AF - 46046�
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C�
� Ci of Fridle Min.n. �
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BUILDING PERMIT
N° 6629
Date: _�'V..�.�._� _.;l__.._._..._._._....__ ... ........... �//��
_ ,!
� _ a �
Owner: _..���'.� . . ._.� : .. ..__.W�.�.w!st�...� Builde _..___. ..._.. �:�'�::�........._....._......_...._...._.__._.._.._.._.._.
Address............._:..._.__.__._.___..__.__..__�_.._..._ ............._.._.___....._.._. Address _.._.....___._.__._..._..........____.._.._........__...---__.....--•__...___.__.__....._
�� �- ATI F BUILDING
N . _ _.... .... ._ .. Street ...._LP-�:••• --!�... ... _ ... _.� P oF Lot •--..._....... __.
� -�- ,,.�=----.._. ..... ...... .._.
. . _..__ . _. ..
Lot ....._...... _.�I..__....._....__ Block ._.___..._.�„------•-----........._. Addition or Sub-Division �-- �•
_ . _..____._ ._.._ . __.
Corner I.ot ...__......_..._._.... Inside Lot ....._...::�:'�---- Setback .._.,�--.5�.�...�..r--•-----. Sid ard ......_.._I __..�_r...•. �......._...._.__._�._.�
Sewer Elevatiam ....._...__..._......._----.._.._.._._._...._...._..__..------------._.._ Foundation Elevation
DESCRIPTtON OF BUILDING
... v _ _�._..... ._ Front __.lP..� . Depth .�.�._. Height .. .��. _.. Sq. F� /� Cu. F
��.��
.. Front Depth _..._� �Teight ....._...---..� Sq. Ft. ._.__._.._.__. Cu. F� _.__._._._
__.__._...._..._..._._...._._......_.. ._ _ .___..._.__
Type of Construction _�;�'�'��'_�..__.. Est. C .��..��,,r.°:.�._`_....�T° be Completed ....:_..._._..._...�_..____.._._.
In consideration of the issuance to me of a permit to construct
th� proposed work in accordance with the description above set for
ordinances of the city of Fridley. , �
I ag� do
pr of
�
�,�, w
In ca�sideratfon of the payment of a fee of ���"'�._.., permit is hereby granted to_._...._._
•_..__,....___....._.._......._.._�_.._.___. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, ernployees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Frldley, Minnesota regarding location, construction, alteration, maintenance, repair and movinS of buildings
within the city limits and this permit may be revoked at ar�y time upoz� violation of an,y of the provisions of said
ordinances. �, _ _ �-^�
�
NOTICE:
ihis p�rmif doa not eowe flu eonslrueNoa, iiuhilallon fee wieiny. Phnnbing. ou h�atina, s�w�r or wat�r. B� wn to sN
th� Buildieo In�p�chr for s�psrat� p�rmhs for th� tt�ms.
+� . a
�'16v'�TS??3.' S NAME
APP'LYCATiON FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
BUILDER
A�i:P.LSS ADDR�SS
�,OCATION OF B
No. ��j ^_.� Street � -� � Part of Lot
-------��""1"�
Lo� �Block �Addition or Subdivision
Cora.er Lot Inside Lot Setback Side-Yard
�_
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front---1�-- Depth Height ���
Sq. I�'t. .._ Cu. Ft.�`� � j' ?�
_._.—.
Front Depth Aeight
Sq. Ft. Cu. Ft.
��
T�pe of Construction -�.� Estimated Cost � dY_.l� '°--
To be Completed
The undersi�ned hereby makes application for a permit for the work herein specified,
agree3ng to do all work in stxict accordance with th� City of Fridley Ordinances �nd
rulings of Che DepartmPnt of Buildings, and hereby declar.es th�t. all the facts and
representations stated in this applicatian are true aad cor t.
DATE `f � SIGNATURE C� l
(�chedule of Fee Coses can be found on the Reverse Side).
• •
a a a w . V ` �... �. r
1
City of Fridley �
,�
>f,;:r ,
Applicatioe for P'lumbing and Gas Fitting Perm�t �"�
Depi. of Bldgs. Phone SU 4-7470 �
DESCRIPTION OF WORK 74 9�' /'q b% e S%` . /�• t'r
Number, Kind and Location of Fixlures Loca2ion
0 �n � N � (�9 WATER HTR.
� 3� � �a � m ? 3� o� ; � a V a� < 3 �< � n� p F N GAS ELEC.
�
Base „t
lst ,�
2nd
3rd
4th
• Future Conasctiori Opeaings
* New Fixture, Old Openiags
with
'�
3ewer �
Cesspool (�
- PARTIAL RATE SCHEDULE
PLIIMBING f'IXTLiRE $ATES: NO. RA'1"E TOTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . � x $1.50 $ � � • �
Future Fixture Opening . . . . . . . . . . . . . . . . x 1.20 $
New Fixture Old Opening . . . . . . . . . . . . . x 1.00 $ �
Catch Basin ... .......... x 3.25 $
Water Heater (Up to 200,000 BTU) . . . . . . � x 2.00 $ 4 � �
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures _� x$1.50 $� � Q
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU . .... ..... .... x 2.00 �
REPAIRS 8c ALTERATIONS—Refer 2o Code
Description................................................$
TOTAL F'EE $ � 3 • SG�
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn. 't/ V��l /% , 19� 3
dwner ,�d /�R�/ �i�'lc�rrS
Kind of Building /� r a
Used as %� w c/%' �� a_
To be completed about _
Estimated Cost, $
Old-1�Tew. Building Permit No. u' �� Permit No:� �(O o�–'
gigne . `� � v¢+�-< .
By��• �a.: �
Business Phune No. � •` • -5 – � � L �
ROUGH � � I � � ��
FINAL
az YM
Application �or Power Plants and Heating. Cooling, Yentilation, Refrigeration and
Air Conditioning Systems ond Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 $
Replacement of Furnace . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 5.00 �
Repairs & Alterations—up to $50Q.00 . . . . . . . . . . . . _ . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU . . . . . . . . . . . .
each add. 60,000 BTiT .. .. ....... .. ... .. . . . . .
Replacement oP Furnace .............................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 ..............
8.00 $ '
2.00 �
5.00 $
5.00 $
2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . � . . . . . . . . 5.00 $� D � �
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ...................... x $1.50 $
Additional Fixtures . ............... x .50 $
Gas ftange to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING
FAN HEATING SY$TEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
�
See Fee 3chedule
$
TOTAL FEE � % D • 0'0
Depi. of Bldgs. Phone SU 4-7470
LoCStion 7'� %,s /� �i % C S j' . iV ' F,
.'.�.::4� �.
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�
$#.
�
City of Fiidley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
�idley, Minn. ?/ tJ / \���, 19 ��
Owner �� %Qa v /J L a` � a� e r S
Kind of Building - Fr Q'yri e '
Used as � w �' l� ! � �i �
To be completed about
Estimated Cost,
Old—New. Building Permit No.
Permit No. � �
WORK
HEATING or POWER PLANTS�team, Hot Water, Wazm Air—No.
Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTU H.P.
Total Connected Load Kind of Fuet
BURNER — Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTU H.P.
(REMARKS-OVER)
.
. • � •. �_._ % –
_ ,�
/� ti _ ��� _ � '
��<z sM Business Phone No- �: `, S�^.� � C 2
Application �or Power Plants and Heating, Cooling. Ventilntion, Re�rigeration and
A�r Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
GG
Furnace Sheli & Duct Work . . . . . . . . . . . . . . . .. . . . . . . ��--X 8.00 $�..�
Replacement of Furnace ............................. 5.00 �
Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $50U.00 . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 12U,000 BTU . . . . . . . . . . . .
each add. 60,000 BTU .......................
R.eplacement of Fi.�rnace . . . . . . . . . . . .. . . . . . . . . . ... ... .
Repairs & Alterations—up to $50Q.Q0 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .
8.00 $
2.00 �
5.00 $
5.00 $
2.50 $
3TEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. FDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURIvER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER tup to 409,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $
GAS FITTING FEES:
lst 3 Fixtures .....................
Additional Fixtures .................
Gas Range to 20Q,000 BTU . . . . . . . . . . .
AIR CONDITIONING
FAN HEATING 3YSTEM
VENTILATING SYSTEM
ALTERATIONS 8c REPAIRS
ROUf3H
FINAL
NO RATE TOTAL
_x$1.50 $ _
_ x .50 $
_ x 2.00 $
�
3ee Fee Schedule
$ r/
TOTAL FEE $�
Depi. oi Bldgs. Phone SU 4-7470
�
LaBuo � y g s- /.� l� �-�, �v. � �
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance' with the City Ordinances
and ruling of the Department of Buildings, and hereby declares _that all the facts
and representations stated in this application are true and correct.
Fridley, Minn.��7� � 2-U , 19 �
Owner ` �etd� /��(� •
Kind of Building
Used as
To be completed about ��.CX� � 3 6
Estimated Cost, $��
Old—New. Building Permit No.
Permit No. �r
DE8CRIPTION OF WORK
HEATING or POWER PLANTS-�team, Hot Water, Warm Air—No.
Trade Name ' Size No
Capacity Sq. Ft. E.D.R.�QQ�i_ BTU H.P.
Total Connected Load����� �3 qT— Kind o! Fuel t�i .
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R. BTiJ H,p,
(REMARKS—OVER)
��,� sM
Signe � l� �
By
Business Phone Na �� • � - � << ` S
52-8�. �915.5i
City of Fridiey
Application for P'hrmbing and Gas Piifing Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK 7495 N E Able St
Number, Kind and Locaiion of Fixtures L°�8h°n
� O I � I� � I � I Z I� �a I c � I 3 I J a� I<� I O 7 I� a�� �Z( I u� �� R I N I G STER ELEC.
3� 7 m VI 3� OLL N LLO Um <�i ii� ii4- i�o
Base !.n
lst
2nd
3rd
4th
• Future Connsct€on Openings
* New Fixture, Old Opeaings
PARTIAL RATE SCHEDULE
3ewer �
Cesspool j�
PLIIMBING FIXTURE RATES: NO. RATE TOTAL.
Number Fixtures . . . . . . . . . . . . . . . . . . . . . . x $2.00 $
F�ture Fixture Opening . . . . . . . . . . . . . . . . x $1.50 $
New Fixture Old Opening .............. x$1.50 $
Catch Basin . . . . x $325 $
Water Heater (Up to 99,000 BTU) . . . . . . x $3.00 $
New Ground Run Old Bidg . . . . . . . . . . . . . x $3.25 $
Electric Water Heater z$2,pp a
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .......................... x �2.00 $
Additional Fixtures .................... x $ .75 �
Gas Range to 199,000 BTCT . . . . . . . . . . . . . . x $5.00 �
Gas Dxyer 1 5.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $�
5.�0
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares Chat all the faci
and representations stated in this application are true and correct.
2-8-68
Fridley, Minn- - - ; 19_
Owner J��s woOg
fZ'3IIle
Kind of Building
Used as r8s
To be completed about 2-�-��8
Estimated Cost, $ 10.00
Old—New. Building Permit No ���? PB1��'l ��-�—.—
� � .
,�,�.�,� �:: , -
�y �� :
By
Business Phone No.
ROUGH
FINAL
az
sue�ecr PE
c�ty of Fridley � 25 312
AT THE TOP OF THE TWINS g � I L D I N G P E R M i
r
� �
COMMUNITY DEVELOPMENT DIV.
r `� v � PROTECTIVE INSPECTION SEC. 3� j�
I � �
i-.--�,��'��;'� CITY HALL FFiIDLE� 55132 NUMBER REV OATE PAGE OF APPROVED BY
i 612-571-3450 9t0-Ft5
7/24/97 / /
JOB ADDRESS 7495-97 Able Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 9 2 Nagel's Woodlands SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PMONE
ABLE PROPERTY MANAGEMENT 9920 Zilla St NW, Coon Rapids Mn 55433 754-0743
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO
Kozitza Construction 9175 Isanti St, Blaine MN 55449 786-3625 2650
a ARCHITECT OR DESIGNEF MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Duplex
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE ,_
8 DESCRIBE WORK � ` ;
Construct a 22' x 22' Detached Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide a hard surface driveway.
Variance on rear yard setback approved by Appeals Commission on 8/14/96.
WARHIHG
Before di�ging call for
ail utility to�ations
SEPAftAT� PERMITS REQUlRED FOR 45A-0002
�NiF�NG, NEA7ING, PLUMBING AiUD SIGNS. R�Q��REU BY LAVII
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 STALIS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT �8 � 949 ��F. �FJ
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING cor,- �149. %S Fire SC �S.9S
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
`�� �i �/�\ C.� PLAN CHECK FEE TOTAL FEE
l �
License SC $5.00 $168.17
SIGN TUAEOFCON'AACTOAOAAUTHOAIZEDAGENi IDATE� WHEN PROPERI ALIDATED THIS IS YOUR PERMIT
� � , �-�y 9�
_- S�GNATURE OF OWNER i�F OWNER BU4DERI IDATEI BL� INSP ���
��' I:�V
AllDN
AL1'ER
ll
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L )
C['I'Y OF HRIDLEY
SINGL� FAMILY ANI) DUI'LEXES R-1 AhTD R-2
BUILDING PLI�IVIIT APPLICATION
ConstructionAddress: � � �i�
Legal Description: _ �� j '
Owner Nanie & Address: "l ,1..
Contract
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
�'` �i7
�%S /_s,4�C;; �
° �!
`S
L-;ffcctivc U t /97
C� � � as �� �
.:,4 Tel. # '7 5 Y- � 7 `�3
/�.�5 i MN LICENSE #
�� �_�i�c.a�. Tel. # ��Y�G'2�( 3
Attach to this application, a Certificate of ���y !o�'the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
�n� Width Height
Length �2 �. Width a � Height
�ng� Width Hgt/Ground
Sq. Ft.
Sq. Ft. �'�
Sq. Ft.
Construction Type:_ �; �,��rQ ;��.�,.�,,,,,,� Estimated Cost: $ (s, Lpc� ���� q*� �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ _$
DATE: Z- �� APPLICAN'T: �'';�� ,.�_ Tel. #�% � Y^ 6 7 4! �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Lscrow
Erosion Control
Park Pee
Sewer Main Charge
��'c��rn 1 _
fi�l'({'t�1.;1�1'It)Nti:
CITY USE ONLY
$ �/ , 7� Fee Schedule on Reverse Side
� r�! y .001 of Permit Valuation (1/lOth%)
$_ `7 �� $.50/$1,000 Valuation
� $950 per SAC Unit
� � � � $5.00 (State Licensed Residential Contractors)
� Alt. "A" or Alt. "B" Above
�_ $450.00 Conservation Plan Review
$ Fee Determined by �ngineering
� Agreement Necessary [ ] Not Necessary ( ]
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sue�ecr PER .
City of Fridley 679 3
AT THE TOP OF THE TWINS g � I L D I N G P E R M i T
r
� ` RECEIPT N-O./
� ' y����� COMMUNITY DEVELOPMENT DIV. � ji���ry
� � PROTECTIVE INSPECTION SEC. ��y �
i_--.�,��'��;'� CITV HALL FRIDLEV SS43� NUMBEP pEV OATE PAGE OF AGPROVED BV
i 612-571-3450 9t0-F15 7/23/98 � �
JOB ADORESS
7495-97 Able St NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. (� 2 Na el's Woodlands SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Able Pro er a
3 CONTRACTATR,OP • MAIL ADDRESS Z�P PHONE LICENSE NO.
Y
Able B� Man 9 2 Zi 55433 754-0743
4 ARCHITECT OR DESIGNER MAIL ADORESS ZtP PHONE �ICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW 0 ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof 22 S T ar-
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GHOUP OCCUPANCV LOAD
SEPAFiATE PERMITS ARE REOUIRED FOF ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR Alii 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 FOFi A PERIOD Of 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CEfiTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yp�UATION SURTAX
AND ORDINANCES GOVERNING TNIS TVPE OF WORK W�LL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 1834.HO �.92
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PiiOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIO R THE PER NCE OF CONSTRUCTION. �rj9. rj� Fire SC �1.83
/� PLAN CHECK FEE TOTA� FEE
G�- License SC 5.00 67.25
S�GNATUFEOFCON'RACTOAORAU OR�ZEDAGENT IDATEI WHEN PHOPERLY LIOATED TMIS IS YO R PERMIT
S�GNATUREOFOWNEQi�FOWNERBU4DERi IDATEI BLO �NS� ��FTE
NEW
ADDN
ALTER
[]
[1
��
CITY OF FRIDLEY
SINGLE FAIVIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: `7 � ��$ �% ,�%�.�' � � S' %`, �� •
Legal Description:
Effective 1/2/98
� ���
� �
Owner Name & Address: �,�� � /�,�'� ���(� � Tel. #
Contractor: ��%�� MN LICENSE # ��—
Address: ���U � /' f��3 S'% �C0.�1,�'•�tf'i�JS � L..'��Tel. # �%���- � %`��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IIVIPROVEMENT
LNING AREA: Length Width Height Sq. Ft.
GARAGE -AREA: - Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �, D���ztz�' `L < <S� "" `�S�<�
Construction Type: /�Sp� -��/�, Estnnated Cost: $ ���
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
:
APPLICANT:
$ � �
$ r .
$ <��
$
$ -S\c �
$
$
$
$
$ C�z�
Tel. # !�7 '� � �
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1ilOth%)
$.S�J/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
0
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
_ .�'''�
PERMIT O.: 2004-01267
DATE ISSUED: 08/06/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 7497 ABLE ST NE
PIN : 123024230011
LEGAL DESC : NAGELS WOODLANDS
: LOT 9 BLOCK 2
PERMIT TYPE : BUILDING
PROPERTY TYPE : DUPLEXES
CONSTRUCTION TYPE : WINDOW/DOOR REPL
VALUATION : $ 1,500.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DUPLEX PER R317 OF
THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS.
INSTALL AN EGRESS WINDOW. PERMITS REQUIRED FOR BASEMENTBEDROOM FINISH.
STATE LICENSED CONTRACTOR 1
APPLICANT BUILDING PERMIT FEE 54.00
TRENDY ROOFING SONS INC (20027543) FIRE SURCHARGE 1.50
210 ZACHARY LANE STATE SURCHARGE, VALUE 0.75
PLYMOUTH, MN 55441- LICENSE SURCHARGE 5.00
TOTAL 61.25
OWNER
ASHRAF LLC
2947 BENT TREE HILL RD
NEW BRIGHTON, MN 55112
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or canc 1 the provisions of any other state or local law
reg la ' con truction or the erformance of cons ction.
Applicant - Date .
Bldg Ins Dat �
SEPARATE PERMITS REQUIRED FORoVVOI�K•OTHER THAN DESCRIBED ABOVE.
NEW
ADDN
ALTER
�
Construction Address: �
Legal Description:
Owner Name 8� Address:
Contractor. � '���
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION ��,�.! t J� �^� /�/„ �1
[ l_ ��' /
�'9 `�r _
�
s
Tel:
���
MN LICENS # ________
J Tef���� "� �
,� �,-��o:�� � ��_
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
UVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length _ �Nidth "_ Height Sq. Ft.
DECK AREA: Length Width HgUGround Sq. Ft.
QTHER:
J ;cx�_`��,
Construction Type:�� Q ��, n�v� Estimated Cost: T�^����
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _ _$
,1
DATE•� ^ ^�� APPLICANT: � Tel. # (v� ��t � �33
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5T1- 8T if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ ,5z •� Fee Schedule on Reverse Side
$ -" 65% of Permit Fee
$ / .� C'� .001 of Permit Valuation (1/10th%)
$ . 'l:�r $.50/$1,000 Valuation
$ $1350 per SAC Unit
$ �S. ��(� $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 [ ]
$
� .�5� STIPULATIONS:
1���ay �o�n �'� ��,� t� r� C� � 3 � 5 q �_ -�
� � � °�� �
� s� ���av�
�
'� � - � ��,
� _.�.w....�.....�. � a „w: � ! x , � �� T�, ��
X; S 1, � w; �� �� �, EA
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_, , a �� � lo� /c � ���
--� ���SS w,�au� --c��,�kUVI
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-� '.� $ '' X g � ''
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�� � J�' Ov � S� �� o � (3 locl< <clof�
��oo {� o: S� �"0 13 ��i'� �. o� o t �.., � �a o.�
'F 1a,v� � �a.� a � 12 �,., � �� � � � o .r�
--� Rem�, o�a �;na�� � �ak� ����1 �� �
� Q e� Q1 �s� �,.� ; u a�
Building
Inspections
763-572-3604
DA7'E �C °I � ' O J�
SITE ADDRESS ___�
THIS APPLICANT 1S:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
�
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
� �
�i'OWNER �f'cONTRACTOR
NAME: dFy-� ci %'r�/f� ,�
aDDRESS: /�So`t � � �
7�e� '�%�'
/^M � G�
Permit No.:
Received By:
Date Rec'd:
%,j �Qr i? `e _STATE_ZIP
��
STA7'E LICENSE # �C oZi9 .� J �d�o2 EXP DATE .3' �I � � �
ADDRESS: CITY STATE_ZIP,
O SINGLE FAMILY/NEW CI
❑ TWO FAMILY/NEW CON
O ADDITION
O BASEMENT FINISH
� DECK
TYPE OF WORK: I o
�
DESCRIBE WORK BEING DONE:
SiZE OF IMPROVEMENT
ROOFING �.l
NUMBER OF SQUARES . �CJ
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Viny!
O Aluminum
O Other _
V1'INDOWS
IN EXISTING OPENINGS ❑Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1�97 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $;�o�Q'D' OCCUPANCY TYPE
� � �-o �
FAX
RUCTION SIZE
iCTION STORIES
❑ GAR.AGE/SHED O WINDOWS
.�ROOF ❑ DRAIN TILE
O SIDING � OTHER
� SWIIvIIvIING POOL
❑ ADDITION
O REMODELING
�Sf��-� a,�Qy�
.ENGTH WIDTH HEIGHT
❑ HOUSE ONLY
� HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
O Fascia
LACATION OF WINDOWS
NUMBER OF
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of swctural members W be used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDI7'IONS. & PORCHES SUBMIT:
L Site Plan/Survry showing the acisting swctures
and proposed projecL
2. Two seu of consWction plans
3. Energy Calculations
Permit Fee $ � o�$� See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $ �� .001 x Permit Valuation (1/10%)
License Surcharge $ �� $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft+ 6 ft= ft x$20 =$
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary () Non Necessary ()
Total Due $ 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 aclrnowledge 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. �
SIGNATURE OF APPLICANT �� /. PRINT NAME ����� t°�'!'/ �� DATE r/`� /��� S