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MIT NO. 15886 SUBJECT City of Fridley O AT THE TOP OF THE TWINS BUILDING P E R M i • • _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. ua( 1 S i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF JAPPROVED BY 612-571-3450 910-F15 8/18/80 JOB ADDRESS 1348 - 76th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 Meadowmoor Terrace 2nd SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Garjac Inc. 8637 Arthur Street N.E. 784-3579 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 CI NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK IF%WWA Construct a 251 x 40' Dwellin and a 24' x 24'. Gara e WWIUFG WWI call Ioc�l iF1i�1�i� 9 CHANGE OF USE FROM TO REQUIRED By LA STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. CALL IN FOR SEWER AND WATER LOCATIONS. SEWER WYE: From the Sanitary Sewerl•aanWe enterline of Meadowmoor Drive and 76th Avenue; 29 185.30 feeA tLq t o tP1hr rt�$r ;� I& WATER LOCATION: 10 Lina feet east c�gV*jaW MR9� � ELIVATIC,.: SEWER approx. 12' Deep In Street PERSONS UVW�ko PUfMES ONLY AN✓ � WYE ELEV: Approx. 892.50 ON THE SM � �I�MATION SEPERATE PERMITS REQUIRED FOR WIR (N HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 Z 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 $ 41�8SO $20.93 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE O LOCAL LAW REGULATING CON- $.01.45 $425.00 STRUCT) OR THE PERFORMANCE CONSTRUCTION. PLAN CHECK FEE TOTAL FEE BQA-A $25.36 $572.74 SIGNATURE OF ON. ACTOR OR UTHORIZEDAGENT (DATE) WHEN PROPERLY VALIDATED THiS IS YOUR PERMIT r:� BLDG INSP D E SIGNATURE OF OWNER 0F OWNER BUILDER) IDAT I, MIT NO. 15886 !111 POW unuf#®Ave e3 N5 �N�ttiROiN/MQ �fM...�reDo?.. �d�rrov,nS?M32 i r, d a ,V :r,. .;a„ i...c.n.c.�,t •.a•.0 (rs •.y l an,..,;.a. •,-M • Lard P:anNat 4 at) ci-11 kowt DA Certificate of Survey for i7AAU4 6APS -- �,�: • Ute SCR LG � / � 30 � o �io�¢s iibin1m. chumi�r Lor 44 8LOCK' 2 1V1C,gDoW 1009 WEWRACE 2 �n I 1hereby certify that this 6 o trYo and correst representation of o survoy, of the bow►deries of the absw described food, ood of the lotatton of all buildings, the s+n, and ell visible olssreochments, if any, from M an said loved. As surveyed by me thio doy of ,,� C, A. D. 19IJ I SURUM AN INGINEIiRING, INC. ��^ _ snpitso ru1 slot Puhi,d,P.f All RbhKRew#ved Sf9'w(�.� �%is.n Ltd Vie' � �"�. C� � I '� %E �'S1'�'� lA) 'Vf{iO•— � � 1r i 4 (¢ i2 h� � � �� /p �l � � �C] j 'S--� eA 1 Z OWNER: ADDRESS: TEL NO: CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs.) BUILDER:C_ ADDRESS: A/ TEL N0: 79 Construction Location STREET NO : iT-�"ba+ STREET: d % lQ V LOT: _T BLOCK: o` ADDITION: � ® C10/Z 1� �Le pZ A" . Corner Lot: Inside Lot: !l Setback: �S Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION C©NS`TRU 67' 2 rX1-1v . o 'ryam e Front: Depth: �� Height: e qARA4r ay X,? t� Squane. Feet: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: �9 �► Estimated Cost: $ 6 To Be Completed: X11O V Alt. A Al t. 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 applicationa true and//cor%r�ec�t�.� DATE: % d b SIGNATURE: �"^�/ ( V - ""/ Stipulations: 96Q► ;X_ 101. y� Re. asv.3c Ty 24 1 C6�'j -7 �. 46 wRv- k Irv, goxaq = cul x? U*h krLuck. yv ------------ = locw 9 9 3 .,' aC I'L q Y;L qz CX )c to 1- %o V G,23 sego. q9 3 )0 11, 00). 57G k fit• �I S, O��l.�(o 41,%Sa. G. If Item III is the same as,,'or less than It you have met the intent of State Building Code 6006 '(c) Z. H. If Item IV is the sato@ as, or less than Item IZ, yon; have met the intent of State ' Building Code- 6006.::;(e) 1. I Add . I tem - I J. Add Item III + new R. If the sum of Items 111 &rut , IV. are -loss 'than 1te" 'VAnd 11,' You have met the intent of the Code for total owelops sypto. �4 The undersigned, ,as applicant for a' Wilding pethait, hereby''affirms the above information.has Been prepared and submitted by'.himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required. plans .in support of the building permit application. By: -«- -- — - - --- - DATE: a •y �� E E. `. 'rerraine the "U" vale of Each sr�tnc_nt- 1114) and multiply by t:he area am 6. //fib x .lull _ 62 2___ � . x '-U" _ 8. n x 0X* ADD 1-9 OR TOTAL {BALL SEG14ENTS ITEM III F. Determine the "U" vague of each segment (1012) and multiply by the area as follows: 10. ��� X nun x nun "" ADD 10-12 FOR TOTAL ROOF/CEILnM SZONEWS ITEM IV G. If Item III is the same as,,'or less than It you have met the intent of State Building Code 6006 '(c) Z. H. If Item IV is the sato@ as, or less than Item IZ, yon; have met the intent of State ' Building Code- 6006.::;(e) 1. I Add . I tem - I J. Add Item III + new R. If the sum of Items 111 &rut , IV. are -loss 'than 1te" 'VAnd 11,' You have met the intent of the Code for total owelops sypto. �4 The undersigned, ,as applicant for a' Wilding pethait, hereby''affirms the above information.has Been prepared and submitted by'.himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required. plans .in support of the building permit application. By: -«- -- — - - --- - DATE: a •y �� E 4. CITY OF FRIDLEY R APPLICATION FOR P!.JMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE x $3.00 N NO. RATE >4 m 4—x r $10.00 o REPAIRS & ALTERATIONS x 0 New Fixture, Old Opening Water x $2.00 $ Catch Basin each add. $100.00'or fraction x $5.00 $ .cater Heater - to 99,000 BTU �_ 0 C 100,000 B -TU to 199,000 BTU .0a & W C a REINSPECTIOAT FEE Heater 0 aJ 1-1 x $5.00 0 Electric .cater Heater H —1 0 $r N it L •4 x W c c 3 pp 0 .•4 +� o .c 6 0 N cul 0 Cn U 0 111....... U ..t a q 0 q c to 3 M 7 s+ o O W 00 V1 .-4 M to11o U MiG 47 0 r $ 71 a C7 :j .a � .0 o W as lec r , r is' �U Ind 3rd f i t th (Rj - nature Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE x $3.00 PLUM3IXG FIXTURE RATES: NO. RATE TOTAL :.`a.:.ber Fixtures 4—x x $3.00 $10.00 Future Fixture Opening REPAIRS & ALTERATIONS $2.00 $ %•Qb New Fixture, Old Opening First $100.00 x $2.00 $ Catch Basin each add. $100.00'or fraction x $5.00 $ .cater Heater - to 99,000 BTU �_ x $5.00 $ S 60 100,000 B -TU to 199,000 BTU TOTAL FEE x $10.00 $ dater Softener REINSPECTIOAT FEE x $7.00 $ New Ground Run Old Building pJ0. 00) x $5.00 $ Electric .cater 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 $ REINSPECTIOAT FEE pJ0. 00) Job Address / Y8 -- Department i l� 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•roprosontations stated in this application are tr.:e and correct Fridley, Mn. 193X-) OWNER �� `C L C KIND OF BUILDING SCR h USED AS S TO BE COLLETED ABOUT � ESTIMATED COST 19,00 , NE'A 8 ILDING PERMIT NO. PERMIT NO. �' /«✓ Company G Signed B Tel. ROUGH INSP. Date FINAL iNSP. 16 ''Z `r' trio Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMING PERMIT IS $7.50 PLUS $.50 STATE SUR-HARGF. CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $ AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ $'_0.00 $ GR,IVITY WARM AIR: RATE TOTAL Job- Address Furnace Shall & Duct Work $12.00 $ ' t R.eplacerent of Furnace Repairs & Alteraticns-up to $500.00 7.00 7.00 $ S Department of Buildings • P.epairs & alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL i ARM AIR: Furnace Shell &•.Duct Work to 100,000 BTU each add. 50,000 BTU * Replacs.nent of Furnace Repairs S:lccratior. ,-up to $500.00 Repairs & Alterations each add, $500.00 OR MT KATER SYSTEIf: Boiler & Lines up to 100,000 BTU each e d4L-,. 50, 000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNEi:- to 3 gal. per hour each add. 3 gal. per hour G.aS BUR\ER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING PEES: a The undersigned hereby makes application for a permit for the work herein $12.00 specified agreeing to do all work in strict accordance with the City Codes 4.00 $ and rulings of the Department of Buildings, and hereby declares that al; the 7.00 $ facts and representations stated in this application are,true and correct. 7.00 9.00 $�—` Fridley, Dunn. , 19 OWNER $12.00 $ 4.00 $ 7.00• $ 6.00 $ $'_0.00 $ 10.00 $ $10.00 $ lst.3 Fixtures x S 3.00 Addicie.al rixtures x $ 1.00 Gas Range to 199,000 BTU x , $10.00 AIR CONDITIONING rAN HEATING SYSTEMS See Fee Schedule �'r.NT'ILA1'IN'G SYS?'I::•1S ALTERATIONS $ REPAIRS State Surcharge ' TOTAL FEE RC -UGH ISSP. Date Fn.AL iNsP. 16-,�3 Date � Q APPROVAL FOR PERKIT l 6i, REII3SPECTION FEE 010.00) S 2Si::I ." FEE FOR MY HEATING PEMMIT IS $7.50 PLUS $.50 STATE SURCHARGE. •Atta&.od stack verification form KIND OF BUILDING " ' USED AS TO BE COMPLETED ABOUT ESTI,MATED COST OLD -BU ING RMIT NO. PERMIT NO. DESCRIPTION OF FUR ACE/BURriEER - HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name` Size No. Capacity , Sq. Ft. EDR BTU fl�?)Jnq HP Total Connected Load Kind of Fuel �9 BURNER - Trade Name Size No. ' Capacity Sq. Ft. EDR BTU HP company Signed By �y Tel. No.�� HEAT LOSS CALCULATIONS DEPARTM NT OF BUIL INGS Weatherstrips A.S.H. Construction No. Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No Yes—No 19_ � FV Vj 7-) Room I Length 1) P Width Height II 1 F1 Windows and Doors—Crackage and Area L P Width Height No. of Lineal ft. Area No. of pane of pane lighte of crack sq. ft. , ,3t 0 �y`> 21E Coef. Btu Infiltration Coef. Btu Infiltration Infiltration Exp. wall Jo Glass 6 uf� — Exp. wall " Exp. wauo Net exp. wall 91 Int. wall Ceiling Ceiling f Floor Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I I / F1_I �_ R.,.,...I I.�el6 /'/l W;Ai . /.G/ U.-ka, Windowsand Doors--Crackage and Area L P Width Height No. of Lineal ft. Area No. of pane of pane lights of crack Be. ft. No. ofLineal ft. Area lights of crack eq. ft. Oof OFYT 21E Coef. Btu Infiltration Infiltration Glass 10 f Infiltration Exp. wall D Net exp. wall Int. wall 6 Ceiling �- Floor Total Btu.G` Required sq. ft. E.D.R. or sq. ins. W.A. Leader area % F1.1 -,I-,Z Room I Length / Width, # Height Windows and Doors--Crackage and Area L P Width Height No. of Lineal ft. Area Noa of pane of pane lights of crack eq. it. No. ofLineal ft. Area lights of crack eq. ft. Oof OFYT 21E Coef. Btu Infiltration Infiltration Glass Infiltration Exp. wall Net exp, wall D Int. wall 6 Ceiling D Floor Tbtal Btu. sq. ft. E.D.R. or sq. ins. WA. Leader area 3 li Insulation Kind How Applied 0---1 i ---.1. . —. w:aa. I / u.: -i.. Windows and Door&—Crackage and Area L P Width Height No, ofLineal ft. Area No. of panes of pane lighte of crack sq.. ft. No. ofLineal ft. Area lights of crack eq. ft. Oof OFYT 21E Coe Btu Infiltration Coef. Btu Infiltration Glass Exp. wall Q Infiltration 6 Glass D Int. wall " Exp. wauo Net exp. wall Int. wall 91 Net exp. wall Int. wall Floor Ceiling Floor Total Btu. 3 Required sq. ft. E.D.R. or sq. ins. WA. Leader area / Li i 7'. /z R....... 11 .ws.l. -/ A W;Ak6 JG u.int.l• Windows and Doors—Crackage and Area L P Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. No. ofLineal ft. Area lights of crack eq. ft. Oof OFYT 21E Coe Btu Infiltration Glass Exp. wall Q Infiltration Net exp. wall / D Int. wall ® Ceiling Net exp. wall Int. wall Floor Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area ' Room I length Width 3 Height Windows and Doors—Crackage and Area Width Height No. pane of pane No. ofLineal ft. Area lights of crack eq. ft. Oof OFYT 21E Coef. Btu Infiltration / D Glass Exp. wall ® [j Net exp. wall Int. wall Ceiling Floor Total Btu. sq. ft. E.D.R. or sq. ins. WA. Leader area connvivu PRIMT1Nrt L env ro CITY OF FRIDLlEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432 TELEPHONE ( 612)571-3450 October J i i� 31, 1980 Mr. Gary D' Aigle Garjac Inc. 625 Highway #10 Blaine, MN 55434 Re: Final Inspection at 1348 - 76th Avenue N.E. Dear Mr. D'Aigle: A final inspection was made on October 31, 19.80.of the above address and the following items were noted which must be completed before the structure can be f inaled out,- 1. ut; 1. Sheetrock the basement by,November 15, 1380.. 2. Provide sod in the side and front yards by June 15, 1981. 3. Provide a handrail on the lone: ctcps by No1: er 15, 1380. 4. Provide the City with.a copy of the verifying survey by December 1, 1980. We have, also noted that you have not submitted verifying surveys for the properties at 7637 Arthur Street N.E., 7613 Arthur Street N.E., and 1320 - 76th Avenue N.E. We will expect these surveys to be also submitted by December 1, 1980. Reinspections will be conducted on the above dates to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh p. CITY OF FRIDLlEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432 TELEPHONE ( 612)571-3450 October J i i� 31, 1980 Mr. Gary D' Aigle Garjac Inc. 625 Highway #10 Blaine, MN 55434 Re: Final Inspection at 1348 - 76th Avenue N.E. Dear Mr. D'Aigle: A final inspection was made on October 31, 19.80.of the above address and the following items were noted which must be completed before the structure can be f inaled out,- 1. ut; 1. Sheetrock the basement by,November 15, 1380.. 2. Provide sod in the side and front yards by June 15, 1981. 3. Provide a handrail on the lone: ctcps by No1: er 15, 1380. 4. Provide the City with.a copy of the verifying survey by December 1, 1980. We have, also noted that you have not submitted verifying surveys for the properties at 7637 Arthur Street N.E., 7613 Arthur Street N.E., and 1320 - 76th Avenue N.E. We will expect these surveys to be also submitted by December 1, 1980. Reinspections will be conducted on the above dates to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh SUBJECT PE City of Fridley ' 79- 6 AT THE TOP OF THE TWINS BUILDING PERMIT _ r REC 164 ------ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �� i1 i ��---,-� CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY ----� 612-571-3450 910-F15 5/3/85 JOB ADDRESS 1348 - 76th Avenue N.E. 1 LEGAL LOT No. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 Meadowmoox Terrace 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Hanson 1348 - 76th Avenue N.E. 784-5674 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Pacific Pool & Patio 6922 .- 55th Avenue N., North St. Paul, MN 770-1313 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK 1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a.]= 161 x 32'.Inground Swimming Pool (18,350 gallons) 9 CHANGE OF USE FROM TO STIPULATIONS -See letter dated May 2, 1985 for stipulations. WARNIN ®erre digging calf faejr 6,fifflds SEPARATE PERMITS REQUIRED FOR TELEPHONE - ELECTRIC - GAS Etc. WIRING, HEATING, PLUMBING AND SIGNS. REQUIRED BY LAW 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 S0. 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 1 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 $lO, OOO $5.00 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- $80.50 ST UCTR THE ORMANCE OF CONSTRUCTION. L%10 _ -1 PLAN CHECK FEE TOTAL FEE $85.50 SIGNATURE OF CONTRACTOR OR AUTHO IZ AGENT IDATEI NN WHEN PROPERLY„ VALIDATED THIS IS YOUR PERMIT _ BLDG INSP AT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Addri Legal Description Owner Name 6 Address: ��A�?ES llddl j 3 o" 3 She 7d "� 6/F Tel. # Contractor: /vz '-t ���� Tel. # Address /*,;5* ST /t� 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: ou"VDSGyi✓J�-cam/eV(2 �o /c���3�D Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback / Side Yard Setback Type of Construction: �.✓�✓'ac�C�y �L��i ��� %/�CAr�G Estimated Cost: $ Z Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: �S APPLICANT: Tel. #22-e CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ TOTAL $ Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS• r G7YOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 May 2, 1985 Pacific Pool & Patio 6922 - 55th Street North North St. Paul, MN 55109 Be: Swimming Pool Construction at 1348 - 76th Avenue N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, two (2) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. 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. 5. 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. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. 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. (e) 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. May 2, 1985 Pacific Pool & Patio Re: 1348 - 76th Avenue N.E. Page 2 8. An automatic chlorinator should be provided with a suitable test kit. 9.' All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. 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. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. 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 of the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, (L .. JAW-WJ& DARREL G. MARK Chief Building Official SJO/mh CC: Mr. James Hanson 1348 - 76th Avenue N.E. USE BACKBRACE AT PANEL JOINTS AND AT CENTER OF 6'-0' LONG STRAIGHT PANELS (MARKED 14-6, 8'-�1--8'—s�-- 8'—► —8' —041'TYP. X X X X X X X X X X X�� X x 4' TX X 18'•0' INSIDE X LOCATE BRACE AS X 6' POOL SHOWN ON VERTICAL X RIB ON 4' LONG PANELS x �X(TYPICAL 4 PLACES) T / x_t X X X X X X 32'-0' INSIDE POOL X X X X X X �6'�81 �81�41� ' X x x x x x x x x x X x X X X X X X X X X X X x x x x x x x x x x11 ..--]Ixx THIS BROCHURE IS FOR ILLUSTRATIVE PURPOSES ONLY. The manufacturer makes only those representations which are staled in Its written warranty. Any other representalions. statements, or contracts made by the dealer and/or the contractor to the customer regarding any materials produced by the manufacturer are attributable to the dealer and/or the contractor only. The dealer or contractor who sells or installs your pool Is an Independent contractor and not an agent or employee of the manufacturer. The construction methods illustrated are suggestions and apply only to normal ground conditions. There may be additional precautions and/or methods of construction. The responsibility is the contractors. 4 STRAIGHT STEP (TYP.) X X X x 3' X 8' 8' X X 6' x 4 3' (I X X== X X X X X X X %X 4' x „ X �- 4 6' X 4' x 6' S' f x x 6'4' X 4' 81 4 X XE + X X , X 4' 4' 5' X 4' X I� —L x X X ar a�J X X X X OPTIONAL STEPS AND LOCATIONS NOTE: USE 8' SIDE STEP SHOWN ON NON -HOPPER POOLS ONLY OPTIONAL STEPS AND LOCATIONS (CAN BE LOCATED ON EITHER SIDE OF POOL) -J SEE PAGES 60 AND 61 FOR BOTTOM CONFIGURATION AND DIMENSIONS i / F% /) t ,�-r J Wall Panel Layouts -PACIFIC- 160 ACIFIC 16' x 32' Pool/Step Pool §t,Hei ifali- CI)OW. office op9.Crewl7mbf Pacific Pool & Patio 5=200 Yileer 3 3 Dopy: � copr. Customer 'A Minnesota Package Prodln.Ks Company Brooklyn Center Store No. SL Paul Store Burnsville Store Rldgedale Store 4311 -.BSM Ave. No.tiM - 85th St No. . 9278 W. Co, Rd. 42 WeYtBta 13hrti Brooklyn Center, Mn 55420 , " No. St. Paul. titn. 85188 Burnsville. Mn 55337 Mlnrretorka Mn: 68343 (88D4W42) (770-1313) I 350D) Ii8A1-918[1) alAHn :RIOLB®. 011TH 11�R '7R PA -new_ IC_R - 7aHT vam VMC Bzidleq Was 53432 Diagram Pool site in relation to house, garege, property and wives. #Mlow 3" variance) I � v ,, ,✓- a-SIC..>r�x. fps ;; - iAJCErS _ 04.* location of filter ardor heater by (B2} 13 EEevatlan frarl location marked "A" in diagram: + // ,[ fShaw type end location of slide If app9cabte _ ate deep end by pt} t4- Customerho retain any a all dirt from pool Location fordisposel otdlrE ! CIdlu w/ 11 any obstructions be encountered — such as trees, IHC Pool & Patio re00rmnands that customer Install OkNhes poles or powedphone fines oto.: C-1 (As 9-0 as possible following pool oonslruptl-) 1. Rain gutters adjacent to pool a Retelling wall where diagramed 3 FAM Off control Or&Wnfmkl • ' CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLOWING • • Some damage maybe dare to the yard andwr driveway entering and leaving the yard during cmretrtictlonl bdlal /1 Customer assumes responsibility for electrical wiring and groumti� of the pool Qncluding permit If requked): Intew Cusomter assumes responsibility for the gas installation of Treater If applicable Vnckmft permit H required* Initial If debris, structures, or substance foreign to normal soil should be encountered while excavetirrp which requlrea handling artNor disposhmg — Cuatonrershall assume responsibility if any extra costs are Incurred. lntW R you wish to change: filter position, slope of tend, or anything else stated in"outline. please call our office —1313. Crew chiefs are not authorized to clumps anything on the labor make any promises forwak to be dare by tl emL Any changes that are not authorized by fire office will be cbs�,roge/ds�aka U lard ram no exceptlorma. Pacific Representathre Signature I �, Customm Signature CREW CHIEF /// Equlpmend Needed Back hoe OP66 Cat O Cat QTruck 0 Snow Fance O Inspections ❑ Wells Contract ❑ Fiumbing • Footing O Before t3ttcldill O Other 7- _ alAHn :RIOLB®. 011TH 11�R '7R PA -new_ IC_R - 7aHT vam VMC Bzidleq Was 53432 Diagram Pool site in relation to house, garege, property and wives. #Mlow 3" variance) I � v ,, ,✓- a-SIC..>r�x. fps ;; - iAJCErS _ 04.* location of filter ardor heater by (B2} 13 EEevatlan frarl location marked "A" in diagram: + // ,[ fShaw type end location of slide If app9cabte _ ate deep end by pt} t4- Customerho retain any a all dirt from pool Location fordisposel otdlrE ! CIdlu w/ 11 any obstructions be encountered — such as trees, IHC Pool & Patio re00rmnands that customer Install OkNhes poles or powedphone fines oto.: C-1 (As 9-0 as possible following pool oonslruptl-) 1. Rain gutters adjacent to pool a Retelling wall where diagramed 3 FAM Off control Or&Wnfmkl • ' CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLOWING • • Some damage maybe dare to the yard andwr driveway entering and leaving the yard during cmretrtictlonl bdlal /1 Customer assumes responsibility for electrical wiring and groumti� of the pool Qncluding permit If requked): Intew Cusomter assumes responsibility for the gas installation of Treater If applicable Vnckmft permit H required* Initial If debris, structures, or substance foreign to normal soil should be encountered while excavetirrp which requlrea handling artNor disposhmg — Cuatonrershall assume responsibility if any extra costs are Incurred. lntW R you wish to change: filter position, slope of tend, or anything else stated in"outline. please call our office —1313. Crew chiefs are not authorized to clumps anything on the labor make any promises forwak to be dare by tl emL Any changes that are not authorized by fire office will be cbs�,roge/ds�aka U lard ram no exceptlorma. Pacific Representathre Signature I �, Customm Signature FEATURES OF THE S-200 SERIES MANUAL AIR RELIEF for easy, safe manual re - hum of air from system. FULL VIEW LEXAN, DOME. Clear S" threaded Inspection dome lets you see operation of filter and provides convenient access totop of filter. TOP DIFFUSER. Assures even distribution of water over the top of the send media bed. All internal pip- ing Is 2" to ghre smooth, free-flowing performance. AUTOMATIC AIR RELIEF. Automatically purges filter of any entrapped air during operation of the filter system. CORROSION -PROOF, HEAVY-DUTY FILTER TANK. Injection molded of tough, durable ABS for dependable all-weather performance with only minimum care. BOLTED CENTER FLANGE. Provides extra strength and securely and safely fastens tank top and bottom together. Allows for future service ac - can to all filter components without disturbing piping and connections. 0 -POSITION HAYWARD VARI-FLO CONTROL VALVE with easy-to-use lever action handle to let you "diet" any of the 6 valve/filter functions. FIL- TER, WASTE, BACKWASH, RINSE, CLOSED or RECIRCULATE UNION LOCKNUTS make assembly or disassem- bly of the control valve easy. EFFICIENT MULTI -LATERAL UNDERDRAIN AS- SEMBLY. These precision engineered, corrosion - free, self-cleaning laterals give totally balanced flow, even when backwashing. Laterals Individu- ally thread Into center collector hub to assure positive sealing, and allow for fast, easy servicing. SUPPORT SKIRT. Rugged and attractively styled to provide strong, stable support for the filter as- sembly. Totally corrosion, -proof, too. DRAIN PIPE ASSEMBLY allows for total draining of filter for winter or service. %" garden hose con- nection thread for easy hose attachment Drain assembly Is replaceable from outside of filter. ALL FILTER COMPONENTS are serviceable using only a screwdriver and wrench. The 5-200 and S-240 High Rabe Send Filters are available with three base options: 1. Standard pump mounting base. 2 Pump/fitter platform base. 3. Deluxe pump/filter platform base. The System II Series Is furnished complete with Hayward UL Super Pump and clear Leven union. All components factory assembled on deluxe platform base. System If Series available with 4A, 1,1 % and 2 HP pumps. Your dealer will recommend the model with the pump horsepower that will provide optimum Performance. at the lowest operating cost. • Systern 11 Seperate components system also available with choice of Super or Max -Flo pumps, % thru 2 HP. HAYWARD POOL PRODUCTS, INC. 900 FAIRMOUNT AVENUE, ELIZABETH, NEW JERSEY 07207 / Phone: (201) 351-5400 Printed in U.S.A. CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer "Air Conditioning - All Sizes Rate TOTAL $ 20.00 $- $10.00 $10.00 $ $10.00 $ $ 10.00 $ Z4 - 616 $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE $ fSO MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS d '_ 4S4 :26 A j UE 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. S ,1993, OWN 0 BUILDING USED AS A,�5//DD - �E ESTIMATED COST 3,)' G , ® ® PERMIT NO. 1136--2 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name BTU HP Size No. EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY �n Attm J�di �L,532 Signed By 700 W. Linde Avveenue Minneapolis, MN 55440-1 16�5 Approved By ough-In Date Final Date �O FILL OUT BACK SIDE FOR STAG TION ON REPLACEMENT FURNACE 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 ( ) S. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV, 6434 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: 9,-19-99 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Bath Wash Floor Catch Auto. Urinal Tut;_ Shower St►1k Tray Fount Drain Ba str Washer NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE JOB ADDRESS The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true a correct. O -2 4? _'1997 Owner.1� Building Used As Estimated Cost �r��, PERMIT NO. PLUMBING COMPANYAW SIGNED BY TEL NO.•�����-S� Approved By Rough—In Date Final Date' MINIMUM FEE F6191 ANY PLUMBING/ PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. CITY OF FRIDLEY INSPECTION DIV. 643.1 University Ave NE Fridley, MN 55432 572-3604 W Stories Close Basement Floor 1 Floor 2 Floor 3 _. Floor 4 PLUMBING FIXTURE RATES Effective On January Q1, 1997 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT �eL"'51 l " q q �l�o NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** —� $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance JOB ADDRESS i3 Z6 / /�'- - / �.� AI'y, s y32 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. C I , 1997 Owner i p Aa- , Building Used As l4u,2A Estimated Cost PERMIT NO. PLUMBING COMPANY SIGNED BY �� TEL N0, Approved By /�. Rough—In Date_ State Surcharge $ .50 MINIMUM FEE OR ANY PLUMBING TOTAL FEE PLUS THE $.50 STATE SURCHARGE Final Date q7 NIT IS $20.00 **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. SUBJECT E. MIT NO. City of Fridley 26316 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. -��% � 1 � 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/22/98 JOB ADDRESS 1348 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 2 Meadowmoor Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Toven 1348 76 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Royal Construction 28222 96 St, Zimmerman, MN 55398 444-0458 20050156 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 Reroof House & Garage (26 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 ISTALLS 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 $2,168 $1'08 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 PROVI NS OF ANY THER STAT OR LOCAL LAW REGULATING CON - $74.75 Fire Si'. $2.17 STR T NOR E ERFO AN OF ONSTRUCTION. PLAN CHECK FEE TOTAL FEE XXX License SC $5.OQ $83.00 SIGNATURE OF CONTRACTOR OR AUTHORIZE ENT iDATEi WH E PE LIDATED THIS IS Y URMI 0 SIGNATURE OF OWNER OF OWNER BUIL IDATEi 06M INSP DATE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION�� ConstructionAddress: 13 TW 767-14 IAve /)e - Legal Description: Owner Name & Address: X�—" *F0 V w Tel. # Contractor: Rf)VCd CbXkS UCTIOA/ MN LICENSE# Address:, A611 -W ST 21�w f.$eAW o Tel. # V 4/q— y S 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: Construction Type: �2 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: r 701 —�7K APPLICANT: Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: P Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] Building $ BUILDING Permit No.' Inspections RESIDENTIAL APPLICATION Received 763-572-3604 Surcharge $ (Q(y J10 2007 License Surcharge $ CITY OF FRIDLEY SAC Charge DATE $1675 per SAC Unit (Plans to MWCC for determination) YOUR E-MAIL ADDRESS $ SITEADDRESS Erosion Control $ $450 Conservation Plan Review THIS APPLICANT IS: O OWNER OCONTRACTOR Sewer Main Charge PROPERTY OWNER/ NAME: Anfte— M Ar. kr*-,-A s $ e .S ADDRESS: I b48 "'ii tf, 1iR= L-) CITY h...6ckk1w .+t STAT$j�iP_.geSL(, QL TENANT PHONE: -ILO ''S 18-16 1 ap C CONTRACTOR NAN E: STATE LICENSE u ENP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE-21P— TATE-21PWITH WITHAPPLICATION PHONE FAX PROPERTY TYPE 19 SINGLE FAMILY C,p%.Z r SIZE O TWO FAMILY NEW CONSTRUCTION STORIES PERMIT TYPE O ADDITION O GARAGE SHED O WINDOWS O BATMENT FINISH O ROOF O DRAIN THE VECK O SIDING PkOnIER O SWD&vIING POOL TYPE OF WORK 0 NEW O ADDITION $MAINTENANCE REPAIR DESCRIBE WORK BEING DONE: fie ,}�O.REMODELING 1 S`SCS . ('cLt`�(�Q L 1f1,AQ lJAare— Yl SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING O HOUSE ONLY NUMBER OF SQUARES O HOUSE & GARAGE BASEMENT REMODELING SIMNU: GARAGES O ATTACHED GARAGE 1. Z. Existing Flo" Plan Proposed floor plan PROPOSED SIZE: O DETACHED GARAGE 3. List of straaLual members to be nand PROPOSEDHEIGHT: SIDING FOR NEW CONSTRT TCTION INCLUDING DECKS, O V;T, OSot it ADDITIONS. & PORCHES SUBMIT: O Alumina O Trim 1. Sitc Plan Survey showing the existing structures O Other O Fascia and proposed Project WINDOWS Z. Two seta of construction plans IN EXISTING OPENINGS OYcs ONo LOCATION OF WINDOWS 3. Encrg} Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ /, Al -7, CSO OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ �'� , / 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ (Q(y .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = fI x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ e .S Make checks pavable to: Citv of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMrr-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 req*vis review and approval of plans. - / SIGNATURE OF e -/-,41X,6'," REVIEWED 4BLDGE CEcio�' y: if ■ Fm :/o c� c a aw �� r �v J y �rh ON 0 0 -j�e X"ha-,fpayzLe s o„ IS, i T Building BUILDING Permit No.: �`� '0 I 3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 go AUG CITY OF FRIDLEY Date 763-502-4977 FAX EFFECTIVE 1-1-09 EFFECTIVE l(v c `1 DATE b • . 1 YOUR E-MAIL ADDRESS i® SITE ADDRESS 116L � �k Tr"Q_ 0 e - THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME: (ri O V:S \ l3 SUBMIT A COPY OF STATE LICENA # a o b a sg'0 1 EXP DATE 0.3 �� � 0 YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: P, \0 10, �V� U a.; ��- � CITY \y �O� STATE �IA)ZIP S''4LA INSURANCE PHONE (� 12 , a31 - 'S O FAX PROPERTY TYPE PrSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑� ❑ DRAIN TILE �ROOF ❑ DECK D r, S-IDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR @-REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SID G FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl flit ADDITIONS. & PORCHES SUBMIT: 13 Aluminum im I. Site Plan/Survey showing the existing structures ❑Other Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF, WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ l000 OCCUPANCY TYPE Permit Fee $ 13qT5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ '1 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ S $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1 4;1.4 -1 Make checks savable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinancd des the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicatioLf p it a d work is not to start without a permit on site; that the work will be in accordance with the approved plan in the cas ow is uires review and approval of plans.SIGNATURE OF APPLICANT ` PRINT NAME k A u�Y