PRE 2010 DOCS01
SUBJECT
City of Fridley
FT�ro
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECE NO.
• COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
1 = �
CITY HALL FRIDLEY 55432
NUMBERDATE
PAGE OF
APPR VED BY
612-571-3450
910-F157RE
10/17/89
JOB ADDRESS 125 - 76th Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
1
Oak River Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Charles Westling 5536 - 7th Street N.E., Fridley 572-0823
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 381.x 261 Dwelling (61x121 Foyer); a 34' x 24' Garage; and a 16' x
eS/�lEPARAT�pE g �a
9 CHANGE OF USE FROM NYIRING,T6-'IEATINGs PLUMBING AND SIGNS.
STIPULATIONS Provide Sod in the front and side yards. Provide a hard surface driveway.
Provide City with copy of verifying survey before capping. Paid $1500.00 Park
Fee. See notations on plan,
SEWER LOCATION: 98' West of Manhole at center of cul-de-sac. Inv. Elev: 852.38
WATER LOCATION: 90' West of Manhole measured along sewer line.
Mini mv.,-�> 856.00 (of finished floor, lower level)
e`r,nS
Before dig";i n( C211 for THE CITY OF FRtI a .h' '-I_I,�>";'+N T FE TH"
all utility locations ACCURACY OF UTIL_IT`i I -I ---: .�_) '_E''ATIOINS).
41541-0002 THIS DATA iS t FOR INFR-0; ;r�ON,' f 1�;� USES ONL'Y'
@
B�/ LAW W AND PERSONS, IJ5'.ING INI OMOvIai10N SHOU'LE
VERIFY !T ON' T'1-112:
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 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 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
$80 000
$40 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
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$549.50
$575.00
STRUCT N OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
02,3 -i
E (0-2,3- i
A 1
$1164.50 + PF
SIGN URE OF CONTRACTOR OR AUTH ENT IDATEI`
N
W EN PR PE V LI ED THIS IS YOUR PERMIT
/04 9
LOG INSP SATE
SIGNATURE OF OWNER IIF OWNER BUILDER I IDATEI
01
NEW [ ]
Attach
Permit Fee
Effective 5/1/88
ADDN [ ]
$ /7/0,00
I-1 AND R-2
ALTER [ ]
$
Building Piermit Application
$ A, OD , 06
Construction Address:
A)w,,
legal Description:
40-r
Y7f K I Q'&x KrJli�
�TS�°flTs��
-
Owner Name & Address:
Contractor: _—ill
tag tJ L; -
Address:
Address:
1,;% n-t'f
- S 3 6 - '? i � ST-
T
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
nuc aN OF nM)VEM r
2- �F7sK
. ISVIlaG AREA: length _ _ Width Heid 2 Sq. Ft. i Lo 16
GARAM AREA: length- 3 L( width 2- L/ Height q Sq. Ft. F/ 4o
DECK AREA: length tp Width _� Hgt/Grm-d Sq. Ft. 1-(
Z
oma•
Conner Lot [ ] Inside lot [ 4 Ft. Yd Setback 5'0. Side Yard Setbacks ' 4 / z
Type of Constniction: o F,, -,g ms-- Estimated Cost:
Approx. CmPletion Date: ;rAj l S 1 v
Proposed Driveway Width If New opening Is Desired: _LL—Ft. $ $.
`'� Width + 6' See Back Page
DATE: �IAPPLICANI': +FiS . ly� S T` �f &, Tel. # 19-% 2 -oa Z 3
$-2.L' IZ
Permit Fee
$
State Sur&arge
$ /7/0,00
SAC Marge
Driveway Ess=ow
$
Park Fee
$ A, OD , 06
Sewer Main Qzarge $ --0-
- O
$a . S0
S'I'IPULATIMS:
CITY USE Oi�II�Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Emjineer; n
+ *r* Necessary [ ] Not Necessary [ ]
LOT SURVEYS COMPANY, INC.
LAND SURVEYORS
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
7601 -73rd Ave. No. 560-3093
INDUSTRIAL— JUDICIAL Minneapolis. Minnesota 55428
COM MERC IAL —TOPOGRAPHICAL
ur12EDrs C�Er#ifirtt#r
CITY LOTS — PLATTING
DOUG PETERSON
5ety" SVC qg W oF ftlamvie
G+Cen►cr
df -Ae.
iAv e)-ou: 8S'2.38
''••tt oo�� �" p
Vt/4�W �c(V17G 90 W ,�F /hPP�1OlL
/►iFosW-ed aB®-.+y a�ewyr l�v`�. O G
Lot 5f.Block 1, OAK RIVER
ESTATES
llrILrr-f 4 P=iwh e
i C-1-14
,T 1
0
1
INVOICE NO.
F. B. NO.
SCALE 1" 30F
O — DENOTES IRON
We hereby certify that this is a true and correct representa-
tion 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 23rdday of t!'n G' 19 86
CITY OF FRIDLEY
Effective Date May 1. 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
$ 20.00
$
20
Gas Piping
$ 10.00
S
l a
(piping needed with new furnace)
Gas Range
$ 10.00
S
Gas Dryer
$ 1Q.00
S
%6
• Air Conditioning (all sizes)
$ 10.00
$
0
All Others/Repairs and Alterations
11 of Value of Appliance or Work
S
COMMERCIAL/INDUSTRIAL
11 of Value of Appliance or Work
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Inap.
Date
Final Insp. / _ 6 Q
19
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
S
$ .50
$
Job Address Z 7 — I `^' A,
Department of Buildings, 6431 University Ave. N.E., Fridley. MN 55432
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.p
p Fridley,Minn. ( O- 2- 7 . 19 0 1
` 1
OWNER `�A�l �'S V • `�'E ST 1 ,-a Cr
KIND OF BUILDING 'n l-1 oM E — �2V +k V -
USED AS {2 S + a L L
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEN BUILDING PERMIT NO. Z a (' O PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Not Water, (ears Air No. P
Trade Name 44� 1 L. / q J 9% E f F Size No. S 5 M (>T U
Capacity Sq. Ft. EDR BTU !�S (U HP
Total Connected Wad Kind of Fuel , (o F1S
BURNER - Trade Name
Capacity Sq. Ft. EDR
Size No.
BTU HP
CompanyAJ L -/ r ✓/ ,, QI
Signed By ( / v GU.L ! 4tL—
Tel. No. -�--7Z'O0 Z3
Fill out back side for stack verification on replacement furnaces
CHIM14EY 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 ( )
5. Meets all current Code requirements for size and
total BTU connected Yes ( ) No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed By
Da to
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
Back Flow Preventer Required.
Type
NO.
RATE
$ 5.00
$ 3.50
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00
TOTAL
$ DD
$ oo
Yes ( ) No ( )
$ 5.00 $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
Effective Date May 1, 1988
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
(� `Fr1idley, Mn. (o 2 , 19�
OWNER \ 1-EPr2 L 6_'5
V W f ST (_ -J&
KIND OF BUILDING 4- O Vti %r� — �2�rrti� T
USED AS (c & G, 0 C- 0 G eS
TO BE COMPLETED ABOUT ( 1 9 b
ESTIMATED COST
OLD - BUILDING PERMIT NO. Z ( 6 PERMIT NO.
Company ()(J awl IC IC
Signed By�
Tel. No. S Z C-) D Z- 3
ROUGH INSP.
Date
FINAL INSP. (/
Da e
APPROVAL FOR PERMIT
PIINIMU-M FEE FOR ANY PLUMBING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
W
b
U
K
N
Water
mm
E
d
.11
tP
Heater
.0)
N
yy.��
N WO
N
m
N
al
p
po a
ani
m
m
�•
O
8
+� m43
e
a
.G
itl u
a
m
3
a w°
boi
w
v an
a
c�
o
s
lec
vi
1st
t
Z
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
Back Flow Preventer Required.
Type
NO.
RATE
$ 5.00
$ 3.50
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00
TOTAL
$ DD
$ oo
Yes ( ) No ( )
$ 5.00 $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
Effective Date May 1, 1988
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
(� `Fr1idley, Mn. (o 2 , 19�
OWNER \ 1-EPr2 L 6_'5
V W f ST (_ -J&
KIND OF BUILDING 4- O Vti %r� — �2�rrti� T
USED AS (c & G, 0 C- 0 G eS
TO BE COMPLETED ABOUT ( 1 9 b
ESTIMATED COST
OLD - BUILDING PERMIT NO. Z ( 6 PERMIT NO.
Company ()(J awl IC IC
Signed By�
Tel. No. S Z C-) D Z- 3
ROUGH INSP.
Date
FINAL INSP. (/
Da e
APPROVAL FOR PERMIT
PIINIMU-M FEE FOR ANY PLUMBING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
CiTYOF
FRIDLEY
CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450
February 27, 1990
Mr. Charles Westling
125 - 76th Way N.E.
Fridley, MN 55432
Re: Final Inspection at 125 - 76th Way N.E., Fridley
Dear Mr. Westling:
A final inspection was conducted on February 22, 1990 of the above
address and the following items were noted which must be completed
before the structure can be finaled:
1. Provide sod in the front and side yards by June 1, 1990.
2. Provide a hard surface driveway by June 1, 1990.
We will expect these items to be completed by the scheduled date
and a reinspection called for. If you have any questions on this
matter, please feel free to contact me at 571-3450.
Sincerely,
C::" alo
DARR L G. CLARK
Chief Building Official
DGC/mh
I /
SUBJECT
PER
City of Fridley
314 0
AT THE TOP OF THE TWINS
BUILDING
PERMIT
t
RECEIPT NO
_ COMMUNITY DEVELOPMENT DIV.
t INSPECTION SEC.
r � PROTECTIVE
t
1 . t
�•� CITY HALL FRIDLEY 55432
IL
NUMBEA
qEv
DATE
Of
AvagOvEO BY
.... J%,
L 612-571-3450
910-F15
10/ 13/00
FPAGE
/
JOB ADDRESS 125 76 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
1
Oak River Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Fred/Shirley Arbour 125 76 Way NE
763-574-2408
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Lundy & Company 6561 Fawn Lake Dr NE, Stacy, MN 55079 651-462-4637 7555
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
0 NEW ER ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Construct a 12' x 8' & 16' x 10' Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARNIMm-
RATE PERMITS
Before digging cell for
REQUIRED FOR:
all utility locations
WIRING HEATING4540002
PLUMSINd AND SIGNS
REQUIRELD Ina IV LAW
SEPARATE PERMITS ARE REOUIRED 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 A INED THIS APPLICATION
1
STALLS GARAGES
SAME TO BE TRUE AND FIRE T. LL PROVISIONS OF LAWS
VALUATION SURTAX
CES GOVERNING THI TYPE OF ORK WILL BE COMPLIED
$2,816 $1.40
PECIFIED HEREI OR N T. E GRANTING OF A PERMIT
U TO G VIOLATE OR CANCEL THE
PERMIT FEE SA HARGE
FS O LOCAL W REGULATING CON.
$83.25 F e SC $2.82
THE P F CONSTRUCT N
RS�GN
PLAN CME E O AL FEELic
L FEEACT
se SC $ 0 92.47
AOR AUTHORIZEDAGENT iDATE,
H PR LY VA ED THIS IS YOUR PERMIT
J! -64
B �NSPDAtE
SIGNATURE OF OWNER IIF OWNEA BUILDER. iOATE,
I /
NEW []
ADDN []
ALTER [ ]
Construction Address: `� 5
Legal Description:
Owner Name &
Contractor:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
(0(763)572
/1/2000
CITY OF FRIDLEY dg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
J .5'
5 J % Ll'r'4
v d` Tel. #
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length T� , -6 Width Hgt/Ground ,,__�__ Sq. Ft.
450W(6 01),yy
Construction Type:% W AF Z) Estimated Cost: $1
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$
DATE: O 4APPLICANT: Zd` r8a o
CITY USE ONLY - Call (763)) 672-3604 for Permit Fees if mailing In application
Permit Fee $ ?� Fee Schedule on Reverse Side
Fire Surcharge $ 001 of Permit Valuation (1/10th%
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ S, $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS:
I
SUBJE&
I
City of Fridley
7�'
3 662
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
J
r�J
j PROTECTIVE
E �
_
I 1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
''j 612-571-3450
910415
3/6/01
JOB ADDRESS 125 76 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
1
Oak River
Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Frederick & Shirley Arbour 125 76 Way NE 763-574-2408
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd,
St Louis Park, MN 55426 952-933-6300
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
City License
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION j7 REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping
rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
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 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$4,204 $2.10
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-
111.25 Fire $@4.05
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Ali
PLAN CHECK F TOTA FEE
117.40
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE,
HEN OP ALIDAT THIS IS UR P IT //j
�O
BLDG NSP r)ATE
S-GNATURE OF OWNEROF OWNER SUILDERi J ATEi
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FANIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 2 �1` -+�
Legal Description:
Owner Name & iA__d''dres : lz
Contractor:
Address:9 n�i i1o, rr
Tel. #
MN LICENSE #
H/VTel. #
Attach to this application, a Certificate of Survey owe
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF I NIPROVEMENT
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: ReAc",-M�MrX(I�U,� Estimated Cost:
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: ;1PFOl APPLICANT: C
Tel. # 4�
CITY USE ONLY
Permit Fee $ `/ e Fee Schedule on Reverse Side
Fire Surcharge t-/05' $ d .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1050 per SAC Unit
License Surcharge $ _. r�- $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ , Agreement Necessary [ ] Not Necessary [ ]
TOTALS -
11 -7", $
-- I=
STIPULATIONS:
If
.NE
■o
LOT SURVEYS COMPANY, INC.
^ LAND SURVEYORS
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
7801 -73rd Ave. No. U0-3093
INDUSTRIAL —JUDICIAL Minneapolis. Minnesota 55428
COMMERCIAL—TOPOGRAPHICAL 4,uriaegars Cler#ifirtt#e
CITY LOTS — PLATTING
1 Top of Block Elev. = 864.
Lot 51,Block 1, OAK RIVER
ESTATES
LJTI L. i T`f # VP1�11 ld�C .
�(�l`i ElJI
Sb•0 1 1
.eA a 1.4
':Z' f elr=> * . I—
INVOICE NO. 8543
F. B. NO.
SCALE 1" _ 301
O — DENOTES IRON
,
�/ " °tpo-000
4ild
We hereby certify that this is a true and correct representa- /
tion 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. Signed
Surveyed by us this 44thday of 19 —Raylond A Prasch, Minn. Reg. No. 6743
Custom
Home Builders Residential
AV%I
Uc. # 7555 Design & Build
651) 462 - 4637 Company
5/4 x 6 Custom
Decking Hand Rai
Cedar
2 x 4 Nailer Q
2 x 2 Cedar
Pickets
4 x 4 Cedar Posi
5/4 x 6 Custom Decking Ce
Lag Bolts -
2 x 8 Floor Joists 1
1(9'e6 e -
4x4 Treated Posts
Post Brackets--------
Grade
racketsGrade �<<
a
v
Frost Ftg 42" Below Grade
a
119
T
Uuu[.1 u u
Dbl 2 x 10 Beam ( Treated )
4x4 Treated Cross Braces (if
needed)
I=
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective April 1, 2004 I'd
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT - ��$I.
ILS
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range""
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance��
State Surcharge $ .50
TOTAL FEE $ LS.
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.
DATE: '!� 4a10 , 20,0'5_
OWNER l_/' -cc.(' /-t, c3 _ e --
BUILDING
BUILDING USED AS /C s � J h G---�
ESTIMATED COST
PLUMBING COMPANY.
SIGNED BY
Approved By
Rough -In Date
PERMIT NO.
TEL N0. 70
Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
777-
Wash
Floor::::
Auto.
:::::;:: Gas
Mit:_;:::>.:
Water Heater
stories
!.
-.......
:
Drain
s
.....Ran a
....'`•.,.........G
s
E ecShower
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range""
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance��
State Surcharge $ .50
TOTAL FEE $ LS.
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.
DATE: '!� 4a10 , 20,0'5_
OWNER l_/' -cc.(' /-t, c3 _ e --
BUILDING
BUILDING USED AS /C s � J h G---�
ESTIMATED COST
PLUMBING COMPANY.
SIGNED BY
Approved By
Rough -In Date
PERMIT NO.
TEL N0. 70
Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
4
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstru6tions,
and is securely supported and firestopped where required.
i
Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
Appliance #2 Type
specifications including sizing, length, number of elbows and terminatidn.
Yes (} No( )
The undersigned also verifies that the replacement unit is a listed assembly
BTU Input
and meets the current codes and manufacturer's specifications. This does
Total Appliances
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes () No ( )
Tf►e existing combustion air is sized and installed to meet the current codes
Appliance #1 Vent Connector Height
and manufacturer's specifications.
Yes () No( )
When required to install a new combustion air, it will be sized and installed
ft Length
to meet the current codes and manufacturers specifications.
Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
ft Diameter in Type
R is a listed assembly and meets the current codes and manufacturer's:
specifications. This does include AGA-GAMA Category I Central Fumice
V6nting Tables for fan assisted and natural draft appliances.
Yes () No ( )
15 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
Tctal Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter. in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :