The URL can be used to link to this page

PRE 2010 DOCSSUBJECT PER NO. City of Fridley 0 18420 AT THE TOP OF THE TWINS BUILDING PERMIT 'r ` RECEIP COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i 1 � ; CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/8/86 10B ADDRESS 117 - 76th Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6/6A 1 Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3rd Generation Construction, Inc. 10026 University Avenue N.W., Coon Rapids, MN 3 CONTRACTOR MAIL ADDRESS ZIP LICENSE NO. Same 784-4134 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 a 26' x 40' Dwelling; a 20' x 20' Gara e _T" 'EQUIRED FOR WIRING, HEATING, PLUMBING AND SIGAIR 9 CHANGE OF USE FROM TO STIPULATIONS Provide sod in the front and side yards. Provide City with copy of verifying survey before capping.. Provide a hard surface driveway. Check to make sure proper drainage is provided for walk-out; submit elevations for approval. Paid Park Fee of $1,500.00 SEWER LOCATION: "Y" 94' West of Manhole WYE ELEVATION: 852.63 TOP OF FOOTING: 855.63 Minimum Elevation WATER LOCATION: Same trench as sewer. WARNING THE CITY OF FRIDLEY DOES NOT GUARANTEE THE Before digging calf ducal ACCURACY UTILITY OF LOCATIONS AND ELEVATIONS. util TELEPHONE-ELECTRIC-�,q� THIS DATA IS FOR INFORMATION PURPOSES ONLY, Et E�C, PERT USINGTHE THIS INFORMATION SHOULD REQUIRED --AND ON 0VERIY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 l 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 $33.68 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $67,350 DOES NOTPR SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE OVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $337.00 $475.00 S CTI O THE P ORMANCE OF CONSTRUCTION. PLAN CH,FCK FEE 84.25 TOTALFEE $929.93 + Park Fee I NATURE FCD iRACTORORAUTHORIZEDAGENT IDATEI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT BLDG INSP s1' SiGNATURE OF OWNER I IF OWNER BUILDERI (DATE) NEW �] ADDN. ] ALTER. [ ] Construction Address Legal Description:_ Owner Name Contractor: Address: City of Fridley R-1 AND -R-21 Building Permit Application Y -- I Effective 4/1/86 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length C>? Width — ! Height - Length �S� Width Height /U Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ Ft. Yd. Setback J U Side Yard Setback � /`� Type of Construction: �\-w AA01f'\_ Approx. Completion Date: 3 m622 -EA Proposed Driveway Width If New Opening Is Desired: Estimated Cost: Alt. A Alt B See Back Page for Explanation DATE: 511? APPLICANT: -JoILIA,' C-ef'?C� rS C =- Tel. # Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: IL�& CITY USE ONLY $ 711)0 UU Fee Schedule on Reverse Side $ q 25% of Building Permit Fee $ 33. $.50/$1,000 Valuation $ 40) 5100 $475 per SAC Unit $ IT -40.0y_ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] $ A i �a� a ac�. Framing Area - 0- o4vL PAK SEGMENT PAGE RESOURCE SHEET # AA ,, J •~�•-�/V EX7'EItIOIt liNVr.LOPr. �--�� TIII:RM;.1. TrnN r •� ,f t S_ MITTANCIs 103'- STANDARD WORKSHEET' ' Site Address- '7 - _... Doors Tv e h� Owner_.- 1 ContractorC�� r j�rlfC.f� '�j VvIT Phone. N "' 4':�'•-�' Date Architectural Draftinj Building Type (check one), ( ) One and Two FnMfJ-v DlJcllfnft•_ Assembly (Describe type -'.from Table 3 Area Aor --ghnij •1 I • 1 :tlrttlntinn, nI1 P'ar`t+ Insulated Area +(A-ValuejUx 2 �� ¢ j + Foundation Wind w4 tid rnmint+ AYA•, (62. Other (describe) 0_Sky] i211 s w � r'I,.... .. _Other (describe) M Other (describ'e) w Other (describe) `� C3 + Dc? _. 1 a1S_ 4 4 214 v 2 Avera gti-�a1,!��_(1L�1'L(1�) frnm i;.,.,1 tlr9Ftk*tkt@ �' } 3 _Required U -Value from 6 Required U -Value (from text).' --..— �. v' W7, 77 • 5 great Framing Area - 0- o4vL PAK SEGMENT PAGE PROGRAM Windows, •]'yPe D� � / 103'- • '7 - _... Doors Tv e h� ' 1 7 Rim Joist Area 1�57Z'-F Architectural Draftinj N j%TA 11 Foundation Wall (abo 152x.6 � •1 I • 1 Foundation Wind w4 .1 . Other (describe) d o Other (describe) w Other (describe) `� C3 + Dc? 4 Total l4 X -62'-i 1 U x`j0 5 fiver. .'1_ 6 Required U -Value (from text).' --..— **:i*** IA.line is Rreater.than Line 3 or line 5 great r e line 6 u 7 Area (Line 1) +Area (Line 4 •}- _l exte for enve ope.• a • a� & 1x/r xr• 1 •Hi •Ai(T inr+ + 0 9 Area (I,tne 1) x U -Value (Eine 3 a •x t:/t*9e:ie ***><* di 10 Area (Line 4) x U=Value (Litre 6) ;c >a*** w .-t " Lir_e. 11�Acrn 12ative U -Value Line 11/Linc 7. 4.1 i If line 8.is Treater than Line 11 fine R alter assemblies as required' so T PAK SEGMENT PAGE PROGRAM t ' 1 7 24 Architectural Draftinj Pak Forrn a • .. RESOURCE SHEET # rXTERIOR ENVI?LOPJ: STANDARD w6RKSI1IiL'T Assembly • G�� •yj ' Assembly tcri-�Ir:��. < ribr Phicknes nescriibc_ �Ihtekn•ti1' R-V•11u • _SSte Ca (S rd- Ins Interior f -Value (sce 'fable 2) --Tru-<13 •I'ot-.iI AsS-0I111IY 61'11C1'm;l E.:; I st.111('1 . ti;;uula y - ;1 u�. ::��1�1.1b u11) . , ,.., Interior f -Value see Table '2 F.�:torior f -Value 'see T.tl)le'2 Interior f -Value' (see Table 2) .jam• Total Assembly Thermal Resistarce Assembly U-Va Exterior- f-V.tluc (sec! Table 2) Total A:sscmblv'r.lermal Resistmc , ue (see1a a Enter on P.-1 e 1 .��._ Assem y -ave see a e Enter on 'care 1 his s '* y LL -Assembly - G �-d - -v -- t « �Z ,o —y4 ds 2.060 YZ_` _ Interior f -Value e: Table 2) Exterior f -Value see T;+ble 2) Ir.teria f -Value see Table 2). • (p Total Assemblv Thermal Resistance ,p Exterior f -Value see Table 2 Total Assembly Thermal Resistance Q •` U - Valu u ` s'semo y . - a ue see "fable- 1-nte- on Pas+e 1 Oct •• Assembly - _ Assembly a Material descri e) 1hickness R -Value Material (descri a) Tldcknes R-Vdlue 16. 6 V} 5`Z t •`r, Go g If (M) 1. I 361 Z t r f- -n ue ee Exteriorf-V�•1J.ue see Ta ].e 2 Table 2) ' .119 Interior .f -Value see Table Total Assembly Thermal Resistansea4z Exterior f -Value (see Table 2) _8 Total Assembly Thermal Resistance Assembly ;j -value r on We W�,e e T�ble 4-)' � ntc Assembly U -Value see '1'.1ble -76 (43 Assembly ii ( _ Material describes 111ic:ness K -Value Assemol Material S2" Tntrrior F-V;tlnc O.C.e1 :J:-Ible 2 .(o Exterior f -Value _ (o-1 e c 7 :n b l e 2) 'fort 1' AT:s��mh I �• '1'hrrni i l�ltr:ti i�- Incc 2 UNIT PAh Slcl;frll;N•T > PAGE 05 1 7 ^S 1 May 1;1]4 � escrz.le u c nes: - a uc Interior f -Value (sce 'fable 2) Exterior f-V;t]UL. (see Table ,2) •I'ot-.iI AsS-0I111IY 61'11C1'm;l E.:; I st.111('1 . ti;;uula y - ;1 u�. ::��1�1.1b u11) . , ,.., PROGRAM Architectural DialtinR Pak Fain+ CAUTION' �PROVIDE-NOTICE1OFLREQUIREDBSTRUCTURALILATERALTDRACING,DTHISNDESIGNI& SHEETS10 TOL FIELD,ERECTOR REQUIRED SPECIFICATIONS on sheet 10 are part of design. See appendix for joint details, cutting, etc. REACTIONS -57L LINEAL INCHES OF BEARING REQUIRED =0.072 TIMES OVERALL SPAN IN FEET FORCES TOP: -129L -112L BOTTOM: +124L +•85L FORCES DIAL: -24L +35L VERT: TRUSEB BRACING ARE- C SYMMETRIC BRACING -SHOWN-IS- FOR -MAX.SPAN NOT FOR USE AFTER 03/8'0! C R D S --------- DOUG -FIR -L MAX SPAN WEBS ARE 2x4 DOUG -FIR -L STND 2x4 M: C: 19% TOP BOTTOM NO2 23` 3" 26` 9" FOR WEB*SIZES SEE ALSO PLATING BELOW DN2 25` 6" 30` 2" NO1 26` 6" 31` 2" 2x6DN1 . 29` 0" " 34` 5 _ (�.-zs)/•q •T NO2 34% 3" 35% 6" T ' DN2 37`11" 40` O" N01 38% 3" 40% 0" 2x6DN1 41`11" 40` 0" 12 QOp NO2 44` 6" 40` e" F1 tJ' DN2 49` 3" 46` 8" ` N01 49` 9" " � 54` O" """•IV DN1 54` O 54 Oil = �• a- ... a o.tl... ' 2x10 =' - ��• NO2 54` O" 42` 8" •,.» '`-.��''" vz DN2 54` O" 49`11" ttL NO 1 54% O" 54% O" DN1 54` O" 54` O" _' _ '::'. "° 15 NO2 54` 0" 52` 3" .., =--� L• SPNJ DN2 54` 0" 54` O" N01 54` O" 54` O" �,► $'�j✓ .re,..._.."se :! �V.-zoyI�b DN1 54` O" 54` O" ' A=18 gauge plates; W=heel wedge; 3X512gS = 3X5g & 3X12gSOL (TYPICAL). =reinforced heel; FOR STEEP WEBS (55-85degrees TO THE CHORD) WITH DD, DV, DVD&PDD SINGLE PLATE JOINTS USE THESE CHORD BITES: 1. 5" FOR 3"&4"HIGH PLATES; 2" FOR 5"&6"HIGH PLATES; --------- ---------------------- P A N El - •C L I P P L A T E S -------------------------------- BOTTOM CHORD .. HC.. .. BCS.. TOP CHORD . TCS. .. PDD... WEBS .. S...... DD... . 2x4 14` 0" 3X5 3X5 2x4 14` 0" 3X5 3X5 14` 0" 3X1.5 3X4 2x4 18` 0" 3X6 3X5 2x4 18` 0" 3X5 4X5 18` 0" 3X1.5 3X4 2x4 231 O" 3X8 3X6 2x4 23` 0" 3X5 4X5 23` 0" 3X1.5 4X4 2x4 27% Ox4 311 „ 3X8 4X5 2x4 27` 0" 3X5 4X6 27` 0" 4X2 4X4 ?x4 34` 5" 3X8g 2x4 29` 0" 3X5 5X6 311 O" 4X2 4X5 2x6 40` O" 4X8 5X6 5X6 5X8 2x6 36` 0" 4X5 5X6 36` 0" 4X2 4X6 2x6 54` O" 2-3X8 5X6 2x6 41.`11" 4X5 5X8 40` 0" 4X2 5X6 9 2x8 54` O" 5X6 5X8g 451 O" 3X4 5X6 49` O" 4X3 5X8 DOUBLE CUT WEBS 541 0" 4X3 5X68 L=OVERALL SPAN in feet 1.000 PANEL CLIP COMPANY TOP LL 40 SPACING SLOPE SPAN TYPE CAMBER BOTTOM CHORD L/60 inches (313)474-0433 TOP DL 7 24.in 4/12 541 O" FINK 20T POWER KLINCHER 5x8x12 syp BOX 423 BOT LL 0 PLATE HOLDING POWER = 190psa FARMINGTON ,MI. INCREASE DATE DRAW NUMBEF- NDS 82: TPI 78: ICBO 2059 Criteria 48024 TOTAL 57 15.0% 03/24/84 FI-4-COMP-O� GERALD T. X* BRUNSWICK VE, S.. L®T SURVEYS COMPANY RAYMOND A. 6917 IDAHO AVEVEYNE N. GOLDEN VALLEY, MINN. BROOKLYN PARK, MINN. MINN. REG. NO. 4741 LAND SURVEYORS MINN. REG. NO. 6743 REGISTERED UNDER LAWS OF STATE OF MINNESOTA INVOICE NO. 7601 - 73rd Ave. No. 560-3093 F. B. NO. INDUSTRIAL — JUDICIAL Minneapolis, Minnesota 55428 SCALE 1" 30 t COMMERCIAL — TOPOGRAPHICAL CITY LOTS —PLATTING Urpyurs Trr ifiratr Q — DENOTES IRON DOUG PETERSONOtto Lot 6 and 6A. Block 1, OAK RIVER ESTATES We hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land and the location of all buildings and visible encroachments, if any, from or on said land. Surveyed by us this 5th day of_ May 19 86 1 \\ l Signed \ 5.00 COMPANY W14i k- ik 5 n—opl'-� ;�--_ fill +—� 111C 1 I ✓ CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Can Dryer RATE TOTAL $ 20.00 $")0-0,0 $ 10.00 $ 1&.60 $ 10.00 $ $ 10.00 $ Air Conditioning (all sizes) $ 10.00 $ All Others/Repairs and Alterations It of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Work $ State Surcharge $ .50 TOTAL !EE Reinepection Fee ($15.00) $ Rough Insp. Date Final Insp. Date p Approval for Permit 019 MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE Attach stack verification fora with replacaent furnace permits *Air Conditioners can not be placed in side yard without written pccsission frco adjoining neighbor. Job Address b l / — 710 ) Department of Buildings, 6131 University Ave. N.E., Fridley, HN 55432 City of Fridley Tel. 1571-3450 The undersigned hereby stakes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley. Minn. 5'Q C' , 19,� OWNER c Lo rk� e��J_ J�0 !9 KIND OF BUILDING t9� USED ASd- TO BE COMPLETED ABOUT � 64 ESTIMATED COST / 79C/ Q / OLD - NEW BUILDING PERMIT NO. PERMIT NO. a DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS. nSteam, Not Nater, Macs Afi W.r� W� ha P�12 Trade Name (iLi 0-r,I `0-ICm Bise No. 54 6S-07 ee — Capacity ?&0Sq. Ft. CDR BTU �5' WC)I __HP � Total Connected Load Kind of Fuel N BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU )� NPD Company Signed By "x41U Tel. No. HEAT LOSS -CALCULATIONS DEPARTMENT OF BUILDINGS 2JR-is A.S.H.V.E. c Guide 11 . onstruction No. S Reference Out. Wall Int. Wall Ceiling Roof Floor To 19— --z -/ G. IT CITY OF Insulation Kind How Applied*;r-�.',., Room I Lenitth 1 'Width 10 11 3 '�,' F1.1 be -A 16A*i- Room I Length Width IV V7-- Vrindows and Doors—trackage and Area WWth Ight N% of Lineal ft. Area of pane !Irepanr lights of crack sq. ft. - ; ? q g), e 5 L - — Coefj `19 Coef. Btu "tration Btu q1' - X" loh Class1q, / 39, ID SSD F: wall �q(, 3.r. a q 9'4 Virexo. wall PAT, C' booa- N, "Jid emp. wan to v P qz Int. wall Int. wall 000r, Li (D Ceiling kcaling ��Tnw Btu. 1179 :1 S-9 2) e— �' sq. IL E.D.R. or sq. ins. W.A. Leader area q 01 1 +;: L,/L Room lLength /9 Width f�- / -7 Height �Y,'-4V'mdom and Doors—Crackage and Area ppryWidth Height No. of Lineal ft. Area of Vane of pane lights of crack sq. ft. 3(- Coef. Btu 6q (0 (a F-9.0 �;'F=P-' wall Net cm. wall q "LL wall ,Ceiling 273. 2,6(o –cj?A(j-, i A C Pe- 1 '70 9 -7 -e- ["TOW &1L �!Itewsbvd sq. fL E.Da or sq. ins. W.A. Leader area I /q,7k10L, M,' VIA. V. r h D Rrinm I Lencrth D J Width ]A- HeiahtV rl`llli�'Mmlowz and Doors—Crackage and Area V Width Haight No. of L16 Ll tt. Area Of PLO@ of pane lights Of crack sq. ft. Ft , Coefj `19 I Coed Btu ["Umtration qls q J6 '70 Glass I z, Z 12- 9' 3.r. a 41q4 L�'EmL way Net exp. wall N, "Jid emp. wan to 2--7t. qz Int. wall Int. wall Ceiling kcaling 1179 :1 S-9 2) 0'.' -Floor 1 -2- '?'1 1-2 1 f�- / -7 �&ToW Btu. N "u" , L, .,P.eq cmd. sq. ft. E.D.R. or sq. ins. W.A. L Windows and Doors—Crackage and Area V Width Iteight No. of Lineal It. Area No. of pane, of pane lights of crack sq. It. —zo q1 lo, 20. -Y/2.Q Coefj `19 Infiltration JCoef. Infiltration Infiltration qls q Glass Glass I z, Z 12- 9' 3.r. a 41q4 Exp. wall Net exp. wall Net exp. wall to 2--7t. qz Int. wall Int. wall Ceiling Ceiling 7-9(o 7-,! 6 (5 j&)00 Floor '!� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 2r -a M-1 Pdl, 6---,-Poorn I Length 10!)— Width )i? Y-z-Hd" Windows and Doors—Crackage and Area V Width Helgh t No. of Ll -al ft. Area No. of pane of Pa.s lights of crack .4. tL Coefj `19 Infiltration Coef. B1 Infiltration 2-o.4 qls q Glass I z, Z 39,a Al Exp. wall Net exp. wall to 4-0 Int. wall Ceiling Floor '!� Total Btu. V Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 13�6z FI -1 Room I 1---nath width Hei" Windows and Doors—Crackage andArea Width Height No. of Lineal It. Are& No. of Pane, of pane lights of crack sq. tL Coefj `19 Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor 11 Total 13tu. I - -. -Required .sq, ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT qCity IS r_____ COMMUNITY DEVELOPMENT DIV. INSPECTION PROTECTIVE SEC. 1 � il ,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 7/15/87 JOB ADDRESS 117 - 76th Way N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6,6A 1 Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerome/Mary Boedigheimer 117 - 76th Way N.E. 574-1463 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER z` MAIL ADDRESS ZIP PHONE LICENSE NO, 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEWJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 141 Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notation on plan WARM Before d1gftTjjj 4b�! bt4j.'fia TELEPHONE ME IC - GAS Ete, UPAPATR RAMITS" AEOUIRE1231 r6p REQUIRED BY LAW WIRING, HEATING, PLUMBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,950 $.98 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. $32.50 LAN CHECK FEE TOTALFEE 8.13 $41.61 SIG RE OF ONT CTORORAUTHORI2EDAGENT IQATEI HEN PROPERLY VALI D THIS IS YOUR PERMI ^1--5-^ • ' 13LDG INSP ll �Y DAVE S1 NA R F OWNER(IF OWNER BUILDERI IDATEI NEW [ ] ADDN. [ ] ALTER. [ ] City of Fridley �R-1 AND R-21 Building Permit Application Construction Address: Legal Description: Owner Name & Addre Effective 4/1/86 Tel. # — J 14z'�' -3 Contractor: v Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Groundo Sq. Ft. OTHER: XG . C-- q0 Corner Lot [ ] Inside Lot ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: eAy_�p Approx. Completion Date: �i7AI— 31 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: APPLICANT: Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Char QT T10TIT AT CITY USE ONLY =I Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering lq ;o 01- ON10 -'O� Oe, rj GERALD t COYN@ 800 BRUNSWICK AVE L. GOLDEN VALLEY. MINN. MINN. REG. NO. 4141 INDUSTRIAL — JUDICIAL COMMERCIAL — TOPOGRAPHICAL CITY LOTS — PLATTING LOT SURVEYS COMPANY LAND SURVEYORS >{NeipTi M V=m LAW OF WA17 or IOTA 7601.73rd Ave. No. 88D-3083 Mme. Minnesota awe cnp��r� - �irr9,if�rtttr Lot 6 and 6A. Block 19 OAK RIVER ESTATES ;-�•of e, A RAYMOND A. PRASCH 6917 IDAHO AVE N. BROOKLYN PARK. MINN. MINN. REG NO. 6743 INVOICa No. 18860 P. 4 NO. 346-1 SCALE I" 0 30, Q — DENOTES IRON a�•�b I �9 z -T, vb y ut-. „/ L=11.45 5.00 We hereby certify that this Is a true and correct representation / of a survey of the boundaries of the above described land and the location of all buildings and visible encroachments, If any. from or on said land M$'IIBd f Surveyed by w this l.?thday of November ly 86 LOTO ,u(6) J,1;h1-1m i�� 4,2,// ort.0 Aus c 16 kiwq- CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 July 22, 1987 Mr. Dennis Wood Service Electric Route #1, Box 160 Rush City, MN 55069 Re: 117 - 76th Way N.E. , Fridley (Aff. #B087186) Dear Mr. Wood: I was called by the homeowner ,to inspect the electrical wiring at the above address. I was unable to gain entrance to the structure on July 22, 1987, however, it was reported to me that the air conditioner is wired incorrectly as there are fuses being blown when the unit is operating. I will expect the necessary correction work for the above noted problem to be completed by August 10, 1987 and a final inspection called for on the entire dwelling. If you have any questions on this matter, please leave a message for me at Fridley City Hall, 571-3450, and I will get back to you. Your pranpt attention to this matter will be appreciated. Sincerely, CLARENCE B. JORIMN Electrical Inspector CBJ/mh / CC: Mr. Darrel Clark, Chief Building Official `'' Mr. Bob Clauson, Electrical Inspector Mr. or Mrs. Boedigheimer CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 July 22, 1987 Mr. Paul Peterson 3rd Generation Construction Inc. 10026 University Avenue N.W. Coon Rapids, MN 55433 Re: 117 - 76th Way N. E. , Fridley Dear Mr. Peterson: It was brought to our attention that someone is now occupying the home at 117 - 76th Way. You have allowed this hone to be occupied without calling for any of the final inspections required by City Code. The plumbing and heating contractors must call our inspector to set up an appointment to perform the final inspections. The electrical inspector has written a letter to the electrical contractor to try and make arrangements with the homeowner to complete some corrective work and to call for a final inspection when finished. I was able to gain entrance to the dwelling last week and found the following corrections that must be completed before the Building Permit can be finaled: 1. The mortar in the fireplace is very loose; the joints must be ground out to at least 1/2 inch and then retucked. 2. The open web of the block which forms a brick ledge must be grouted full so water can not run in; there are three walls where this must be done. 3. The owner reports that they have experienced water leaking into the basement under the front entrance. This must be corrected. 4. Install a products of combustion fire/smoke detector in the basement. 5. Install joist hangers on floor joist that run perpendicular to the basement stairway. These items must be corrected before we can give the home final approval. I will reinspect for these five listed items on August 10, 1987 when I will expect then to have been completed. Any corrective work on the other phases of construction (mechanical, plumbing & electrical) must also be completed by this date. July 22r 1987 3rd Generation Construction Inc. Re: 117 - 76th Way N.E. Failure to complete these items may result in the City Attorney for his legal consideration. this matter, please feel free to contact me a Sincerely, DGC/mh Page 2 t this matter being referred to If you have any questions on 571-3450. �D EATING PLUMBING, INC. Heating Air Conditioning Plumbing 6011 LONE OAK ROAD • ROCKFORD, MINNESOTA 55373 • (612) 477-5505 September 11, 1987 City of Fridley Civic Center 6431 University Avenue Northeast Fridley, MN 55432 Attn: Darryl Clark and/or William Sandin Re:117-76th Way,, Fridley 47 Lr. Gentlemen: K & K Heating and Plumbing, Inc., did not do any finish plumbing, venting or heating in the 3/4 bath for the above address. Nor did we do the wiring of the A/C system. Enclosed is the check for the permit for the A/C system, in the amount of $20.50. Also enclosed is the permit application. Sincerely, Robert Willette, General Manager RCW/sa Enclosure PURCHASE ORDER PURCHASED BY / THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F 11505 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US SUPPLIER 7- a). /��s,9� ^^��L-��e. ��. rl _ ADDRESS ��B °,2 � "' /� `� �i�-y � ��.i 'Ec //�� _ L -e UFJ� , O/ AJ ZS-iaU CITY OF JJ1 ''gl - //q3 FRIDLEY PHONE NO. 4 6431 UNN. AVE. N.E. �1 FRIDLEY, MN 554324384 CONTACT o �C7/{7•9 S l�#i LaSA� 812-571-3450 PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOL1WED IN THE P MENT OF THE BELOW STATED,�I . M �. eAA'UWTH0!FUZE0 BY ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE AMOUNT Q AC 00 55 S, J TOTAL THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. EXEMPT FROM SALES TAX AS A POLITICAL SUBDIVISON OF THE STATE OF MINNESOTA CITY OF FRIDLEY NO. 8030301 WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. FA SUBJECT P City of Fridley 29672 AT THE TOP OF THE TWINS BUILDING PERMIT r • ------ COMMUNITY DEVELOPMENT DIY. I ; V INSPECTION SEC. r I � PROTECTIVE NUMBER REv DATE PAGE OF APPROVED BY I 1 CITY HALL FRIDLEV 55I32 �'' 612-571-3450 910-F15 6/11/99 JOB ADDRESS 117 76th Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 & 6A 1 1 Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerome Boedi heimer 574-1463 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Suburban Exteriors 9701 Penn Ave S Ste 1881-82*12 4289 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION ®X REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 28 S Tear -of 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 SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2447 $1.22 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• STRUC ION OR THE PERFOR NCE OF CONSTRUCTION $83.25 Fir SC 2.45 PLAN CHECK FEE TOT EE •��`� Li ce 5. DO 1 92 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI EN R P VALIDAT IS Is Y UR P MI t r ! DA S�GN4IURE OF OW NERiii OWNER BU4DERI --DATE I Bl INSP FA .8 1 - IC) NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEYt ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION _ a Construction Address: Legal Description: c -� Owner Name & Address: Tel. _ i'� �,� „� „��2, Tel. #_,'� Contractor: _ ,�_o,�:�.L�,� �,-�. �_.Lt, i �� MN LICENSE # Address: !0 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT 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: �� -� ' �<� �. Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: IC r ' Cj' APPLICANT: �=�, � \ �.�'1r�, � �_� Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge 0 0611 K11 I STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 bniversity Ave NE Fr5&y, MN 55432 572-3604 L4 1l-00 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On �an-1, 2000 • �Q' __ � e.`Q � New Fixtures � �4• . , •• F^`St` ��e�g_ — riY•[-ice ,._. _ __ -_._-_- - ing ME $ 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 PLUMBING FIXTURE RATES: 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 $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge JOB -ADDRESS 54NI - t e- - a mi✓ I 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 BOEDIGHEIMER, JEROME I fb .2000 117 76TH WAY NORTHEAST FRIDLEY, MN 55432 Owner _ (763) 574-1463 Building Used As �k61ps;p cz 1 Estimated Cost PERMIT NO. I PLUMBINGCOMPANY oet=M FLUAla&j SIGNED BY�---- TEL NO.�jI �"(5Z`�C? S-5 Approved By Rough -In Date Final Date TOTAL FEE $Z1550 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.. COMMON VENT INFO ON BACK SIDE elAoffi GIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 September 11, 2000 Jerome Boedigheimer 117 76 Way NE Fridley, MN 55432 Re: Final Inspection 117 76 Way NE Contractor: Norblom Plumbing Co. Dear Mr. Boedigheimer: A plumbing permit was issued on June 26, 2000, for the above noted address, to install a gas water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, CITY OF FRIDLEY INSPECTION DIViSION 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 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 2000 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Allied Fkesidt dba Fireside Corner DATE License #20090911 2700 N. Fairvlew Ate. HEATING CC QQMjH1& uw +W 51/633-2561 Signed 11e� ,. �� TEL # Rough -in Date Final Date JOB ADDRESS // / 1&17, (,cJ OWNER v ,; Rate TOTAL BUILDING USED AS sr 06h�&-_e $ 30.00 $ ESTIMATED COST PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ Fuel Total Connected Load Burner Trade Name Size No. $ v� BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Allied Fkesidt dba Fireside Corner DATE License #20090911 2700 N. Fairvlew Ate. HEATING CC QQMjH1& uw +W 51/633-2561 Signed 11e� ,. �� TEL # Rough -in Date Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat. Appliance #3 Type BTU Input Fan Assisted or. Nat. Total Appliances Total Btu Input Common Vent Type Vent Height op Diametar r , -` "Mches Appliance #1 Vent Connector Height ft Length ft Diameter in""pe Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : AIA78 Building BUILDING Permit No.: - q/ Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE YOUR E-MAIL ADD S i4 SITE ADDRESS THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: e� P --t 3 N & CITY r ADDRESS: l 1-7 STATE IP SS TENANT '~%O PHONE: W2- ZvL —�24 CONTRACTOR NAME: STATE LICENSE # o EXP DATE 3 L.0 CITY G-AAVA,4 STATE—N&Py554Z7 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 2 WITH APPLICATION PHONE 3- — 8 426 FAX PROPERTY TYPE >2MINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAIINTENANC ./REPAIR ❑ REMODELING 21 r DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WID HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑soffit ,/ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS Ves ❑No LOCATION OF WINDOWS 3. Energy 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 $ i 1. 82,Z OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 3i $ S9/ $ i�%• $ °�•�� See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation —Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) —ft +6 ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and 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 requires^view ir4val of plans. cl 1 $I r / SIGNATURE OF $ T qiF, See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation —Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) —ft +6 ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and 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 requires^view ir4val of plans. cl 1 $I r / SIGNATURE OF JAN 11 2006 1:03PM HP LASERJET 3200 P•2 r Building MECHANICAL Pex. Lit No.:. UC -2 Inspections RESIDENTIAL APPLICATION Res, eived By- tZO 763-572-3604 CITY OF FRIDLEY Dme Ree'd: DATE I I i lLg 105 YOUR E-MAIL, ADDRESS Sutcharge SITE ADDRESS -7 U r - $ THIS APPLICANT IS: DOWNER %CONTRACTOR PROPERTY OWNER/ NAME.. _ C -j= ' C-1^_%^ A a , Ci I SOr �r,�1 ADDRESS: 111 1 %0 ' LjLi Gl ut N CITY Erid I&c,t 3TATEMZTP" TENANT PHONE: EPra COMPANY NAME: t CONTRACTOR SUBMIT A COPY OF CONTACT PEON: r'S ,� k►e.Q—. YOUR STATE STATE LICENSE 0 EXP DATE ,,�,,.,�� rj STAT]��+E�1 ZIP7 LICENSE 1]i►ITH ADDRESS: i CrrY APPLICATION PHONE I&B-3-8 -i 13 FAX, 2(p,3'383" UiGLE FAMILY 0 TWO FAMILY O TOWNHOUSE PERMIT TYPE 13 NEW PLACEMENT 13 ALTERATIONIREMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK 2W 10.. PER MS 16B.665 the permit fee is a minim am of $15..00 or 5% of the total cost np to $500.00, wbiebever is greater, for the improvement, installation or rephMment of a residential fixture, excluding the fixtures. (This should refle;A only the cost of labor ) Labor cost under S300= $15.00. Labor cost between $300 to $500 =cost of labor x.05 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ONS] 0.00 PER FDa URE, EXCEPT WHERE NOTED. FECrURES: gNDICATE TOTAL NICER OF EACH BELOW) MODEL: 8 BZEMTU Equipment Installed WO: MODEL' 5 BTU l` imse, crai R>y C-hf #- S pZEBTU OAS RANIMOVEN $10.00 NEW GAS GRILL $10-00 GAS UNIT HTk 510.00 POOLH&o.TERS35.00 VENTILATOR $15.00 Number of fixtures @ $10.00 MFG lMFG:: MODEL: 523.00 FIREM ACE (OAS) $15.00 _LA/C AIR TO Amit EXCHANGEER $15 _FRUM ACE (WOOD) $35.00 BOILER 535.00 FURNACE $35.00 CHIMNEY LINER $10.00 GA S DRYi+dt 510.00 GAS PIPING 510.00 DUCT WORK $10.OD Permit Fee $ _SQQ•m Sutcharge 50 TOTAL DUE $ l` imse, crai R>y C-hf #- S pZEBTU OAS RANIMOVEN $10.00 NEW GAS GRILL $10-00 GAS UNIT HTk 510.00 POOLH&o.TERS35.00 VENTILATOR $15.00 Number of fixtures @ $10.00 x $10.00 - $ Number of fixtures @ $15.00 x $15.00 = $, Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.0C x $35.00 = $ S pate Surcharge �$�50 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 acuate; that the worst will be in conformance with the ordinances and codes of the City of Fridley and with the Mknesota Constracttion Codes; that -I understand this is not a permit but only an appli 'on 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 a]1 ork which review and approval of plans. j� SIGNATURE OF APPLICANT PRINT NAME 4YI S r� DAL'E %�D City of Fridley Building Inspections Department 6.431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977