date And Time Of Ocwrre Pio a Of Occurrence 10-19-20 111 b rd Way cti m rm, Nome And Nomeofroprietor us ness Address Busineis one Clarence W.Tye i onto ressHome one 111 63rd Way. 5b0-1112 ' H Victim Is Sex Ade Notivity Color Occupation: A Person ;j Reported By (Nome And Rel HOMO To Victim) Hone Address Home Phone Same game Same Business 'Address Business Phone Quantity LOSS. �I Description Of Property i Value Notes f om Inspection Dept. Copy to above II Was Property Insured p Yea Q No Value Currency Jewelry. a Pi M. Furs ClothingMiscellaneous _ Total Of 'Value DETAILS OF 0 ENSE (STATE FULLY ALL OTHER CIRCUMSTANCES OF THIS OFFENSE) Compl.caall�,d to state that he feplLs that he is being. harassed by the Ins ,action Deptpof the City of Fridley. This concerns a hedge by his hoMe'. No other' details. He was referred to' the Inspection Dept.,buj,t he granted tq, make an official complaint on the.mat or* ii This Offense Is Declared: How' Report Received Date/Time '.Report Received Radio O station O 10-15-70 1745 By Russell Citizen On View O ` Investigated Ij Assisted 43y Detscilves , ssigned Persons Orested -Suspects=Witnesses And Additional Detailed Report On Other Sidit i :Sgt. Appmvol Chief Approvo L ii i . 53-84-s-915.51 iI�JECT City of Fridley AT TNR TOP OF TME TWIN$ --- COMMUNITY MVELOPMENT DIV, PLUMBING PERMIT APPLICATION PROTECTIVR W909CYWM OE/T, CITY MALL FRICILKY ii*: iIE-590'3mo Inev. IBATF IVAAF ? 4w V 0 2115/73 1 1 800 Job Address 111 N. E. 63rd, Way ner Address Phone Clarence Theisen Contractor Address P ane -TE � ekVINNEG4SCr �;3� MARQUE p`�Ela Kind of Building Use Mnb., Frame Res. Completion Date Estimate ost 5 -lo -74 10.00 Plumbing Fixture Rates: NO. RATE TOTAL II �IUI i I I' W W ' - --+i Number Fixtures x $2.00_ Future Fixtures x $1.50 aoevol I ( I en � �� New Fixture -Old Open. x $1.50 O '1ddY ; I I Catch Bast ? n x $3.25 CYO ! •zIa i —� Water Heater -99,000 BTU x $3.00 'OBIN I I II i I Ground Run Old Bldg. x $3.25 eaa, �I •MNwal I I Elec. Water Heater x $2.00 fd SNI8Y8 a. � i Gas Fitting Fees: �O o SNlvao I I 3 °o aO°'AI a 1st 3 Fixtures x $2.00 O.0 I saaMo►Igl jp b i Additional Fixtures x $ .75 '1Nn0.4 I I I I HNIaa iI Gas Range -199,000 BTU x $5.00 I IM �b 8AYa1 a NSYMI .. I I I i Repairs & Alterations SMNIg I I ISee I Description: Install Grill Code 5.00 V .NISYSI a� I I I State Surcharge Class "A'2' Surcharge .500 .50 I i Soni I TOTAL FEE $ 5.50 I Nsve I I I !The undersigned hereby makes application for a permit 81YNIanI I I I I for the work herein specifiedo agreeing to do all work S,.as°,n n strict accordance with the City Ordinances and rulinj I f the Department of Buildings, and hereby declare that ill'the facts and representations stated in this applicat_ � n� true and correct.py, Ce `Y 'Signature --' - L= - Date City of Fridley SUBJECT - 9 6 4 8 2 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIPT NO. •1 6 COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. PROTECTIVE Oo 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450910-F15 2/2/82 JOB ADDRESS 111 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clarence W. 7h.eisen 111 - 63rd Way N.E. 571-2943 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Stucco Home Add Two Fireplaces, finish kitchen Reroof Dwelling, Add Basement Bathroom 9 CHANGE OF USE FROM TO STIPULATIONS Use 50 or 90 lbs. 36" wide for starter roll on reroofing. Use treated bottom plates. Provide ==xhz**wz?L combustion air. Provide fire alarm. SEPERA71E PERMITS REQUIRED FOR WN"G" HEATING, PLU'WBING AND sE 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 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. EW -LG. 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 $11,000 $5.50 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 CONSTRU ON. $86.50 PLAN CHECK FEE TOTALFEE 92.00 IGNATU F ONTRACTORORAUT • IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT S GNATUR F OWNER IIF OWNER BUILDERI IDA:'EI BLDG INSP MYTE IN CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION! FOR RESIDtNTIAL BUILDING PER14ITS (New, Alterations, Additions, or Repairs) ADDRESS: 3 d �� t7 - TEL NO: .67 - ;2- 5/3 BUILDER: ` /— ADDRESS: TEL NO: Construction Location STRITT NO: % STREET: a d(A IF IAT: (� BLOCK: ADDITION: 4-6 /�j Corner Lot: --7 Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. / A DESCRIPTION OF CONSTRUCTION V0 a 0 0 aJ-eFront: cc p1l) ae Square. Feet: '14 A�4/4114 e d ® Front: `�i�¢� ��c,.�� 6 ' �S�}��a��,Square• Feet: Type of Construction: `` Zb Be Ooripleted: 0 � � a Z, Depth: Height: Cubic Feet: Depth: Height: Cubic Feet: Proposed Driveway Width If New Opening Is Desired: luoie My'aod Estimated Cost: $ �'�000° Alt. A Alt. B SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the ��ork• 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 th t all the facts and representation stated in this application are true and orrec D, : � SIGNATURE : R� �r / �� Stipulations: Wq-L Fall/ v/ " ,"-ot"I � � SUBJECT PER O. City of Fridley 18717 AT THE TOP OF THE TWINS BUILDING PERMIT _ R � COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � � PROTECTIVE 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J\ 612-571-3450 910-F15 10/21/86 JOB ADDRESS 111 - 63rd Way N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 EVa, Erickson River Manor SHEET -F-PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clarence Theisen 111 - 63rd Way N.E. 571-2943 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. AMRE 3700 Annapolis Lane, Mpls. 55441 553-0020 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 Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $5 382 $2.69 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT F DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE RO ISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $56.50 CTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $59.19 SIGNATUR F ON#=16R OR AUTHORIZEDAGENT (DATE) WHEN PROPERLY V ED THI IS YOUR PERMIT / 6 m2 r SIGNATURE OF OWNER IIF OWNER BUILDER) (DATEI BLDG )NSP 0A E NSW [ ] City of Fridley ADDf; . [ ] �R-1 AND R-2 ALTER. [ ) Building Permit Application Construction Address Effective 4/1/8( v - Legal Description: ,, owner Name i Address: C�� ®/ Tel. : Contractor Address %► t1 �' // // L�_ i�,,%1 .I �iL`_ a �/. �►, i ��J - 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: � 12 Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback. Type of Construction: -'+�o Estimated Cost: Approx. Completion Date: en r 06 Alt. A Alt R Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATEI��"8� APPLICANT:Tel. # CITY USE ONLY Permit Fee -S?J Fee Schedule on Reverse Side Plan Check 25% of Building Permit Fee State Surcharge t �� t.50/$1,000 Valuation SAC Charge t $475 per SAC Unit Fee t Fee Determiners by Engineering Park __ Sever Main Charge ! Agreement Necessary [ ] Not Necessary [ ] TOTAL S P� a STIPULATI0NS: SUBJECT PERMIT NO. City of Fridley 20336' AT THE TOP OF THE TWINS BUILDING PERMIT f COMMUNITY DEVELOPMENT DIV. _ v PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/4/9.0 JOB ADDRESS 111 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 Eva Erickson Manor SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Clarence Theisen 111 - 63rd Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Minn Rusco Inc. 7429 Washington Avenue South, Edina, MN 55435 942-0641 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION (R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace doors and windows 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $13,330 $6.65 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $153,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 1 ] n e ��/►(F /J�I�y,70 4 JSIG-NATURE $159.65 LLIDDA�TEDTHIS IS YOURL PERMIT ONTRACTOR OR AUTHORIZED AGENT IDATEIWHEN/�PRQOPOERLY IXJI� ii. C.Y � a%Ld �3 BLDG INSP AT SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/go ADDN [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: _ !� l �v �� /�iPl D L C Legal Description: 4o T /P Gk` 4:4 F)ef C'Ck�S Owner Name & Address: CL Ae,64-c 6 7/7 Tel. # Contractor: 1 4ts G' -rtrc Tel, # Address: % 9 d- 9 IWASA iv 6 - o .•v A V,c- So Z -V //y tf SSL(.? S Attach to this application, a Certificate of Survey of the lot, with #the proposed construction drawn on it to scale. LIVIM AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: ldoa,0 AR tym e Estimated Cost: Approx. Completion Date: A _5 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: 90 APPLICANT: M Tel. # Yeo? - D & i/! 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Width' Windows and Doors--Crackage r y rtr .e Windowa and Doois --Cfac 'age and Area wiiatn ii.- ht iVa. ar. I In .t < . r• �Yldth , - Helsht, Nn. of Lineal ft. Ares No. of pane of Pans. Ilahts or rrn k `�at oa�e. - of pane '- Ilahtat of crack ao. ft. ... - troef. _s0.7tuBtu -- - Infiltration~ t �p .v'ail '77�� -' _ �Eap wall -1 I Stilt t c P. w tt' fsipt exr. wall i flit. wall- t .g .:ei8tng ic•iBinK--- -- -- r - - .____.. f Iotnr ? Floor 9 Total Bia. — — - r i-1144 xt yne W t�l.`.lFader ares I<ettulrrri ay. It. I...l",- ;x sy Int.- d ;- I C `'`� -b .. Rfom LeD - - _ 1 'ngth^ Width Height - - F1.1 I Idixtin l t T , tlF� . •n i I a ,t - Windows slid Uaikrs-Cra kage and Aria 4 Windows ani �uorr-Craik i ,'.rr Y '� Kldth .' kf ElK ttt T to. -~ Llnaaa lt. Aria s+IJlb lie uah of crack N. ft. -. Nn of pano of tat tights r- °(- _> < - Ceti. -_.8 ittliliratittt� �. ,P , M-,. In3llt;sut,n..__ _ __. - 1 "� � •�' (Ilata Ext,. wall Mee rxp. W-111 h�ct exp. wix18 t _ _ lne wall l h fnt: wall _ _---' _.._T. ----_- __. ilin F1,tnr t r i. l BCU. _ 1. ¢dl n tu. _ _-- .._ I !tngv�red sq: fl_ L..D.E'. t,l $q int. W A. Leader Fl u Idixna 1�nuth - Widtl• llcight \V.ntlows and Dovia �.'ra�+Mage and Area Windowa"i nd D«;?p--$rt, —..-- - -P'1.1, h 1i ei�r.,.- No. of Lineal it. Area N6.'' Pr pane . of pe- 119 'a of areek W, ft. No. i of pane A - - - - - Coef. Btu Iskbltration r a � %P. ;all Exp. wall _ m Net d:xp. wall A�l1 it 1'flFt Cis y3..bY •9!L-._..__,._ . ►,t. wall a'ei8ing �!i • ro .. Ce Il >t�i BX ; r m•� ' °c, Tota8 tutu i e:�ulied sq. $t. .D.aZ or ins. W.A. Lander area Required u.`Qs. $ f'7777!;4.�_ -9 Ur t-MULLY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763)572-3604 Effective On Jan 1, 2002 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PLUMBING FIXTURE RATES: New Fixtures Oki 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 Reinspection Fee $47.00/Hr NO. RATE TOTAL JOB ADDRESS ��icd Z.4jt , ItIs $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 900 OD $,___ 50 $ 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. g�l6 .200 Owner Building Used Ash Estimated CostPERMIT N0. PLUMBING COMPANY SIGNED BYCZ&��L NO. 2� 6r7_� FAX # Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE �viHttfc Nunnnttc Ur' MATURES TO BE INSTALLED ON EACH FLOOR. " Floor .<.. Auto .:a {•��.: � Water Heall Stones' t> �,. Urinal 'yam<-: Sht+er = Tray - �3�!C�: �<::;�>� .: Drain '};;Y> Was her ,;w�' :f<i>. Ra %%:�.:;^;. „?<r>; EI •Gag _ . Ne .:.:.,: ,-..�.µr,.iti.. • yYixya..:y{SJ% Basement ::�•}>... - •:r:.yr_.�._: y .... ... a -n . v:: •Y>•.,:::..:::.; ..-;: is?i :.�:tU{?: v'3:. Y :.j:.,.;!meq:..: J ..; s� 'T• : t; r':,'•::;iii!..• S'+} `}}�:i'f'%`- _ ..-xy'r/::y.•-f. <hC'�-"L' .r.{: :v .n. \• .1 v:;RN`.rr. ...: Floor ti:"lir L::.f:4::f:: ilj<�::i i'S'}?i>:? ra:! -+ .;:.w:;.: r-}}:•: y . n.iv. r•::'£i%i�t:? :-ti�:•��}} — }rx•: •••�h `t: 2 Floorn inY.y:+::�}<:.i!> iiiY'e'•':: }:�•.`-'•5'!v.' f•?l X:::p; C}:a.}'.;:,.:ifi]:v J. i.. ; •:,;}; }:^.v:?;t-:}.,. .. .%ty :5:..; :y.'..-::-r'fa• r'iAl-'?n!:fi}:$:::i _ '��.::>4:;,f::: .{{A.. :;.} ., }. .y,} `i"7r'?:}ryrJ? i:••' -C . .v?.• •']•>!ix•.•}:w x.. Roar 3 r....... �• ixlii."-+•ni:F.^.•f4 X•:ti}SYti}':l}Y •: yY.... ..•:::--<x: 4\'x•.:; vfx.: -:�:=}Y..._r �>. '!,�Yr.'�:hr7:,•:,, a, .1'F.df:i••u• .v �::i4•:?• <>:i::::�:;x:?Y.��::;,:-:<: 's+r-ivf� }..:?:l?f .{.x.,5:.::r}-.}z •.y ryf..r: i v.. :.�:y,.,x...Y.: t•:rrxa;.w; rrr::>;t ;4.rtggo;:<2;;: ?`.+'sa'-i5y>•-:}• ::lL:., .Y. n:.} : f3+ trv.;f ~'Y :••s`:hi:Yz:•:::� yf- "• =t {i<+}'i'•!Q.' .?r:..•%�};}:< �:'::ar�.�! �+ r'a::` -:.-r`. r:.: u:}}. .. r:Y .A•. .l FI �r w i.(!Y�rt �r•'1.,..J A® 4 i', y {• ! n .2.?. ,r.•:: .ti:!'.. ''?+.•} jGY:fi;.}•/" :::9'>Y}fr: �+: fi.•--�{.+.:..3;:J f': '!i{:�:ti':Y%: y:`Y :+• i�:4 yvii:+ - .r '�.�eiii •a �^il � 1:-•$> :i•;��::, ;•:/.HA.• r••}i�;'i.�.•�}r.•/. r: i r:}.x&<•%4^vY : i•.S.j?i :t+ •4'+^--•-'�:.t•.i t-:;v,'.e {:r:: .: 'fSfi%i:}� `:{::: :S {4Ty t?v' •'''�•"i• i°vn'�} PLUMBING FIXTURE RATES: New Fixtures Oki 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 Reinspection Fee $47.00/Hr NO. RATE TOTAL JOB ADDRESS ��icd Z.4jt , ItIs $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 900 OD $,___ 50 $ 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. g�l6 .200 Owner Building Used Ash Estimated CostPERMIT N0. PLUMBING COMPANY SIGNED BYCZ&��L NO. 2� 6r7_� FAX # Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When Mplsaneny.a.,,$Yung furance, the undersigned hereby verities that the venting has been examined and is free from rust,, deterioration, obstructions, and is securely supported and firestopped where required. The venting system is plastictPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. 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. `'- hg -BX pn r! oMhatg •en air is sized and installed to meet the current codes and manufacturer's specifications. When required to ina�„yr &-nmho entinn airy it will be sized and installed to meet the current codes and manufacturer's specifications. When installing a now ventinoSySWm, 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. 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( ) Yes ( ) No ( ) Yes (} No.( Yes( ) No( ) Yes ()No() Yes() No() Yes{ )No( ) op Appliance #1 Type „ TUpe and Si7 aLCnmmnn Vent and Vant-ppng&ar Infnrmatinn 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 Lengthft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date: A oil, SUBJECT City of Fridley 73 3 4 5 2 AT THE TOP OF THE TWINS BUILDING PERMIT ►• RECEIPT- COMMUNITY DEVELOPMENT DIV. 17✓ r PROTECTIVE INSPECTION SEC. / J NUMBER REV DATE PAGE OF APPROVED By 1 = 0-11 CITY HALL FRIDLEY 55432 %'' 763-571-3450 910415 4/21/03 JOB ADDRESS 111 63 Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clarence Theisen 111 63 Way NE 763-571-2943 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 Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct an 8' x 12' & an 18' x 12' Detached Deck; Remove existing deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WARNING 89for® digging call for all utility locations 454-0002 IFOI " L011% 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 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 1 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 $3,875 $1.94 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 CONS RUCTION PLAN CHECK FEE TOTAL FEE $103.07 _SIGNAT REOFCON'FACTOAORAUT O A ENT X®�i vT�E� R D� IVIHEN PROPERLY VALIDATED THIS IS YOVR PE MIT SNATURE OF OWNER,TF WNER BUILDER, ,DATE, 12G ,NSP r)&Yt A oil, NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 10– ro /o C Legal Description: r Owner Name & Address: C k a. r -t , k / a k ( 1 2 t S a A/ Tel. #� W 4--)/, SSG 3 Contractor. t— MN LICENSE # Address: s Irv». C' -r koL9 V4— Tel. # c'�vr e o cL Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width �Height _� _ Sq. Ft. -;2 / DECK AREA: Length �_ Width a2 HgUGround 'Sq.F OTHER: C11— QC411W71La e Construction Typ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft - Ft x $ _ $ c-7— 963% DATE: / APPLICANT. Tel. # Call (763) 5723604 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. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge- License hargeLicense 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 $ 103.0 STIPULATIONS: arl S. loll »VoIv Surveyor's Certificatessoel;Zles S~eA + o t Paat 9. Sc/ watt7, �. . N Con4t4,on (c,, , �1 H 9, f R 4 •. F 11 V C O 11 f 11 4 I MI N1l F:4P(1 LIS 1U, MI IlNF6U • 4 HARRY S. JOHNSON ROEFRT R MEREDMT I� w 77.4 �A/NAGE IND N i� org/Ty EASE E 0 b�•- 1 d� �Z% osa�Is e V,9 1-1 — t6 !2 *.�l VV 9 he wb y ce t -q y that th-+:a 44 a t tua acid c o4" -c t *,e pox ipe ,a t 4xn of a da-tue y oy the, b oNnda ti p a of Xot 18, Block 2, £ V(4 C 9 9 C K 5 v N k 9 V C k M N N 0 k, Hnok a Cowity, Mime ota, and of the t oc LUon . oy aGC bpi td i,f4, 4 any, theAzors, and aGl. vi i,bte e u r oacJuw,4&, + j ural, J4,M o f on daid ta sd. 'A ala.o shows -the Inca t i an o? a p44poa ed brat.t dire .. t4 awtue yed by are .thiA 22,u1 day of Novembe t, 1961. amP ��-all CITY OF FRIDLEY PERM �N2004-0063_-`° 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 05/04/2004 r63) 572-3604 FAX: (763) 571-1287 ADDRESS : 111 63RD WAY NE PIN : 153024420057 LEGAL DESC : EVA ERICKSON RIVER MANOR : LOT 18 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SHED (GREATER THAN 120 SQ FT) VALUATION : $ 500.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 12'X 10' SLAB FOR A FUTURE SHED. FUTURE SHED TO BE OFF FROM THE EASEMENT. APPLICANT THEISEN CLARENCE W & E L 111 63RD WAY NE FRIDLEY, MN 55432 THEISEN CLARENCE W & E L 111 63RD WAY NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulap ,g cop*uction or the performance of constructions { Bldg Insp I Date I BUILDING PERMIT FEE 23.50 FIRE SURCHARGE 0.50 STATE SURCHARGE, VALUE 0.50 TOTAL 24.50 PAID WITH CHECK # 31336 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [] CITY OF FRIDLEY PC�-503 Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION 6 3 �� ,� � Jr,,� J 1 � V Construction Address: J �'1 Legal Description: Owner Name & Address: Contractor. Address: S R nlAa' Tel. 7 / / ^ -�' i V Attach to this application, a Certificate of Survey of the ~ 3 lot, with the proposed construction drawn on it to scale. WA I LIVINGAREA: GARAGE AREA: DECK AREA: OTHER: Construction Type:. Driveway Curb Cut (9 'g- 0 DATE: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Needed: Ft + 6 Ft = Estimated Cost: x$ = iri6#J�il-a�. �3 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ �i �d Fee Schedule on Reverse Side Plan Review $ 65% of Permit Fee Fire Surcharge $ eS .001 of Permit Valuation (1/10th%) State Surcharge $ 5-0 $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut 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 $ �7� �� STIPULATIONS: $1,000,001 and up $1,000 or fraction thereot SCROW DRMWAY DEPRESSION nly) Curb Streets Only) (Concrete - Driveway width plus 6 feet times $17.00. ro er d utter only - application to allow for Proper P d replacement of curb an g of 24 fours from die time of Removal an p a minimun► �truction will be issue the construction site. Permits for co structure and T10N required before review of the proposed stru yERIFICA'ION OF FO�IDA of Survey of the lot, showing the location of the existing foundation will be proceeding with the framOnl ing. New Houses / '1961 'WgwanoI/ 10 Imp ln'zz voy} aw h9 lrahaawp vN ''Trr"q P•avodovd v jo ay7• v"ar °T'19 V 'P"°7 P -2m vo do rrdr� 'mm 1, a79wrn rr-, Inro 'vo-'V-P "-v %' "A!'pr—q n. P° NavrV O7 -mo ;° P" `ham"'°J vjo-H `N o Al H IJ ?.l 3 t7 G ?I N P 3 N J G ?I 3 H n 3 `e T --07A `91 707 ;o vvrm7pwoq yr oto hair* v v to a'rrr v yr v."p 7°yY h%r."m h7"6 ----,� f/744--1 9--- 66'Z8 �••,ce y ft q•Lie09 C77 r\ a • � aso�os� � � \�1 Jd7S �b W vt�r 'Ol o� �� I N3W�Sd3 1/1/1 i i 1 1 I y I 1 i 1 INl103a3w a iaAaoa NOSNHof 'S AaaVH Y•t)9 JNIrIW .lt `..1 .. •.�-INN.W ,. ., <.. , � . � , ,.. - � , .. ,.. •.,,� i.°:rnM'Wu°J i7vnnn�s' � r'''°r/ = tioF hammS� S'd,-7�ZP)P®S'S 7 r1 t4 14 I,YUAS Orr 7- LA CIc (AW-) CITY OF FRIDLEY BUILDING INSPECTION Effective 4/1/2004 V 9 3431 University Ave NE 9=ridley, MN 65432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION L 763-5723604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 9 JOB ADDRESS I l �'� D n RATE SCHEDULE Fee Total/� Residential Owner aCe.ren\ 0_,e Furnace Shell and Duct Work, Burner & (� also Replacement Furnace $35.00 $ Building Used As Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ ESTIMATED COSTfA2S ®® PERMIT NO Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10,00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning -All Sizes $25.00 $ o` BTU HP EDR v/ d T Fuel Total Connected Load All Other Repairs or Alterations (List on Back) r 1% of Value of Appliance or Work $ Burner Trade Name Size No. A Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Y Improvement whichever is greater on work less than $300.00 '- The undersigned hereby makes application for a permit for the work herein � Commercial lndustriallinstitutional specified agreeing to do all work in strict accordance with the City Codes } 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commerc'ral/industriaVinslitutionai and repre-sentations stated in this application are true and correct. CENTERPOINT ENERGY Y State Surcharge .50 HEATING CO 13562 CENTRAL AVE NE BLAINE, MN 55304 TOTAL v TOTAL FEE $ Signed Tel # 763-757-6202 REINSPECTION FEE $50.00/HOUR FAX 763-757-6701 Date IT *Air Conditioners can not be placed in side yard without written approval N from adjoining property owner - oopy to City N FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved b,4— Rough4n Date Final Date F0, d 74101 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 (]6 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 existin combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (io 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 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 -LAMA 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 s Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) CENTERPOINT ENERGY HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 _ Signed By: — Date F6LM * A TGV.915L 01 A31012ld d0 .4110 WON -4 C7: T T 000E-22-Hd13