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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT 4 Date: ' �"'�• , Owner: _ Builder Address Address �r � r L C ION F BUILDING No. ' Street . �. � 1!_s � -- Part OUt Lot _ Block Addition or Sub -Division p{ Corner Lot Inside Lot —o"" � Setback Sideyard ,�+'r ? , safe Sewer Elevation _. Foundation Elevation DESCRIPTION OF BUILDING To U 11# r Front Depth Height 90 Sq. Ft. Cu. Ft r Fron Depth Height Sq. Ft. "__� __�__ Cu. Ft. Type of Construction � Est.. Co `f= o be Completed 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 all 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 ye=t in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Mitmesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violain of any of the provisions of said ordinances. .., : A Building Inspector NOTICE: fhb perm* don not cover the comMvddon, I dWbftn for wkhl& plMhtne, an hoattng, ower or water. Be sure to am the WHO* inspector for operate permits for thea hems. OWNER'S NAME ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS LOCATION OF BUILDING No. Street Part of Lot Lot Blockdation or Subdivision�� i t� Ad_ '. (!/ Corner Lot Inside Lot Setback Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. To be used as; Type DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. of Construction Estimated Cost To be Completed 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 '7 / StGNATtgm (schedule of Fee Costs can be found on the Reverse Side). 1 •� MONTH CI 3 �r DATE DAY CONTRACTOR CALL-TIliE INSPECTION & ADDRESS TD4E 1) I _ A /, lam- ��---,e!.! /�� �� - • ri 1. � �� C • � � :l � ��� f !Y ° ! �i � � '' I / r APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S . NAME—Asd&Tcf (y14L LIIV BUILDER .04AI &A ADDRESS/I" W..E. % ?�'/�YE ADDRESS FA'/riLfY LOCATION OF BUILDING NO. 13X1 STREET 7t VA0 Ye LOT 9 BLOCK 3 ADDITION OR SUBDIVISION .00A0J- CORNER LOT INSIDE LOTl,400' _SETBACK SIDEYARD J SEWER ELEVATION TOP OF FOOTING Applicant attaoh to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be.:Used As:. I �ant..T�_ Front yy'� �%� Depth %` Height /d , Square feet P -CR Cubic Feet From Depth Square feet Cubic Feet Height Type of Construction .tf4/q a Estimated Cost ZJ-Oo2-r- To Be Completed /�f #/ dM ® �— 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 J�—-�''di SIGNATURE Gf/ G1i /*Ad" (Schedule of Fee Costs can be found on the Reverse Side.) 0 c " • 1 0 rl otillY Load Plotinl'17Y C87S -Hi y -045 N I f Land Surveymy uWdIVI& 3 2. So;/ -s Teshity EINGINEERING1 INC. 111,7ne:w `7 ctvll I'Municipal RhRt 44066 En9i�teerin9 E%) lneer-s Sur veYO rs fez! D. L. AVAI-)�Q SOVA BLD.R. LOT ANOKA. 4�O'Jtll'lry Scale: Ooenc4es Iron Obcd I -ed re -e P 5Wvey 401be bcvnc,'0P;e5 0�'ihc O&W Ck5c a h-ze erred cort p m,,71afi',,i , �q me .Y e ewcroo:blneals, li cny, {rcpt or oa sad land. As -svry�ycd SU3U128AJJ R46INFERIN5, IN%'--. PI SUBJECT P City of Fridley 1500'7 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ®� 1 � i ' /'••1 CITY HALL FRIDLEY 55432 NUMBER' REV. DATE PAGE OF APPROVED BY "•• �'J 612-560-3450 910-F15 11/7/78 JOB ADDRESS 1351 - 75th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. g 3 Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeff Cook 1351 - 75th Avenue N.E. 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 metal asbestos chimney for woodburning stove 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE FERMI r5 REQUIRED FOR WIRING; HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Metal THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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. $1,000 $'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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEETOTAL FEE sh 00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN P PERL V ID S IS YOUR PERMIT - SP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) PI • I CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PE1214ITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OVINER: JANai.TEFF COOK—* BUILDER: $',A / -on E • Address: 1351 Awe NC Address: Tel. No.: No. 13 SI Street: AV h" N LOT: BLOCK.: ADDITION: CORNER LOT: INSIDE IAT: SETBACK.: SIDEYARDS: Applicant attach to this form 7Wo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRI FTION OF BUILDING , To Be Used As -.U - 1J�b Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ !Q QQ. ®d To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: SIGNATURE: Stipulations: SUBJECT PER City of Fridley_ 194 AT THE TOP OF THE TWINS BUILDING PERMIT I `y _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � ` ,.� CITY HALL FRIDLEY. 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---. L •,` 612-571-3450 910-F15 14/29/88 JOB ADDRESS 1351 - 75th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 3 Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeff Cook 1351 - 75th Avenue N.E. 786-4651 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 O NEW ❑ ADDITION ❑ ALTERATION X7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (2.6 squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. On all new roofs or tear-offs and replacement roofs, State Code requires that 2 layers of 15 Ib. felt, mopped together, be installed to a point 24 inches up from exterior wall line, or the use of other approved underlayment membrane. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT, AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1300 $, 65 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- $22.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $22.65 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI aye ,WHEN PROPERLY V ID TED THIS IS YOUR E MIT o� a Iff SIG TURE OF OWNER OF OWNER BUILDERI I ID EI /QATE NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 1561 `751-- AycntAe N•L, Legal Description: Lo+ q Block 3, -Dares I 5' Addi fiokh -- Owner Name & Address: a1reff C C.aok-, asl 72- pNf- Ne Tel. # Contractor: Tel. # Address: 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: roo-f ks� �� sti wires Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ 1� Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: q g APPLICANT: ca"ez /J - b0k' Tel CITY USE ONLY Permit Fee $a- U Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ $ 5,5Q per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �S STIPULATIONS: M M 0 �a CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR DOWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1267 Residential Furnace Shell and Duct Work, Burner Also Replacement Furnace (Side Vent . Fill Out Back) Gas PiRing (Needed with new furnace, but not replacement) Gas Range Gas Dryer *'Air Conditioning • All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 a Commercial/Industrlal 1.25° of Value of Appliance or Work o Slate Surcharge u TOTAL FEE 0 MINIMUM FEE FOR ANY_HEATIMG/_ o -, �s M REINSPECTION FEE $47,00/Hr N L'Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective January 1, 2003 JOB ADDRESS _ 1351 1 ?4- 4'v 1C ,6c? f OWNER TOTAL BUILDING USED AS ,-Nes-1- ESTIMATED COST. PERMIT NO. p1� $ DESPTjON OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hol Water) Warm Air) $ Trade Name Size No. BTU HP ®�2 EDR $� Fuel- Total Connected Load Burner Trade Name Size No. $ BTU HP EOR $ 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 1 .50 rulings of the Building Division, and hereby declares that all the facts and $ S—U representations stated in this application are true and correct. DATE a" 3 7—,o 3 HEATING CO Z,7'?'fie C Signed Z,2 A404 44 TEL # 4-/d . 3 f-9 FAX # 741 3 ® 313-0313 Approved By _ _ Rough -in Date` Final Date FED -10-2003 00:11 FROM CITY OF FRIDLEY TO 3230313 P.07='07 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED _AC__MMA VM CONNF-CTAR AWn C -IMAI ICTIQN AIR MIFIC:OTIAI�U When _nie6na a=aviOfejta. 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 k1 No( ) The venting system is plastiGPVC and meets all current nodes and manufacturer flans including sift, length, number of elbows and temrination. Yes ( u No � The undersigned also verifies that the replacement unit is a listed assembly and meets the cement codes and manufacturer's specifications. This does include AGA-GAMA Calory I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (4 No( ) The is sized and installed to meet the current codes and manufacturet's specifications. Yes (4 No( ) When required to ' will be sed and installed to meet the current codes and manufacturers specifications. Yes (1 No ( ) When mawaspMm the undersigned hereby verifies, that it is a listed assembly and meets to currem codes and manufacturer's sp t`ications. This does indude AGA -,AMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes N No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separ W* as per current codes. Yes (4 No ( ) 4nsli�� anm T4q=An��VXdGCk mjW Vaal and Vent f_annacinr InfaCmadan Appliance #1 Type F-&4 A-) BTU Input 7 gqs oliiieo orNat Applarm #2 Type BTU Input r Nat Appilance 03 Type BTU Input Fan Assisted or Nat,_ Total Appliances Total Btu Input Common Vent Type Vent Height �m �� Dlameter�Inches AppPwm #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appy 03 Vent Connector Height ft Length It Diameter in Type _ HEATING CO: a 111111111111 1 TOTRL P.07 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ((JSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ BUILDING Plan Review Permit No.: 3uilding Inspections $ RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 License Surcharge CITY OF FRIDLEY �� ��(� $5.00 (State Licensed Residential Contractors) Date Rec'd: )ATE //- / YOUR E-MAIL ADDRESS Curb Cut Escrow •ITE ADDRESS S% 7S P4 �✓-� Erosion Control $ $450 Conservation Plan Review Park Fee 'HIS APPLICANT IS: ❑ OWNER EXONTRACTOR Sewer Main Charge PROPERTY OWNER/ NA1vIE. 3e? 7 Cc��lC Total Due ADDRESS: 13 -TI Arir.: CITY STATE ZIP TENANT PHONE: 7Gs 3'- 78W %%T% CONTRACTOR NAME: '5y'hs% Ex�e„�i� fS STATE LICENSE # moa Y t R EXP DATE,&,Y-- `-DG SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: G'iy �'�td`"� S �c CITY ,- "Ole _ STATE/1�ZiP 5)-y%) WITH APPLICATION PHONE��� .3-7u `�� FAX SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH PROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMM[ING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR M -REMODELING DESCRIBE WORK BEING DONE: 7' /4 r- ��'i °" &fit e SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. itOOFING ❑ HOUSE ONLY gUMBER OF SQUARES a� O.HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 3ARAGES ❑ ATTACHED GARAGE 2q 1. 2. Existing Floor Plan Proposed floor plan ?ROPOSED SIZE: �q ❑ DETACHED GARAGE 3. List of structural members to be used 'ROPOSED HEIGHT: >IDING FOR NEW CONSTRUCTION INCLUDING DECKS, :3 Vinyl ❑soffit ADDITIONS. & PORCHES SUBMIT: :3 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures :1 Other ❑ Fascia and proposed project 2. Two sets of construction plans WE41)OWS 3. Energy Calculations N EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS JR FOR NEW OPENINGS -DESCRIBE SIZE OF DPENING CHANGES & r TYPE OF WINDOW TO BE INSTALLED YPOD ' NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ((JSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ i. .001 x Permit Valuation (1/10%) License Surcharge $ �� ��(� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requir s review and approval of plans. SIGNATURE OF APPLICANTT PRINT NAME�Z/1✓//.S C ��f J^ DATE �� 7-