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PRE 2010 DOCSCity of Fridley SUBJECT 44rAT CREC THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ` � CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/12/86 JOB ADDRESS 149 - 76th Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rosemary/Nick DeGroot 5640 East River Road N.E., Fridley 572-2068 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑� M X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIROVE El 8 DESCRIBE WORK a Construct a 40' x 28' Dwelling and a 40' x 24' Garage Before digging call 10c,,11 IELEPHONE - ELECTRIC - GAS Fir, 9 CHANGE OF USE FROM TO REQUIRED s STIPULATIONS provide a hard surface driveway. Provide City with copy of verifying survey before capping. Provide sod in the front and side yards. Final grade must meet the overall plat drainage plan. Paid Park Fee of $1500-.00 Paid Driveway Curb Cut of $297.00 on Rec. #22773. SEWER LOCATION: "y" 30' West of Manhole "Y" ELEV: 850.84 MINIMUM TOP OF FOOTING: 853.84 WATER LOCATION: In same trench as sewer.F JEPAR� � rE Av ` .. 146"R� THE CITY OF FRIDLEY DOES NOT GUARANTEE THE f p Q�j�R ry ACCURACY OF UTILITY LOCA�"IOWAND ELEVATIONS. ��R THIS DATA IS FOR IN 1AATION PURPOSES ONLY, NO AND PERSONS VMG fms iNFORMATIOIy SHOULD SIG 41 VERIFY IT ON ,THg SITE. 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 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 1552 + 960 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $35.45 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $70,900 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE -PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $475.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $346.00 CHECK FEE TOTALFEE �4 7PLAN $ 86.50 $942.95 + PF sG AT URE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) F WHEN PROPERYY VALIDATED THIS IS YOUR PERMIT BLDG WSP DAT SIGNATURE OF OWNER dF OWNER BUILDER) (DATE) ps LOT SURVEYS COMPANY, INC. LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA 7601 -73rd Ave. No. 560-3093 INDUSTRIAL—JUDICIAL Minneapolis, Minnesota 555428 COMMERCIAL—TOPOGRAPHICAL �urVe vrs CPrtifiratz CITY LOTS — PLATTING LrTIL(TY � =&IllQC-E (=CF7EME.I r Lot 2, Block 1, OAK RIVER ESTATES ,D INVOICE NO. Xe -543 F. B. NO. SCALE 1" = 301 O —DENOTES IRON G ,04 1tv �D 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 23r jJay of Ja%,e. 1g 86 t� Signed I t P� (f ( ff /I ° �t -t c t'9 l- o 0,71- t Al G t` I- z X S ,SPS' Wt -Zoz_ NEW City of Fridley Effective 4/1/86 ADDN. [ ] F R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: Legal Description: K/Qsy� Owner Name & Address: � .»tel �l!aZ` V � �e /JG' `� �O et Tel. # Tel. # Contractor: SC / Address: �llTf?• �-�I4 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 4t>) Width Height Sq. Ft. GARAGE AREA: Length Width � Height Z Sq. Ft. O DECK AREA: Length Width _ Hgt/Ground __L - Sq. Ft. OTHER: Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback State Surcharge $ 72�,S_14 SAC Charge Estimated Cost: $ Type of Construction: $ Ism • Sewer Main Charge $ TOTAL $ Approx. Completion Date: J^! t_, p Alt B Proposed Driveway Width If New Opening Is Desired: (� $ 0,ac) $ See Back Page for Explanation "//-y �7z/ DATE: APPLICANT: 4-�� Tel. CITY USE ONLY Permit Fee $ , q 6.00 Plan Check $ 436.5-0 State Surcharge $ 72�,S_14 SAC Charge $ 41)S%Zl o Park Fee $ Ism • Sewer Main Charge $ TOTAL $ Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $4.75 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 120)900 STIPULATIONS: ^^ e)tV�� CY'T07/ K3 Q FA VERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB L(C)CATION: OWNER/G(*iq?FtfteTE) Alld @ Cr,, jkU O t ADDRESS: �� %(p f I "y PHONE: A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area 2. Total door area 3. Total sliding glass door area 4.. Total fireplace wall area 5. Total wall framing area (average .10%) 6. Total net wall area above floor(average 90%) 7. Total ri_m joist area Subtotal: Total exposed wall area above floor 8. Total foundation window area 9. `total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA z o'�� B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I 3 44,p C. Determine the Total Exposed Roof/Ceiling Area as follows//: 10. Total skylight area ,3 6 � ^ 11. Total roof /ceiling framing area (10%) 12. Total net insulated roof/ceiling area 1112- GRAND l)2GRAND TOTAL EXPOSED ROOF/CEILING AREA s D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II S24 E. Determine the "U" value of each segment (1-9) and multiply by the area as follows: 1. 2 SD x fluff - 2. _ x flu" ®, 32 3. X "VU" _ 4. —_ x nun = 5. "' x "u" _ 6. x fluff o- 43 a = tl4' go 7. x ovule 8. x Ifu" _ 9. x fluff _ ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III 2� F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. 3 x fluff o - S'1 = Z 1.2 x 'lull 12. x "u" _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent of State Buildinq Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6p006 (c) 1. I. Add Item I ' 0 ® + Item II J. Add Item III Z - 444 + Item IV 6 -'3 = Z75- 714 K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. _ By: DATE: L, 46 'r tY .v: _1, h rYy r y s a-. Y m�. _Q.�.1G.. Tc.s.,_. .., 7+(`�4- ...�_.........�..-.•. .. ...._........a....,..__. _,,...... -. � a Sr qj a tom! , ro-i; i Ettectave Aug. 1, lyal CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT e N N m o U 4j a K w d Water e e 14 �e• Heater Ou�pp C M 8 .0 C H m 't1� m 1. e b~ U 'JM Ia ymy m qaq +Mei W W a� ao U aaiCa 3 A�myy f�a 3 GD Al 4 l7 8 leC � C I 3rd 4th (R) - Future Connection opening Connected with Sewer l') - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixture@ Old Opening, New Fixture Beer Dispenser Slow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 S 10.00 $ 10.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance Rei 6.4-- State Surcharge Fas S (515.00) TOTAL FEE TOTAL s�a $ Job Address Department of Buildings U City of Fridley Tel. 0571-3450 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 �jI ' ` �o Fr dley, Mn. % , 19 r I OWNER //..� KIND OF BUILDING USED AS _A - To BE COMPLETED ABOUT /O — 7 -- ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT 80. Tel. ROUGH INSP. Date FINAL INSP. ® �� Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE S.50 STATE SURCHARGE Rough Inep. Date - Final Inep. _&L -10 —V7 Date Approval for Permit � MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCILARGE Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written iw•rmission from adjoining migldwir. DESCRIPTION OF FURNACE/BURSTER HEATING or POWER PLANTS, �S,teem.1tte , Marta Ai'r- No. Trade Name )'�ii-4 ,� ite No. Ae ° tea CapacityCL1 Sq. Ft. BOB BTU HP Total Connected Load E Rind of Fuel BURNER - Trade Name w Site No. Capacity Sq. Ft. EOR BTU ^ HP` Company —1 JI�YC� Siqned lbByr— %� Tel. No. Kw��,1` �1 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE �f SESIDE1yTIAL RATE TOTAL Job Address Furnace Shell and Duct Work, (Also replacement furnace) $ Department of Buildings, 6471 University Ave, M.E., Fridley. MN 55472 Burner City of Fridley Gas Piping $ 10.00 $ 1C) Tel. 0571-7450 (piping needed with now furnace) $ 10.00 $ The undersigned hereby waked application for a permit for the work herein Gas Range specified aqreeinq to do all work in strict accordance with the City Codes Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application alt* true and correct. Fridlie�y, Minn. . 19 • Air Conditioning (all sizes) $ 10.00 $ ll II {� All Others/Repairs and Alterations OWNER (�qOL° J 6 6 1 It of Value of Appliance or Work RIND OF BUILDING Yf0t�t0± Cs COMERCIAL/INDUSTRIAL Y USED AS It of Value of Appliance or Work $ "-' TO BE COMPLETED ABOUT �. tq, P� ESTIMATED COST �l�\ w State Surcharge S .50 (� !'EE $� OLD - NEW BUILDING PERMIT NO. PERMIT NO. TOTAL Reinspection Fee ($15.00) $ Rough Inep. Date - Final Inep. _&L -10 —V7 Date Approval for Permit � MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCILARGE Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written iw•rmission from adjoining migldwir. DESCRIPTION OF FURNACE/BURSTER HEATING or POWER PLANTS, �S,teem.1tte , Marta Ai'r- No. Trade Name )'�ii-4 ,� ite No. Ae ° tea CapacityCL1 Sq. Ft. BOB BTU HP Total Connected Load E Rind of Fuel BURNER - Trade Name w Site No. Capacity Sq. Ft. EOR BTU ^ HP` Company —1 JI�YC� Siqned lbByr— %� Tel. No. Kw��,1` �1 l HEAT LOSS CALCULATIONS Weatherstrips A.S.H.V.E Guide Windows Doors Reference Yes—No I Yes—No 11 19— m I R......, I t ....t6 6 ADVANCED HEATING & AIR CONDITIONING, INC. 7805 Beech Street N.E. Minneapolis, Mn. 55432 Construction No. Out. Wall JInt.WaI1 I Ceiling I Roof I Floor Kind W;Ath 100,' H.iaht Windows and Doors—Crackage and Area Width Height Na of Lineal ft. Area Na of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of Dane of pane lights of track sq. ft. Za Z ° 41-' Coef. Btu Infiltration Coef. Btu Infiltration v Net exp. wall Glass Int. wall ®t Exp. wall " — — Net exp. wall IS19 S -11 Int. wall 3ro 1 15 [SEW Ceiling U621 -3 Floor I Total Btu. 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I [ADA Width Height Windows and Doors--Crackage and Area Width Height Na of Lineal ft. Area Na of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area G1 I Rnnm I L enath Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pans of pane lights of crack sq. ft. Coef. Btu Iflfiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area 0 M I R....... I1 .nath Phone: 786-488$ Insulation How Applied Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required3q. ft. E.D.R. or sq. ins. WA. Leader area ml R....rn I 1 math Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Mtration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area m I R..nm I I Priath Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal Lt. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area E Ho flonn"D a sons WELL DRILLING FOR FOUR GENERATIONS 15688 JARVIS STREET N.W./ELK RIVER, MN 55330/612)427-6100 INCORPORATED Date:_ July 31st, 1987 MINNESOTA DEPARTMENT OF HEALTH 717 SE DELAWARE STREET DIVISION OF ENVIRONMENTAL HEALTH MINNEAPOLIS, MINNESOTA 55440 ATTN: Mr Jim Nye (612) 623-5339 SUBJECT: WELL ABANDONMENT RE: NOTIFICATION Dear Mr Nye, top This letter is to notify you of a water well in your district that should be sealed according to the Water Well Construction Code MCAR 44725.2500-2900. E.H. RENNER A SONS, INC has been notified by the owner of this property or an interested party and have subsequently submitted to them an estimate for the sealing of this well under our LICENSE #71015. We have also included a copy of the current code with our estimate. In submitting our estimate, the owner may also receive additional estimates and hire any number of Minnesota licensed water well contractors in the area to seal this well. However, there is a possibility that this well may not be properly sealed and thus jeopardize the ground water and Public Health. E.H. RENNER & SONS, INC. wishes to provide you this, information for future reference with the abandonment report when submitted. PROPERTY OWNER: Mr. Doug Peterson PHONE # 537-2551 ADDRESS: 5637 Brooklyn Blvd. Brooklyn Center, MN 554MTE July 31st_ 1987 LOCATION: 141 76th Way WELL DIA. 311 Fridley, MN. DEPTH: UK Sincerely Submitted, Raymond T. Renner, V -President E.H. RENNER & SONS, INCORPORATED STATE LICENSE #71015 cc: City of Fridley 6431 University Ave. NE. Fridley, 55432 ATTN: Darrel Clark & Don Carrigan- 571-3450 ► 4arre� ��1f � J us � u- �� Q ,� % t Yd � ► ^'�� 4-4,� 1-7 �O.S.R#8er0Estates GO d i /g Peterson CO Ll rz -:z - AL / /1 < W t- W W AL Li IDA 16U / •r • VLe- y F• z 41Nl CD 4 r y 1$ is=; Y Minnesota Department of Health Division of Environmental Health 925 Delaware Street Southeast P.O. Box 59040 Minneapolis, MN 55459-0040 May 30, 1991 Mr. Darrell Clark Building Inspector Ins C City of Fridley 6431 University Avenue, Northeast Fridley, Minnesota 55432 Dear Mr. Clark: This letter is in response to your telephone call on May 17, 1991, concerning an unused abandoned well reportedly located in Oak River Estates, Lot 3, Block 1, Fridley, Minnesota. The information provided by your office and by Mr. Kevin Hop oH. Renner and Sons, Inc., indicates that an unused abandoned 1 is loC ted under or near the foundation walls of the house located a( 149 76th ay, Lot 2, Block 1, in Fridley, Minnesota. The Minnesota Department DH) will send a letter to the property owners of the property located at 149 76th Way and explain to the property owners their legal obligations concerning an unused well on their property. The MDH has been provided with no frmia—ttap which suggests that a well exists on the property located a 141 76th W y, Lot 3, Block 1. If evidence indicates that an unused well doe , or if a well is uncovered during excavation, the well must be put into use, a maintenance permit obtained from the MDH, or the well sealed by a Minnesota licensed well contractor. If you have additional questions or require further information, please contact Douglas Edson at 612/627-5141 or myself at 612/627-5151. RDT:DSE:sg cc: Mr. Jeffrey Buckley Sincerely yours, - - V(� &A \ t:-� T, Ronald Thompson, Supervisor Well Management Unit Water Supply and Well Management An Equal Opportunity Employer ' SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2789 i� q • COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY l : CITY HALL FRIDLEY 55432 ��',•� ---- L j\ 612-571-3450 9�aF�s 9/21/98 JOB ADDRESS 149 76th Way NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED OESCR. 2 1 I Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Barb & Les Haanpaa 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Disanto Construction (DRI) 26103 Verdin St Isanti 55040 444-0024 20069323 a 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 C;} REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (36SQ) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 'VALUATION$3,085.00 SURTAX @ $1.54 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- STRUCTION $87.25 Fire SC $3.08 OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TAL FEE -..,J- 4&. .. 'I. � I g _vj4r0 Li se SC//5.00 $96.87 SV ,GN TUAE OF CON' ACTOR Op 4UTMOAiZEO AGENT TEr MVA E;) THIS 1 U VE IT ` S-GNATURE OF OWNEA,iF OWNER BUILDER, ,DATEi1414G nAtE NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION XConstructionAddress: /I lr I —2L �U-)A, I/ N , F , �— ( i ,Legal Description: Owner Name & Address: AContract Address: 0 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: _I DESCRIPTION OF E%IPROVEMENT C) Effective 1/1/98 ENSE# �00llt��o�� Tel. # c-/c-�— 6 C7 I� Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ Ql (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: All,Tel. # 7 K Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: CITY USE ONLY O $D2 Fee Schedule on Reverse Side $ e 08 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $ S-00 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] Building . $ BUILDING Permit No.:010&7 Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY DatK'DdiA P R 0 2007 DATE O 1 YOUR E-MAIL ADDRESS 0 rk 11 G C QP I t= ALS . 6C1 Iv, - SITE ADDRESS .0005 x Permit Valuation Minimum $.50 THIS APPLICANT IS: ❑ OWNER `CONTRACTOR PROPERTY OWNER/ NAME: CL r L'D I> Cain D rn 4i50 1' ' TENANT ADDRESS: CITY FP— 1b LE -1 -STA4*26i AL3 2 PHONE. -I LC — I - 159,t 8 CONTRACTOR NAME: t1S C OF 2.. E{kvo-5 STATE LIC'EIN/SE # Z i 00 Z (o'/ Z EXP DATE 3 - I - Z CACI SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: -'t 6 b ( K 1 C- ii � I CITY � l�E V ► 6 wU STATI1 � AkIP�Z `/� WITH APPLICATION' PHONE S�/ - - 5 FAX �/ - Z8 7 -04 6,6 PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE Total Due ❑ DECK ❑ SIDING E%OTHER '70 ',)3 ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR XOREMODELING DESCRIBE WORK BEING DONE: I - ?— AS f4 -77 f - / 7(2 4;2- SIZE OF IMPROVEMENT N LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SLIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑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 ES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ' 30---1(USINGTHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $Er-"` OCCUPANCY TYPE Permit Fee $ %1.35 5 See Back Page for Fee Schedule Plan Review $ D, 8 65% of Building Permit Fee Fire Surcharge $ • Do .001 times the total job valuation Surcharge $ / 3 , C�6 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ '70 ',)3 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application fora ermit 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�eshich r_evte approval of plans. SIGNATURE OF APPLICANT T PRINT NAME L O.M �Q 1 f� -F- DATE �^ 0 -1 r ` iling height & ailing height? W2436-1 R 1 WE3624 1-1 cou . rr d J I d ° CWTX�60 er cabinet w/doors 3 Z W2436 SCW2742a-2R !< uckle hinCe do • azy susayl` • 3D18 • SLy�33 open shelf BROS24 r�qF.} hq 1 quartz countertops : ;U '�``� Yft.–Meiling Bamboo floor horizontal cut roised counter Forest web brown mart O 1 Ci r S27 } r/DI F1,W U trays ` r` �1 I":\ lazy susa \., T' 3 — t —2 "---j 1 Us" ` 14 a' 30" 5" L " - .... `_... -109 CY 1 —121 ;., Ulm bates. All dimensions _size designations given are20 subject to verification on job site and adjustment to fit job conditions. 2011 TECHNOLOGIES (released This is an original design and must not be or copied unless applicable fee has been paid or job order placed. Designed: 4/11/2007 Printed: 4/18/2007 Matson Quest All Drawing #l: I SEPARATE PERM REQUIRES FOR: PLUMB�INd "AND'S%M 1 E N 4, x 48 acrylic shower;^:, s lid surface walls CO CO 1 i7 W 36" knee wall , •� � -� w/36" glass block =+•1%w! above V- - - - - - - TOILET.6T i /,gym ' � , ` 4. 84" all w/3 dr l i ele 1 --21 1 ��M All dimensions -size designations given are subject to verification on job site and adjustment to fit job conditions. This is an original design and must not be I Designed: 4/11/2007 released or copied unless applicable fee Printed: 4/18/2007 has been paid or job order placed. Matson angle shower 3-29 All Drawing #: 1 s ,�' _ t�: a�„� � In � ,� �,; �`r� `r � ;' � . • i ,� t�,.� ,i Rd . ` � t �l i 7 �� y -l.. (�� _ l+ �' t� �� l ':� � � )�.4 ! I F 1 � .� N a�r, � s �� t� s ;' �-�+ r J F f �: a�, r '�r � ,..:;vim 4; j a i� r � i� �• f t �lr� ` fry/ j r%� I t i -'. � y �L� � i'® �' r,;, � � " ,� els i.� ` }.:..� � j f � q �` � tl" 1 y, L,_ t %.. �. I t � s Z „i r � e it t � � •ire i � . `.� i ��, �._t�.. fU � t ..sa • -~ ' " From: 6512870406 Page: 212 Date: 5/4/2007 3:39:35 PM Lir—j-p- I s a -y,,. a C. Y 1 a C.0 - o 1 71-1 a- Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By- 763-572-3604 CITY OF FRIDLEY Date Recd �7 DATE �Z7 �?:a7 YOUR E-MAIL ADDRESS VM Z ALd,�b�'� � �L°:�L►S ( N!FT SITEADDRESS W -7to-Gh MZ11XtY Mn THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: Yl,)R STATE LICENSE # MS 0 S' 'PYYI EXP DATE I U - dQ f STATfi�ZIP.951� SUBMIT A COPY OF YOUR STATE ADDRESS: 060,1 � • CITY n LICENSE WITH pHONE(L-SSP,i-.5l d FAX APPLICATION PERMIT TYPE Y'SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE 0 NEW MIREPLACEMENT TYPE OF WORK: DETAILED DESC TION OF WORK 1ZF I OCCk SbO &V I IAV 5 1 till ((nm fsm TATA) PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL ER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _FLOOR I BATHTUB _ GAS PIPING (NEED crrrucrosE) _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER _ OTHER Permit Fee $ 8GS Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $. ggo State Surcharge = $ .50 Total = $ 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 a4 work which requires review and approval of plans. SIGNATURE OF APPLICANT VALPRINT N EjElt KtL6 DATE ZZ O'"1 c� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ MECHANICAL Permit No.: ,�p�j 2.01a->_� Inspections TOTAL DUE $ RESIDENTIAL APPLICATION Received By: 763-572-3604 State Surcharge = $ .50 CITY OF FRIDLEY D 'JUL - 6 20( rl ® DATE / YOUR E-MAIL ADDRESS Mrd w l un—e" LOrtrl � SITE ADDRESS " 100 11 d THIS APPLICANT IS: ❑ OWNER P605NTRACTOR PROPERTY NAME: OWNER/ TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR COMPANY NAME: i o CONTACT PERSON: SUBMIT A COPY OF YOUR STATE LICENSE WITH STATE LICENSE #PpA DATE t I C� ADDRESS: ITY _STATE 15 APPLICATION PHONE I 7,07—IFAX— PERMIT TYPE V J NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: I VNEw VREPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) ° Equipment Installed MFG: tA vrk t) is I et 1 MODELSIZE/BTU 1210M 10M MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU L/A/C $25.006K_I 6PL�� FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 _ TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 LER ` _FURNACE $35.00 _GAS UNIT HTR $10.00 LINER $10.00 J✓�l�t7 plr L� _G DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 AS PIPING $10.00 VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 0L x $10.00 = $ 2 o, dD Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = Number of fixtures @ $35.00 x $35.00 = $_Tg-, cwD State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowle that the ' ation above is complete and accurate; that the work will be in conformance with the ordinances and codes of the C' ofFridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wor is not to s without a permit; that the work will be in accordance with the approved plan in the 400rk which req ' es v' val of plans.SIGNATURE OF APPLICa RINT NAME_;UM,ES Z AkR- YL.�,�I�ATE �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.::2 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 7 ®� DATE �- YOUR E-MAIL ADDRESS SITE ADDRESS 1 !�j 76 WC. THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: lw4lvl + , �'c�`o Y ®or i ADDRESS 15� / 7L " tea � ✓Le-- CITY] STATE—ZIP TENANT PHONE: 6 571 -110- 53 6.3 &-,, P- i, C, CONTRACTOR COMPANY NAME: i� kk�'� D 00Z -F r CONTACT PERSON: SUBMIT A COPY OF p, YOUR STATE STATE LICENSE # L -1 "1 QDATE 13 110-7 LICENSE WITH b ➢EXP ADDRESS: O`7 00 109441 � /v CITY STATUMn ZIP APPLICATION PHONE".95 cSrl (-�t�SaS FAX 9(.03 - -S ] A ^%aR ''` PERMIT TYPE 9SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT f(ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKr+5/ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE NEW TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 '1'1 $PTtOCT+OR ER'$5TS0' _ Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ ,— Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 review and approval of plans, pp^^ '/ / / -7 SIGNATURE OF APPLICANT PRINT NAME 3e�T Sc �1 f i �D DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977