PRE 2010 DOCS9
City of Fridley, Minn.
0
BUILDING PERMIT N® 3384
Date: .. ..... ....... ................
owner....................................... Builder O.. .....
Address ...................................... Address ...........................................
/� +f
LOCATION OF BUILDING
No. . a / / ... Street ...� . !: .. a` :moi':. /. !..-- .. Part of Lot ............................. .
Lot ... Block ................ Addition or Sub -Division R'4�-- aWA1 .
Corner Lot ............ Inside Lot .. X....... Setback a3.� .—. ®. Sideyard ' . .? ..i ........... .
DESCRIPTION OF BUILDING
To be Used as:
n � �.. -.... Front ���... .,Depth ::/® xeight .� 1�.: ® Sq. F't. '106V Cu. Ft; 4Ac2 a fQ
.. Front !? ®0 Depth .9R�p.f .,l(0 Height 119 ' � Sq. Ft. ��:� Cu. Fto3..'Y`.O If &
Type Cobf /� � �' ... To be Completed
of Construction ................... lust. ........ ...................
In consideration of the issuance to me of a permit to construct the building desribed 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.
A
....................................................
In consideration of the payment of a fee of �.7:'-'.., permit is hereby granted to ...................
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items. A
City of Fridley
Application fcw Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK n --7
&74
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
$ �, d
t2
x 1.20
$
New Fixture Old Opening ..............
OZ
biz
0.:
J
$
O
Z
&
WATER HTR.
x 2.00
1$
New Ground Run Old Bldg . ............
3c�
$
�'�
GAS FITTING FEES:
y
3�
o�
x $1.50
�Q
��
<3
��
��
'np
F
N
GAS
ELEG
Base
e
1st
e
2nd
3rd
4th
• Future Connection Openings I
Connected with
* I
New Fixture, Old Openings
Sewer
)
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
$ �, d
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......—�
x 2.00
1$
New Ground Run Old Bldg . ............
s x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures ..........................
x $1.50
Additional Fixtures ....................
x .50
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ / ,2. 5
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application 7
a true and correct.
Fridley,1VCM/ , 19'5-
Owner tura . 19
Kindof Building
Used as
To be completed about � A5
� L
erg
JF
19—
Estimated Cost, $
d–" Building Permit No
Signed
Bq
Business Phone No- ST c?J& J_7
Connection Permit No . .......................................................
Water
Sewer �' 61-2
Meter Deposit 1;2 ' L --d
�Yv 5-0
G
11 IM -8-S8
Application for Power Plants and Heating, Coaling, Ventilation. Refrigeration and I
Air Conditioning Systems and Devices ,
PARTIAL RATE SCHEDULE DepL of Bldgs. Phone SII 4-7470
GRAVITY WARM AIR: RATE TOTAL L .. o, 7 I ^ le Z S
Furnace Shell & Duct Work .......................... 8.00
Replacement of Furnace ............................. 5.00
Repairs & Alterations—up to $500.00 .................. 5.00
Repairs & Alterations each add. $500.00 ............... 2.50
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00
each add. 60,000 BTU ....................... 2.00
Replacement of Furnace ...........:................. 5.00
Repairs & Alterations—up to $500.00 ................. 5.00
Repairs & Alterations each add. $500.00 .............. 2.50
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam....... 8.00
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00
Each add. 200 sq. ft. EDR Steam ...................... 2.50
Each add. 320 sq. ft. EDR Hot Water .................. 2.50
OIL BURNER --to 3 gal. per hour ........................ 5.00 $_
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ ✓
GAS PIPING (Up to 3 Fixtures) .......................... 1.50 $
(Add 50c each over 3)
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
REMARKS:
See Fee Schedule
TOTAL FEE ' J—o
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct. pp
dley Min 1951-
gb
Owner er�" 195—
Sind of Building Al 195—
Used as x -c
To be completed about
Estimated Cost, $
Old New. Building Permit No. 399
[
DESCRIPTION OF WORK
HEATING or PO)WER PLANTS
D--Steams, Hot Wa , Warm Air —N ' 7
Trade Name �=��Q C� X2- d Size No G
Capacity Sq. Ft. E.D.R. T of D-� BTU H.P.
Total Connected Load 9/ ' `� / Sind of Fue .
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
RAY N. WELTER HEATING 01f.
S - E� 69 A-E
NEAPOLIS 7. MINNEBOTAA
11 posr 1 M-8-58 Business Phone No4 Z
( ,J�
SUBJECT
PER
City of Fridley
21490
AT THE TOP OF THE TWINS
?
BUILDING PERMIT
Ir
REC
-_'---7_3COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
7 �
r � �
NUMBER
REV
ATE
PAGE OF
APPROVED BY
i �'-'{ CITY HALL FRIDLEY 55432
A " ,j 612-571-3450
910-F15
r8/13/92
JOB ADDRESS 271 -- 67th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
4
1 Rice Creek Plaza South SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Katherine Christofferson 271 - 67th Avenue NE 5712724
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install egress window in basement
9 CHANGEOFUSEFROM TO
STIPULATIONS
Window must meet State Building Code requirements
SEPARATE PERMITS REQUIRED, FOR
WIRING, HEATINGF PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$300
$.50
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-
Fire SC $.30
STRUCT R THE E MANCE F CONSTRUCTION.
$15.00
PLAN CHECK FEE
TOTALFEE
�2
$15.80
Slfi ATU OF CONTRACTOR AUTHORIZED AGENT IDATEI
HEN ROP RLY V ID ED THIS IS YOUR PERMIT
Fl a �
w
KAI, 2-1
/ L
JSLDG INSP DATE
SIGNATU RE OF OWNER I IF OWNER SUILDERI IDATEI
NEW [ ] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER[ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: -7 �i� NC-�
Legal Description:
Owner Name & Address: Tel. # 71 ? 7
Contractor: Scz F MN LICENSE # I!li+
Address: 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:
—6W'
INS7-At' -*%Jd/1/
Lc -7 2e: Ss t�i.y�o�'
,N zAsevK(�-nl7
Corner Lot [ ] Inside Lot [ )
Type of Construction:
Approx. Completion Date:
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Ft x $
(Cost on Back)
DATE: 1 z-� APPLICANT: / Tei. # S Z
1. Y
CITY USE ' ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL
Fee Schedule on Reverse Side
.001 of Permit Valuation. (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS: •
Building
BUILDING
See Back Page for Fee Schedule
Permit No. ® 4
Inspections
RESIDENTIAL APPLICATION
Received By: `
763-572-3604
CITY OF FRIDLEY
Surcharge
Date 01:JUN 3 0 200
763-502//—^^4977 FAX
License Surcharge
$ 0C�
$5.00 (State Licensed Residential Contractors)
SAC Charge
EFFECTIVE 1-1-08
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
6 YOUR E-MAIL ADDRESS
DATE 3 Onn
ft + 6 ft = ft x $21 = $
-7
SITE ADDRESS �C 6 61Ar—
/
$
THIS APPLICANT IS: ❑ OWNER dl2�NTRACTOR
Park Fee
PROPERTY OWNER/
NAME:����/�
Sewer Main Charge
ADDRESS: CITY
�' STATE�� ZIP„5 �' �
TENANT
$ I.1
PHONE:
NAME: v,-1 r
CONTRACTOR
ADDRESS: 3 c".,z Ci D se -J C / CITY 5707' 1 ���sTA�ZIP
SUBMIT A COPY OF'
PHONE - o) R� – S ? FAX
YOUR STATE LICENSE
—eal
&O
STATE LICENSE # / C2,0 EXP
DATE
PROPERTY TYPE
INGLE FAMILYNEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ G FISHED ❑ WINDOWS
❑ ADDITION'
❑ BASEMENT FINISH 1F ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW—HOME CONSTRUCTION ❑ ADDITION
INTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING D0NE-.---,J9W1_
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT SQ FT
ROOFING❑ HOUSE ONLY
�'
& GARAGE
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES USE
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3. List of structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS. & PORCHES SUBMIT:
❑ Vinyl ❑Soffit
1. Site Plan/Survey showing the existing structures
❑ Aluminum ❑ Trim
and proposed project.
❑ other E3 Fascia
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:
SING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ 930 OCCUPANCY TYPE
Permit Fee
$ Z3.,As
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ �^ '
.001 times the total job valuation
Surcharge
$ 0 1
.0005 x Permit. Valuation Minimum $.50
License Surcharge
$ 0C�
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 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
$ I.1
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 1 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 appy plan in the case of all work which requires view andlap�'roval f pl s. ?
SIGNATURE OF APPLICANT SID h l �� PRINT NAME lam/ �DATE 'J ���
APPROVED BY DATE
Building
BUILDING
Permit No.: I
Inspections
RESIDENTIAL APPLICATION
Received By:/X E-0
763-572-3604
CITY OF FRIDLEY
Date:
763-502-4977 FAX
t*W-1—kQ
EFFECTIVE 1-I-09
1
DATE (t I ll j of
YOUR E-MAIL ADDRESSYY� CD f j�(, "
W�VI . C 0m
'h
SITE ADDRESS �%(
(% Alff-. ME
THIS APPLICANT IS:
❑ OWNER `CONTRACTOR
PROPERTY OWNER/
NAME:�1�oc sc-�Ons~el
TENANT
ADDRESS: all (E% Ave- Of CITY 'i n%1e1(Ati
STATE P10) ZIP-TSY3-�
PHONE: Co IQ 41% -?S-55
CONTRACTOR
NAME: a
SUBMIT A COPY OF
STATE LICENSE # HSSg I rn g
YOUR STATE LICENSE
Oo EXP DATE
AND CERTIFICATE OF
ADDRESS: L%6 D.L&r.'vCITY
STATE M .�
INSURANCE
PHONE FAX
(
PROPERTY TYPESINGLE
FAMILY/NEW CONSTRUCTION SIZE
13 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING R(OTHER
❑ SWIMMING POOL 3 Sec.
h - h
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR WREMODELING
11
DESCRIBE WORK BEING DONE:fi my 6�'� a iiwtl 3 5er�n w U� ja
C;Ohtle"4 J0 14 Sc4*0W%.
SIZE OF IMPROVEMENT
NiENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
13 HOUSE & GARAGE
1.
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
INEOPENINGS ❑ LOCATIQQN OF}JI,r[ND WS.
CRIBE
OR FOR NEW OPENINGS-DESSCRIBE SIZE OF �CJ� el
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS i'KI
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION 3= W OCCUPANCY TYPE
Permit Fee $ ybaG See Back Page for Fee Schedule
Plan Review $' I 65% of Building Permit Fee
Fire Surcharge $ 30U .001 times the total job valuation
Surcharge $ 60 .0005 x Permit Valuation Minimum $.50
License Surcharge Sn $5.00 (State Licensed Residential Contractors)
SAC Charge $ $2000 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 $ , O Make checks Davable to: Citv 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 applicatio fo a it 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 wh c requires review and approval of plan`s.
SIGNATURE OF APPLICANT PRINT NAME �eb"l �AcN�N`; �'� DATE
I
-4
:0-",-
41 ()
C'
o,'6
MINDEREANGINE ING COo.91NCO
ENGINEERS AND SURVEYORS
LAND 9UQVEYINO
CIVIL d. MUNICIPAL ENOINEERING SOILS TESTING
6418-5b TM AVENUE N. LANO PLANNING
MINNEAPOLIS 77, MILAN.
b t_-, KE 7— 3637
' or (p not
All thatart of Lot 4, Block 4,
Rice Creek Plaza Seuth Addition
that lies Northeaeterly of a
line which is 75 Peet Southwest-
erly and Parallel with the
Northeasterly line of said I§��;',���
10t and as measured along ; ,Y,
the Southeasterly and the
�` �
Northwesterly lines there_ . fjY
or. I,, ' • I J4 t t.,
5
VX
r Vol' .
,.re
WE HEREBY CERTIFY THAT THIS 1$ A TRUE ANO CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE
LANG ABOVE DESCRIBED ANO OF THE LOCATION OF ALL BUILDINGS, IF NMY, THEREON ,AND NL.L VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SMO LAND.
/ MINDER ENGINEERING CO., INC.
DATED TKIS DAY OF Z4 Lr A.0.1�5 �?'
ENGINEHRS AN'p $Up-vEYOR.S
by (, L;
s�
spa
}
or. I,, ' • I J4 t t.,
5
VX
r Vol' .
,.re
WE HEREBY CERTIFY THAT THIS 1$ A TRUE ANO CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE
LANG ABOVE DESCRIBED ANO OF THE LOCATION OF ALL BUILDINGS, IF NMY, THEREON ,AND NL.L VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SMO LAND.
/ MINDER ENGINEERING CO., INC.
DATED TKIS DAY OF Z4 Lr A.0.1�5 �?'
ENGINEHRS AN'p $Up-vEYOR.S
by (, L;
Table 1101.8
Componet
Date Certificate is installed
Dwelling or dwelling unit Location
Residential contractor
Insulation installed in or on ceiling,/roof, walls slab -on -grade, and floor
Rim joist and foundation wall insulation
Fenestration
Ducts outside conditioned spaces
Mechanical ventilation system
Makeup air and combustion air systems (if installed)
heating system
Domsestic water heater
Cooling system (if installed)
Radon control system
liIrrfEeP 11.1
271 67th Ave NE
Handyman Connection 20428169
Walls R-19
Ceiling R-30
Esisting slab on grade
Doors (2) U 0.6 (steel insulated)
Windows (4) U 0.33 Jeld-Wyn Vinyl
NA (not applicable)
NA
NA
NA
NA
NA
NA