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PRE 2010 DOCSSUBJECT PERMIT City of Fridley 33'78" AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 2/12/76 JOB ADDRESS 1640 - 76th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leigh Inv., Inc. 6305 East River Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S. J. Construction 6305 East River Road N.E. 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 X 8 DESCRIBE WORK I'TANT-- Construct a 44' x 24' Dwelling and a 20' x 22' Garage -OR NOTIFY THE FRIDLEY ENGR. N DIVISIO TO REMOVAL AND REPLACEMENT 9 CHANGE QF USE FROM "WISION SUM CIO"` T R7L RIVFway STIPULATIONSI Below k�tis �i�l"�.`dQ af��' r't�ved when final plat was approved by Council. Provide a hard surface driveway:"'rovide a verifying survey before capping. Provide sod in the front and side yards. SEWER LOCATION: (Approx. 10' Deep) 262' East of Manhole (E. Inv. 893.32) WYE ELEV: 896.18 TOP OF FOOTING: 899.18 Minimum WATER LOCATION: 10' East of sewer service NOTE: The City does not guarantee accuracy of utility locations. (�(d� _BEff digair;g call kcal r.�filitii � �p •� �,/ �'re 1-Q1( vVII\ING, Il_i.EPHdr't i C �nE - LELECTmlc - CAS E;x.. HEATING, PLUMBING AND SIGNS. REQ R TYPE OF CONST. OCCUPANCY GR U PANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 1056 +440 125,520 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, 16.62 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $33,240 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 OF $47.21 $350.00 OR THE PERFORMANCE 5,ONSTRULTION. ��`^ PLAN CHECK FEE TOTAL FEE j r -Ti C4:1 A) �° �� ®^'/ - I2 76 $413.83 SIGNATURE OF CONTRACTOR 0 A11 ORIZEDA T IDATE) HEN PROPERLY VALIDATED THIS IS YOUR PERMIT .A c!�r2' ry` s a -/Z -"� BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME :l/l, �,v'v--7 /,�/ G BUILDER: �,y ��i✓��'�� ems/ c+.tl ADDRESS: �`%�Oa� ' ,' 7- FIV �� ADDRESS: NO:. STREET:, A LOT: �wBLOCK: ADDITION: tQ6,"/ sWF77;_0-7 DT7F_r2.&�/9 c gF CORNER LOT: S INSIDE LOT: SETBACK: �� 1 SIDEYARD: Z / 6 to! Applicant attach to this form Two Certificates of Sun-rey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING a .Front: _Depth : -� Height: Square Feet: %? 5 � Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: C7 0Type of Construction: /W-,gM c Estimated Cost: To Be Completed: - 7 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 h"s application are true and correct. DATE: SIGNATURE (See Reverse Side For Additional Information.) ass A�fP © ae"01oE T� W l ew m air �'Q° GERALD T. YNE WI K 300 BRUNSWICK AVE S. SCH LOT SURVEYS COMPANY 6917 GOLDEN VALLEY, MINN. IDAHO D HO AVE N. BROOKLYN PARK, MINN. MINN. REG. NO. 4741 LAND SURVEYORS MINN. REG. NO. 6743 REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS INVOICE NO. 505'_ 5747 W. Broadway 533-9922 F. B. NO. iF9_3:. INDUSTRIAL — JUDICIAL Minneapolis, Minnesota 55428 COMMERCIAL — TOPOGRAPHICAL SCALE 1" p CITY LOTS — PLATTING 1llrliPJlliB lPttr�tl' O — DENOTES IRON .5C•t 'o . xcavation • F1 l'v .i i. L l� datu',1 tiv-IICIfP® RTANT- a. ,� .rn E�.. { �/ !`31v 140'nFY THE FRIDLEY ENGF � DIVISION REGARDING CURB �, `' r ]REMOVAL AND REPLACEMENT AT DRIVEWAY OPENINGS. "VISION SAFETY' CONTROL ZONE'" i OO iNOT PLANT OR PLACE ANY- - THING IN THIS AREA WITHOUT AP- - PROVAL OF THE CITY OF FRIDLEY. LI I FZE ® BY LAW' —' I { � Prr, Vii. ."_-y, i %��'m /'•%FL's ,�_ � ` �:' . j �N 1 ry N, �JII I S b We hereby certify that this is a true and correct representation 1 of a survey of the boundaries of the above described land and r' the location of all buildings and visible encroachments, if any, s �� r� �' • From o, on said land. Slgned Surveyed by us this ' day of Januar19 7F �LO ;SURVEYS COMPANY y Hsi- tiv-IICIfP® RTANT- { � 140'nFY THE FRIDLEY ENGF � DIVISION REGARDING CURB �, `' r ]REMOVAL AND REPLACEMENT AT DRIVEWAY OPENINGS. "-"5"' i 80on, d°f �'�b C3,1 10c,11WIffi8t' I"ELI:PHJNE *�� -ELECTRIC- GASt'& LI I FZE ® BY LAW' We hereby certify that this is a true and correct representation 1 of a survey of the boundaries of the above described land and r' the location of all buildings and visible encroachments, if any, s �� r� �' • From o, on said land. Slgned Surveyed by us this ' day of Januar19 7F �LO ;SURVEYS COMPANY y -�:j q�--) C9 e7 w 21 ;;> 1,6z CJ i (v/1.0� 13P / - 7�Q "7 .1 �50 7 �� -------------------------- C4 lU 3 .. 67Z a2 o 6"2- b �e x 002,40 o rya x 33 020,0 . ti mow PARTIAL RATE SCHEDULE PLVKBING FIXTME RATES: 006 RATE TOTAL Numb Fixtures ................ x s.Oe - e-) INAum Finture 01 e ning .. o . © . • . • . $ 51.50 $ .. New Fixture Oleg ming ........- o . % SL50 1 j{ Catch Baoln > ................... x 53as :- 'Water Heuer (Up to 99.000 BM) .... �..� : 13.00 S c New Ground Run Old Bldg • . • • • • • • • qD 4_® i B F4AYFa0 (04W. GAS MC. 5 GAS 111 TIXG rEEB: NO. RATE TOTAL lot 3 Fixtures • ............. • . • • Z : $200 $ Additioad IIWII a ............... z S .75 $ du Rause to 199. 0 BTU ............ x $5.00 i • State Surcharge $_50 & a . ti mow PARTIAL RATE SCHEDULE PLVKBING FIXTME RATES: 006 RATE TOTAL Numb Fixtures ................ x s.Oe - e-) INAum Finture 01 e ning .. o . © . • . • . $ 51.50 $ .. New Fixture Oleg ming ........- o . % SL50 :- Catch Baoln > ................... x 53as :- 'Water Heuer (Up to 99.000 BM) .... �..� : 13.00 S c New Ground Run Old Bldg • . • • • • • • • x $3.25 i Electdc Tatar deafer .............. a 52.00 5 GAS 111 TIXG rEEB: NO. RATE TOTAL lot 3 Fixtures • ............. • . • • Z : $200 $ Additioad IIWII a ............... z S .75 $ du Rause to 199. 0 BTU ............ x $5.00 i • State Surcharge $_50 AEU & ALTERATIONS-4Weir to Ceft YOfe■yrwn. ..... . e . o s o . s .. .... s.. • . o . •.. o S TOTAL a ey-off. e Via`/! The undersigned hereby mnkes opplication for a Permit ke tW wed hemi specified, &greeing to d® an work in strict accordame with the My M-dinmev and ruling of the Mpartment of . BufldlnM and hereby declares that W1 the Hect mid represqMitnuom stated in this appllcad= &To true and cou°ree% Fl0110F1 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 S. J. construction Inc. 6305 East River Road N.E. Fridley, Mn. 55432 TELEPHONE ( 612)571-3450 Re: Final Inspections at 1640 -76th Avenue N.E. and 1620 -76th Avenue N.E. Dear Sirs: On June 11, 1976, final inspections were made of the above addresses. The only item noted that was not complete was the installation of sod in the front and side yards at both addresses. We will expect this item to be completed by August 1, 1976 when a reinspection will be made to determine compliance. If you have any questions on this matter, please feel free to contact me. Sincerel , PON HOLDEN Building Inspection Officer 'wT10,V A U m 6 �rlg.�yl� SUBJECT PERM.I.L-N - City of Fridley 2 2 2 4 0 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. r � , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/19/93 JOB ADDRESS 1640 76th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrell Carlberg 1640 76 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sawhorse Builders 4740 42 Ave N, Robbinsdale MN 55422 533-0352 2382 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 KO ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 181 x 12t Addi,ti on p Relocate deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. Tv ARNING Before digging call for all utility locations 454-0002 REQUIRED 13Y LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 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 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 $17,710 $8.86 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- $189.00 Fire SC $17.71 STRUCTION OR TH PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE � � License SC $5.00 $220.57 SIGNATURE OF CONTRACTORPR AUTHORIZED AGENT IDATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI Ij J F 74 O i a B ! 'Al ��� i I X, p > IF -ell { I - P 1� Y t 1 1 I. AA x i- 1_. N fl I I lll y - JC� I l GEkAtQ T COYNE - •;tDLPi VA Y. NMI tNN ,y1't• lftIAL. - )VOICIAL ..7y5 PLA TING LOT SURVEYS COMPANY�@ i R 9 • 17 7 I 'if'+AyQs.A1%ii : LAND MRK, IKuaiL7 r LAND S01-tVr, 016 1RIMISTE1311D I)"FJt LAWS Or STATE or WaMIESOTA I.IC1;maBD BY 06DINAL409 Or CITY or WIbtbIL"OLIS Nbulleapoh'i, inncr-csia *tlrbeporz Certificate Raft 900F, St _ALE: I-000 f 1 Will li ' Ito 4-1 14 41 1 1\ ,---- - i 1 Will li ' Ito %ve evrehy certify that this it a irue end Corr*ef reprasanto+iOn of a $McVay of the be und9ries of 1t'i Sbao a dt%cr bc.4 r.• ape,' . .ed of the lorrelion of all f,.,.ldings, iT any+ ihery?.o, end all visible encroachma pit, if any. from or un ta,ii lend ih4 r.ivv, $ mad0 only in .0nne0'an wifh a +—igsgb I,.an —j— tiding placod on the props rtp and nc ha6f+:r, 1; „- �,.,•oa ... r,r to fbe hodor of ...h 100+49a9e any elber .nteret# acquired 6v roasoo of such martgage. 11 „ vnJer- �lot•d —c -meed no mor.umenls ha— boon plac*d for the purpota of 'wo614 g^lot NO or undafpcmtaets. =x r .}� �• ice` - /t ��r.uyea t. ,rs fhit -..-_ dey of IX T Sf.J {VE`t'S COMPANY �S :?-'T `r, , ET inF2ri '1=0—d 86n0—y ?Pd-- ;a. 1\ %ve evrehy certify that this it a irue end Corr*ef reprasanto+iOn of a $McVay of the be und9ries of 1t'i Sbao a dt%cr bc.4 r.• ape,' . .ed of the lorrelion of all f,.,.ldings, iT any+ ihery?.o, end all visible encroachma pit, if any. from or un ta,ii lend ih4 r.ivv, $ mad0 only in .0nne0'an wifh a +—igsgb I,.an —j— tiding placod on the props rtp and nc ha6f+:r, 1; „- �,.,•oa ... r,r to fbe hodor of ...h 100+49a9e any elber .nteret# acquired 6v roasoo of such martgage. 11 „ vnJer- �lot•d —c -meed no mor.umenls ha— boon plac*d for the purpota of 'wo614 g^lot NO or undafpcmtaets. =x r .}� �• ice` - /t ��r.uyea t. ,rs fhit -..-_ dey of IX T Sf.J {VE`t'S COMPANY �S :?-'T `r, , ET inF2ri '1=0—d 86n0—y ?Pd-- ;a. NEW [ ] Effective 1/1/93 ADDN CITY OF FRIDLEY ALTERbd SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Le 4C0 Legal Description: G' TS E_V_Ac C Owner Name & Address: 1"u� p Tel. # Contractor:G-W�. }p ��E '3u ► �.t�E MN LICENSE # 2'02. Address: 4 -140 42 tt° Amoy. U. 2o S a, kE Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length ! r°> %o" Width 1 Z -o " Height 8 '- " f Sq. Ft. Z 1 [,Q. GARAGE AREA: Length $ Width Height Sq. Ft. DECK AREA: Length $ Width Hgt/Ground Sq. Ft. OTHER: 12Z- V -,C- Lt:) Corner Lot iA,.. Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: f V,4_"e Estimated Cost: $— Approx. Completion Date: 0 - Driveway Curb Cut Width Needed: DATE: II 16 1 q (Cost on Back) Ft. + 6 Ft = Ft x $ = $ APPLICANT: �J G Tel. # Permit Fee $ f cqq 40 Fire Surcharge $ 12, 1l State Surcharge $ SAC Charge $ License Surcharge $ 5.00 Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: $ C;�20_ '!�7 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 10 Darryl Carlberg Date: 11/3/93 1640 76th Ave. Rev : 11/9/93 Fridley, MN. (per CPR & C/O) 55432 Job# 623 ------------------------------------------------------------------------ [] SCOPE OF PROJECT: Remove existing deck and relocate to allow for 181x12' family room addition, deck to be a "step" down from addition. [] Remove the existing deck and reinstall, as best as possible, in new location behind garage. 1. Remove existing patio door(throw) and install new oak jamb, princeton casing, and railing in existing opening. (Match existing as close as possible). * oak railing: * Oak shoe: * Oak newel post: * Oak balusters: * Oak rossette: 1.A Remove existing casing on service door in kitchen and replace with new Oak princeton trim, per CHANGE ORDER. 2. FARNORTH 2-2460 clad casement window, per CHANGE ORDER. * Rough opening: 214 1/1611x 514 11/16". * Glass size: 2411x6011. * Glazing: Low -E insulated glass. * Exterior finish: "white" aluminum clad. * Interior finish: Unfinished wood. * Jamb size: 6 3/411, due to new 2x6 stud walls. * Sash to open as per plan. * With wood removable grids. * No blinds or shades included in this contract. * Trim: Oak princeton casing, stained by owner. 2.A FARNORTH 60x60 clad casement picture window, per CHANGE ORDER. * Rough opening: 514 1/1611x 514 11/16". * Glass size: 6011x6011. * Glazing: Low -E insulated glass. * Exterior finish: "white" aluminum clad. * Interior finish: Unfinished wood. * Jamb size: 6 3/411, due to new 2x6 stud walls. * Fixed Sash. * With wood removable grids. * No blinds or shades included in this contract. * Trim: Oak princeton casing, stained by owner. 3. MORGAN 51x1' fixed transom, per CHANGE ORDER. * Rough opening: 511 5/1611x 111". (confirm) * Glass size: 541lx8"+/-. * Glazing: Low -E glass. * Exterior finish: Unfinished wood. * Interior finish: Unfinished wood. * Jamb size: 6 3/411, due to new 2x6 stud walls. * Fixed Sash. * With wood removable grids. * No blinds or shades included in this contract. * Trim: oak Princeton casing, stained by owner. 4. MORGAN 5068 AF wood prehung door w/ fixed transom above per C/O. * Rough opening: 4111 3/411x 718 5/811. * Jamb size: 6 3/4" due to new 2x6 stud walls. * Exterior finish: Unfinished door w/primed frame. * Interior finish: Unfinished wood. * Door swing as per plan. (if swing changes, adjust electric) * With wood removable grids. * No blinds or shades included in this contract. * Sliding screen door included. * Hardware: Lever to match existing passage set, w/ DEAD BOLT (key new deadbolt and rekey front entry deadbolt per C/o) * Trim: Oak princeton casing, stained by owner. 5. Existing doors and windows to remain, protect as required. 6. Remove existing hose bib and dryer vent, relocate per plan. [] Raise or relocate existing plumbing vent as required. 7. Use existing basement window for crawl space access. Install pegboard cover over existing opening. 8. Use existing basement window for new heating ducts. GENERAL NOTES [] Any yard damage REPAIR including trees, shrubs and all landscaping by owner. [] All painting, staining and decorating by OWNER [] Clean up of building debris at job completion by SAWHORSE. [] Heating and air conditioning by OWNER. A/C relocation of refrigerant lines and unit by OWNER. [] Floor covering by OWNER. [] Electric per contract: * ALL FIXTURES furnished by owner and installed by Sawhorse,if on Job at electrical finish. (includes exterior flood lights) * Switch and outlets to be "IVORY" color. * CABLE TV and/or PHONE rough -ins are by owner. Sawhorse will advise owner when to call for installation. * Any SECURITY SYSTEM repairs or additions by OWNER. * No DOOR BELL BUTTON relocation is included in this contract (door chime for basement jobs) * No smoke detector is included in this contract, but may have to be added depending on the condition of your existing detector. [] Electric per contract continued: Note you have been charged in this contract for: 5 - standard receptacles (wall outlets) 1 - fourplex outlet for entertainment area, confirm location. 1 - ground fault interrupter "GFI" receptacle 1 - standard light openings (no fixtures included) 1 - standard ceiling fan openings (no fixture included) 1 - standard switches 2 - standard 3 -way switches 1 - service mast extended to meet code 1 - elect.disconnect and reconnect for A/C (confirm location) Any changes to the above quantities will be charged or credited accordingly. Indicate any special receptacles needed for computers, entertainment centers, etc. and any special heights wanted. CITY OF FRiDLEY INSPECTION DIV, Effective On January 1;1993 6431 Unlverslty Ave NE Fridley, MN 65432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3644 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS l 6 7 o � 6 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correc ,1993 Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST 30c) PERMIT NO. 113.3 *Air Conditioning - All Sizes $10,00 $ All Others/Repairs &Alterations (LIST ON BACK) DESCRIPTION OF FURNAQE AN12 OR BURN R I% of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1% of Value of Appliance or Work ��_-----�. State Surcharge $ Fuel Total Connected Load Burner Trade Name g �.50 - Size No. TOTAL FEE ----- EDR MINIMUM FEE FOR ANY HEATINGXOO_�INGNENTILA i N REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00 Signed BTel No,2- PLUS THE $,50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By Rough -In Date _„_____ Final Date - AL` *Air Conditioners. can not be placed in a side yard without written permission from adjoining property owner. FiLL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney ,or stack: .1. Has been carefully examined Yes ( i No ( ) 2. Is free from rust or -deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( j 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 :D SUBJECT PERMIT NO. `21973 City of Fridley AT THE TOP OF THE TWINS g U I L D I N G PERMIT 'P RECEiPT­NO. COMMUNITY DEVELOPMENT DIV. _ L PROTECTIVE INSPECTION SEC. /%% "r CITY HALL FRIDLEY 55432 / NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 9t0 -F15 7/15/93 JOB ADDRESS 1640 76th. Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrell Carlberg 1640 76th Avenue NE 784-8616 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Fireside Corner 2700 N Fairview, Roseville MN 55113 633-2561 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 C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Install fireplace gas Heatilator GC 3Q0; Remove old fireplace 9 CHANGE OF USE FROM TO STIPULATIONS Follow specifications of testing agency. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING MOT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 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 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 $2 QQQ $l. QQ 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- $45.00 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License qC $5 0_ $53.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI W R P VALIDATED THIS IS YOUR GPERMIT ` dLDG INSP MATE SIGNATURE OF OWNER IIF OWNER BUILDER$ (DATE$ :D NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] �R-1 AND R-2 � `7 f ALTER. PC] Building Permit Application Construction Address: / 40 -76 Legal Description: Owner Name & Address: �a�2 �= ��- C PQ" Z;ayzC" l Tel. P 79 Contractor:D �� e- [[ 8l Tel . # 633 -ZS'6 Address: 2-7oo - I b0,J e SeYI 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: t.OTHER: Com£ & la S Tt/JiIQ Zo iZ Qi, e. e O 77/iA C44 csl0, Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: I /JS -rA c..`. N%S1 GA -15, JT9AQ!tA L%rEstimated Cost: $ 2-incDo, 00 Approx. Completion Date: 7— ZZ -9- % 3 Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B $ $ See Back Page for Explanation DATE: APPLICANT Tel._�33'Zv�6/ a�x7. L 3 0 CITY USE ONLY �-v v Permit Fee Q/ $ J ,IC- State Surcharge $ Q (? e, $ J n n Park Fee $ Sewer Main Charge $ TOTAL $ .� STIPULATIONS: Fee Schedule on.Reverse 25% of Building Permit l $.50/$1,000 Valuation $525 per SAC Unit Fee Determined by Engine Agreement Necessary [ ] T 5ivti�o�v da eve I��'n 3, T1e6Mt na*ne OVPepezeee 'ROUGH FRAMED OPENING 241/2" CHIMNEY WILL rr _ ROTATE 180° I 23%I I 11'/4" 5/8 A1�" 339/,e" 41 � 261/2' t-- 411b" 8'/18" ALL DIMENSIONS IN INCHES 36" —1►� 41" —� 136/9" MODELS DESCRIPTION GC300 36" natural gas, standing pilot, heat circulating fireplace GC300E 36" natural gas, electronic ignition, heat circulating fireplace GC300L 36" L.P. gas, standing pilot, heat circulating fireplace GC30OLE 36" L.P. gas, electronic ignition, heat circulating fireplace A T' kS LINE PASS-THROUGH Features 29,000 Btu input, 65% operating efficiency. Large sealed glass front. Five ceramic fiber logs. New HEATILATOR Flame Tech- nology (HFT). Top Direct Vent (TDV) with a 180 - degree arc of venting possibilities. Approved for bedroom installations. Flexible stainless steel gas con- nector with shut-off valve. Pre -wired for plug-in installation. A.G.A. Certified in the U.S.A. Warnock Hersey Certified in Canada. One-year limited warranty. Figure 1 44" MIN. MANTEL HEIGHT 38%" " 111s/is" PASS-THROUGHS Options Models Description BC10 Fan motor rheostat control CS200 Direct vent cap shield CV6 Vertical termination ca FO Fan kit, 160 CFM FS6 Firestop spacer RC4 Remote control(standing pilot) RC5 Remote control electronic ignition) RF6 Roof flashing TA1 Kit including termination cap, 90 degree elbow and VK24 TK200A Trim kit, antique brass finish TK200B Trim kit, polished brass finish Trim kits include five pieces of louver trim and one hood. Models Description VK5 900 elbow VK12 1' length ventipe VK24 2' length vent pipe VK36 3' length vent pipe VK48 4' length vent pipe VS4 Vent support WS6 Wall shield to ensure horizontal clearances NOTE: This information is provided for planning purposes only. You must consult the GC300 Series Installation Instructions (#17832) before attempting to install this decorative gas appliance. Installations/Room Placement The GC300 Series gas appliance can be installed in a wide variety of ways and will fit nearly any room layout. It may be installed in a recessed position, framed out into the room, or across a corner. The unit may be installed at a height which is level with the floor or it can be raised up from the floor to enhance its visual impact. Figure 3 illus- trates a variety of ways the appliance may be located in a room. This unit is also certified for installation in a bed- room. All models have a firebox visual interior area of 761 sq. in. Proper clearances to combustible sidewalls, as illustrated in Figure 3, must be maintained. Note: If optional Fan Kit (FK4) or Hand Held Remote Control (RC4 or RC5) are to be used, wiring must be done prior to finishing to avoid reconstruction. Safety Listings Certified by A.G.A. to Z21.50b-90 as a decorative gas appliance with direct vent which allows for installation in, among other locations, bedrooms, subject to local codes. All components are UL or A.G.A. Safety Certified. Certified by Warnock Hersey to C.G.A. 2:22-M86 as a decorative gas appliance in Canada. Also approved for bedroom application. All components are C.G.A. or C.S.A. Safety Certified. Mantels A combustible mantel may be installed at a minimum of 441, above the base of the unit. Figure 2 2 44" 1/2" MIN. i I I I I , II 11' 721/is" / 50Y5/16" I I MAX. ii REACH I i I e m m 1" min. 11' MAX. T �41 REACH T m 231/2" Figure 3 Airflow Chimney - Horizontal Termination The GC300 Series is energy efficient and maintains high indoor air quality. A sealed combustion system keeps indoor air from escaping out the flue while it uses outside air to produce a flame pattern that reflects an actual woodburning flame. Room air is warmed inside a heat circulator built into the fireplace and then distributed back into the room for excellent heat output. An interior air wash on the viewing glass keeps it cool and clear. Surrounds When finishing the unit, combustible materials may be brought up to the sides of the unit but must never overlap the black area. The black metal may be covered with non-combustible material such as marble, tile, stone, etc. NOTE: Air slots cannot, in any way, be covered on this appliance, as it may create a fire hazard. See Figure 5 for air slot location. 75 7?; Figure 5 JR SLOTS The Top Direct Vent (TDV) system of the GC300 Series serves as the "chimney" as well as the combustion air supply. Venting can terminate only within the shaded area shown below. The horizontal run of vent must be level or have a'/4" rise for every 2' of run towards the termination. NOTE: Any horizontal run of vent must be level or have a 1/4" rise for every 1' of run towards the termi- nation. Never allow the vent to run downhill. This will cause high temperatures and the possibility of a fire hazard. A 10" x 12" hole in the wall must be located so the pipe will run level and perpendicular to the wall. The height of the hole must be situated to meet all local and national codes and not be easily blocked or obstructed. The termination cannot be within 9" of an opening, such as a window or (X) 11' MAX. 1'4" MIN. (Y) 6' MAX. 50%" 1' MIN. Min. VENTING CAN ONLY TERMINATE WITHIN THIS AREA F 3' Figure 6 door, into the living area and must be 12" or more above ground level. This venting system is not designed to pass through a floor. After selecting the termination height, follow the cutting instructions in the installation guide. Use only pipe that is supplied with this appliance. Maintain minimum clearances or greater. Do not fill air spaces with insulation or other material. The outer shell of the termination pipe must protrude a minimum of 1" from the exterior wall while the inner shell of the termination pipe must protrude a minimum of 21/2" from the exterior wall. Each additional 900 elbow that remains horizontal sub- tracts 3' from the 11' maximum possible run. L,.. F o V E 1 Figure 4 Surrounds When finishing the unit, combustible materials may be brought up to the sides of the unit but must never overlap the black area. The black metal may be covered with non-combustible material such as marble, tile, stone, etc. NOTE: Air slots cannot, in any way, be covered on this appliance, as it may create a fire hazard. See Figure 5 for air slot location. 75 7?; Figure 5 JR SLOTS The Top Direct Vent (TDV) system of the GC300 Series serves as the "chimney" as well as the combustion air supply. Venting can terminate only within the shaded area shown below. The horizontal run of vent must be level or have a'/4" rise for every 2' of run towards the termination. NOTE: Any horizontal run of vent must be level or have a 1/4" rise for every 1' of run towards the termi- nation. Never allow the vent to run downhill. This will cause high temperatures and the possibility of a fire hazard. A 10" x 12" hole in the wall must be located so the pipe will run level and perpendicular to the wall. The height of the hole must be situated to meet all local and national codes and not be easily blocked or obstructed. The termination cannot be within 9" of an opening, such as a window or (X) 11' MAX. 1'4" MIN. (Y) 6' MAX. 50%" 1' MIN. Min. VENTING CAN ONLY TERMINATE WITHIN THIS AREA F 3' Figure 6 door, into the living area and must be 12" or more above ground level. This venting system is not designed to pass through a floor. After selecting the termination height, follow the cutting instructions in the installation guide. Use only pipe that is supplied with this appliance. Maintain minimum clearances or greater. Do not fill air spaces with insulation or other material. The outer shell of the termination pipe must protrude a minimum of 1" from the exterior wall while the inner shell of the termination pipe must protrude a minimum of 21/2" from the exterior wall. Each additional 900 elbow that remains horizontal sub- tracts 3' from the 11' maximum possible run. Chimney - Vertical Termination Framing Dimensions The GC300 also allows vertical termination, provided the The GC300 Series will fit a rough framed opening of 411/211 following clearance requirements are maintained: wide x 385/8" tall. The cavity depth must be no less than Height 40' from the base of the appliance, maximum 231/2". See Figure 7. 12' from the base of the appliance, minimum Run Every 1 ' of horizontal run requires at least 2' of vertical rise. (Example: A 12' overall installation height may offset as much as 6' horizontally.) Elbows Each 900 elbow on the rise (vertical -to -horizon- tal or horizontal -to -vertical) eliminates 1' of allowable run. Each 900 elbow on the run (horizontal -to -hori- zontal) eliminates 3' of allowable run. Available from: h,#, eanelator r V/2„ re 7 Electricity Requirements Electronic ignition models require a 110 volt line to ope- rate. It is best to include a second 110 volt line in case an optional fan is added later. Standing pilot ignition models do not require any electrical power to the unit in order to operate. It is best to run a 110 volt line to the unit, though, in case an optional fan is added later. This will avoid the cost of wall reconstruction later to add an electrical line. HEATILATOR is a registered trademark of Heatilator Inc. NOTE: Technical specifications and available options subject to change. Please consult the installation instruction provided with the fireplace prior to installation. Please consult local building codes prior to installing this product Model numbers available in Canada: CGC300E, CGC300LE, CGC300L, and CGC300. Heatilator Inc. / 1915 W. Saunders Street / Mt. Pleasant, Iowa 52W, / A HON INDUSTRIES Company 4 Form No. 71334A 4/93 T21GRI CITY OF FRIDLEY INSPECTION DIV. Effective On January 1,'1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS %447 RATE SCHEDULE The undersigned hereby mikes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner – rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correct, • �� �S �-� ,1993 Gas Piping (Needed with new furnace) $10.00 $ OWNER���P/� Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST P�' � PERMIT NO. I�L *Air Conditioning – All Sizes $10.00 $ • DESCRIPTION OF FURNACE AN12 OR BURNER All Others/Repalm & Alterations (LIST ON BACK) I% of Value of Appliance or Work $_Zzw— No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/industrial BTU HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ ,50 Burner Trade Name Size No. s� BTU HP EDR TOTAL FEE HEATING COMPANY 6'AJ'rJ1_% MINIMUM FEE FOR ANY HEATING/C0041NGNENTILATION REFRIGERATION/AiR CONDITIONING PERMIT iS $15.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By �2r Rough–In Date Final Date 2-1-0-2-7 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CH M Y ANO STACK VBRIFICATION The undersigned hereby verifies that the existing chimney or stack: .l. Has been carefully examined Yes ( j 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 ( i 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 List Alterations Beigg Done: HEATING COMPANY signed By Date SUBJECT PERMIT N City of Fridley(--2"2'2 7_ AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. 1 •� PROTECTIVE INSPECTION SEC. r � � 1 C NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 1/3/94 JOB ADDRESS 1640 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESAL 1 2 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrell Carlberg 1640 76 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Gary Nordstrom Construction 10510 Robert In, Rogers 553-1768 8832 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 [R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK HKANX Reroof Dwelling (20 Squares) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Provide adequate attic ventilation. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2,000 $1.00 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- $45.00 Fire SC $2.00 STRUCTION OR TH RFORMANCE OF CONSTRUCTION. PLAN CHECK FEE License SC $5.00 TOTAL FEE $53.00 ri J Mt4�_ SIGNATN&FCONTRACTORORAUTHORIZEDAGENT IDATEI WHEN P OPE VALIDATED THIS IS YOUR PERMIT BLDG If4qP GATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] Effective 5/26/93 ADDN [ ] CITY OF FRIDLEY _X#�R ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: '119{0 ��� Avg p�, if _ Legal Description: Owner Name & Contractor: Address: t . Tel. # _ MN LICENSE # Tel. # 55'3, I� 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 Z �0 Height GARAGE AREA: Length ?2 Width Z �t DECK AREA: Length,,__ --Width Hgt/Ground / OTHER: �? �� l T5-" - () r -F) C is Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [°Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:�Q,Q Estimated Cost: $ Zex-o Approx. Completion Date: o qq * .4, Qco7t_-�Z (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:` APPLICANT: Tel. # J53, I rl[o(S Permit Fee $ S CITY USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ p0 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Aft. "B" Above Erosion Control $ Conservation Plan Review $450.00 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: SUBJECT P City of Fridley 2 5 5 8 3 AT THE TOP OF THE TWINS BUILDING PERMIT r NO. COMMUNITY DEVELOPMENT DIV. 9 r PROTECTIVE INSPECTION SEC. mo 1 . , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/30/98 JOB ADDRESS 1640 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrell Carlberg 1640 76 Avenue NE 784-8616 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Renewal By Andersen 350 73 Ave NE Fridley, MN 55432 502-4777 20040630 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 7 windows in home with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Sleeping room replacement windows must meet the State Building Code. Install smoke detectors onall levels, adjacent to and in all sleeping rooms per the State Building Code. e 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 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 1 HEREBY CERTIFY THAT 1 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 $5,560 $2.78 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $112.25 Fire SC $5.56 PLAN CHECK FEETO FEE Lic C 5. 0 125.59 SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT IDATEI N ROP VALID THIS IS Y R PE;!PAJb SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI 8Lp & I F BATE Prepaid Plan Check $ Estimated Cost $ SIT Receipt # Effective 1/1/98 CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION ,J�O� Construction Address 1�A0 `� (��^ .yrC r4 C zoning Legal owner & Address OL1Q.Q, LL Ca Lfie r 1640 7b Alec i � JI'1tJ ST`F32. Tel# n4-8616 . CONMAC OR & ADDRESS ALA! AAMIeN = 73 e6g. 1* MOLid f(W S"L Tel# 502 • +-M Architect Reg.# Engineer Reg.# BUILDING CONSTRUCTION TYPE OF WORK ❑ New U Addition LI Alteration-Describe'(>tALIG— "� hllrfQdhtS JN ybme wu res kt er 1 r4Seolr W irJ port. OFC. AREA: Length Width WHSE AREA: Length Width 0= AREA: Length Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. APPLICANT -nM SCI4a44G Tel # %%' 2BJ ' VALUATION Date *3 •Z"1 •q 00 Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type Occupancy Group Air Conditioning (]Yes (]No Fire Protection Provided U Yes U No Performance Bond Amount $ See Reverse for Schedule Received U Yes U No Permit Fee Plan Check Fire Surcharge State Surcharge zA��Charge Erosion Control Park Fee Spec. Assessments $ See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th o) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1000 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary U Not Necessary U Driveway Escrow $ feet x $13.50/foot TOTAL $J'195 I ATTACH STIPULATIONS