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PRE 2010 DOCSVillage ®f Fridley, Mum. BUMBING PERXrr 3 1'.'4 I Office of INSPECTOR OF BUELDINGS Fridley, Minn., LOCATION OF BUILDING yf _Part of Lot Addition or Sub -Division Q'L& RIPTION OF BUILDING Front -2- _'O�f PT eight Storie Manner of Construction To be used as d 0 completed Estimated Cost To be complete Permit is hereby gftnted to In, + the building described in the above statement. This permit Is granted upon the express condition that the r4son to whom it is granted, and his agents, employees and workmen, in all the work done in, a and and upon Wald 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 t* e upon violation of any of the provisions of said ordinances. inspector of Buildings. AGREMWNT AND SWORN STATEMENT In conslderat�lon or the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit,j� I hereby agree to do the proposed work in accordance with the description above set forth a according to the provisions of the or. 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 st ted. Subscribed and Owom to before me at Fridley, Minnesota, `.ibis — day Of --A.D. 19S4. Village of Fridley, Minus, NO BUILDING PERMIT 645 Office of INSPECTOR OF BUIIMUMSS Builder Fridley, Mian, i9'` LOCATION OF BUILDING No.— Street—2`4 ` " ` r' `� Part of Lot Lot � Block Addition or Sub -Division DESCRIPTION OF BUILDING FrontDepth A , F Height�Stories a ! Manner of Construction To be used as w ,. ...., .�. � To be completed ti - = Estimated Coat . Permit is hereby granted to = the buildine described in the above statement. This permit is granted w upon the express condition that the person to whom it is granted, and his agents, employees P Yeea and workmen, iall the work done in. around and ordi- nances said building, or anY Part thereof, shall conform in all respects to the 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. T"sgector of Buildings. AGREEMIM 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, day of A -D. 19 i, Minnesota, this `> 6' :�M 52-84-S915-51 City of Fridley Application for Plumbing and Gas %sting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 359 N E 66th Ave Number, Kind and Location of Fixtures Locatior� y Gel � iii ?d5� i i �i c� °C Z i�3 Z o ?1W� J (� U' Z 0 O � F • N WATER HTR. GAS ELEG Base Inst Gas Drye� 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer E] Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ...... ..................... Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 199,000 BTU .............. Gas Dryer 1 REPAIRS & ALTERATIONS—Refer to Code x $2.00 $ x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ — x $3.25 $ _ x $2.00 $ NO. RATE TOTAL x $2.00 $ x $ .75 $ x $5.00 $ 5.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 9-3-68 19— Owner Stuart Kind of Building frame Used as re8 To be completed about 9-8-68 Estimated Cost, $ 31Q nn Old—New. Building Permit No Permit No. //7–? 3 By Business Phone o ROUGH FINAL Description ..................................... ........... 5.00 TOTAL FSE $ 42 City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERM _ 16 0.5 9�' r • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; i CITY HALL FRIDLEY 55432 L J \ 612-571-3450 o CP EI NUMBERREV. 910-F15 DATE 3/6/81 PAGE OF APPROVED BY JOB ADDRESS 359 - 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Lovelace 359 - 66t1i Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings 6331 Riverview Terrace N.E. 574-9966 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 Reside Dwelling 9 CHANGE OF USE FROM 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION $4,300 SURTAX $2.15 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 REGULATING CON- PERMIT FEE $27.00 SAC CHARGE STRUCYPN OR THE PERFORM CE OF CONSTRUCTION. (� �I PLAN CHECK FEE TOTAL FEE $29.15 191114TURE6FCON RORAU HORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDEM IDATEI CITY OF FRIDLEY APPLICUMA FOR RESIDENTIAL BUILDING PEW41TS (Hew, Alterations, Additions„ or Repairs) a OW14ER: ADDRESS: -"-j F TEL NO: DUI LD7:R : � -�� 1`' '4 =2-=-^ ADDRESS; �pf TEL 1-10: (-d0: Construction Location ' STIM, T NO: STREET: L07.': BLOCK: �_ ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of.Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic feet: Type of Construction: Estimated Cost: $ c To $e Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE Rc VERSE SIDE OF SHEET . The 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 that all the facts and representations stated in this application are true and correct. DATE: (�, 'd (y SIGNA'.VURE :� & �4' 4 ::; �� Stipulations: • � � moi• O.0 ' FIRE DEPARTMENT MEMO TO: BUILDING INSPECTION SSING T SUBJECT: FIRE DAMAGED STRUCTURE SDA Jan. 21, 1966 FIRE HAS OCCURRED AT 359 - 66th Ave. NE (ADDRESS) Jan. 16 1986 (DATE OF RE FD -7 SUBJECT PE City of Fridley o 18317 AT THE TOP OF THE TWINS BUILDING _ P E R M I T r EIPT O COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 ( i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 1/24/86 JOB ADDRESS 359 - 66th Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 2 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Lovelace 359 - 66th Avenue N.E. 572-2559 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Giertsen. Co. 5147 Winnetka Avenue North, New Hope 535-3212 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 27 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Garage repair after fire 9 CHANGE OF USE FROM TO STIPULATIONS Replace garage rafters from 2"x6" to 2"x811, 16 inches on center. Double all 2"x6" rafters on carport RA TSEPA PtPAIIITS I-�'�.� ° h?�(��Jp), y R Z ¢"fir'`''' FOR' AND 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 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 SIX $2.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5/000 DOES NOT PRESUME TO GIVE AUT ORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE OFANYLOCALOR REGULATING CON- HERMA A $50.50 STRUCT ON O ER E OF NSTRUC ON '\' � )$53.00 PLAN CH CK FEE TOTAL FEE ®P. /� (/dr- ( ` SIGN E OF CONTRAqf0R daAUTHORIZEDAGENT (DAT _ WHEN PROPERLY LI DATED HIS IS YOUR PERMI BLDG INSP 1 aV- OAJE SIGNATUREOFOWNER(IF OWNER BUILDERI IDATE) NEW [ l City_ of Fridley Effective 4/1/84 ADDN. [ ] f R-1 AND R-2 I ALTER. Building Permit Application Construction Address: ' � 7 Legal Description: Owner Name & Address: Z2 �� �- / / CA G Tel. # Contractor:--- al g X 7-r t Oy (2a, Tel . # Address: -5/'/ 7 01 AJAJ L ZA- O-�- I O 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 DECK AREA: Length Width OTHER: AO a a C C'- s � t /L Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Type of Construction: Approx. Completion Date: G 6 Proposed Driveway Width If New Opening Is Desired: Height Sq. Ft. Hgt/Ground Sq. Ft. Side Yard Setback Estimated Cost: $ 12-000 ey-- Alt. A Alt B See Back Page for Explanation DATE: APPLICANT: Tel. #1:'3 Z�Z-- Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY ' 3. U-0 Oa Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 z $10.00 $10.00 $15.00 State Surcharge TOTAL FEE $ .50 JOB ADDRESS 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. _ 1997 Owner Building Used As & Estimated -Cost PERMIT NO. PLUMBING COMPANY �co_ _ r' '(Z O� SIGNED BY442 TEL N0. A Approved By/-- W Rough—In Date Final Date MINIMUM rtt J:UH ANY F'LUMbINU/ PLUS THE .50 STATE SURCHARGE 00 **COMBUSTION AIR SHALL BE PROVIDn PERU MC SECT N 504(A) AND TABLE 6- MINIMU//SIZE 9 SQ CHES. �C f ` -CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 Ov 6431 University Ave NE � Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, �✓i . V' 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS \,3 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in, strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $6(0011 representations stated in this application are true and correct. (Side Vent - Fill Out Back) `j '52- A 1997 Gas Piping (Needed with new furnace) $ 10.00 $ OWNER �� /f? f� �8 4,01 57 ZZ - 2o%7 Gas Range $ 10.00 $ BUILDING USED AS �gs, Gas Dryer $ 10.00 $ ESTIMATED COST PERMIT NO. 1_3C *Air Conditioning - All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) �arrmnAXir Trade Name e yVA.0 V Size No. Commercial/Industrial . BTU__ jge5,QC2Q HP EDR 1.25% of Value of Appliance or Work $ Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. BTU HP EDR_ �� TOTAL FEE $ HEATING COMPANY MINIMUM FEE FOR ANY HEATINGJCOOLI�ENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough -In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNA E A; A / i & P) �Z_ �1) , Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 1 CEUAUgEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefiilly examined Yes o No ( ) 2. Is free from rust or deterioration Yes (W No ( i ) 3. Has no foreign objects lodged within Yes (X No ( ) 4. Is securely supported Yes AA 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 M 0 O 0 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yesp No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: City of Fridley AT THE TOP OF THE TWINS suBJEcT BUILDING PERMIT PER _ COMMUNITY DEVELOPMENT DIV t. PROTECTIVE INSPECTION SEC. r ; CITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO. NUMBER 910-F15 REV DATE 6/16/97 PAGE OF APPROVED By JOB ADDRESS 359 66 Avenue NE 1 LEGAL DESCR. LOT NO. 13 BLOCK 2 I TRACTOR ADDITION Rice Creek Terrace Plat 2 SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas Larson 359 66 Avenue NE 572-2088 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 Kitchen Remodel (Change wall, floor, windows, countertops) 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,400 $3.20 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ PLAN CHECK FEE TOTALFEE on $134.35 $I U OF CON ACTOR ORA HORIZEDAGENT IOATEI WHENPE DATED THIS IS�PERMIT T-51 GNAT OWNER IIFO NERBUILDERI (DATE) BL G INSP MATE u 01 NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 6&CR 0 ConstructionAddress: j &&t* &y A Legal Description: Z Z Owner Name & Address: / e6Q&-) 3el 6,refK 4/t he Tel. Contractor: Address: MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. # DESCRIPTION OF MOROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ,� D 6 & A4%0 Ole, Construction Type: pQr:i/ Estimated Cost: $ axe — (Fee Schedule on Back) = Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: fol 7 APPLICANT: c% ` ems I Tel. # ,S7 Z– ZOO Permit Fee $ Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS.—--/ �S � S CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 [ ] 1 trMA 4 MAIC WA iEQr T`wk. Wim - L r:7 ul -1 U'_ SUBJECT PERMIT NO. City of Fridley' 32310 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. •COMMUNITY DEVELOPMENT DIV. L.' V --.--- INSPECTION SEC. r � � PROTECTIVE 1 = "1 CITY HALL FRIDLEY 55432 IL A NUMBER REV DATE PAGE OF APPROVED BY ---- 612-571-3450 910-F15 11/8/01 JOB ADDRESS 359 66th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 2 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Larson, 359 66th Ave, Fridley, MN 55432 763-572-2088 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Modeen Company, LLP, 8579 Jefferson Highway, Maple Grove, MN 55369 763-425-3600 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 3867 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install 4 vinyl replacement windows. 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. 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 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,654.00 $1.33 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 PERFORMANCE Q& CONSTRUCTION $83.25 Fre SC $2.65 PLAN CHECK FEE TAL FEE Lice 5.00 $92.23 ATURE OF CON 'R TOR OR AUTHORIZE D AGE N T IDATEI HE PR LV V LI ED THIS IS YOUR PERMIT 00, j S,GNATURE OF OVVNER 16 OWNER SUILD,ERI IDATEI OGI P nArE NEW [ ] Effective 1/1/2001 ADDN (] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION r:nnctn w4inn 4rfHrpec- . � 5-'9 r�f�, I' '4' _ xIf Legal Description: Owner Name & Address: f 0/17 A—l-7 35T cc," A- & tTel. # 7,143 - 522 -a®� Contractor. ae'®g.u, 4 L "'::7 MN LICENSE # Address: e67%rl �7,-,-, /%Af _Tel. # %��-�•7S-c3��� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:Estimated Cost: $��5e/ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ® APPLICANT: _ / i�'I //"<a� � i Tel. #7 CITY USE ONLY - Call (763)) 572-3604 for Permit Fees if mailing in application Permit Fee $�?s� Fee Schedule on Reverse Side Fire Surcharge $ .2- S .001 of Permit Valuation (1/10th%) State Surcharge $ 1.3-3 $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $..... �D® $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 $ - 02-3 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION plp -vb Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 357 CBCT - /Y � RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and $ D representations stated in this application are true and correct. DATE HEATING CO er5'®A-e' Signe TEL # ��03 2v X06,0 IV q - *Air Conditioners can not be placed in a side yard without Approved BRough-In Date Final written permission from adjoining property owner. OWNER 6 /Al Rate TOTAL // ` J kQ 6%de BUILDING USED AS n/ -C 4! $ 30.00 ESTIMATED COST V PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. $ 25.00 T_ $ 5 �K BTU Fuel HP EDR Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and $ D representations stated in this application are true and correct. DATE HEATING CO er5'®A-e' Signe TEL # ��03 2v X06,0 IV q - *Air Conditioners can not be placed in a side yard without Approved BRough-In Date Final written permission from adjoining property owner. COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () 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 manufacturers 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter. in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 October 17, 2001 Mr. Tom Larson 359 66 Avenue NE Fridley, MN 55432 Re: Final Inspection at 359 66 Avenue NE Contractor: Peterson & Pinney Inc. Dear Mr. Larson: A mechancial permit was issued on August 16, 2000 to install an air conditioner at your address. According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the mechancial work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Mechanical Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection, or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh Building ermit Fee BUILDING See Back Page for Fee Schedule Permit No.:940?--6/3/�o Inspections 65% of Building Permit Fee .RESIDENTIAL APPLICATION $ 4 c ev Received By: L) 763-572-3604 $ CITY OF FRIDLEY License Surcharge Date Rec'd: — :5—®c? 763-502-4977 FAX SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 8-19-09 Erosion Control $ DATE— 'q _ I — Ua1 YOUR E-MAIL ADDRESS $ SITE ADDRESS 35`l 6 6 c,v e . )1J, 1= Fv , `cQ Mil Ssy 32 $ THIS APPLICANT IS: OWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: C it Ca,' f TENANT ADDRESS: 35-W L6^- Q V 2 Al r CITY —Y,' STATE_L6,LZIP SS4 ?a? PHONE: �� 3— S�-� —lot I CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE P�tINGLE FAMILY/NEW CONSTRUCTION SIZE 3 ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE BECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: t_' C SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT $ G SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I . Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: IDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. 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 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: e (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ f�t06S OCCUPANCY TYPE ermit Fee $ 11,�j' See Back Page for Fee Schedule o"Plan Review $ 65% of Building Permit Fee ire Surcharge $ 4 c ev .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = R x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT &",,4K - PRINT NAME ! R l�/ 6 Al bRl�l 414- DATE _VV d0 f 7� I. - 7E M- Al C-7--