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PRE 2010 DOCSSUBJECT PERMIT NO. City of Fridley 0 5 9 2 AT THE TOP OF THE TWINS BUILDING PERMIT i ? RECEIPT NO. w ----- _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. -1,76 r I r i ) CITY HALL FRIDLEY 55432 NUMBER REV PAGE OF APPROVED BY 612-571-3450 1 910-F15 TATE 9/25/90 JOB ADDRESS 1021 - 67th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Michael Servetus Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brickner Builders 6240 Highway #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. B USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 44' x 36" Dwelling and a 24F x 20'.Garage SEPAPERMITS REQUIRED FORRATE- 9 CHANGE OF USE FROM YM�IR190, HEATING, PLUMBING A fIGP� 1 'V f iV1Qr 1V ND qjGhig STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards, Provide City with copy of verifying survey before capping, See notations on plan. SEWER LOCATION: 40t West of Manhole INV, ELEVATION: 862.34 MINIMUM TOP OF FOOTING: 868.23 WATER LOCATION: 30" West of Manhole ILFNG WA � Before digging call for THE CITY OF FRIDLEY D,, -."ES NOT GUAFIANTEE THE all utility locations ACCURACY OF UTILITY LGCAT IONS AND ELEVATIONS, 454-0002 THIS DATA IS FOR INFORNIATiON PURPOSES ONLY, REQUIRED BY LAW AND PERSONS USING THIS INFORMATION SHOULD VERIFY IT ON THE SITE 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 ] 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 $102,500 $51,25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AU RITY TO VIOLATE OR CANCEL THE T E R LOCAL LAW REGULATING CON- PROVISIONS OF Y OTHER ST, $650, 00. $600.00 STRUCTION E PERFORMAXI F CONST UCTION. PLAN CHECK FEE `re SC $102.50 TOTALFEE $1,403.75 IGNATURE OF CONTRACTOR O UTHORIZ GENT (DATE)HEN PROPERLY VA ATED THI IS YOUR P RMIT 9 as o LDG )NSP OAT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEW [ ] Effective 8/16/90 ADEN [ ] R-1 AND R-2 AUM R [ ] Building Permit Application 1� Construction Address: ) d Z/ - � i - A ✓e- Iv, c Legal Description: Gd % f dL /< / 19� )!aC-1, i VS A e,9 A,), Owner Name & Address: Tel. C7ontractor: Tel. # Address: 6 2,�� // V Lo, � r� � 2i o ,p Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP aN OF narIOVEMM LIVING AREA: Iength '{' Width J�, Height Sq. Ft. AREA: Length Width Height Sq. Ft. AREA: Length Width Hgt/Gr Und Sq. Ft. 07HER: Corner lot [ ] Inside lot D<1 Ft. Yd Setback t Side Yard Setbacks fit" 4- Type of Construction: fA/W, " SG6 'cow- Estimated Cost: Appm nx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLICANT: Tel. # Permit Fee $QW00 Fire Surcharge $ ' (1a • State Surcharge SAC Charge Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL 0. . / 46' SrIPMATION;S: CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary .[ • v7j,)e45 S0W 09S'Z°0/ �`Z =L 8LO 'sv 5%s XAL AW Sdr- I Cht S M W fgoC,V' j gg-bi Xqj(.9 A6 �Z7��►Z "m*y9Q?j plot `TS %I I % to rLO gob kZ 002. lewovo ru0 3t -,ojp3j v2mn 5-q)Q3 X -412-0i 0 z at X e x OT 0 Om"t WC.IP) 17,01 I] I S4,L% it of .®! � •I1 $I ip 9IC X h 1,,-, S )v`2% 4 John Bradley wchitectur d consultwts "oil VAST. S.E. OSSEO, YN. e836Y rH. (l12f-1th�t Dote I -- ca- 7-77 o Owner Contractor=-Z3'rz-c�r-'rr- Site Addre I)TOTAL EXPOSED WALL AREA sq. ft x'U 2)TOTAL EXPOSED ROOF/CEILING AREA 33� sq• ft. x --U" 10? — 3 -4 WALL AREA CALCULATIONS: TOTAL WINDOW AREA sq.ft.x U 2 = G -Q • d 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" .07 = n %a sq.ft.x'U"-42-= 7-9,4 �— sq.ft.x'U'L = I S 5^ isq.ft.x 1 : A 1 t 39 I sq.ft.x'U" e,,y d sq_ft.x'U" TOTAL FOUNDATION WINDOW AREA 3) TOTAL ZoS. _ If item 3 is the some as, or less than Item 1, you have met the Intent of 2 MCAR 1.16008 A and D. ROOF/CEILING CALCULATIONS .TOTAL SKYLIGHT AREA sq.tt:z'Uit — = ''1 TOTAL ROOF/PEILING FRAMING AREA I `t iq.ff.x'U'%6= NET INSULATED ROOF CEILING AREA 4) TOTAL. z - .1f item 4 Is the some os,or less than item 2, you have met the intent of • 2 MCAR 1.16008 A and O. ALTERNATE -BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the sum of Items i- and 2 shall be greater than the sum of items 3 and 4.. J) +2) _ hereby certify that the burlding here described meets or exceeds a State /Ni Soto Energy Conservation Act. (signed) `~� CONSTRUCTION FRAMING SECTION I _Interior air film 0.68 3 St incises of soft wood 5 6 exterior air film 0.17 TOTAL R 1 L " U = I/R '= SECTION (INSULATED) I Interior air film 0.6 0.68 2 g 19. 4 2.O (s 5 s���a�, .o l 6 exterior air film 0.17 TOTAL R-4.1.1-1 U = VR - 2-91_ DIST SECTION I interior air film 0.68 2 `-=��r It P-.-\4+ 1-m- 19. 3 g. -G4. &1 4 Ls fist e--JW4FN-F- 5 '�Ir�iJeti .81 6 exterior air film 0.17 TOTAL R1 ro 1 U = 1/R o 0 ATION SECTION I interior air film 0.68 u 2 L�-c0a o �,l 3 G—.ti I Z4+ 4 exterior air film 5 0.17 -TOTAL R 1.5 U = Il/R— I d VENTED CONSTRUCTION CEILING. -SECTION (INSULATED) _. (1 interior air flim 0.61 (2 ' 16 lGHSETZac_K i50 (4 exterior air film (still) 0.61 TOTAL R , 49.19a U=-_I/R02,7Z _ CEILINd FRAMING SECTION j 1 Interior olr film 0.61 Scs-v-•►occ_r— . Stn 1 "%LJL., 33 (4 interior air film 0.61 (5 winches of soft wood 4.SS TOTAL R .9cy- Il-. U = I/R DZLP CEILING SECTION ( INSULATED). ( 1 Interior air film 0.61 (2 (4 exterior air film (still) 0.61 TOTAL R U = I/R CEILING FRAMING SECTION _ ( (_interior air film 0.61 ---(3 (4 interior air film 0.61 (5 inches of soft wood .TOTAL R .0 = 1/R EXPOSED BEAM CEILING SECTION (•1 interior air film 0.61 (2 (3 (4 (5 exterior air film 0.17 TOTAL R L = I/R Gu 3ivill A3'bIwuj REGISTERED UNDER LAWS OF STATE OF AMNESOTA 7801- 73rd Avenue North 680.3093 Minneapolis, Minnesota 65428 $mrgam (gttffta! ,,ICFNFP. BUILnlns, INC. fence 00 Boz Uf k+y Drainage EAsemen+ 3 n �► 1 � �/1upoSE o /�oJSE � /2 �o 4 CqR 14 i �`J J s '74.9 , GI T H t 8, Block 1, MICHAEL SIINMW ADDITIM __' "IDEN0`'ES IRON Sat CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Job Address [ ��( Cf� � �� � � RESIDENTIAL IRATE TOTAL , Furnace Shell and Duct Work, Burner (Also replacesent furnace) $ fl 20.00 $090 10 6 Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. 0571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ The undersigned hereby makes application for a parsit for the work herein specified agreeing to do all work in strict accordance with the City Godes Gas Dryer $ 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. • Air Conditioning (all sizes) $ 10.00 $ M. 0 0 � Fridley, nn. All Others/Repairs and Alterations OWNER It of Value of Appliance or Work $ KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS It of Value of Appliance or Work S TO BE COMPLETED ABOUT 00.00 ESTIMATED COST State Surcharge S .50 FEE $b OLD - NEW BUILDING PERMIT NO. PERMIT NO. � TOTAL . Reinspection Fee ($15.00) S DESCRIPTION OF FURNACE/BURNER Rough Insp. HEATING or POWER LANTS, Steam, Hot water, wars Air- No. Date �r Trade Name Size No. Final Insp. Date Capacity Sq. Ft. EDR BTU HP Approval for Permit ��- Total Connected Load '> �J �� Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU H MINIMUM FEE FOR ANY HEATING PERMIT IS :15.00- Company PLUS $.50 STATE SURCHARGE Signed By Tel. No. *Air Conditioners can not be placed in side yard without written persission fro, adjoining neighbor. 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 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE i a �, NO. RATE (A. a 15 q u a x w 0 Old Opening. New Fixture Water Heater 0 S -e+ w S �'i 1C�� m $ 5.00 S e w EU $ 5.00 S Rain Water Leader S 5.00 ow Hydraulic Valve S 5.00 S Sump or Receiving Tank •.1 S H .4OE S 7.00 S Hot Water Heater G GAS Range U3 OMM0 U 0 Gas Dryer S 10.00 S O Q U. O W V y Ny U Y N 4 Z uR+� Iq yN O 'leC 1% of Value of Fixture or Appliance O Rninsl.ection Fee $_ to i S .50 U) TOTAL Ia � I SS' l7 >� t7 s let 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer V) a New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 15 $ 5.00 Future Fixtures a2 $ 3.50 Old Opening. New Fixture $ 1.50 S Beer Dispenser S 4.00 S Blow Off Basin $ 5.00 S Catch Basin $ 5.00 S Rain Water Leader S 5.00 S Hydraulic Valve S 5.00 S Sump or Receiving Tank S 5.00 S Water Treating Appliance S 7.00 S Hot Water Heater S 5.00 GAS Range S 10.00 S Gas Dryer S 10.00 S Back Flow Prevent" Required. . . Yes ( ) No ( ) Type $ 5. U0 S — ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance S Rninsl.ection Fee $_ State Surcharge S .50 (515.00) TOTAL FEE � I SS' Effective May 1, 1990. Job Address /�l — Ilk) d4y- /t-/, F Department of Buildings City of Fridley Tel. 1571-3450 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 Department of Buildings, and hereby declarea that all the facts and representations stated in this application are true and correct Fridley.. Mn. �1 . 19 1 OWNER KIND OF BUILDING (�` q ' �_ a cl („;:-) USED AS c ' TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company 1,F-�rlry-li�;Drz.�-)Vmsl,-"�-i,, Signed BY Tel. No. - -7-71 ROUGH INSP. Date FINAL. INSP. 2 -20- F Date APPROVAL FOR PERMIT !1INIHU4 FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STkTE SURCHARGE CI YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 March 1, 1991 Brickner Builders 6240 Highway #65 N.E., #208 Fridley, MN 55432 Re: Final Inspection at 1021 - 67th Avenue N.E., Fridley Dear Sirs: A final inspection was conducted on February 20, 1991 of the above address and the following items were noted which must be completed before the structure can be finaled: 1. Post address bn structure by March 15, 1991. 2. Provide handrail on stair to crawl space by March 15, 1991. 3. Install door closure on both doors between house and garage by March 15, 1991. 4. Provide sod in the front and side yards by June 1, 1991. We will expect these items to be completed by the scheduled dates and reinspections 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, i DARREL G. CLARK Chief Building Official DGC/mh CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 June 13, 1991 Brickner Builders 6240 Highway #65 N.E., #208 Fridley, MN 55432 Re: Final Reinspection at 1021 - 67th Avenue N.E., Fridley Dear Sirs: A final reinspection was conducted on June 13, 1991 of the above address and the following item must be completed before the structure can be finaled: Provide sod in the front and side yards by July 15, 1991. We will expect this item 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, r' DARREL G. CLARK Chief Building Official DGC/Ynh SUBJECT PERMIT NO. City of Fridley �12 AT THE TOP OF THE TWINS BUILDING PERMIT i • ECEI COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. IL CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY ---"j1%'' 612-571-3450 910-F15 4/2/92 JOB ADDRESS 1021 - 67th Avenue ME 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Michael Servetus Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS . ZIP PHONE Douglas. Haugland 1021 - 67th.Avenue NE 571--3509 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 Ek NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 16%°.x 24t Abbe Ground Pool; a.deck around pool 9 CHANGE OF USE FROM TO STIPULATIONS See -notations on -plan. See stipulations on letter dated 4/2/92. Affinull K bo Before digging call for all utility locations 454.0002 REQUIRED BY LAW SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUM113ING ARID SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. 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 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 $6r,, 718 $3.36 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- $90.00 Fire SC $6.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $100.. 08 SI'N TUBE FCONTR CT BORA IORIZED GENT (DATE,, �. H I P P RL VALIDATED THIS IS YOUR PER I�/T L�!�Z 4NATU BLDG -NSP BATE OF OWNER OF OWNE UILDER- IDATEI NEW [ j Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: /D 1:20 6-) Legal Description: . R &0 C' /L/ �� Owner Name & Address: bo u c, 14 t7a a cl 14 )11 d U Tel. #_'5 Contractor: MN LICENSE Address: Tel. # s , - , 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 IMPROVEMENT Length Width Height Length Width Height Length 3 J- Width (0 Hgt/Ground 16 �, y 46ove_) G rdu,ct Poo %- — Sq. Ft. Sq. Ft. Sq. Ft. Comer Lot [ ] Inside Lot I ] Ft. Yd . Setback Side Yard Setbacks Ce, v . Tre u,47eA © B Type of Construction: � a Fstimat�l Cost: $ Approx. Completion Date: to w s p ® L BG (Cost on Back) 7 ° Driveway. Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ �1 l 7 l —SSy DATE: .3 / � APPLICANT: -Tel. # � � - � % CITY USE ONLY Permit Fee $ '/0' izo Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 3_3 ( $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00. (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "•B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ j Not Necessary [ TOTAL $ STIPULATIONS: GIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 April 2, 1992 Mr. Douglas Haugland 1021 - 67th Avenue NE Fridley, MN 55432 Re: Swimming Pool Construction at 1021 - 67th Avenue NE Dear Mr. Haugland: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As indicated, one (1) inlet of approved design for fresh and/or repurified water will be provided. 3. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 4. A deck of at least three ( 3 ) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 5. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: a. The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. b. The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. C. Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. d. The opening between the bottom of the fence and the ground or other surface, shall be not more than four inches. April 2, 1992 Mr. Douglas Haugland Re: Swimming Pool Construction Page 2 6. An automatic chlorinator should be provided with a suitable test kit. 7. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 8. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 9. The pool fill spout must be protected by a vacuum breaker or air -gapped. 10. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1 1/2 times the pool diameter, and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this letter, please feel free to contact me at 572-3602. Sincerely, CLYM E. WILEY Building Inspector DGC/mh THE; POOL S 10100 HWy. 65 NE BLAINE, MINNESOTA 55434 (612) 786-9563 TORE, INC. q Name Ole j Street & No. City State ZIP e �. � • 1990 Christensen Ave. WEST ST. PAUL, MINNESOTA 55118 (612) 451-7778 O SWIMMING POOLS Home Phone, 4v Work Phone; Terms Salesman �'�{'1',-b c Date /r - 7 2, POOL ❑ ,� LINER ❑ 20FB ❑ 20 EXP ® 25 EXP FILTER ❑ /� f J- t , SKIMMER ❑ 2091 ® 2094 ❑ 2095 LADDER ❑ Deck ® Safety ❑ Other M. KIT ❑ Test Kit Leaf Skimmer Vac Kit THERM 50' B/W Hose C. KIT ❑ PH+ PH- STAB -Chlor -Shock -DE SOLAR] COVE PIECES W. COVER ❑ Standard ❑ Deluxe HEATER ❑ Size ❑ Nat ❑ Prop. ❑ Pipes FILTER BASE ❑ RECEPTACLE '❑ AUTO CHLOR ❑ OTHER ❑ I the buyer have received: ❑ Safety Poster, No Jumping & Diving Signs, above Pool Package & has been notified that Safety Posters must be posted at pool area. RETAIL SALES DATE BUYERS SIGNATURE TAX Any warranties or the products sold hereby are those of the manufacturer. As between this retail seller and buyer. the product Is to be sold "AS IS* and the entire risk as to the quality and performance of the products is with the buyer. The seller expressly disclaims all warranties either expressed or implled TOTAL SALE Including and Implied warranty of merchantability or fitness for a particular purpose and the seller neither assumes nor authorizes any other person to assume for It any liability in connection with the DOWN PAYMENT Salo of said products. This disclaimer by this seller in no way affects the terms of the manufacturer's warranty. The buyer acknowledges being so Informed prior to the sale. BALANCE DUE 13 b "`? 3 3 Z �2 DATE BUYERS SIGNATURE THE POOL STORE, INC. ROYAL ELECTRIC CO., INC. 7401 Central Ave. N.E. MINNEAPOLIS, MN 55432 phnna 7SZA_AGAr, X0 M YOM OEM 3504 Customer Instructions: wIf—I; y�i Ly ,ti'C4,V r(.!`t_ IP, A+c-{ck .GETW_ Job Report: OAT E FOR ER � CUSTOMER'S ORDER NO. PHONE MECHANIC M' PER TING DATE BILL TO TAX ORDER TAKEN BY DATE COMPLETED WORK ORDERED BY (—)U ADDREss $ ^ //� I ,�A{�v H ✓ 109J 7� � D DAY WORK /f aCJ % f—/ t.l v CONTRACT FR AI 1 / r • EXTRA JOB NAME ANO LOCATION JOB PMONE DESCRIPTION WORK• X11 Customer Instructions: wIf—I; y�i Ly ,ti'C4,V r(.!`t_ IP, A+c-{ck .GETW_ Job Report: Signature PRO = 75&3 NG Bis laC t 6Moa !deet OI471. iJ � S No one home 0 Total amount due Total billing to for above work or be mailed after I hereby acknowledge the satisfactory completion completion , of the above described work. of work i i TOTAL MATERIALS TOTAL LABOR TAX DATE COMPLETED WORK ORDERED BY (—)U TOTAL AMOUNT $ Signature PRO = 75&3 NG Bis laC t 6Moa !deet OI471. iJ � S No one home 0 Total amount due Total billing to for above work or be mailed after I hereby acknowledge the satisfactory completion completion , of the above described work. of work i i THE POOL STOR 10100 Hwy. 65 NE BLAINE, MINNESOTA 55434 (612) 786.9563 E, INC. 1436 S. Robert WEST ST. PAUL, MINNESOTA 5511 (612) 451.7778 ANDQ A `�1WALL' RAME; 25 YEAR WARRANTY HEAVY DUTY WALLS; 30 YEAR WARRANTY '7' DEPTH � � MIL EXPANDABLE LINER20 MIL EXPANDABLE LINER � DEPTH 23 YEAR WARRANTY -30 YEAR WARRANTY SILICA I SAND OR CARTRIDGE FILTER DELUXE SEQUEL II DE FILTER 1 HSP POWER PAK I PUMP 1 NSP POWER PAK II PUMP WITH 'PROGRAMMABLE TIMER STANDARD IHWALL SKIMMER '• FILTER i PUMP BASE SOLAR BLANKET CHOICE OF DECK LADDER OR OVER THE WALL LADDER MAINTENANCE KITt A. VAC SET 2. TEST KIT 3. LEAF SKIMMER 4. THERMOMETER -• PERMANENT POOL COVE * DELUXE SKIMMER '�• AUTOMATIC CHLORINATOR CHEMICAL STARTER KIT 30' BACKWASH HOSE PUMP RECEPTACLE FREE DELIVERY FREE DEMONSTRATION INSTALLATION CASSETTE YOUR ITEMS TO CHECK Is CODES A. FENCING B. ELECTRICAL REQUIREMENTS C. LOT LINES D. POWER LINES E. UNDERGROUND STRUCTURES 3' 42" I 36" HIGH RAILING -SPINDLES 6" O.C. 4x4 POST TO BE.10.' O.C. OR CLOSER ALL FRAME WORK TO BE TREATED LUMBER SELF CLOSING GATE 2x4 2.2-6" G.C. 2 6 2x6 JOIST 16" O.C. 2x6 DECKING REDWOOD OR CEDAR 2 12 ._ .'2x8. , POOL 4x4 POSTS ti O — — -- -:4 • O l,wQ T, nAMTMnO EA k 3 e � a 3 � k 3 e SUBJECT -MI City of Fridley 32997 AT THE TOP OF THE TWINS BUILDING PERMIT f NO. L `v _ COMMUNITY DEVELOPMENT DIV. -____ � PROTECTIVE INSPECTION SEC. p 460 r � REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432NUMBER L 763-571-3450 910-F15 8/19/02 JOB ADDRESS 1021 67 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Michael Servetus Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doug & Miriam Haugland 1021 67 Avenue NE 763-571-3509 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 952-933-6300 a 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 windows in existing openings 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. permit Inspection Cards Will Be mailed To Homeowner To Post 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 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 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 $7,625 $3.81 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Cit% License $164.68 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT (DATE- HEN PROPERLY VALIDATED THIS ISYOU13 PERMIT _'40 - S,GNATURE OF OWNER, -F OWNER BUILDER. IDATEI B DG -NSP DAyE NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 5722604 Bldg Insp ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: D� i GAire l'V C F fevt1/U Legal Description: �-�! Owner Name & Address: a ► c /✓ Tel. # 7637- 571-350Ti Contractor. a ` MN LICENSE # /-X r Address: 32 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: IC el WC n v 1 Construction Type: X1/ 1 dW S Estimated Cost: $ 0 �5- as Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: V APPLICANT: Tel. # ` ' 6 To 'a Call (763) 5722604 for Permit Fees if mailing' pplication o x to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ -�5 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ - $.50/$1,000 Valuation SAC Charge $ $1200 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*Engineenng Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 6 �1,&6 STIPULATIONS: 1*1102- CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: ADDRESS : 1021 67TH AVE NE PIN : 133024230057 LEGAL DESC : MICHAEL SERVETUS ADD : LOT 8 BLOCK I PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 2,894.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE & GARAGE (25 SQ) TEAR -OFF STATE LICENSED CONTRACTOR IM U-2-61 CQFA�v 1 D & B HOME IMPROVEMENTS (7773) 4901 105 LANE NE CIRCLE PINES, MN 55014- (763)784-0922 OWNER HAUGLAND DOUGLAS M & NIIRIAM B 1021 67TH AVE NE FRIDLEY, MN 55432 1 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time atter work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the mcxAsions of-Wother-state or local law Bldg ;41j 15 V-lal/ PEWgiXO. 2004-00398 , a DATE ISSUED: 03/29/2004 BUILDING PERMIT FEE 83.25 FIRE SURCHARGE 2.89 STATE SURCHARGE, VALUE 1.45 LICENSE SURCHARGE 5.00 TOTAL 92.59 PAID WITH CHECK # 5061 ! RRPARATR PRRMTTR RROITTRRT) FOR WORK OTHER THAN T)RRCRTRRT) ABOVE 1 C&-'���i NEW [ ] CITY OF FRIDLEY Effective 1/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION )1 D0392 Construction Address: / In _ (0-7fA • . • - �% %�IL��i�'1/GtGtilMN LICEN -7Contractor: ISE# 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 I Width Height Sq. Ft. DECK AREA: L—enigth Vyidth Hgt/Ground Sq. Ft. bqYConstruction Type: - Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = x $ =$ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - 0O $ 3-c�S Fee Schedule on Reverse Side $ 9 .001 of Permit Valuation (1/10th%) $ /, feS $.50/$1,000 Valuation $ $1350 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 [ ] TOTAL $�• S STIPULATIONS: Building PLUMBING Permit No ��— &2,4 Inspections RESIDENTIAL APPLICA'T'ION Received By: 763-572-3604 CITY OF FRIDLE'Y Date Rec'd: DATE February 21, 2007 YOUR E-MAIL ADDRESS wne1son0_1a[sonl31umbina.com SITEADDRESS 1021 - 67th Avenue NE _ THIS APPLICANT IS: DOWNER ®CONTRACTOR PROPERTY NAME: — bniiqlnzHaiiqlnnd OWNER/ ADDRESS: 102 - 67th Avenue NE CITY Fridley sTATEMNzIP 55432 TENANT _ PHONE:. 763/571-3509 CONTRACTOR NAME: Larson Plumbing, Inc. STATE LICENSE # 3341 PM EXP DATE 12/31/2006 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW CITY Andover sTATEMN zip LICENSE WITH .55304 PHONE 763/427-7680 FAX 763/427-9448 APPLICATION PERMIT TYPE 11 SINGLE FAMILY O TWO FAMILY 17 TOWNHOUSE TYPE OF WORK: ❑ NEW N REPLACEMENT DETAILED DESCRIPTION OF WORK Water Heater Replacement 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 fixtures. (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 paw cmucam) SWIMMING POOL WATER SOFINER ($35) _ _ CLOTHES WASHER _ KITCHEN SINK g CLOSET BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY t%WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER -.h:. Ni,;S ..4) ..�t..e. .. . . '�k.:llWc.'.r•�t.YiX... a. ..+ixnt:.. ,. M z T . ;1"•U1Lr Jldl➢ • . g., ...r+.v�.;f},. .1 - ,:x:.-,;... .;�47' ..... £ ,�• ,. ��-• . .�::, • � ��, r. �,.,, _ t � ,P' ��- �"I?��t.P��7E`a::::s"-��R� ���0 Permit Fee $ 35 QQ Number of fixtures @ $10.00 x $10.00 = $ Surchar je .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 35. 50 Number of fixtures @ $35.00 x $35.00 = $ 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 alJ work which requires review and approval of plans. SIGNATUREOFAPPLJCANT �, PRINTNAME Wendy Nelson DATE 2/21/07 ry • :. • :.:. .. ::.: ': E' : XJ =:.. it % til ': '3vI...... City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building __ _ � BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 1*7 763-572-3604 CITY OF FRIDLEY nate R AUG 0 -( DATE O YOUR E-MAIL ADDRESS SITE ADDRESS / O%/ A THIS APPLICANT IS: XOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: I2Z 1 147 esC AX CITY C ST AoflP ssZ PHONE: 154 zn CONTRACTOR N ,{J ,V ouu/ ' d2 STATE LICENSE # EXP DATE ADDRESS: eaA Qw %! S ZI Xfy SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHO 10 30 97 FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STO PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED JEWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR OgREMOIDELING DESCRIBE WORK BEING DONE SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used 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. WINDOWS—r /_ fi' zeA 2. Two sets of construction plans IN EXISTING OPENINGS Wfes ❑No LOCATION OF WINDOWS i 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF .! J°/ ®%f OPENING CHANGES & CA sA1J*.040��%%��� TYPE OF WINDOW %�`TILIMBER TO BE INSTALL E) OF WINDOWS ALL FEES ARE BASEDUN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.CbEE SCHEDULE) TOTAL JOB VALUATION $ V- 92 B 10 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ I V.4 — See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev 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 and wo ' t to start without a permit; that the work will be in accordance with the approved plan in the case of all work whi requires rev' and roval of plans. op SIGNATURE OF APPLICANT PRINT NAMES L! / A, DATE