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PRE 2010 DOCS0 i Village of Fridley, Minn. N° 897 BUILDING PERMW Office of INSPECTOR OF BUILDINGS owner Architect Fridley, P i a Builder &36_�O�CATI N OF BUILDING Street' x •-•a Part of Lot Lot Block Addition or Sub -Division DESCRIPTION OF BUILDING Front p Depth_! ' Height Stories ,. Manner of Construction f 1" -, To be used as , `" " '** T To be completed {T * R ' Estimated Cost Permit is hereby granted to the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. ` Ii spector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, this day of `� �—A.D. 19 .• .t A`. 4 City of Fridley, Minn. N9 9882 BUILDING PERMIT • Date: August 12, 1968 • Owner: Charles E. Bramhall Builder ___ Gorco Address 12- N. E. 632 Way Address 3384 Brownlow Ave. St. Louis Park, Minnesota LOCATION OF BUILDING No. _ 12 Street 631, Way N. E. _ _.__ Part of Lot Lot 1 _ Block 16 — Addition or Sub -Division . Fridley Park Corner Lot ---- Inside Lot _ Setback M _ _ _ _ _ _ _ Sideyard Sewer Elevation To be Used as: Garage Front -- Front Type of Construction Frame Foundation Elevation DESCRIPTION OF BUILDING 12' Depth $20' Height 10Sq. Ft. 240 Cu. Ft. 2400 Depth _ _ Height Sq. Ft. Cu. Ft. Est. Cost ^1100.00_ _ 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. In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to...._.. Gorco 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 violation of any of the provisions of said ordinances. 11 Breher Official Building EMpOR • NOTICE: This permit doss not cover the construction, Installation for whine, Plumbing, gas heating, sewer or water. Be sure to see the Building kigmtor for separaN pwmNs for these items. 1 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER NS NAME dgW' JA, Ln �Gd/ia.�� BUILDER ADDRESS % N �p 3 r ADDRESS 13 e LZ jv LOCATION OF BUILDING NO . % e2 STREET LOT BLOCK ADDITION OR SUBDIVISION�"- COP -'\M LOT IFSIDE LOT SETBACK SIDEYART SEWER ELEVATION TOP OF ?FOOTING Applicant attach to this storm, T -To !"ertifioates of Survey of Lot and proposed building location. dralrLi on, these: Certificates 7ESCR.- F11" ON OF BUILDING To Be Used As: A. Front % Depth cZ O Height l d Square feet •9C/v Cubic Feet 0 Front Depth Height Square feet Cubic Feet Type of Construction Estimated Cost ® .o -a - To Be Completed 2— -/.v- 6 i 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 Buildin-gs, and hereby declares that all the facts and representations stated in this application are true and correct. DATE % - G SIGNATURE - (Schedule of Fee Costs can be found on theAVY-e-L-Sid.. STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD I. LOCATION OF WELL MINNESOTA UNIQUE WELL N0. County Name Anoka (leave blank if not known) Township Name Township Number Range Number Section No. Fraction 4. WELL DEPTH (completed) Date sealed N E k hof h Fridley 30 Sr 23 wr 15 SW NE SE 39 ft- June 9, 1992 Numerical Street Address and City of Well Location or Distance from Road S. DRILLING METHOD (if known) Intersection 1❑ Cable tool 4❑ Reverse 7MDriven 10❑ Dug #12 631 Way, Fridley 20 Hallow Rod go Air 60 Bored 110 Show exact location of well 30 Rotary 6❑ Jetted 0 Power Auger (in section N id with •X•) Sketch map of well location 6. OBSTRUCTIONS U.11 k.# ted V No W MENU ME MEMM =oom e o s rue ® ea ❑ Obstructions removed CM Yes ❑ No If obstructions cannot be i H/6t^L 30' 3/4" drop pipe ref ved. contact NOH E. ore I 7. USE T „�� iL IM Domestic 4❑ Monitoring 6❑ Haat Loop ( 213 Irrigation 0 Public C Industry 1 ( 313 Test Well 60 Municipal IC Commercial S 2. PROPERTY OWNER'S PANE Mailing Address if different than Kent property address indicated above Erlandson HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known. indicate formation log from now well or nearby well. 16. REMARKS, ELEVATION. SOURCE OF DATA - CASINGS REiOVED, CASINGS PERFORATED, ETC. OFFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) 2 mPatmurs F7W RW2W D88D 7❑ Air Conditioning 10 B. CASINGS) 113 Black 40 Threaded 70 20 Galv. 5Q Melded 30 Plastic 60 Stainless Steel 1U in. to 36 ft. in. t0 ft. 9. SCREEN ® sereened well from 3 6 ft. to 3 9 ft. (If known) ❑ Open Role from _ ft. to _ ft. 10. STAT C HATER LEVEL 25 ft. ® below ❑ above 6-9-92 land surface Date Measured 11. WELLHEAD COMPLETION IE3 Pitless Adapter 4❑ Found Buried 21Z Basement offset R❑ 30 well Pit 12. GROUTING INFORMATION IM. Neat Cement 43 Bentonits 33 Grout material Nt. Cmt. from 5 ta39 ft. cu. d. --L b 13. NEAREST SOURCES �� �OF�� AMINATION 12 feet —i15Lf 411 direction sewer D 1 pe type Well disinfected before sealing? M Yes 14. PUMP ❑ Removed ® Hot Present Type: 1D Submersible 43 L.S. Turbine 0 Reciprocating 2M Jet 4[3 Centrifugal d 15. EXISTING WELLS (Please sketch -locations of abandoned and active wells in remarks section or an back.) Other unused well(s) an property? ❑ Yes ® No Abandoned: ❑ Permanent ❑ Temporary E3 Not sealed 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under aly jurisdiction and this report Is true to the best of my knowledge and belief. Mork Well Co., Inc. 02133 Licensee Business •Mame License No. Address e , no ca, 5 Signed Qite 6-9-92 reg Ricke ate 6-9-92 Name of Driller ag 303 SUBJECT PER City of Fridley22163 AT THE TOP OF THE TWINS BUILDING PERMIT r ' , REC NO. COMMUNITY DEVELOPMENT DIV. v r i PROTECTIVE INSPECTION SEC. �� i NUMBER REV DATE PAGE OF APPROVED By = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 12/29/93 JOB ADDRESS 12 63 1/2 Way 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kent Erlandson 12 63 1/2 Way NE 574--9934 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 Reroof (15 Squares) Tear off 9 CHANGE OF USE FROM TO STIPULATIONS i3nderlayment must comply with State Building Code, Provide adequate attic ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement, 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 60 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 $1,500 $,75 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- $35.00 Fire SC $1,50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE A. $37.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH E E LIDATED THIS IS YOUR PERMIT 1� DG DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 5/26/93 ADDN [ ] CITY OF FRIDLEY�`� ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 2- A) 6�'- Legal Description: Or—r Name & Address: C c Tel. # 5? q- �q 3'f C A- MN LICENSE # I ( w,1(- Tel. # 5 v� (�e�� attach to this applic��-�' d�% rvey of the -�ZQW lot, with the proposer �arawn on it to scale. ze `d k. aQk DESCRIPTION OF IMPROVEMENT LIVING AREA: Lengm GARAGE AREA: Length DECK AREA: Length OTHER: Corner Lot [ ] Inside Lot [ ] Ft - Type of Construction: Approx. Completion Date: Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. dU Yd Setback Side Yard Setbacks •'� DD Estimated Cost: $ ! S�� 15-5 (Cost on Back)— U/ i I ( b�� Driveway Curb Cut Width Needed: Ft. + 6 Ft -- Ft x $ 1© Z D/3v %'t7c2 fuer DATE: av APPLICANT: t,y i DS C Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee CITY USE ONLY $ UU Fee Schedule on Reverse Side $ 1-5-6) .001 of Permit Valuation (1/10th%) $ - 9,5 $.50/$1,000 Valuation $ $750 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ Conservation Plan Review $450.00 $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ °�� STIPULATIONS: CITY OF FRIDLEY PERMITO.: 200401086 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 07/12/2004 } 572-3604 FAX: (763) 571-12117 ADDRESS 12 63 1/2 WAY NE PIN 153024410034 LEGAL DESC FRIDLEY PARK LOT 1 BLOCK 16 PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 7,000.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, BRYANT, 40,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT ELK MECHANICAL HVAC INC 6361 SUNFISH LAKE CT STE 100 RAMSEY, MN 55303 OWNER J B LEWIS 12 63 1/2 WAY NE FRIDLEY, MN 55432 7000 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 wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel he provisions of any other state or local law ref,0—aN&cons0Uction or the performance of construction. Applicant S Date/ Z . Ery HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 0 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) g-03`7LI4 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND. HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total r $35.00 $ $10.00 $ Gas Range $10.00 $ Gas Dryer $10.00 $ doo *Air Conditioning -AII Sizes $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.0.0 for Residential or 5% of cost of Improvement whichever is greater on work less than $300.00 JOB ADDRESS 2 Owner J. k3 • LE�V\I 157 Kii� SI Building Used As ESTIMATED COST _ �� 00l1. -00 PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units_ Circle One (Steam). (Hot Water)(Warm Ai Trade Name (SELtArJ-r Size No. BTU ¢o, oa o HP EDR Fuel [JA?- 6Aa5 • Total Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional 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 Commercial/IndustriaVinstitutional and representations stated in this application are true and correct. State Surcharge $ _ 50 HEATING • L .na6l4/-1 N 1 ZA L- P/ VA I N e TOTAL FEE $ 60 Si e PJM 5!a a'-,0 Tel REINSPECTION FEE $50.00/HOUR FAX # �7e? ' 6,26 ' � � �) Date _Z Z Z a 6 !�L *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approvedby Rough -in Date Final Date 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 ( ) 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 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-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 Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Common Vent Type VENT IN LINVbnt Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: '16-- l G Signed By: '/ 4;i2c Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS 12 63 1/2 WAY NE PIN 153024410034 LEGAL DESC FRIDLEY PARK LOT 1 BLOCK 16 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOW/DOOR REPL PERMIT N().: 2004-01098 DATE ISSUED: 07/�13/�20044 VALUATION : $ 5,885.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 7 WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR 1 APPLICANT RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C ROSEVILLE, MN 55113- (763) 502-4777 F A11L _: J B LEWIS 12 63 1/2 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 regulgting consiTuction or the performance of construction. t a Bldg Insp) MDat �3 a BUILDING PERMIT FEE 125.25 FIRE SURCHARGE 5.89 STATE SURCHARGE, VALUE 2.94 LICENSE SURCHARGE 5.00 TOTAL 139.08 PAID WITH CHECK # 36160 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 04/02/2004 FRI 13:21 FAX ELDER JONES 4C Q001/001 NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg [nap ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: WaIA Legal Description: Owner Name & Address: ®� - Tel. # 4�0 Contractor. MN LICENSE # oZOIW93 1t [$ '-t Address: RENEWAL BY ANDERSEN Tel. # (0S j';R(0'i "'1 T7f-+ 1920 COUNTY ROAD "C" WEST ROSEVILLE, NIN 55113 !cats of Survey of the ,i drawn on it to, sca le ° DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width Height 50". F' GARAGE AREA: Length Width Height Sq. F4. DECK AREA: Length Width HgVGround®® Sq. Ft. OTHER: �- ( (; w\--) g s4ii\Q, Qm� I�ilCj. (� Construction Type: Estimated Cost: $ CO F '�-6 S Driveway Curb Cut Width Needed; Ft. + 6 Ft = Ft x $ _ $ DATE: S -S Ur, -Q N APPLICANT: 4 u,,&, Tel. # 4S 0 - 3LL S-- I!DC LI Call (763) 672-3604 for Permit Fees if mailing in application. Fax to 763-571-VP7 U using credit card and we will call you for card number. -j Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ j �aS.a51 CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Aft. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] - STIPULATIONS: Building $ BUILDING Permit No.: Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Rec'd: v DATE 1.0– I '�) — w� YOUR E-MAIL ADDRESS b -e n qp (a O u On a iM a d • C O Wl SITE ADDRESS I Z- ' ' 1 .0005 x Permit Valuation Minimum $.50 THIS APPLICANT IS: XOWNiR ❑CONTRACTOR PROPERTY OWNER/ NAME: t renA $ ADDRESS: \? o � ,a, � CITY ry-gid Ie STATE%%`'/V_IP_55Y-3,;�, TENANT Curb Cut Escrow PHONE -1 CO 3 - 5oa - 8,5/01 CONTRACTOR NAME: $ STATE LICENSE 4 EXP DATE $450 Conservation Plan Review SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE A.SINGLE FAMILY/NEW CONSTRUCTION SIZE $ R i .�?'S ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAM TILE ❑ DECK ikSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Td �'n SIZE OF IMPROVEMENT ENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES E3 ATTACHED GARAGE roR�ed floor plan PROPOSED SIZE: [33. DETACHED GARAGE 3. List of structural members to be used L PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, OLVinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WMDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ S 0 00 OCCUPANCY TYPE Permit Fee $ as, See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3, a) .001 times the total job valuation Surcharge $ (-Sb .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ R i .�?'S 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 pf Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for apermit ' work not to start without a permit; that the work will be in accordance with the approved plan in the case of all work �e ZZZr r proval of plans. Building BUILDING Inspections RESIDENTIAL APPLICATION Received By: _ 763-572-3604 CITY OF FRIDLEY Date a'�: NO V 2 7 2.001 DATE � O� � D� YOyUR/�-MAIL ADDRESS 4 � SITE ADDRESS �' / `� THIS APPLICANT IS: ❑ OWNER *ONTRACTOR PROPERTY OWNER/ NAME: T7 IU -e L-,-' i ADDRESS: nZ 3 a, �J� CITY F-,-fi Ge 7l STA _ IP 5� TENANT PHONE: & 7 CONTRACTOR NAME: u , t'•�� o �{ C� S SUBMIT A COPY OF (9 STATE LICENSE # �i i ` EXPDATE b e-� ZIP S�{A YOUR STATE LICENSE ADDRESS: aZ 23-5 a-0eg'44191 U °e CITY S . V e SAT� WITH APPLICATION PHONE 7+— a cl 0 FAX a -5 �� — 247 eZ. PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH $ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: -e b o �Ov S -e SIZE OF IMPROVE LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARE ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ ther ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS []Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USJNG THE 1997, P.B.0 FEE SCHEDULE) TOTAL JOB VALUATION Permit Fee $ (& , at U See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ .0005 x Permit Valuation Minimum $.50 L- eta geP1 ( f-�7U $ $5.00 (State Licensed Residential Contractors) SAC Charge $ /D6 , 2�j $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due. $ 727).//,o 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 wor is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w 'ch quir s pprov of plans. %% /, SIGNATURE OF APPLICANT PRINT NAME/WS 4t Sixo )�6y4DAT£ 0//A27/67 -� -74 2 - S"� �.-- y 977 Building BUILDING Permit No.. 1G aU to ,Inspections RESIDENTIAL APPLICATION Receiv 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-2010 -S /W I L H fish„a• %a ~rA er ho4wiq�I1•co DATE `q- d YOURE-M,AIILADDRESS v► SITE ADDRESS 12- 63 V2 /fr THIS APPLICANT IS: QlrOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: GA1 6r +. Is-, oL 9.tr^mer ADDRESS: 1z 67 $1 W" Al it CITY Ar - 1 G y STATE�ZIP SS IJJZ TENANT PHONE: Z - 46,8 - o9d.5 6 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PH NE FAX PROPERTY TYPE WSINGLE FAMILY/NEW CONSTRUCTION SIZE + ❑ TWO FAMILYINEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION 19ADDITION �? ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 4049atlAe- ked do C ox k PP hptR.IC• --- SIZE OF IMPROVEMENT L�Io f 6 k Z' LENGTH 1' (O ! WIDTH 1 '7 HEIGHTSQ FT -' 7 ROOFING ElHOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE:_. ❑ DETACHED GARAGIf 3. List of structural members to be used PROPOSED HEIGHT: SIDING s ` FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit /J, , ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑Trim '� I. Site Plan/Survey showing the existing structures ❑ Other _ ❑ Fascia] a�S ` ` �P 2, and proposed project. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS ^— 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 FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $__yam 11(1S�1V+T I0 i9-4 2U ��62 01 SCHEDULE) 4 �f 3i oT OCCUPANCY TYPE Permit Fee $ qIIIA15 See Back Page for Fee Schedule Plan Review $ (Q 65% of Building Permit Fee Fire Surcharge $ (p 001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks Davable to: City of Fridlev 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 ap rmit ork is not to start without a permit on site; that the work will be in accordance with the approved plan in the case ofA work Wich roquir s review and approval of plans. SIGNATURE OF APPLICANT SEP NAME9CI(IAMT1q Pgry,rl-`V- DATE 5 I+1 zoI MENX * * * Take this sheet to the Building Materials desk to purchase your materials. You selected a 1 level deck with: THIS JOB COPY �HA LL 5E Pressure Treated Framing Material ?VAI ABLE c►,t THE JOS 4 x 4 rr,ming Posts SITE FOR 71..;E F�:;�;M;��G 5/4" x 6" Cedar Deck Boards AND FIN L INSPE T101 Poured Footings 12" Tube 4' deep PremiulYl Gold Square Drive Screws i 2fQtbv `A Galvanized Framing Fasteners At� Lia ai1 � c� Loc-(�, Z You may buy all the mai srials or any part at low cash and carry prices. Because of the wide variable in codes, Menards cannot guarantee gnat materials listed will meet your code requirements. Check with your local municipality for Ian compliance and burding permit. These plans are suggested designs and material lists only. Some items may vary from hose pictured. We do no' guarantee the completeness or prices of these structures. Tax, labor and delivery not included. �J JeC '25 '�(2 llvw, k o*j Illustration intended to shove gener`isize and shape. Some options selected may not be shown for picture clarity. Today's cost for materials estimated in this design with options955o52 *The base price includes: 40 PSF decd; i�,e load, AC2 treated - horizontal 2x6 *(BASE price): $683.55 deck boards, 4x4 posts, W joists and beams, galvanized framing fasteners, ***If purchased today, you save: 69.69*** and premium screws. ***Monthly 81G Card Payment would be: 26.83**` 0 I 'Design a82479 ::::,:: ::::,:, :::::�,::.��, 5/2/2010 t * * Take this sheet to the Building Materials desk to purchase your materials, . -. Level 1: '14' x 16' F_ _ -_-_- _-_- 2' off the q.ound Horizontal Decking 2" x 10" Joists 2 ft cantilever on joists 2" x 10" Beams 2 ft cantilever on beams 40 PSF Deck. Live Load Today's cost for materials estimated in'this design with options:$955.52 'The base price includes: 40 PSF deck live goad, AC2 treated - horizontal 24 *(BASE price): $683.55 deck boards, 4x4 posts, 2x8 joists and beams, galvanized framing fasteners, ***If purchased today, you save: $59.69*** and premium screws. ***Monthly Al Card Payment would be: $26.83*** w b N Post and Beam Dimension Sheet Design# 82479 Posts 3 1' 3' 14' 3' 3' Layout dimension sheets are intended as a construction aid. Not all options selected are. shown. I�r Bean Layout for Your Deck The Scale is 114":1' Design# 82479 U 131 .V �C C NU O•N CW3 Ca 7O Ca O AAS Co � Cc O U v MIH�C lZ rCD =0ic Mark Length _ _ Descri tp ion A 14' 2-2x10 Micropro Treated �eren Cv-lcs G X 06 x S=� Ibns i E= O U CDC. N fa (n a)CCCDN QO"O O CoMCD- COA�� 0 'n U3 CSE2'ao) —M= ;;g:=C -2 �:=a) ��� Q ��,QE �Na)o Q� U C CC Ca N."'C.-. O) O C6 N.0 O) a 0 O)C, (D U C S) (,:>: C' A C-0 O U Q� (n C U ate) civ Co oE V it Layout dimension sheets are intended as a construction aid.. Not all options selected are shown. W MarkLength_ Usage A _ - -15'911 B 13'9" C 1610-1/2" D 14' Joist Layout for Your Deck The Scale is 1/4":1' Design# 82475 Description Usage _ 10-2x10 Micropro Treated Joist 1-2x10 Micropro Treated Ledger 2-2x10 Micropro Treated Rim joist 1-2x10 Micropro Treated Rim joist Joists to be on 16" centers. Joists to be hung from the ledger with joist hangers. Joists to be toe -nailed to beams with 3-11?" (16d) galvanized nails. Rim joists to be face -nailed to joists & ledgers with 3-112" (16d) galvanized nails s� 0 LV ® C i B U �a?C "5- -:0 nU.V O C U E U (D -a5 c) Em; OC/i C= CO Q1 ICS TTi- Cc O C CO CDC --Y � C6 m� CO U C E U N mEc2 a� W W y Ucr cn a)) ML! aJ N U ` N U COUQ - T 0 U) Cn 3E�CUD, _CO= = 'n �: .s3 -ca) w -ma lg N 9 (WD 11 oCO, �� Cc C > U CcU ECn >?C) =7225-5- �CD aa))CCaao ow 00 Layout dimension sheets are intended as a construction aid. Not all options selected are shown. PAGE 1 OF 1 • CASHIER: SPECIAL ORDER CONTRACT FRED30142087 PLEASIE ***GUEST COPY*** 10111111NIMINII 1111011 STAPLE STORE# 3018 Phone: 763-571-8689 GUEST NAME - ADDRESS - PHONE RECEIPT FRIDLEY Fax: 763-571-1932 JENSEN, JESSE 5351 CENTRAL AVENUE NE 12 63 1/2 WAY NE HERE FRIDLEY , NIN 55421-1210 Fridley, MN 55432 THANK YOU! Phone: 651-491-4740 SOLD BY ORDER DATE Alt DR 04/26/2010 EST. DELIVERY DATE NOT BINDING ON MENARDS 0 5 / 10 / 2 010 INC. BASED ON PROMISES BY OTHERS QTY UNIT EXTENDED ORDERED DESCRIPTION SKU PRICE PRICE 1 — 32" x 80" 22"x64" Lite, Single Door, Steel Low E LT -8 blinds 4000446 $400.92 $400.92 lift and tilt c - Glass with mini -blind style saRight Hand Outswing Bore and Mortise, Add Deadbolt Bore _ 4 9/16" Primed frame, Brickmould Applied outswing Aluminum sill Dull Brass Hinges No Kickplate 34 1/4" x 82" Rough Opening 36" x 82 3/4" Brick Opening inside fr a a„ ot_Itsade Door Swing j. a **Please note the following** ThlsMasKercraft® a } • If the unit has glass, the pattern and style may vim doorlsENERGY slightly from the picture. STAR@quallfled. • Door color, the background, and accessories are for representation only. Door is viewed from the outside looking in. Door is shown with lockset for display purposes only. o s viewed from the outside looking in.) • Estimate Number: 1586815 *** By purchasing today,. you save $44.55• ** This is a quote valid today. This quote becomes an order only upon payment and a valid Menardwfeceipt for this order is attached. READ THIS CONTRACT CAREFULLY. The terms and conditions set forth in this document are a complete and SUB -TOTAL: $400.92 n the parties. Any and all claims under this special order contract must be brought within one yearSHIPPING CHARGES' merchandise. Special order merchandise may be.rafimded at Menards sole discretion with a • purchaser is responsible for all measurements, sizes, and colors as stated above. The PRE-TAX TOTAL: $400.92 edy if the merchandise is defective or fails to conform to the terms of the contract is merchandise. All defects and non -conformities must be reported to Menards within 3 days upon PRE-TAX GRAND TOTAL: $400.92 receipt of the merchandise. If there is a specific written warranty from the manufacturer the purchaser understands that dhis meroliandise is sold on an "AS IS", basis and the manufacturer's warranty shall govern my rights. MENARDS MAKES NO WARRANTIES, EXPRESS OR IMPLIED AS TO THE MERCHANTABILITY OR FrrNESS FOR A PARTICULAR PURPOSE OF THE MERCHANDISE. If the exclusive remedy fails its VENDOR: MM Prehung essential purpose; Menards liability shall not exceed the purchase price of the merchandise. MENARDS SHALL NOT BE LIABLE FOR ANY SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES. In the event that the purchaser refuses to and or fails to pick up the merchandise within 30 days after receiving notification of its For the most accurate and up-to-date status of your order, availability, Menards may liquidate the merchandise and shall be entitled to 25% of the purchase price as liquidated lease visitdamages. Menards may withhold any payment received as partial satisfaction for its damages. If the vendor, which p supplies the merchandise on this contract fails to perform, the purchaser agrees that Menards shall not be Gable. Because of wide variations in codes, there are no representations that the materials listed herein meet your code www.menards.com requirements. The Purchaser agrees that any controversy or claim arising out of or relating to this contract, or the breach thereof shall be settled by binding arbitration administered by the American Arbitration Association under its applicable Consumer or Commercial Arbitration Rules. A judgment on an award rendered by the arbitrator(s) maybe If this is a partial pickup, please verify all quantities/items entered many court having jurisdiction thereof. being signed for. Menards isnot responsible for shortages YOUR PURCHASE OF THE MERCHANDISE ON THIS CONTRACT CONSTITUTES YOUR g g AGREEMENT TO ALL TERMS AND CONDITIONS LISTED IN THE CONTRACT. after leaving the yard. 1111111111 IIIll 111111