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PRE 2010 DOCSall* City of Fridley, Minn. BUILDING PERMIT N© 6 6"s Date:` J Owner: Builder Address Address �, TI OF BUILDING No.i-'�— Street Lot Lot__ Block Addition or Corner Lot _ Inside Lot—_„�iktback deyard Sewer Elevation __ _ Foundation Elevation DESCRIPTION OF BUILDING To U Front Depth . ' Height Sq. Ft. XW Cu. Ft. V VMVIA DepthHeight Sq. Ft. Cu. Ft. M: Est.�� To be Completed Type of In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with ;J1 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of 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 within the city limits and this permit may be revoked at any time upon vi��a o'n'�of any of the provisions of said ordinances. �"1snn�'?�' / k Building Inspector NOTICE: This psnalt does not cover the comtrudioe, butelldioe for Vdrteg, phnobieo, on hostb& scum or grater. Be sun to NO the BniWing Inspector for separate portent for these hens. 0, 0 City of Fridley, Minn. N9 9471 BUILDING PERMIT • Date: Sent, 28, 1967 \J Owner: _... Edward 0. jmsp-4 Builder Same Adder 1360 69th Ave. N. E. Address Same LOCATION OF BUILDING No. 136Q Street - 69th Ave, H, E, Part of Lot Lot ........Parcel 5gl0ack Addition or Sub -Division . $evised Aud. Sub. #10 Corner Lot __ Inside Lot _ Setback _ - Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Repairs Front 30 r Depth 26' Height 18' Sq. Ft. 840 Cu, Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Repairs after Est. Cost �4 000.00 _ To be Completed Fire In consideration of the issuance to me of a permit to construct the building described aboveI agree to do the proposed work in accordance with the description above set forth and oe with a'll provisions of ordinances of the city of Fridley. f , 7tc-t%�s,In consideration of the payment of a fee of $--L4. 00 permit is hereby granted to Edward Jenson 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. P in, around and upon said building, or any pari thereof, shall conform in all respects to the ordinances oY Fridley, Miznesota regar�in� location, construct[on, alteration, maintenance, repair and moving of buildings within the dty limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CI"NCE BELISLE Building Inspectw NOTICE 'Ibis permit don not eowr the eendructienr butalFatien for wkIno, plumbb>a, gas beattn9, sewer or water. Be sun to sn tin Buildiu8 hmgm ter for separate permHs for these hems. W . . APT_';,ICAT YW-1 FC;R TIP11- ,D NG .T'r'.'!aMIT Ci-l."Y 02 V.rk';*X1, Y-, r. NN' -s- SCTA OWNER'S NAME �Gl/ � �"d � '� � /✓ - B`.:,1 -DEP. ADDRESS %3 o ADDRESS 7 A �- LOCATION OF BUILDING y� , ® STP.,E�i� l%(VJET � _ �, • PART OF LOT SSO 9 --Ms e c( vd`ten `S Svb. or* l4 LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK. SIDE -YARD SE14ER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING - To Be Used Ad: Front Depth JR?4P� Height /,,W Type of Constructi To Be Completed Sq. Ft. Z> : Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. The undersigned hereby makes application for a permit for the work 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 � � �, � � SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). . 10 . .. ?A j - '0 City a Of fTidley - - Dept. of Bldgs Phone SOD -M C4 DESCRIPTION OF WORE Location— Number. Kind and Locaflas of Fixtures� PARTIAL PATE SCHEDULE PLUMBING FIXTURE RATES. NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ........... x $1.50 i .- New Fixture Old Opening .......... x $1.60 i Catch Basin .................... x $3.25 = Water Heater 'Up to BTU New Ground Run Old Bldg. ..... x $3.25 $ Electvk Water Heater. • . . . . . . . . . . • • _ $100 $ GAS FITTING FEES. NO. RATE TOTAL 1st 3 Fixtures ............... _Z3100 $ Additional Fixtures ............... x $ .75 $ Gas Range to 199.000 BTU . . 4.. . . . .... x $5.00 $ State Surcharge $ .50 REPAIRS & ALTERATION15—Refer to Cc& _ Description . . . . ... . .. .... .. ... . ,... . ...... . . ...• ..... TOTAL FEE : City of Ridley: The undersigned hereby makes application for a permit for the vnwk herein specified, agreeing to doe all work in strict accordance with the City Ck*nance and naling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Fridley. Mina 18L/ owner /[ / Kind of Buildia$' Used as To be completed about Estimated Cost, $ Old New. Building Permit No. Permit No. Signed ") By Business Phune No ROUGH FINAL 30 r 7 to 560-3450 Cit ty of 7,riJ/ey ANOKA COUNTY 6431 UNIVERSITY AVENUE NE April 17, 1974 FRIDLEY, MINNESOTA 55421 i Jq- -21 --1 L1. Mr. Edward Jenson 1360 - 69th Avenue N.E. Fridley, Minnesota 55432 Dear Mr. Jenson: During an environmental investigation of your property on April 16, 1974, it was determined that you were storing your garbage and refuse in violation of Section 113 of the Fridley City Code. Our inspection on that date found garbage and refuse on the ground adjacent to your garage. It was also observed that no containers with lids were being provided for garbage and refuse storage. The aforementioned ordinance requires that all refuse be stored within an approved container. That container must be waterproof, impervious to rodents and insects, less than 30 gallons in size and at all times be covered with a tight fitting lid. Plastic bags are not acceptable for the storage of garbage and refuse and must be placed inside the previously described containers. Also, all wastes must be removed from the property and disposed of in a sanitary manner at least once a week. This department will hereby require you to clean your property free of all litter and deposited garbage and refuse. Furthermore, sufficient containers adequate to store all garbage and refuse inside,must be provided and these wastes disposed of weekly, e.g. refuse haulers. This must be accomplished on or before ten (10) days from the date of this letter at which time a reinspection will be conducted to determine compliance. If any questions or problems arise from this letter, please feel free to contact me at 560-3450, Ext. 41. Sincerely, STEVE J. OLSON Environmental Officer SJO/mh %si i i ur mil&V 97 -9?, -L,16051 APPLICATION FOR PLUMBING AND GAS PITTING PERMIT PARTIAL RATE SCHEDULE PLUMING FIXTURE RATES: NO. RATE m number Fixtures x $3.00 U Future Fixture Opening x o a $ Water u •A ,� W[4 .1°i Catch Basin A $5.00 F .[i x g 41w w w $ Water Softener Heater $7.00 $ S x N $ Electric Water Heater x $5.00 8 49 g O O x '$3.00 $ A w u P m t�i w M S NR O o w ,Or. .•1 M p ep $5.00 $ each add. $100.00 or fraction lec $2.00 $ State Surcharge $ .50 TOTAL FEE v� w t� w 3 0 o as 1st 24, - 3rd 4 th (R) Future Connection Opening Connected with Sewer (•) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMING FIXTURE RATES: NO. RATE TOTAL number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ stater Heater - to 99,000 BTO x $5.00 $ 100,000 STU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Pun Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 REztt�t•t:crt�.:t ret: Job Address 1360 69 Ave. NE Department of Buildings City of Fridley Tel. #571-3450 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 declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 7-3-78 , 19 OWNER ANDERSON KIND OF BUILDING frame USED AS rPc;_ TO BE COMPLETED ABOUT 7-11-78 ESTIMATED COST 20.00 )' j OLD - NEW BUILDING PERMIT N0. PERMIT N0. Company Signed By MINNEGA$CO Tel. No. ROUGH INSP. Date FINALINSP. Date Q APPROVAL FOR PERMIT e/J MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATS SURCHARGE Individual to Cor Form No. 28-M. Miller -Davis Co., Minneapolis Minnesota Uniform Conveyancing Blanks (Revised 1976) TWO3nbenture. made this .................... 16th ...... ...... day of .......... October ................................ , 19$.1......, between .......................... RQ.bext... E...An.der..son.... an.d... B.arbara... L... Anders.on.,...Hus.band... and ... Ali..fe............................... gti;6ir��70zi6�ilu_ ' l- 411 F�4-e, —� Anoka ' of....................................................................................and State of ................ part............ of the first part, and................................................................................................................................................................................. Mufl4ciipal..............................................................................................Ci.ty....o.f....F.ri.dl.e........................................................................................ a corporation under the laws of the State of ................... Minnesota .................................... party of the second part, Witney tiff, That the said part............ of the first part, in consideration of the sum of One...and...no/100....$100.).-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.- ..DOLL.4Rs , to............................................................in hand paid by the said party of the second part, the receipt whereof is hereby acknowledged, do............ hereby Grant, Barbaro, Quiiclaiirc, and Convey unto the said party of the seconpt part, its successors and assigns, Forever, all the tract...... or parcel...... of land Lying and beinb in the County of ......................... AMU ........................................... and State of Minnesota, described as follows, to -wit: A street and utility easement over the south 40 feet of that part of Lot One (1), Revised Auditor's Subdivision No. 10, Anoka County, Minnesota, described as follows: Beginning at a point on the north line thereof distant six hundred forty-two (642) feet east of the northwest corner of Lot Sixteen (16), said Revised Auditor's Subdivision No. 10; thence east along the north line thereof ninety- seven (97) feet, thence south parallel with the west line thereof three hun- dred eight (308) feet, thence west parallel with the north line thereof ninety- seven (97) feet, thence north parallel with the west line thereof three hundred eight (308) feet to the point of beginning; according to the map or plat there- of on file and of record in the Office of the Registrar of Titles in and for Anoka County, Minnesota. The City of Fridley hereby accepts this easement for street and utility purposes. SIDNEY C. IMN City Clerk NO STATE DEED TAX REQUIRED To fbabe anb to fboib flit bamt, Together with all the hcreditaMbents and appurtenances there- unto belonging or in anywise. appertaining, to the, said party of the second part, its successors and assigns, Forever. 31n Trotimotty Wbertof, . The said part........... of the first part ha........... hereunto set ............................ hand ..... the day and yearfirst above v.-ritten. Y *tate of At'nnegota, 83. Countyof ................Arlo.ka............................................... The foregoing instrument was acknowledged before me this ... 16.th... day of ................ QCtober.................................... 19..$1 ........... Robert E. Anderson and Barbara K. Ander- „ vA•MX son, Husband and Wife CLYDE V. MORAv^TZ by ................... 3._L� NOTARY PUBUC — MIMHESOTA % AME fl�� ANOKA COUNTY .................Iy(.�Ommss(On ERplmJas. 07, i�^'� (SIGN RE OF CKNOW DGMENT) ! ■VVWWVW vvvv. THIS INSTRUMENT WAS DRAFTED BY (TITLE OR RANK) Citi[ of Fridley 6431 University Avenue F; Fridley, MN 55432 (Address) d zz i f 3 Y I ! G)i A O 0. N Q O : HCl ti am ° W. 0 V 1 4— V V O O O 'Cw.. h '� O: � � � t • vY •r C+ N C � ✓� O :' ❑ " ! ti SUBJECT PERM _ City of Fridley 2 �. �. 3 9 AT THE TOP OF THE TWINS BUILDING PERMIT ' , NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/28/91 JOB ADDRESS 1360 - 69th Ave NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 1 Rev Aud Sub #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donna Johnson 1360 - 69th. Avenue NE 644-7500 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Daco Inc. 14510 -- 45th. Street NE, Rogers MN 55374 497-3900 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 O NEW 0 ADDITION O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Fire Repair to BAseMent-Family Room (Sheetrock) 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 1 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 $9,200 $4.60 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- $117.00 Fire SC $9.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE T L FEE 30.80 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WF{ PE�LY ID T NIS IS YOUR PERMIT BLDG INS,-�'� SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [) Effective 1/1/91 ADDN [) CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: 0,! 1WAM- \jD,6,�t%0,t% /3�e -�9��� Al EL Tel. # Contractor: l GQ Ave-- Tel. # �%%— 3 (7D© Address: 4/6 eq- .��� �4L�5 �� 5�_3 2 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length Corner Lot [ ] Inside Lot ( ] Type of Construction: Approx. Completion Date: DESCRIPTION OF IMPROVEMENT Width Width Width Ft. Yd Setback Height Height Hgt/Crround Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ ±22-00 , (CM m %*) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 16 - ZS � � � APPLICANT: Tel. # -3 W CITY USE ONLY Permit Fee $ 111#00 Fee Schedule on Reverse Side Fire Surcharge $_ .001 of Permit Valuation (1 / 10th %) State Surcharge $ �1p6 $.50/$1,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] NokNecmary [ ] TOTALode STIPULATIONS: l ` oD FIRE DEPARTMENT MEMO TO: "/BUILDING INSPECTION ASSESSING FROM: RICHARD H. LARSON, DEPUTY FIRE CHIEF DATE: October 28, 1991 SUBJECT: FIRE DAMAGED STRUCTURE FIRE HAS OCCURRED AT: 1360 69th Ave. DATE OF FIRE: 10/12/91 FD -7 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: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader SumplReceiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range NO. RATE TOTAL JOB ADDRESS I340 k_- y $ 7.00 $ 4.00 -$5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 Gas Dryer % $10.00 Back Flow Preventer Required ( )Yes ( ) No Type $5.00 The undersigned hereby makes application for a permit for the work herein ,® 4 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. D, 00 ®" ®0 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 iib of Value of Fixture or Appliance I= i� , 1991 Owner r Building Used As Estimated Cost _ PERMIT NO. PLUMBING COMPANY_4fv-4A' PiA= SIGNED BY 2_�n���TEL N0. 11-'21f_ �Ol�d Approved By Rough- n Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLU14BING/GAS PERMIT IS $15.00 TOTAL FEE�� PLUS THE $.50 STATE SURCHARGE Water Closet Urinal Bath Tub Shower Sink Wash Drink. Floor Catch Tray Fount. Drain Basin Auto. Washer Gas Gas Appl. Range Misc. Fixt. Water Heater Stories Gas jElec Basemen Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader SumplReceiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range NO. RATE TOTAL JOB ADDRESS I340 k_- y $ 7.00 $ 4.00 -$5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 Gas Dryer % $10.00 Back Flow Preventer Required ( )Yes ( ) No Type $5.00 The undersigned hereby makes application for a permit for the work herein ,® 4 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. D, 00 ®" ®0 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 iib of Value of Fixture or Appliance I= i� , 1991 Owner r Building Used As Estimated Cost _ PERMIT NO. PLUMBING COMPANY_4fv-4A' PiA= SIGNED BY 2_�n���TEL N0. 11-'21f_ �Ol�d Approved By Rough- n Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLU14BING/GAS PERMIT IS $15.00 TOTAL FEE�� PLUS THE $.50 STATE SURCHARGE 01 SUBJECT PE. IT City of Fridley 21465 AT THE TOP OF THE TWINS BUILDING PERMIT r RE COMMUNITY DEVELOPMENT DIV. / , I r PROTECTIVE INSPECTION SEC. 4J-1'7 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE Of APPROVED BY 612-571-3450 910-F15 7/28/92 JOB ADDRESS 1360 - 69th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 1 Rev. Aud. Sub. #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donna Johnson 1360 69th.Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Coronado Stone 1634 Hwy 10, Spring Lake Park, MN 55432 786-2341 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 [j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install Class, "A" partial chimney for a wood burninq stove 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $800 $.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- $21.00 Fire SC $. 80 STR TION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE �(L4-'2'x P, — ._ $22.30 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI HEN P LY V LIDATED THIS IS YOUR PERMIT BLD INSPV DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 01 NEW [ ] Effective 3/1/92 ADDN [ ] CITY OF FRIDLFY ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 1366 � 7,t6 ; A1(,6-, (, , Legal Description: / Owner Name & Address: n0 A) A1,'9— J-6!� ; c�S ��0 Tel. #""9y 17 ;2 ,�— Contractor: C® lqo V lqd 6 7 / MN LICENSE # Address: 3 Q ' �� % �� � %e J-�-1 �/t�. /�� Tel. # 2,2G — D-3�11 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: DESCRIPTION OF IMPROVEMENT Width Width Width Ft. Yd Setback Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks — os Estimated Cost: $ ® ®e (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: "' 9A LICANT: - Tei. #�G Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Sewer Main Charge $. TOTAL STIPULATIONS: $ 2� CITY USE ONLY 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 ( ] SUBJECT City of Fridley 4 7 AT THE TOP OF THE TWINS BUILDING PERM/ if f T NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC 3D-� r t /---t CITY HALL FRIDLEY 55432 NUMBER REV DATE OF APPROVED BY 612-571-3450 910-F15 9/12/96 F;GE / JOB ADDRESS 1360 69 Avenue NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pt 1 Revised Aud. Sub. #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brian Narlock 1360 69 Avenue NE 571-5218 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Anderson 1700 Buerkle White Bear Lake MN 55110 430-7277 20040630 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 R ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 6 windows in home - 4 will be complete replacements - 2 will be pocket windows 9 CHANGE OF USE FROM TO STIPULATIONS Replacement sleeping room windows must meet the State Building Code. Install smoke detectors on all levels of home and in all sleeping areas. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 OFFS?REET PARKING 1 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 $4,300 $2.15 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- Fire SC $4.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $99.75 PLAN CHECK F TAL FEE Li s SC $ .00 $111.20 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI t NP LY V LI 4LDG IP, P ED THIS IS Y UR PERMIT rr OAT SIGNATURE OF OWNEROF OWNER BUILDER$ IDATEI Zc!OFTY FRIDLEY TEL: 612-571-1287 Mar 20,96 9:48 No.001 P.01/02. '(] Effective 3/1/96 ADDN (] CITY OF FRIDLEY ALTER ( SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building. Permit Application =� ConstructionAddress: ►3��j E,q "ASE 1�1 ?re. , Legal Description. Owner Name & Address: T:ia k Ari Q`t42VC3caL 1360 GC Ade W.E Tel. # S'1 Contractor: J N n,k. M� 4r-4() -,Q .1 r-4 MN LICLNSE # ZM41Z61(1 Address: I'1�ecl�iaW ly I7E OPAL ('ISE /Y1 rY .-SI 14 Tel. # 4r36 .7 ZSV Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCREMON OF Il61PROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE, AREA: Length Width Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHER: aegLAug:, 6 apo►• -r S , 4 aomE- 4 W r4o0K% wik , AF:-- Coln Coiner I.ot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: _ Estimated Cost: $_-- Approx. Completion Date: 1„0.10 • alb (Cost. on. Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x' $_ _ $ DATE: • 10 %6- APPLICANT: -rim Scw-! V-- Tel. # 9=.4 •ZVS4 _ CITY USE ONLY Permit FCC $ q C1 Fcc Schedule on Reverse Side Fire Surcharge $ 3a ;001 of Permit Valuation (1/10th%) . State Surcharge $ 2 . S $.50/$1,060 Valuation SAC Charge $ . $900 per SAC Unit TAcense Surcharge. $` S' . $5.00 (State Licensed Residential .Contractors) Driveway Escrow $_ Alt. °A° or Alt. "I3" Above Erosion Cpntrol $ $450.00 Conservation Plan Rcvicw Park Fee $ --- Fee Determined by Engineering Sewer Main Charge $ -- Agreement Necessary [ J Not Necessary [ ] TOTAL STIPULATIONS: SUBJECT City of Fridley 6_f 5 9 4 AT THE TOP OF THE TWINS BUILDING PERMIT RECE ^---COMMUNITY DEVELOPMENT DIV L PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/19/97 JOB ADDRESS 1360 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. Pt 1I Rev. Auditor's I Subdivision #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brian/Joan NEM Narlock 1360 69 Avenue NE 571-2892 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 j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 12' Porch Without Windows 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454.0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 $2'000 $1.46 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 O THE PERFORMANCE OF CONSTRUCTION F �5L PLAN CHECK FEE TOTAL FEE $79.13 IG ATUREOFCONTRACT OR AUTHORIZED AGENT IDATEI WHEN PROPERLY V I� THIS IS Y UR PERMIT BLDG ASP r�ATE SIGNATURE OF OWNER.,F OWNER BUILDERI IDATEI NEW [ ] f R Effective 1/1/97 ADDN [ ) CITY OF FRIDLEY 5/9y ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress.lam! ' ' ' �E VVV �v Legal Description: �.{j-�- ,Q►;� ii V'S �b�i J�'S ��Yl */0 Owner Name & Address: I`Cc� h y �� Tel. # Contractor: l ,� MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: D �,orr,h OTHER: (Jolze)l1Q DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Length . Width Height Sq. Ft. _ Length Width /2 ' ` Hgt/Ground Sq. Ft. -A c2 ! — Construction Type: -Fre c,4e a Estimated Cost: $ 2 , 0no , 0 o (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _$ DATE: l C2 7 APPLICANT: Tel. # TOTAL STIPULATIONS: 5C lC , C0(2--571-ZS (Z_ CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ %Z .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: 5C lC , C0(2--571-ZS (Z_ t. Ucf�n AVE r 'V) VFW, FLOOR FRAMING PLAN ;,OVEREO 5GREENED PORCH -LEY FRAMING EENED PORCH — Un RATIO :N 7 DIAGRAM EENED PORCH i� a 2 x 4 BLOCKING 2 x b END J015TI of, 2-2x6BEAM GONGP.ETE FOOTII 4 x 4 SUPPORT P( 2 x 6 JOIST5 e Ib' O.G. 4 x 4 RAIL P05T 2 x b RIM J015T 0 rV 12'-0" X 14'-0" ROOF FRAMING PLAN 5GALE: 3/8' = 1•-0' COVERED 56CREENED PORCH 12'-0" x 14'-0" 5EGTION A -A 56ALE: NO' = 1'-0• COVERED 50REENED PORCH f', RIDGE BEAM x 4 NAII_FR x f+ RAFTER c 5 "OD-FA50A e 10 FA56IA Y. ri L'EAM PLATE ?x6E'•EAM x 6 WALL TIE GARLINGHOUSE t1 �; � Sheet No. 6 Of 8 �TNrrL.fO:vlinyhnusaCo..Inc. i All Right:; uJ:.• • %" PrinlaJ in ..to Unite Slates of America I p whole or m Rnpratlu[I,nn ut Ihca; C,,vci- COVERED part. :m•.lur!u,.l an7 tl�rgcr copying andror I c proparohgtt JI dPLvd Lvq vrorks Ihoreal. for ar:y reason S flit poor wntten permission of me L.F. Gmtun;no,r;�; Ca., Ir.c. ,s strictly proh,G'ec SCREENED The pw r. n;rr of ;hrsr Cravings ,n no +s;+}• i clloj trnnslcrs an} eppngnt ur other ownersh•p mlerect m thcmt to thr b,.,ar eacepi toy a limited Icenwe to I nn drrn'q; : la• th•: [ooseuc of qu only one, struct.r.•�. Thr purchase of addn,rnta! c • • PORCH"sv""'�t sets of thuc•• �7av:c,a<." a nWuceprtl pncC t,j"mer t!.• � oyirynal '.•tt .. r . uar' ,I ,, mukip!e Se: f•:1 -i.1 :• . dor•: r..., i htl•• ❑,• bup,!, wdh a hc,:c::.. Qr%/• AQQ111 9nnn8 con -inn t i tructur.. I 17-0" x 14'-0" SECTION D-5 REO SCREENED PORCH VALLEY CONSTRUCTION 12'-0" x 14'-0' FLOOR COVERED SC 12' 0' x 5EGVON G -G WITH VALLEY FRAMING L2: -O - COVERED SCREENED PORCH 9 SUBJECT City of Fridley 3 0347 AT THE TOP OF THE TWINS BUILDING P E R M I T r RECEIPTNO. _ COMMUNITY DEVELOPMENT DIV. fr ..... , INSPECTION SEC. f � � PROTECTIVE L G✓ 1 "'1 CITY HALL FRIDLEY 55432 NUMQER REV DATE PAGE OF APPROVED BY 612-571-3450 910-FIS 10/4/99 JOB ADDRESS 1360 69th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 1 (Par el 580) 1 Rev. Auditor's Subdivision #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brian Narlock 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Amek Construction 133 E 7th St St Paul 55101 612-941-7844 20164402 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 O ALTERATION X49 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house 10 S Tear-off 9 CHANGEOFUSEFROM 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 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 $874 $.50 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- $35.70 Flr SC STR CTION OR THE PERFORMANCE OF CONSTRUCTION $.87 PLAN CHECK FEE TOT FEE L- Licen $-5 $ .07 IGNATURE OF Cen!AgWR OR AUTHORIZED AGENT iDATEI EN R VALID E THIS IS/Y/OUR PERK 'T LD iNSP !( VV T1ATE S.GNATURE OF OWNEROF OWNER BWLDERi iUA TES NEW [j- - Effective 5/10/99 ADDN [ ] CITY OF F UDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 I BUILDING PERMIT APPLICATION e�L\ Construction Address: / JAQ- Legal Description: /e- (� F `��% rG d r� Owner Name & Address: f r �%� e4 _ 9K (- r 7 � k Tel. # Contractor: e- CAMS 16(- LL aGk)d✓ MN LICENSE # ,; 0/6, Address: /33 cS & vt 55-101 Tel. # 601 %y%- 66 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: /O fti= -s (4�)Lts6, U Construction Type: Estimated Cost: $ 2z Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ E59 DATE: � APPLICANT: \ j6(�-d Tel. # (7V/- Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ ��✓�v $ U% $ �O $ � 07 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] SUBJECT MIT NO. City of Fridley 32564 AT THE TOP OF THE TWINS BUILDING PERMIT 16 RECEIPT NO. ` COMMUNITY DEVELOPMENT DIV. v INSPECTION SEC. r PROTECTIVE 1 . � NUMBER REV DATE PAGE OF APPROVED BY IL�CITY HALL FRIDLEY 55432 ---- A, L 612-571-3450 910-F15 5/6/02 JOB ADDRESS 1360 69 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pt Lot 1 Revised Auditors Subdivision 410 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary Hogan 1360 69 Avenue NE 763-502-9991 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 Reside House & Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Per Section 1402., 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Caulk and flash 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 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 $3,000 $1.50 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- $83.25 Fire SC $3.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FE TOTALOOP%E $8,7.75 $IG IA TUBE Of CONTRACT A OA THOR4E0 AGENT (DATE- HE PROP L VALIDAT D IS IS YOUR QER 000, ,OF�_S,GNATIUREOF OWN R0f OWNER BUILDER. IDATEI BL -NSP GATE NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 1 6 5? kk- A)4-- Legal )4 Legal Description: Owner Name & Address: i�1 _ L . a5 f9 �U Tei. # .3 - Contractor. CD C- MN LICENSE# e%. -'l - 777 - In- - 3!s - Address: Tel. # 763 - 50 -- - � ff l 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 L a 2!��Lk� GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width - Hgt/Ground Sq. Ft OTHER: K r-- S : c' � 14 ® 0 % e_ C. 6> a Ce•- S C: Construction Type: U i Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: -5- - d - APPLICANT: Tel. # X Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-5714287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ 33 --?r $ 3;®o $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2002 6431 U niversity Ave KE Fridley, MN 55432 APPLICATION FOR 00WER PLANTS AND HEATING, COOLING, VE 11L.ATION, , (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTWS AND DEVICES z JOB ADDRESS 13� BTE SCHEDULE OWNER?La Residential Furnace Shell and Duct Work, Bumer - 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) I% of Value of Appliance or Work Commercial/ladusttrial 1.25%ca of Value of Appliance or Work Rate TOTAL $ 30.00 $10.00 $10.00 $10.00 $ 25.00 State Surcharge TOTAL FEE oI Nn nInIn a I,-rn "'S. REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner- 0'r---ks ; xa(10 $ -50 PERMIT 1110. �/ AND OR PURNO Ream) (Hot WaterC(WHaAiry ' Size No_ FD id Load Burner Trade Name Size No - BTU HP — EDR 111- 0 n 0 r m 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and carr CL �- DATA HEATING Signed FAX #. TEL #763- "'S. 763- w m a 1� /®, 00 JUN -05-2002 10!09 FROM CITY OF FRIDLEY TO 5229197 P.05•05 THE BELOW MUST BE FILLED IN THEN REPLACING RJEL BURNING APPLIANCES OR THE APPLICATION U1 LL BE RETURNED Whenlaplaninnan Isting finnam, the undersigned hereby verifies that the venting teas been examined and Is free from met, deterioration, destructions, Old Is securely supported old frrestopped where required. Yes No ( } They venting system is plasWPVC and meets all current codes and manufaafurer spe0cations including suing, length, number of elbows and termination. Yes I No( ) The undersigned also vaerfltes that the replacement unit is a listed assembly and meets the current cods and manufacturees spedfications. This does include AGA -LAMA Category l Centel Fake Venting Tables for fan asdd and na lwal draft appffaences. Yes No( ) Tire is sized and installed to most the current codes sand maanufackaraWs specAcations. Yes (/No { } Whaasn required to hcdbm 2 'it will be sized and installed to rneet the cunvA codes and manufacturees specifications. Yes �j No( } Whaen' , the undersigned hereby verifies that / it is' a Ofsted assembly and meets the current cxxiles and manLeacturer's spec tions. This does include AGA4AMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes� No( co ) Is the common vent arrd vent connecters sized and installed comedy after an appliances has been removed ftm the comrnon vent and vented If separately as per current cis, Yes Appliance #1 Type �L�� BTU Input °�'� Fan Ass' or Nat Appllanes #2 Type BTU Input an Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Not Total Appliances Total Btu Input Common Vent Type Vent Height_ Diameter Inches Appliance 91 Vent Connector Height R Length ft Diameter in Type Appliance #2 Vent Connedor Height Length ft Diameter in Type Appliance 03 Vent Connector Height ft Length ft Diameter In Type r HEATING CO: Sd Syr 2 t ,� � Date: Ls � ®� TOTAL P.05 CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002 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 3 0 RATE SCHEDULE OWNER 10&t� A , 9�— Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ A (Side Vent - Fill Out Back) ESTIMATED COST -300 PERMIT N0. Gas Pipir4, eeded with new furnace, $ 10.00 $ ..t not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 y G�o2`2 C' $ No. of Heating U its Circle One (Steam) (Hot Water (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU (oUTr? HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/ Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ 50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE $ - DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO r REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved BRough-In Date Final Datd& written permission from adjoining property owner. t7 C6/ 0,1D® xJ rdZt�� FILL OUT BACK SIDEqFORTACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT VENT CONNECTOR AND COMMIRTION AIR VIFIRIFICATIM When ro la _i g an exacting 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 ex--ys=^g _nmB ustinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( No( ) When required to install a new cnmhtjstinn airTit will be sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When installing a new ventingiY_ctem, 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 #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 HEATING CO: Signed By: Date :