PRE 2010 DOCS01
SUBJECT
City of Fridley
8 5
AT THE TOP OF THE TWINS
BUILDING PERMIT (t::6
O.
_ COMMUNITY DEVELOPMENT DIV.
L
9,7—
PROTECTIVE INSPECTION SEC.
3,P6
� /"'1 � CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED BY
IL ---- A 612-571-3450
910-F15
12/'5/90
JOB ADDRESS 1000 - 67th. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Michael Servetus 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Brickner Builders Inc. 6240 Hwy #65 N.E. #208, Fridley 574-9871
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
Construct a 381 x 381 Dwelling and a 261 x 20.331 Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide City, with copy of verifying survey before
capping. Provide a hard surface driveway. Provide sod in the front and side yards
Paid $1,500.00 Park Fee.
SEWER SERVICE: 60'1' East of Manhole @ 67th & Oakley St. INV: 863.13 @ Main
WATER SERVICE: 10' East of Sewer Service
Lowest Walkout Elevation 868.9 per Drainage Plan by R. Nelson Engineering.
Before digging call for SCE -PA F -A T E i ; -TS Few; -1,l
all util4y locations 1rVONG, HEATING, PLUMBING ANU�11,214S.
454-0002
R -WIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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 I 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
$84,450
$42.23
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.
$572.00
$600.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
AN CHECK FEE
F' e SC $84.45
TOTAL FEE
$1,298.68 + PF
:el -2 -
ZC�SIGNATURE
OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
HEN PROPERLY VACATED THIS IS YOUR PERMIT
■ BLD4 INSP 04E
SIGNATURE OF OWNER IF OWNER BUILDER) IDATEI
01
01 j vu c.t - 2. 0 � 'f 7Iu
�/ ✓. = 96 3 �3
3c t. ovi TOP
62.-73
Lot 3, Block 1, MICHAFI. SERVEMS 2ND ADDTTIW
,S'JT I
�J
J
wty,,
My M
ADEN [ 7
AMER [ ]
R-1 AND R-2
Building Permit Application
Effective 8/16/90
Construction Address: ] C L d 6? 711N G4. U e . y 1✓
Legal Description: C p l- 3. 8& U C k. 1 /41/c, h cA- e. C 5e- r u c..16t 5 al � CA dd' 11) O H
Owner Name & Address:
Contractor: r c.kne v v.� c C v S S c Tel. # 5-/7 18,7 l
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed vonstruction drawn on it to scale.
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
07MM:
Corner Lot [Vj Inside Lot [nn ] Ft. Yd Setback Side Yard Setbacks 4-
Type of Construction: Ujop& c,,,m < Estimated Cost: $ T�
Approx. CaVleti.on Date: '� - 90
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: 11- 19 - 5 J APP11CANI': /T��� I �i�c � Tel. # 5-72-9912.)
Permit Fee
$ 1)
Fire Surcharge
State Surcharge
$
SAC Charge
$►�;
Driveway Escrow
$
Park Fee
Sewer Main Charge $
TOM P"KIMtox
STIPUTATIONS:
kow(raT UAW cxr ELA'0 . CS
CITY USE ONLY
Fee Schedule on Reverse Side
.001 x Permit Valuation (1/10th o)
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
4 °Cox.0 t A.
qv
,-SbtSb t r) t9 CS
����-MMRZ*d
l
)ohn Brad ley '
architectural consultants hr
9008 30 ST. S.E. OSSW MN. 96389 PH: (610-474-977;..
Plan "jL 3 'a' o Date I 1-7 —)
Owner,
Contractor)
Site Address:
I)TOTAL EXPOSED WALL AREA �e7 sq. ft x'U"-
2) TOTAL EXPOSED ROOF/'CEILING AREA P;13 sq. ft. x'U" -3-4
'
WALL AREA CALCULATIONS:
TOTAL WINDOW AREA
GLAZED
TOTAL DOOR AREA
TOTAL GLASS DOOR AREA
GLAZED
TOTAL FIREPLACE WALL AREA
TOTAL WALL FRAMING AREA
NET INSULATED WALL AREA
TOTAL RIM JOIST AREA
TOTAL FOUNDATION AREA (EXPOSED)
sq.ft.x'U
39. sq.ft.x'U" ,41 = Z, I
e
-g:4 ez, sq.ft. x'U" .47- =
.�---- '�
sq.ft. x'U"
b�Z sq.ft x"U"�a9 = 3
sq.ft.x'U"
zZ9 sq.ft.xU" 'Uy =
TOTAL FOUNDATION WINDOW AREA sq.ft.x`U" —
3) TOTAL
If item 3 is the some as, of less than Item 1, you have met the Intent of
2 MCAR 1.16008 A and O.
ROOF/CEILING CALCULATIONS
TOTAL SKYLIGHT AREA -
TOTAL ROOF/PEILING FRAMING AREA
NET INSULATED ROOF CEILING AREA
�– sq.ft x'U"
sq.ft.x U
C _ sq.ft.x'U"LCE
"4) TOTAL
_ If Item 4 Is the some as,or less than Item 2, you have met the Intent of
2 MCAR 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the sum of Items I and 2 shall R
be greater than the sum of Items 3 and 4.
1) +2) _
31 +4) _
1 hereby certify that the building here described meets or excel tate of ' nes
Energy Conservation Act.
(signed)
�.c 6=, w I F!,,,,., ge1.4..je, CONSTRUCTION
FRAMING SECTION
Interior air film 0.68
S
s4inches of soft wood L,S1
g exterior alr film 0.17
TOTAL R 1 o
U = 1/R =
SECTION (INSULATED)
I Interior air film
0.6
0,
.4b
Sj-+ wm6.
an
4 'e -6I 34 E", 64-0 WE
5 sl,o"em
of
6 exterior air film
_ 0.17
DIST SECTION
4
5
5
TOTAL R Z3 . I
U = I/R - —4_
interior air film
0.68
an
'sires � Jey
. 8 L
exterior oir film
0.17
TOTAL R 1 & I
U =
ATION SECTION
interior air film 0.68
4 exterior air film
5 - 017
TOTAL R 15
U = 1/R I It
0
•
m
VENTED
CONSTRUCTION
.CEILING SECTION (INSULATED)
(I linterior air film 0.61
(2
(4 exterior air film (still) 0.61
TOTAL R .4;;.7?E>-
U = I/R-02:Z
CEILING FRAMING SECTION
( I interior air film 0.61
(2 -645 Sim,I slip
(4 interior air film 0.61
(5 Bunches of soft wood 4,Ss
TOTAL R32- 1 —"
U = I/R tQZLO
CEILING SECTION ( INSULATED)
( I interior air film
0.61
_ (2
(3
(4 exterior air flim (still)
0.61
TOTAL R
U = I/R
CEILING FRAMING SECTION
( (.interior air film
0.61
(Q
3
-13
(4 interior air film
0.61
(5 inches of soft wood
.TOTAL R
,
.0 = I/R
EXPOSED BEAM CEILING SECTION
(,I interior air film 0.61
(2
(3
(4
(5 exterior air film 0.17
TOTAL R
L = I/R
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PEF41T
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Effective Date January 1, 1991
( (
Job Address / � GL � � r)-`� LlC ,�
Building Inspection Div. 6431 University Ave NE
Tel. No. 572-3604 Fridley MN 55432
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 Depdrtment of Buildings. and hereby declares that all
the facts and representations stated in this application are true and correct.
a-2 (62 19 C_, /
OWNER J) t L if &L �l> L` L D
KIND OF BUILDING V` p i �e i�� ✓�- T
USED AS H LK
TO BE COMPLETED ABOUT
ESTI14ATDNL-W
ED COST
OLD IUILDING PERMIT NO. PERMIT NO.
New Fixtures
$
7.00 - $ oo
�1
Old Opening, New Fixture
$
10
Company
LP C� 5 �-C h / A_
Beer Dispenser$
5.00 - $
Water
W
m
H
$
7.00 - $
w
e •.
a
q
7.00 - $
a
..
^,
a
a
h.
a
$
Heater
m
u
.4.
$
7.00 a $
E
m
.4
.4 m
w
e
e u
w
Wates Heater - Electric
$
7.00 -
O
w
O
vu
$
H
C
-4
p
O
w
V m
u
u 0
of
40
M
.00
10.00 - $
Back Flow Preventer Required (
) Yes (
)
NO
APPkOVAL FOR PEP -MIT
Type
S
5.00 - $
1st
'
2nd
3rd
acn
(a) Future Connection opening
Connected with Sewer
(•) Now Fixture, old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Effective Date January 1, 1991
( (
Job Address / � GL � � r)-`� LlC ,�
Building Inspection Div. 6431 University Ave NE
Tel. No. 572-3604 Fridley MN 55432
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 Depdrtment of Buildings. and hereby declares that all
the facts and representations stated in this application are true and correct.
a-2 (62 19 C_, /
OWNER J) t L if &L �l> L` L D
KIND OF BUILDING V` p i �e i�� ✓�- T
USED AS H LK
TO BE COMPLETED ABOUT
ESTI14ATDNL-W
ED COST
OLD IUILDING PERMIT NO. PERMIT NO.
New Fixtures
$
7.00 - $ oo
�1
Old Opening, New Fixture
$
4,00 - $
Company
LP C� 5 �-C h / A_
Beer Dispenser$
5.00 - $
Signed By
Blow Off Basin
$
7.00 - $
Catch Basin
$
7.00 - $
Tel. No.
Rain Water Leader
$
7.00 - $
Sump/Receiving Tank
$
7.00 a $
Water Treating Appliance
$
10.00 - $
ROUGH IgSP.
Date
Wates Heater - Electric
$
7.00 -
Mater Heater - Gas
$
10.00 -
FINAL INSP. l 7
Gas Range
$
10.00 - $
Date
Gas Dryer
S
10.00 - $
Back Flow Preventer Required (
) Yes (
)
NO
APPkOVAL FOR PEP -MIT
Type
S
5.00 - $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1• of Value of Fixture or Appliance $ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
$
REINSPECTION FEE $30.00 State Surcharge .50
TOTAL FEE $
CITY OF FRIDLEY
Effective Date January 1, 1991
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct work,
Burner (Also replacement furnace)
Gas Piping
(Piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
li of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
It of Value of Appliance or Work
REINSPECTION FEE 630.00. -
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
RATE TOTAL Job Address I
$ 20.00
$ o O
Building Inspection Div. 6431 University Ave NE Fridley MN 55432
Tel. No. 572-3604
$ 10.00
$ 000
$ 10.00
$
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
$ 10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
$ 10.00
OWNER
S '
KIND OF
USED AS
State Surcharge
yG'�+f•�s
E
$ .50
MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT
IS $15.00 PLUS THE $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
TO BE COMPLETED ABOUT
ESTIMATED COST ,
OLD,�NEW UILDING PERMIT NO. PERMIT NO. 10 rl�S
DESCRIPTION OF FURNACE/BURNER
HEATING or POWERA"wPLANTS, Steam, Hot Water, Warm Air- No.
Trade Name LGA -D Size No. X40 - D ��
Capacity 010
Sq. Ft. EDR BTU �y BP
Total Connected Load �/ �5� Kind of Fuel 1�—�—
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company
Signed By
Tel. No.
Fill out back side for stack verification on replacement furnaces
CHIMNEY 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 connected
Yes ( )
No
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company _
Signed By
Date
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1991
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
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
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
$TLOTALFEE
rrge
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.
" 3 ,1991
Owner b r I-%' r r r � " / L- 10"; C's
Building Used As L L> jk 142—
Estimated Cost / 5 PERMIT NO.
PLUMBING COMPANY___L ev_5
SIGNED BY'�_� ,,i,a�la— TEL N0.
Approved By Rough -In Date Final Date
.50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
$_a PLUS THE $.50 STATE SURCHARGE
UlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-12217
May 15, 1991
Brickner Builders Inc.
6240 Highway 65 N.E., #208
Fridley, MN 55432
RE: Final Inspection at 1000 - 67th Avenue N.E.
Dear Sirs:
A final inspection was conducted on April 23, 1991 of the above
address and the following items were noted which must be completed
before the structure can be finaled:
1. Provide sod in the front and side yards by June 15, 1991.Ok
2. Provide corrected verifying survey by June 15, 1991.
We will expect these items to be completed by the scheduled date
and a reinspection called for. Occupancy of the structure is
approved.
If you have any questions on this matter, please feel free to
contact me at 571-3450.
Sincerely,
a404-1 a4i
DARRE G. CLAAK
Chief Building Official
DGC/dn
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
June 17, 1991
Brickner Builders
6240 Highway #65 N.E., #208
Fridley, MN 55432
Re: Final Reinspection at 1000 - 67th Avenue N.E., Fridley
Dear Sirs:
A final reinspection was conducted on June 17, 1991 of the above
address and the following item must be completed before the
structure can be finaled:
Provide the City with a corrected verifying Survey.
We will expect this item to be completed on or before July 1, 1991.
If you have any questions on this matter, please feel free to
Contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
SUBJECT
MI
City of Fridley
6 315
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
3 ��
r
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/22/98
JOB ADDRESS 1000 67 Avenue NE
I LEGAL
LOT NO.
BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1 1 Michael Servetus 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dick/Judy Niznik 1000 67 Avenue NE
574-1159
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Heiderscheid Bros 716 198 Ave NE East
Bethel MN
55011
434-4578 20060354
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 0.REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (30 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the State Building
Code.
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
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
$1.25
WITH WHETHER SPECIFIED HE R NOT. THE GRANTING OF A P
$2,502
DOES NOT PRESUME O G AUT ORITY TO VIO TE OR CAN L THE
PERMIT FEE
SAC CHARGE
PROVISION OF AN OT R R L CAL L REGULAT CON-
$74.75
Fire SC $2.50
STRU O OR TH PE OR C NS`RU ION.
PLAN CHECK FEE
TOTAL F
Li nse S $5.00
5
$ .50
SI NATURE OFCONTRACTO A RIZEDAGENT IDATEI
PR p q LIDATED T SIS R PERMIT
BLDG SP
MATE
S-GNATURE OF OWNER IIF OWNER BUILDERI (DAT
NEW
ADDN
ALTER
ConstructionAddress:
Legal Description: _
Owner Name & Addr
Contractor: f lyd
Address:, 71 (0
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Driveway Curb
DATE:
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION l
e'er �, 7 � ti.F /-�, Ji
i /off Tel. #_
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Width Needed:
APPLICANT:
30cl
Estimated Cost: $
. STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ c2- -'�D
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 1 s ���
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ GYM
$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 [ ]
L 3, S�
TOTAL
$
. STIPULATIONS:
SUBJECT
'
City of Fridley
2 714 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
/�"1 CITY HALL FRIDLEY 55432
IL....
612-571-3450
910415
8/12/98
JOB ADDRESS 1000 67 Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
3
1
1 Michael Servetus 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Richard NIznik
574-1159
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Panelcraft of MN 3118 Snelling Ave S Hplq 95406
617-2A7R
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
Replace deck railin utters•sof it & fascia;
o o
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
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
$14,077
$6.98
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-
STRUFT79N OR THE PERFORMANCE OF CONSTRUCTION.
$212.25
Fire SC $13.95
PLAN CHECK FEETOT
FEE
✓f
Licen
$5.
8.18
SIGMATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
N OP
L LIDA IS IS U= IT
r
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
BLO INSP
MATE
Vr.. r. ...rr ter. .�- �� � ..�•. .. ..__
NEW [ 1 Effective 8/I/(
ADDN (J CITY OF FRIDLEY ��:
ALTEM (� SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
.. _ .
Construction Address:
Legal Description: _
Owner Name &Address: , C- n 1 Tel.
Contractor: �:)Cc. n e l YY� �� �2_� MN LICENSE #
Address:—_... ... c��L �_., S . _ ._ Tel. !i r
Attach to this appli . n, a Certificate of Survey of the
lot, with the proposed construction drawn oil it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length . _ .. Width _ Height Sq. Ft.
GARAGIC AREA: Length _ Width M Height _ _ Sq. Ft. _
DECK AREA: Length _ Width Hgt/Ground Sq. Ft.
OTJI I -.R:
Corner Lot() Inside11
[ ] Ft. Yd Setback _ Side Yard Setbacks
Type of Construction: Cost: $,, /
Approx. Completion Date: -:S
�'�'
(Cost; on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: 21. Tel. N
SAX USE QW -A )-%x Jl'
Permit Fee
$
Fire Surcharge
$:
State Surcharge—
SAC Charge
$ _
License Surcharge
Driveway Escrow
$
Erosion Control
$ _
Park Fee
$
Sewer Main Charge $
A
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th9
$.50/$1,000 Valuation
$850 per SAC Unit
$5.00 (State Licensed Residential
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [
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(ol CITY OF FRIDLEY WM
3uil.ding BUILDING punt t No.: c ®(," )
;nspecrions RESIDENTYAL APPLICATION Received sy:
763-572-3604 CI'T'Y OF FRIDLEY Date Rec°d:
YOUR E-MAIL ADDRESS
'ITE ADDRESS
"FDS APPLICANT IS: D OAR >(CONTRACTOR
TENANT
SUBMYf A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT
or
ADDRESS: ciry SFAiE,_ZtP
PHONE:
STATE LICENSE
D TWO FAMILYINEW CONSTRULMUN
O ADDI nON O GARAG
❑ BA3EbW Tf FAMISHROOF
O DECK f3 SIDING
DESCRIBE WORK BEING
N*1104 4
OF SQUARES _30-15(�
GARAGES
PROPOSED SIZE
PROPOSED HEIGHT:
�trlrNG
o vinyl
❑ Aluminum
0 Other
VyINDOW&
w mass we OPENINGS ❑Yes ❑No
OR FOR NEW OF24AJGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF wNDOW TO BE INSTALLED NUMBER OF
VALUATION, INCLUDWG TSE COST OF LABOR AND MA'
(USING THE 1997 U.S.0 FEE SCHEDULE)
EXP DATE
❑ WINDOWS
G DRAIN TILE
0 OTIM
LENGTH WIDTU MIGHT P Sq. Ft.
* HOUSE ONLY
❑ HOUSE & GARAGE NSWENT REMQUELMO SUBMIT,
❑ ATTACHED GARAGE
I. &fig Rood Plan
ARAGE
D DE fAC'HED G 3. Pmesed $�
3. Lia of struaeual mmbers to be wd
FOR NEW CONSTRUCTION INCLUDING DECKS,
039M ADDITIONS & MR= MMMM struceuces
❑ Trim 1. Site VWWS�y
13 Fascia and proposed Proja4.
2. Two sots of Wasauction Platte
3. Energy Caiculwons
LOCATION OF WINDOWS
V.
permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Glob Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ Gj -1. JLy _ See Back Page for Fee Schedule
$ 65% of Building Permit Fee Mjnj
$(.0005) times the total job valuation —uum $.50
$ 1.2 .001 x Permit Valuation (1/10%)
$ c, CO3 $5.00 (State Licensed Residential Contractors)
$ $1450 per SAC Unit (Pians to MWCC for determination)
$ �ii+6il= ftx$20=$
$ $450 Conservation Playa Review
$ Fee Determined by En&eering
$ Agreement necessary ( ) N'on Necessary ( )
S In of .q®1 Make checks payable to: City of Fridley Attar
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 aad codes of the City of Fridley and with the NgWesota Consft mfion 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; that the work will be in accordance with the approved
plan in the case of all work whieview and approval of plans-
SIGNATURE OF APPLICANT PRINT NAME DATE- /
Building PLUMBING Permit No.: t�
Inspections RESIDENTIAL. APPLICATION Received By:
Date Rec'd:
763-572-3604 CITY OF FRLDLEy j
DATE Lf d YOUR E-MAIL ADDRESS
SITE ADDRESSI Q-00—C-7 U
THIS APPLICANT IS: O OWNER *ONTRACTOR
PROPERTY
NAME: R I C.td A& b �e Z All /<
F CITY R r 7( E N STATEZIP
ADDRESS: 14900 (P Vt4 40,6 N /��
OVVNETENANT
PHONE:_%
CONTRACTOR
NAME: X 2 2 d U E B A C K r fa P k U m 9, .d &, "JC.
STATE LICENSE # 414,0 sn EXP DATE '?-13 f l ea G �f
SPS , p) G 2 A it & , %jTp�L
SUBMIT A COPY OF
YOUR STATE
ADDRESS: /to 2 Cry N W . ® crrY ZIP
LICENSE WITH
PHONE 74 1 X k1'it, 90 FAX 7 to 3 5 7 2-
APPLICATION
PERAW TYPE
SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE
0 NEW REPLACEMENT
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the futures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV FLOOR DRAINS —SHOWER _ WATER PIPING
—BATHTUB _ GAS PIPING deo cm'uc� _ SWIMMI TG POOL _ WATER SOFTNER ($35)
KITCHEN SINK WATER CLOSET PREV. ($15)
CLOTHES WASHER _BACKFLOW
--DISHWASHER — LAUNDRY TRAY 1WATER HEATER ($35) FOR IRRIGATION
WATER METER+ —OTHER
+/y
ry Permit Fee $ 54 6
Number of fixtures @ $10.00 x $10.00 = $
_�
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $ 3 5C
State Surcharge = $ .50
Total = $
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
'1/' /o
NAMEJ'� C d E � DATE
SIGNATURE OF APPLICANT PRINT
3 .n�r:ac:aty win 3si.�� ,7I12�'.�ER
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
CIN OF FRIDLEY
ii1ding ]BUILDING
.sgecnons RESIDENTIAL APPLICATION
;3-577-3644 C TY OF FREDLEY
Is APPLiCANi' ts: D owNr� ���oN�CTOR
W,t I u••t a+m► DANE: M I F„ - Si'An �V
TENANT ADDRESS: GPfX
PHONE:
• ..�, is �., r�
■ ry 17 i by ! � •
f[M,
>ESCMF, wow, BEING
M
SQvnIMS
tv'r;.. it
-..a �r ixti
WJNG
3 Vimyl
7 0f,.
w
NFaQS7CI 0OPENINGS Byes ONO
.)R FOR NEW OP&NRM-D E SIZE OF
WENINO ajAWGES 8c- - - - - - _
E
V
Plan Review
Surcharge
Pare Surcharge
License Sge
SAG Charge
Cmb Cit Escrow
grosion Control
Park Fee
Sewer Main Charge
ODRAIN TRE
i] O1[lM
tf c-, LENGTH WWTH KWGHT . Ft
O HOUSE ONLY M]BAMNP Rz 0-sc
a -Na 1$M,
i] HOUSE & GARAGR I. Egg ROW
El ATTACHW WAGE
ROM
PIM
wMbes to be 5ad
ODETACHGARAG5 3.
FOR NEW CONSTk =10N IKCLUDU40 DEM.
AriDTRONS. &�OBS��=
O Trim I. Sac rwosw ti shawr>s�g tits c
sln
E3 Fascia sad P proJu-
2. Two sds of 0WftWM Ph=
3. Eaar+Calaui OM
LOCATION OF WINDOWS
VALUATION, INC) UA�Nc'.f'HE COST OT LABOR AND
(USING TIRE 1997 U.S.0 FEE SCMDULE) rrvV
$ . a See Back Page for Fee SdWMe
$ 65%ofBuildingPermit Fee
$ ®� (•0005) tbM the total job valuation _ Bunn S.50
$ .001 x permit Valuation (1/10%)
$ � $5.00 paw Licensed Residential Comte)
$ $1450 per SAC Unit (Plans to MWCC for determ'nadon)
S _R+6ft=-ftx$20=$
$ $450 Cvmservation Plam Review
$ Fee Determined by EnOneering
$ Agreement necessary ( ) Non Necessary ( )
e 0 Lf A-.) Make checks ble to: Ci � of F' ' Mai
TM IS AN APPLICATION FOR A PERMIT NOT VALID UN M MOCE585D
a buildjug permit and I acknowledge that the information above is cmnplete and accmate> that the work will be in
I hereby apply for on Codes; that I unde�staad this is not a
conformance with ft o�cdi and cedes of the City of Fridley and with the Mhmesom Cousaucti
permit but only an application for a permit and 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 whi vie and approval of plans. /& -.. , f r - . — C /, -7A/
SiGNATUREOFAPPLICANr
FWM: Cay of Fedit To: M25-MWX= rmt"16
MECHANICAL Permit Ni
Building Rawi„a
Inspections RESIDENTIAL "PLICATION DEC
?63-5?Z-36414 �`Y OF FRIDLEY
VOM !i-MAII AWA= «
on JW DR=
TMANT prWNS
SUMMIT A COPY OF
YOUR STATE
LIC.MSE W TH
APPLICA710M
PERhUT TYpx
COWANY IMAME —
CONTACT Pi A09 _,
STATE UCSF15611—
DAVE'S HEATING, AIR & ELECTRIC
1601 37TH AVE NE
COLUMBIA HEIGHTS, MN 55421
PHONE
B'M" W FAMY UW0 FAY DTOMMOVU
TYPE (W WORK: 1 D Nsw
of —Woij
R M.ACCtMts W D /1L7'ERATIDN/RBblt1D[iL
UL
sr�►Ts z�P
a-ucioT
PSR M8 l 6B,b65 thapermit fee is a mhdmuss of Sj&0g or 5% oY the toW can dp to SS AWA wh'to� iv graact►1" tits
improvenuM fimdhtm or repiwemwU of a residd]MW (W010, excls>die18 � his ehoutd reflect o�y the oft of labor }
Labor coat uaft SM - S15.00. Labor cost bstwcas:30t1 to 5500 m cM of labor
FOAPaoMlsWW"L"0jLjWC=SW& =SAM gAMONS1008 pjRfVrna1L=WTWKWN0M. PUMMM WMIrATSTOTAL
Nuiit08 OFEACflttEW" Mom a` duh
8Tt�tca I► rlv- _ _ woDOL Sr�ls1'u 0.amL
S VA -MOM4' - Sa Affm
i . a
a✓AIC SU.00 FIiMACE (OAS) 5)5.00_W=IsRoIIdv*PS4I0A
suRTOAAMOCRAWWW =nvjce (WOOD) sm.c aAS tMT TR=1M
conms�s.00 ;IWAc113.00 TL
HaQy LINU stns GAS DRYER 110.00
Fmmit i:ec a Nwnhar of &UM C@4 slow r, x SIQOD S
S 30
Naatbei or (ixivn� ii S.tli? ___ x it S.OD - i
' c
TOTAL MM _$zs.00xss no
NumberWAD::-
So"
of l @ $35.00 x33 AD = 3
film merge v S--- =o
Total - s
T M U AN APPLIC*MM FOR A PEMMff-Wr VALM UWnL PROCR3 W
I hereby apply for a b nUb g part4it mW I achsto A*4p am the information ubma is complete and stews* flit the wwk WHI be in
coniormancs with lice cotlmmms said cods orthe City of Fridley and with lite Vmno to Canst IWiOn CNIM' dW T um&mft td do is
post a pwatit but cdtix tca Wn fes a it au d work is sect to rtmi wW= t a permit; tient *a work wM be in aacotdaaoa with the
apps+oved plea mW and "zoval ofplop.
NOMTM OF
City of -Fridley
Boum Lnspecions Depart
6431 University Avid w NE. Fridley, MN 55432
763.572-3604
FAX: 763-502.4977