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PRE 2010 DOCSViBage of Fridley, Minn. BUILDING PERMIT UILDIN NO 88 Office of INSPECTOR OF BUMDINGS Fridley, Minn. ria: 19 LOCA ON OF BUILDING No.4 d :� street --Lr Part of Lo* Lot_ i Block Addition or Sub -Division DESCRIPTION OF BUILDING Front Dept height stories . A Manner of Construction• To be used as -i �.`,.To be completed Estimated Cost r. Permit is hereby granted to-„-�� �•i�"�-�� '•-: r.• u� . M 7-- the buil I'--- ' 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, ground and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, fin=., 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. 1, p_„<� •`'�^_.- � ��,c-"�-x°�`�'`-=-�LLz r of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridleyof 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. II Subscribed and sworn to before me at Fridley, day of'` } A.D. 19 , . I il'II • Gi Mlnne60t&, this—,�- • ,J SUBJECT PER City of Fridley ?3r377 AT THE TOP OF THE TWINS BUILDING PERMIT • 16 RECEIPT NO. COMMUNITY DEVELOPMENT DIV. y r PROTECTIVE INSPECTION SEC. / i i1 ` ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY --_.� ��"�' L 512-580-3450 910-1715 2/9/76 % JOB ADDRESS 1035 - 64th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph Malinski 1035 - 64th Avenue N.E. 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 ❑ NEVV ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 22' Addition to dwelling 9 CHANGE OF USE FROM TO SrtIPULATIONS Addition to meet energy Codes SEPERATE PERMITS REQUIRED FOR WI HEATING, PLUMBING AND SIGNS. 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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. $7,500 3 • 75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $25.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $29.25 SIGNATURE OF TRACT d R OR RUTH ZED AGE (DATE) I �- -7,�� W EN PROPERLY VALID ED HIS IS YOU PE IT 9 i TURE Of OWNER 0F OWNER BUILDERI (DATE) BLDG INSP DATF+, ;; ,J APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME;�Sc �f� A AL/iJS/</ BUILDER: J ` [. _ F� ADDRESS:_ 16 3 5- `f �i-&Z- WC', ADDRESS: NO:. /0�7 STREET: COSI t l �- LOT: J BLOCK: ADDITION: MOOCL tAe�- 446-C CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: t 44 Depth:. Height: �o Square Feet: j Cubic Feet: 13Q50 .Front: Depth: Square Feet; Cubic Feet: Height: Type of Construction: V7i? iA-)'V1C; Estimated Cost: To Be Completed: 0 - 1 ` 7 �,- The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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. \V DATE:,)- - 9 S SIGNATURE: �� a . (See Reverse Side For Additional Informa si •,a? n ,••.nar ..,rte i{ �' *..1� ."tib i. iDb LYv 7S fe.i.0 ��v Ci�,:tii •....o tee d=d a�...�io `"tao'✓wD.l: p �bL:•:uwli�V's�.q i'�rr��.rv.6 i,.Stovt � cad Ali- PARTIAL G3 PARTIAL RATE SCHEDULE GZAFIi t WARM AIF.: 5.00 TOTAL F.•-^}ce Sl -.ell & Duct Work $10.00 $ Rrp!acr ne^.t of a snsre 6.00 S F•rpa:-c It Aitcrat.ons--up to Sr00.00 600 S Reyai-s & Alt,-ratic-.s each add. 5500.00 3W S NZCZL WARM AM 3 F1:rna a Shcll & Duct Work to 124,000 BTU ..51000 $ e add, CO. BTU 3.W S Pr7'acc--icrt of Srn:ce 6.00 S R_+,airs & Alte-atiors-up to M00.00 6.00 S F -e -,'airs ft Alterations each add. 5500.00 3.00 $ S rd.M o: HOT ?LATER SYSTEMS iyrnacr She'l & Lanes --to 4-'0 sq. ft EDR Stemn VO -00 'a Furnace Shell & Lire ---to 640 :,q ft. EDR Hot Water 2000 S. Each add :C-3 sq. h EDR Steam 3 on S Exch add. 320 sq. it EDR Hot ;dater 3.00 $ OIL BDRNZF.-to 3 gal. per hour 6.00 S. over 3 gal. per hour --See Iree Schedule GAS :9i''RN-ER (up to 1_1�9,000 BTU) 5.00 5 over I53.CCO B'I'i3 3" Foo Schodule GA3 FITTING TM S: No RATE TOTAL 1st 3 Fixtures xo 200 S Additional FIrtures x .75 S__. _. Gas Rarge W MOM %$ 5.00 3 State Surcharge .50 MAT= STS -MI & r-XPh:IM V TOTAL sr, ROUGH L`opt. o: BE%,�. �l'tioiio��• °>r.'Ai �/ ,• x), City of Fridley: The smderslgncd hereby makes application for a permit for the work herdr specified agrc•e•irg to de all work in strict accordance with the City Ord--n-ce: and ruling -of the 7-pa:tment of Building^s, and hereby declares thzt aA the facti and r4vpresen1atiutis stated in this app:r •ation are true a corrti*eL Fridley. '.ii Qwrer TOIS-G-Al &, !1/ �Iw�SEL� Kind of Buildingvz ,�f ✓> /�/ T/ t�1 Used as • . Tn be completer] about Ze Estimated Cost; S Old -New. Building Permit No. _.__ ._ permit No. D'..:f`FiinTIOIi OF WONT HEATING or PO.M'R FLANI.)- Ste:.m� Flet Vater, 'warm Air -No Trade Name Size No- Capacity—_-- _. Sq. FL F_D.R B:U__�? Total Connected Lcead Kind of FVel BURNER - ZYxelke Na* -+P Sire No cor4clty Sq. FL EM a BTU 2�? t>r;-aaAM-CM) n SLS.. L-2 SUBJECT;72 City of Fridley14 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. `y _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � i CITY HALL FRIDLEY 55432 ti.__.Jl•' 'j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/23/89 JOB ADDRESS 1035 - 64th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeffrey Rokeh 1035 - 64th Avenue N.E. 571-3039 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 CR NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 161 x 121 Shed 9 CHANGE OF USE FROM TO / STIPULATIONS L X31 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 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 $1200 $•60 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- SIX= $29.00 STRUCTION THE PERFOR CE F CO STRUCTION. PLAN CHECK FEE TOTAL FEE 0jk 0 �� -$29.60 sl Tu ONTRACTORORAUTHORIZ DAGENT IDATEI WHEN PROPERLY V ATED THIS IS YOUR PERMIT BLDG INSP 9 d ATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NLV [ ] ADDN ALTS [ ] Construction Address: legal Description: R-1 AND R-2 Building Permit Application 03S gee iu F- Effective 5/1/88 Owner Name & Address: �) P_ t� J&4 y E Tel. # S ? 1-3 O 3 q Contractor: S P�Vv1 Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the pMposed construction drawn on it to scale. LTVIM AREA: length -- Width — Height — Sq. Ft. MMM AREA: Length Width ;k Height Sq. Ft. I9� DECK AREA: length Width — Hgt/Ground — sq. Ft. — oTHER: Corner Lot [ ] Inside lot Ft. Yd Setback % Side Yard Setbacks �1( `Type of Construction: Estimated Cost: Approx. CmPletion Date: Proposed Driveway Width If New Opening Is Desired: -- Ft. $ $ ® p p Wdth + 6' See Back Page L1ATE: "� 1 ;O 1 APP7�CANP: Tel Permit Fee $ Moo State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Seder Main Qkuge s-rrPULATIMS: CITY OSE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by rn Irl' [ ] Not wry [ ] ID00 `� 0(i SUBJECT PERMIT City of Fridley -' AT THE TOP OF THE TWINS BUILDING PERMIT Y r • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 -7 i 1 � � L NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/8/95 JOB ADDRESS 1035 64 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Trudi Rokeh 1035 64 Avenue NE 571-3039 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sussel Corporation 1852 Como Ave, St Paul, MN 55108 645-0331 1934 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 Construct a 12' x 20' Storage Shed 9 CHANGE OF USE FROM TO STIPULATIONS Placement, height and anchoring to meet the City Zoning Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,046 $2.03 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- $72.00 Fire SC $4.05 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $83.08 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROP LY VALIDATED THIS IS YOUR PERMIT f � r BB'S INS P r)AT _ SIGNATURE OF OWNERIIF OWNER BUILDER)' IDATEI NEW [ ] Effective 1/ 1/95 ADDN [ ) CITY OF FRIDLEY ALTER () SINGLE FAMILY AND DUPLEXES R4 AND R-2 [ Building Permit Application Construction Address: Legal Description: Owner Name. Address: �,�-k'°r h( Tel. Contractor; MN LICENSE.# . .� Address:. L�S2^'� Tel. # 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: `a l2L C " Corner Lot [ ] Inside Lot Setback Side Yard Setbacks �-®u Type of Construction: �Yd Estimated Cost: Approx. Completion Date: jk� t , t q.cqt �' X�� �� = // �G'yL) (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: S --Q q APPLICANTS-► r-�-��r:�'�`� Tel. # G S-y3►�_ CITY USE ONLY Permit Fee $ %Z, Fee Schedule on Reverse Side Fire Surcharge $ `'f, d j� .001 of Permit Valuation (1 / 10th %) State Surcharge $, 03 $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ _5100 $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 STIPULATIONS: Zea s9870 -V/4.7 01 }� For the oxclusivo use of North Star Abstract. & Titlo Guaranty, Inc. 1 ROY' J. 1'1ANSEN 13907 Spring L -6e Road 1-at'd Su - eyc:— F"' r ' Hopkins, Minn. 553'13 AND ,; L0i� �` {jxII, Telephone 938-E673 Civil En�►.�; OF' PF40PEFITY OF 'ie"'' '"— LOCATION 1035 Lkltn f:V!-:n'.le Minneso"a All ofT,ot 10 :+lock 1 Moore Tan a High1anti s 2nd Addition ex^cot the DESCRIBED AS FOLLOWS I •' *lorth 20 feet of the 't',.yst h9-5 feet thereof. 177. zV- . o f n �1 • ! U \ \ • a r • TL4 n HQJ 1 t n . 1 t � • • . � .___-__._-- • •,� - -GSA-Ts�..,q r%6:--�y:•-IC. ---- , ; - . Scale: _ _____...:inch = ye) Beet CERTIFICATE 01: I.00:TION OF BUILDING CERTIFICATE OF SVRVEV I hereby certify that on I hereby certify that on 1 made a murrey of the lawtion of the 1%nildinFtsl on the above I sure}cJ the prup<rty described above and that the above plat described prrrerty and that the location of said building(s) is is a correct representation of said survey. eorrectl) shown on the aD.lve plat. N.s idt. 1, 3 3 3 ROY J. HANSEN, REGISTEM-0 SURVEYOR P10. 6274 Aa= SUSSELGAIUMS 1852 COMO AVENUE ST. PAUL, MN 55108 Permit by ` Legal Descriptio Lot. Blk Add'n Value Type Const. SLAB: ❑ By SUSSE L ❑ By Owner Approx. ❑ In - 2 -STARTING POINTS ONLY S. P. L. S.S.P. R.P.L. � Alley House F. Street Other ❑ Square With ❑ Sod Rem.. By ❑ A.B.U. ❑ 0 Grade Point ❑ ConIyij_ _ _ _ _______ Blocks: ❑By Owner ❑By Sussel ❑ Wtr.proof: ❑By Own. ❑By Sus. Ej Backfill: 0 B Own. 08y Sussel K.Maintain 8' Total Wall Height - I-ritluding Blocks ORG— ❑ Maintain 8' Wall Height on Top of Blocks ^�I Block Size (Top course) - JVall Fie gi'ht other th 8 1-1 Existing garage: No ❑ ❑ Detached ❑ Attached Yes ❑ Size of existing:___x Existing garage will be: ❑ Left as is ❑ Converted to L.S. - By owner L7 Removed By: Owner ❑ Sussel ❑ Junk Must Be Removed By Owner Stakes visible - ❑ Yes ❑ No Survey available - ❑ Yes ❑ No i7 Special instructions from owner: -_--_-- WORK ORDER .S %� 3 Q 3 HOME PHONE: NAME -1`7 �� / \ d l'�C�C BUS. PHONE: JOB ADDRESS-- -J S 6' `r` � /� � A16 BLDG CODE AREA_! CY1-P�i SALESMAN CONTRACT DAT Z r2/SIZE f I L L ACCESS 0 Good - ❑ Fair 0 Poo PURCHASER'S INITIALS: i-. T j .-- MEOMMMMMMME NFAMMEN ,/ iWI1 ■ ■■■■■■■■■■■■■ ■■■■■■■■■■■■■ ■■ ■■■■■■■■■■ ■ MEMN■■ .■■■■■■■■ ■■■■NEEM■■ ■ ■■■■NNEME■ MESON iME ■■NEE■■ EMENOMM ■ ■■■M■NE ■�■M■■ ■ �■ ■■ ■■ ME■■N�M■MEN■■■ MII■E■■NEEME■■■ �EMEE■■■ ■ MNEE■EM CEEEN■MEMEM NEEMEEM ■��M ■MN■MMENE NC■■■■■■■■■■■ NM■■M■■■NM MM■ N■■EMEM■ ■■NNE■MM NEE ■■■�E■■N■■M■ ■■■■■ ■■■N■■M■ ■MM■ENEE■EN■ .■ n MI■NEME■NEEM■ME ■MEM■■MEM■N■■M■ EN■■■■■MM■EEM EM ■MEMN■■M■ MI NONE ENNEM MI E.M■M■M■ ■■�■MMENMEME E■EM■■ C■CiiCMM■E■■E �it•N����tiil■■E MMMEN M■MENE■ M■MENE■ M■■■■E■ ME E■\ENE■ PLOT PLAN . . . . . . . . . . . J 4- 1 7i --T-4 _0 1 7 I 71 sussniiiiiii "T �yf 4 4 i - NAME " 4- q-4- ADDRESS t NC 4- --- Cl TY _Tff. LEGAL DESCRIPTION -4- 14- LOT: L-4 T - 7 BLOCK: 1 ADDITION: I f I I -T, 4- 71 LOT SIZE: X -7- HOUSE SIZE: 14- T 1 1 lj(,o. SQ. FT. 3 t L-4- Ll CROSS STREETS: AND -4- 77 7- 7,T+.7 7-7 -44A J-, 7 J+ DIRECTION -I J. 14, SVSSELGAR.AGES ROOF: GABLE REVERSE GABLE HIP, EAVE OVERHANG: �Z RAKE OVERHANG: _!1_ SEAL DOWN SHINGLES WITH PLYWOOD OR WAFERBOARD ROOF SHEATHING AND 15 LB. FELT it Roof Sheathing Gj 04 Y} \_ --- Seal Down Shingles Manufactured Tr sses- / 2" x 4" Double Top Plate so NOTE: 1) Roof approved by Minn. State Building Dept. as meeting Minn. State Code Requirements of 30# snow load. 2) Hip roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C., 2" x 8" hip rafters and no plywood gussets are used. RAFTERS: Trusses ® 24" O.C. STUDS: 2" x 4" -16" O.C. 24" O.C. WALL SHEAT NG SIDING: �/�. W'© X64, (' OVERHEAD DOOR HEADER: Double 2" x 12" or 1 -Micro Lams -x-. Slab on grade construction approved per Minnesota State Code. Refer to State Building Code Letter Number 11. SLAB: 4" WITH MESH 6" x 6" #10 Gauge 45 Trim 1"x4" Sub Fascia Fascia L Soffit 3/4" Cove 2" x 4" Studs Siding '9 - 1/2" x 7" Anchor Bolt 2' x 'Treated Bottom Plate a Grade —� 4' CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer /C *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK I% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate. TOTAL $ 30.00 - $ • (✓� $10.00. $ $10.00 $ $10.00 $ $ 25.00' State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Effective On August 1, 1995 JOB ADDRESS f® 5— �f �e=� ALI & 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. e�S /';4' ,1996 OWNER BUILDING USED AS ��/��;�� "."Gtcw, o Z ESTIMATED COST -37,00— PERMIT NO. Lc�lg DESCRIPTION OF FURNACE AND OR BURNER No. of.Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade_Name644,,�a�.��_ Size No. BTU ✓f?® g5�,no HP EDR Fuel ' Total Connected Load Burner Trade Name Size No. BTU HP EDR Sharp Heating and Air Conditioning HEATING COMP, 4854 Central Ave. NLN Colum eights, MN 55421 Signed B 2) 572.0459 Tel No. Approved Byk Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDEUOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATI The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: L A: M17-7,1- 1Ii- HEATING CO: Signed By: Date: WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring WELL AND BORING SEALING RECORD Minnesotalunique No. Minnesota Statutes, Chapter 1031 or W-series No. (Leave blank If not (mown) H 10721 County Name An Township Name Fridle Township No. 30 Range No. 23 Section No. 3 Fraction (sm. -s Ig.) " I' Date Sealed 6-20-96 Date Well or Boring Constructed Numerical Street Address or Fire Numberl or Boring Location and City of Well 1035 54th Ave. NE Fridley 1 1 Depth Before Sealing 00 ft. Original Depth 100 ft Show exact location of well or boring Sketch map of well or boring In section grid with °X°. location, showing property lines, roads, and buildings. N -;r- -T- -;-- --;-- I I I yy -- -? - -T- --�-- E ---I-- YerMe ' a' d tS ����J�"""""" t rwee II AQUIFER(S) [2(Singie Aquifer ❑ Multiaquffer STATIC WATER LEVEL EXMeasured ❑ Estimated - ft. [A below ❑ above land surface WELL/BORING Water Supply Well ❑ Monit. Well ElEnv. Bore Hole ❑ Other CASING TYPE(S) LYiSteel ❑ Plastic ❑ Tile ❑ Other CASING Diameter Depth Set in oversize hole? Annualar space Initially grouted? 2 3 In. from 20 96 ft. ❑ Yes : No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown In. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME Property owner's mailing address If different than well,locatlon address indicated above. Jame SCREEN/OPEN HOLE Screen from 96 to 10P ft. Open Hole from to ft. OBSTRUCTIONIDEBRISIFILL M Obstruction ❑ Debris ❑ Fill ❑ No Obstruction g 631 11" d + ptf s b jet Type of Obstruction/Debrls/FIII Obstruction/DebdNFill removed? [X, Yes ❑ No WELL OWNER'S NAME Well owner's mailing address It different than property owner's address indicated above. PUMP Type Jet pump Q Removed ❑ Not Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM TO If not known, Indicate estimated formation log from nearby well or boring. _ METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: No Annular Space Exits ❑ Annular space grouted with tremle pipe ❑ Casing PerforatiordRemoval In. from to ft. ❑ Perforated ❑ Removed In. from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) Grouting Material N t Crit from 5 to 100 ft. yards 4 bags from to ft. yards bags from to fL yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING Ilk �,t Ni UNSEALED WELLS AND BORINGS Other unsealed well or boring on properly? ❑ Yes X No LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was seated In accordance with Minnesota Rules, Chapter 4725. The Information contained In this report Is true to the beat of my knowledge. l In . 02133 Co usiness N L(cenw or Registration No. 6-21-90 Authorized Reprasentefive Signature Date Randy Danielson LOCAL COPY H 107212 Name of Person Sealing Well or Boring HE -01434-02 10/95R 01 SUBJECT P City of Fridley7478 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • t ----- _ COMMUNITY DEVELOPMENT DIV. V� r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE .PAGE OF APPROVEd BY I.' 612-571-3450 910-F15 6/3/96 JOB ADDRESS 1035 64 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dean/Trudi Gorton 1035 64 Avenue NE 571-3039 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Lake State Remodelers 9278 Trinity Garden N, Brooklyn Park MN 55443 2004729 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 424-0676 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House (23 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, NO. DWLG. UNITS OFFSTREET PARKING 1 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 $1,897.50 $.95 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF AN OTHE STATE OR LOCAL LAW REGULATING CON- $59.50 Fire SC $1.90 THE E ANCE OF CONSTRUCTION TM PLAN CHECK FEE TOTALFEE -1; --1(0 License SC $5.00 1 $67.35 RE OF CO TRA To OR AUTHORIZED AGENT IDATEI WHEN PROPERL BLCJ6 INSP VALIDATED THIS IS YOUR PERMIT / OAiE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI 01 NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY FILTER [ ] SINGLE FAMELY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: I o 3s- ' fa 44'` -H-v 6 - Legal Legal Description: Owner Name & Address: 9FA N d- T2u0 f 4Dre-r6 SOME Tel. # S71 -3o-?g Contractor: LA.�z lkmopayAr MN LICENSE#.2dB47ag Address: U-70 -MMTY 4A&00w N. r0gec 0y 6-r443 Tel. # 4 z4 &, 74, Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF Il"ROVFA ENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: aawl; Estimated Cost: $ Approx. Completion Date: 6-q(� (Cost on Back) Driveway Curb Cut Width Needed: DATE: & -3 -q to APPLICA 6 Ft + — A Ft x $ Tel. # 41-4 -&- -7k, STIPULATIONS: CITY USE ONLY Permit Fee $�%- � Fee Schedule on Reverse Side Fire Surcharge $ /. 9e" .001 of Permit Valuation (1/10th%) State Surcharge $ . ��� $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ $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 $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE — Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 1%ct � 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES . JOB ADDRESS 1 '� L4% C.c`k krl, RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shel uct or Burner- Also Replacement Furnace $ 30.00 BUILDING USED As (Side Vent - Fill Out Back) $�.6 ESTIMATED COST }3 / Gas Piping (Needed with new furnace, $ 10.00 $ 0 PERMIT NO. d.3 but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 17o of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.251y. of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL representations stated in this application are"true and correct. FEE $ MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed DATE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By16 Rough -In Date Final Dater �" 9 written permission from adjoining property owner. List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHMEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Building See Back Page for Fee Schedule BUILDING 65% of Building Permit Fee Permit No.: - Inspections $ RESIDENTIAL APPLICATION $ Received By: 763-572-3604 $1450 per SAC Unit (Plans to MWCC for determination) CITY OF FRIDLEY ft+6ft= ftx$20=$ Date Rec'd: DATE / — 1 (�' YOUR E-MAIL ADDRESS Fee Determined by Engineering SITE ADDRESS e2 It"lig Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNER de-ON—TRACTOR PROPERTY OWNER/ NAME: 71:-, iE c /i ADDRESS: AQ 3 S G t' 171_ A L CITY STATE ZIP TENANT PHONE: � _ S d� ^ 9,4 2 CONTRACTOR NAME:° I i 15 l� STATE LICENSE # oZ Ua. fI 7 ®® I EXP DATE 3/ ^ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:' /J' % /!51 3 3� / ff L -c CITY 6/< �STATEtLfZiiP,_ CZLO q WITH APPLICATION PHONE 'Id,- 32 , 0 FAX PROPERTY TYPE M -SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH EI..R80F ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: rcy, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFINGgg ❑ HOUSE ONLY NUMBER OF SQUARES J e4400 -SE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: [3DETACHED 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 ❑ 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 WINDOW 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 $ OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ (.0005) times the total job valuation — Minimum $.50 $ .001 x Permit Valuation (1/10%) $ $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks payable to: City of Fridley Attach 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 aqd work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w ch r it ie d approval of plans. / 7 SIGNATURE OF APPLICANT PRINT NAME DATE