AF - 46053�
.
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City of Fridley, Minn.
BUILDING PERMIT
N° 6491
Date: _.. �'`•....�.�..t �.�':� !�L� ..,�_.....__..._...._.._M....._.__.._.
Owner: _...�...�y�..�. . _..._... �_ �:Q� Buiider _..._.._. . .__ ....................._....----......----•---...__._._____._..._
Address....._......_...._._.__..._...__..___.r..__.._..._._.._..._._..._...._.._...___--•--._ Address _.___._.__._......._.........___._.._..._..._..__....._.._..._.__.._._......_.___.r.
,, C I N OF BUILDING
No. �-.:•.��.......E�L.._. Street ._..�-�....�..�..�..�������,� ......................... P f Lot •--•--.......... ..___..._. ____. _._......._ _._.....
Lot ....._�_._...._...._ Block _.._._..._..,�.......�.._....---•---�. Addition or Sub-Division a.�.�� ._ .._...�� _._
� / i
Corner Lot ...__...__...._...._.. Inside Lot ----._ ��__...-----... Setback ..��..._..---._........... Si ard ..........._.� _..._.._........._....._...__..._..._
Sewer Aevation ._._......_..___..._...___..._..._......__..�...___.._......_..__......_ Foundation Elevation
DESCRIPTION OF BUILDING
To U :
_ ... .. _.. ... . _ Front _._��. Depth _.�� . Height �.�...._.. Sq. F� /_,��.G+� Cu. Ft�,����
.._._.._._._.___.._.._..__._..__...._ Fro ______.......__ Depth _...___.. Height •---._..��. Sq. F't. ._.___........._. G�. F't. ._._____
Type of Construction _,iy�� �J�2�'_.._.. Est. C sa t�1���._._�o be Completed _..._..._..__._..W___._...__.._.._
In consideration of the issuance to me of a permit to const
th� proposed work in accordance with the description above set
ordinances of the aity of Fridley. _
In co�sideratfon of the payment of a fee of
described above, I agr , to do
hnlianca��bvith all or ons of
permit is hereby granted to.__..__.__ �....�
..,.._ ............._...._._._............._.,....__.___. to construct the building or addition as described above. This pernut is granted upon
the express condition that the person to whom it is granted and his agents, employees 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
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon viol�� of any of the provisions of said
ordinances. �. �n �l / l
Building Inspectar
NOTICE:
'This p�emif do�s nof cow� th� eonstrueHon, inslall�Hon foe wiriny. plwnbtnp. gu h�Nin�, swv�r or waNr. B� sun to sM
th� Buildio8 Intp�efor for s�p�rah pwmits for f6�a h�ms.
.,, �� ..� .r r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
� � ? � �
OWNER' S 1�IL�.F / � /t�� BUILDER � �,�r
r
ADDRESS ADDRESS
LOCATION OF BUILDING
No.��
� �% Street � �Part of Lot
Lot� Block o�-- Addition or Subdivision
._.. / U � o �
Corner Lot Inside Lot � Setback Side-Yard
SEWER ELEVATTON FOUNDATION ELEVATION
Applicant attach to this form Two Certificatee of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
;
i
�� . Front LO Depth �,�— Height ��
SQ. k't. L.fs�� �u. Ft. ,��1� �/ �
�
Front Depth Height
Sq. Ft. Cu. Ft.
C� C�
Type of Construction ,1�YC� Estimated Cost ��� '�—
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
a�reeing to do all work in strict accordance with the City of Fridley Ordinances an8
ruliags of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE S � GiGNATLiRE
—�-- ---.
r
(s�hpdule of Fee Costs can be found on the Reverse Side).
•. R.< � N •
•
� . f ♦ •i
�
Appiication �or Power Plants and Heating. Cooling, Ventilation� Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 �
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 12U,000 BTIJ , . . . . . . . . . . .
each add. 60,000 BTU .. . .......... ... . .. . . . .
Replacement of 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—ta 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 SURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ � �
GAS FITTING FEES: . NO RATE TOTAL
lst 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. • x .50 $
Gas Range to 200,000 BT`U . . . . . . . . . . . x 2.00 $
AIR CONDITIONIMG
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
$
TOTAL FEE �� a• o O
0
i
Depi. of Bldgs. Phoae 3U 4-7470
Location 7 J �J � /g � l � ��. %�� L�
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U-
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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, 1Vlinn. v U'�+ E 6� , 19 �
Owner ��✓ - /?a v %� �e� �- S.
Kind of Building /t'^T a s�,. e
Used as �J W�// •' �. _� W a a 6/ e �
To be completed about
Estimated Cost,
Old—New. Building Permit No.
Permit No.
c�G��
DESCRIPTION OF WORK
HEATING or POWER PI.ANTS�team, Hot Water, Warm Air—No.
Trade N
Capacity.
Total Connected
Size
Sq. Ft. E.D.R. BT(J H.P.
Kind of Fuel
BURNER — Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTU H.p,
(REMARKS-OVER)
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Signed /� � 4I �J s� 9' �i 7` o a �ll� 9 �1��!�kt
By �t - %. / �if?.ti J
� �
Business Phone No.-�%• �7 ^� .Z 1� 2
�
City of Fridley �
Appfication #or P'fumbing and Gas Pitting Permit
De t. of Bld . Pho `
p gs ne SU 4-7470
DESCRIPTION OF WORK �S O� Q�,�� �� j� �,
Number, Kind and Lxatioa of Fixtures Location
< �� � I` j I � 1 Z I` Sy I i p� 3 I.a ot I�`� O 7 I<°6, I i Z<�� Z I F I N I GASTER ELEC.
3� � �6 h• N 3 1- G LL N Y. � m 'C �i () { U� 6' U O
Base
lst
2nd
3rd
4th
• Fuiurs Coaneaifon Openings
* New Fix2ure, QId Opeaiags
wifh
PARTIAL RATE SCHEDULE
Sewer �
Cesspool j–j
PLIIMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... ...�� x $1.50 $ l �' �
Future Fixture Opening ................ x 1.20 $—
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin . . . . x 3.25 $
Water Heater cUp to 200,000 BTin ......—f� x 2.00 $ 4•�
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEE3: NO. RATE TOTAL
ist 3 Fixtures ...... ..................._�_, x $1.50 $ ! • � a
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU . .. ........... x 2.00 $
REPAIRS & ALTERATIONS—Refer ta Code
Description ............................... $
. TOTAL FEE $ oZ � • SO
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 facl
and representations stated in this application are true and correct.
Fridley, Minn. , 1�(23
Owner �� a- v �/ el r s�
Kind of Building r �"' a �,.� � •
Used as /✓ t�! e l� .' }, d 1,l�au �, l e� �
To be completed about
Estimated Cost, $
Old—New. Building Permit No. � Permit No. °� �G
Signe , �*c .
By �j"h )
Business Phone No. �'1 ��• 3-.Z i L Z
ROUGH t � � ^ � �
��
FIN
az ZM
Application for Power Plams and Heating. Cooling, Yentilation. Refrige�,rtion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 $
Replacement of Furnace . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 5.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $
� MECH. WARM AIR
Furnace Shell & I?uct Work to 1?A,000 BTIT . . . . . . . . . . . .
each add. 60,Q00 BTU . . ... ..... ... ..... . . .. .
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 . .. . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 ..............
a �
8.00 $ {�s=
2.00 �
5.00 $
5.00 $
2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDEt Steam .... . 8.00 $
F�rnace 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 BUR1vER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING �
FAN HEATING SY3TEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE � �"
ROUGH
FINAL
Dept. oi Bldgs. Phone SU 4-7470
T.00BtlOn ��� � -� b 1 e �� s N� � �
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.
Owner
Kind of Building
Used as
F�'idley,
�
19 �
U
To be completed about
Estimated Cost, $
Old—New. Building Permit No. �� Permit No. �� ��
DESCRIPTION OF WORK
HEATING or POWER PI�AN15—Steam, Hot Water, Wazm Air—No.
Trade N ame �,D tee,�L•rsw� Size No.
Capacity Sq. Ft. E.D.R. U 6 BTLT H.P.
Total Connected Load�s s�- 7� �j'� ���� Kind oi F�el � v� � l� A s
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.ft. BTU ' H.P,
(REMARKS—OVER)
��az 4M
Signe W � i
By W
Business Phone No. ��{, f � ` ����
A.
B.
C.
D.
� �;� 'r•� ' �� , �� ': ''•�'�'
M 1' I 1 :� 11 I i�• Y.
�• �-� a
�,nn�s � L� nESCRZpr�: '7�'�t - ��3 d�Rt� �i���r J�1� 1 n; �, ,8�.�.� �2,
�-_._��s L�ic�o�C.�4�it)s
O�11VF1Z/OONIIiACr �ASER: � ° � �� � � ..�.. � � �
C�ISPRUCTION L1ATE: � -���°- (�3 ADDIT7ADTS:
(�RTIFICATE OF OCCUPANC.'Y ISSUID: YES NJ � UATE
ZCI�IIlJG ACTION: ORDI1�iJCE 1�:
SPDCIAL USE PEI�IIT (S) : �
IDT SPLIT(S): #
VAL'ATI�1(S) : � ORDINANCE 1�:
E. VARIANCF.S
P,PPEAIS �ISSION: APPROVID DISAPP1mVID D�►TE �A.
CITY OOiJNCIL: APPitQVID DISAPPRpVID L1ATE 1�U.
F. EASIIKF�S : REQ' D '� 1�AT�, �' D
Bikeway/walkway
Street right-of-way
Utility
Drainage
" Alley
Other (Specify)
G. LICF�ISE (S� (List� :
Date of Renewal:
H. STIPULATIONS (List) : DiATE RDQUIRID DiATE OON�LETID
I. MISCELI�Ai�TF70(JS:
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PEFMIT .�
� ��— � �i��s—/
a, an q u • % u Matet
m � w c�.�+ an 4 .'�+ a c�.. � Heater
.�ri �o O C p N'� C 3 � F++ 6 L � U � N
s� .°� � a °�0' � a w o .�e g q°�0' " a °� � �q y
rA U � a0 W m 3 O G. N G. U W � 3 t7 � t7 O ie�
% �
lst
2nd
3rd
4th .
{R) � ELture Comsction apenin4 Connected with Sewer
(*) � New Fixt�re, Old Openinq ��
RATE SCHEDULE
PLUIKBING FIXTURE RATES: N0, RATE
Mew Fi:tuses
Tuturs li:tuzes
Old Opening, Bev Pi:ture
Bser Dispenser
Blov Off Ba.in
Catch eaain
Rain Nater Leadez
Hydraulic Valve
Su�p or R�ceivinq Tank
Natsr Treatinq 1►ppliance
8ot Mater 8e�t�r
Gas Ranqe
Ga� Dryer
�
ALL OTHERS AND/OR REPAIRS HNO ALTERATIONS
lt oi Valua of Pi:tnre or Jlppliance
Reinspectfon !�e $
($15. 00)
S 5.00
g 3.50
S 1. 50
S 4.00
g 5. 00
g 5.00
S 5.00
S 5.00
5 5.00
S 7.00
S 5.00
g 10.00
$ 10.00
State Surcharge
TOT11L PSS
TOTAL
S
S
S
S
S
S
S
S
S
S
S
S
S /%� OD
S
S .50
s D� D
..�� • •
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- - .vv� _,L�
Department of Buildings
City of Fridley
Tel. Y571-3450
The undezsiq�ed hereby sakes applicatlon for a psnait foz the work herein
specified agreeing to do all work in strict accordanca with the City Codea
and rulinqs of the Departaent of Buildings, and hereby declazes that all
the facts and zepresentatians stated in thia application are ttue and correct
�r�a�e�. w,_ 9—.,.�9 — _ ,0�'3
Oiit�F
KIND
USBD
�o BE o�� ,�«� y�� �.�
ESTIMATED CO6T �/��• !%"'�
OLD�l�M BUILDING PERlIIT NQ. PERMIT N0. _/ �/�
'='�------ ,
.!.; � '-.�y, '',i ....e ;�
Ca�pany _r � . ..• �„^' -„�
Siqned By
Tei. rb. �y��i�O -1�
--,
ROUGH INSP.
Data
FINAL INSP. 3'°�' �
�ate
11PPROVl1I. FOR PERMtIT _�
HINIMU!N FEE FOR ANY PLUMBING PBFtl�IST IS 510.00
PLUS THE S.50 ST�TE SURCHARGE
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1991
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES 70 BE INSTALLE� ntv FacN F� nnR
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_ _� 5 �% �� ���L, �T
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appiiance
Water Heater -Electric
Water Heater - Gas
Gas Range "
Gas Dryer �
Back Flow Preventer Required ()Yes () No
Type
$ 7.00
$ 4.�0
$ 5.U0
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.Q0
$ 7.00
$10.00
$10.�0
$10.00
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appiiance
State Surcharge
TOTAL FEE
.50
$��U
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do ali work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that ali the facts
and representations stated in this application are true and correct.
�
� , ..
Owner �� U_CT'C , � �.\ �,
Buiiding Used As � � S � � �-c� � �
Estimated Cost .PERMIT NO. � ����
PLUMBING
700 VN. Linden Aven� �^
SIGNED BY _ �, A,�Ax 11�—TEL N0.
� Mi eapolis, M^s - ;:' ^ -
, ��
i s A
Approved By Rough- nal e �� �'
� ���f ��.
� �
1yI1NNLGASCO X
MINMMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15 00 ~ ��
PLUS THE $.50 STATE SURCHARVE �
sue�ecr P
City of Fridley 2 5 31 1
AT THE TOP, OF THE TWINS g U I L D I N G P E R M I T
r
� �
� � •
COMMUNITY DEVELOPMENT DIV.
r � V � PROTECTIVE INSPECTION SEC. �� �%�
� �
1 ' �'�'1 � CITY HALL FRIDIE� 55432 NUMBER REV OATE PAGE OF APPAOVED BV
�.---'�•' �'' 612-571-3450 9t0-F�5 7/24/97 � �
JOB ADDRESS 7501-03 Able Street NE
t LEGAL �OT NO. BLOCK TRACT OF; ADDITION SEE ATTACHED
DESCii. $ 2 Nagel's Woodlands SHEET
2 PROPERTV OWNER MAIL ADDRESS 2�P PHONE
ABLE PROPERTY MANAGEMENT 9920 Zilla St NW, Coon Rapids Mn 55433 754-0743
3 CONTRACTOR MAIL ADdRESS ZIP PHONE LICENSE NO.
Kozitza Construction 9175 Isanti St, Blaine MN 55449 786-3625 2650
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADDRESS Z�P PMONE LICENSE NO.
6 USE OF BUILDING
Duplex
7 CIASS OF WOHK
� NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Construct a 22' x 22' Detached Garage
9 CNANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide a hard surface driveway.
Varia::ice on rear yard setback approved by Appe�als Comtn.�s�� on 8/14/96.
1�IA�NIt�1G
Before digginS c.a�l for
SEPARATE PERMtTS RE�IUlRED- FOR a►1 utility tocat�ons
1�IfJRI�1G� HEAiiNG, PLUMBING AND S1GNS. 4�4'Q�2
�EQUIRED BY LAW
TYPE OF CONST. OCCUPANCY GROUP ACCUPANCV LOAD
SEPARATE PEFiMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION
QR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOf;K IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CEFTIfV THAT I HAVE READ AND El(AMINED THIS APPLICATfON 2 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORiiECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OFiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIEO HEFEIN OR NOT. THE GRANTING OF A PERMIT �8 � 949 ��F. �F7
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �149.75 Fire SC �H.9S
�± PLAN CNECKFEE TOTALFEE
2'i T License SC $5.00 $168.17
GNn PEOFCON�AACTOAOFIAUTMOQ12EDAGENT �DATE� WHEN PROPERLV LIOATED THIS IS YOUR PERMIT
^ y,� _
S�GN4TURE OF OWNEAUF OWNER BUILDEA� IDATEi . BLD iNSP ��FtE
�\'l;W
�llUN
ALTGR
ll
Ii
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ConstructionAddre;
Legal Description:
Owner Name & Address:
Contractor: ` �a
Address:
Cffectivc 1/1/97
CCCY OF ERIDLrY
SINGLE I+AMILY AND DUPI,EXES R-1 A.ND R-2
BUILDING PI,RM�T !�'PLICA"TION
�� �� 3 �/
LIVING A,REA:
GARAGE AREA:
DECK AREA:
OTHER:
Q� �Dl1�c
f���i
,� � .
i��
Tel. # ?5Y-G7� 3
MN LICENSE #
Attach to this application, a Certificate of Survey of th�
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
�n� Width Height
�ng� � � Width F� a Height
�ng� Width Hgt/Ground
Tel. # �jY��'2�3
Sq. Ft.
Sq. Ft. �
Sq. Ft.
Construc�ion Type: �.1� �.,��LQ � Estimated Cost: $ �s, LD�� . n�� �� ,��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ _$
DATE: 7 - � �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park ree
Sewer Main Charge
'1'O"1'n C.
S'I�11'( )1.;��1'I( )Nti:
APPLICANT: .�i/ '" � ,^_ Tel. # ��;� Y� 6 � Y �
CITY USE ONLY
$ '� ,"/�"� Fee Schedule on Reverse Side
�� 7�' .001 of Permit Valuation (1/lOth%)
�_ "�'�7 $.50/$1,000 Valuation
� $950 per SAC Unit
$_ �i � $5.00 (State Licensed Residential Contractors)
� Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Revie���
� Fee Detentiined by Etigineering
$ _ Agreement Necessary [ ] Not Necessary ( ]
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SuB�ECT •
City of Fridley 2679 4
' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T pT NO. '
r
� � COMMUNITY DEVELOPMENT DIV. ���
� .
V PROTECTIVE INSPECTION SEC.
� � -�» �
r , �;
� � �'�'1 � CITY HAII fRIDLEY 55432 NUMBEN REV DATE PAGE Oi APPROVED BY
�°"�' �'' 612-571-3450 9t0-Ft5 7/23/98 � /
J08 ADDRESS
7501-03 Able St NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITI�N SEE ATTACHEO
DESCR. 8 2 Na 21 � S Woodlands SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PMONE
Able Pro ert Mana ement 9920 Zilla St Coon Ra ids 55433 754-0743
3 CONTRAGTOR MAIL ADDRESS ZIP pHONE LICENSE NO.
Owner
4 ARCHITECT OR OESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILAODFESS ZIP PHONE LICENSENO.
6 USE OF BUILOWG
esiden al
7 CLASS OF WOHK
❑ NEW D ADDITION ❑ ALTERATION � REPAIR p MOVE O REMOVE
B DESCRIBE WORK
Reroof 22 S Tea -o
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING.
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFK OR CONSTRUCTION 20NING SQ. fT. CU. F�.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEFi100 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION 2 STA�LS GAiiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VAlUAT10N SURTAX
AND ORDINANCES GOVERNING 7HIS TYPE OF WOHK W�LL BE COMPIIEp
WITH WHETHEFi SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT 1834. $O . 92
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE Oi; CANCEI THE pERM17FEE SACCMARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STFUCTION THE P� MANCE Of C STRUCTION. �j9. rjp Fire SC 1.83
� PLAN CHECKFEE TOTALFEE
'c s C 67.25
S�GNATURE O� CON�RACTOR OA AUTH i2ED nGEru1 IDATEi WHEN PFOPEft ALiDATEO THIS IS VOUR PERMIT
\
�OI I
S�GNATURE OF OWNEAUF OWNEFl BUILDEFii iDATEi _� G ip5a �iaTE
NEW [ ) Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � �
BUILDING PERMIT APPLICATION a �
�� O�"
ConstructionAddress: 7S"O � — �� �i��� ��'' � .i�0� _
Legal Description:
Owner Name & Address: �,��� �/2�� /�'��� � Tel. #
Contractor. ��%� � MN LICENSE #
Address: �� � G� � l � ��� ��%CJ �/���4`�/-L�� - Tel. �#
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
LTVING AREA:
GARAGE �AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIP'TION OF Il�IPROVEMENT
Length
Length
Length
. �' G
Driveway Curb Cut Width Needed:
DATE:
Permit �ee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
$ 6
� . 3
$ ,�-
$
$ ��'�
$
$
$
$
$ �7Z �
Width Height Sq. Ft.
Width Height Sq. Ft.
�4Jid Hgt/Ground Sq. Ft.
� �1.��% �� �'� �. �c' � ��
� ��
Estimated Cost: $ /S D� .,
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _$
Tel. #
CITY USE ONLY
Fee 5chedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$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 [ J
, , � �
0
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s�z-36u4 r��:
: 7503 ABLE ST NE
: 123024230010
: NAGELS WOODLANDS
: LOT 8 BLOCK 2
: BUILDING
: DUPLEXES
: WINDOW/DOOR REPL
s7i-iz��
PERMI NO.: 2004-01268
DATE ISSUED: 08/06/2004
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 BASEMENTJBEDROOM FINISH.
STATE LICENSED CONTRACTOR 1
APPLICANT
TRENDY ROOFING SONS INC (2002'7543)
210 ZACHARY LANE
PLYMOUTH, MN 55441-
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 wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
re�ulatiu� const�u�ti��formance of cons,truction.
Bldg Insp
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
SEPARATE PERMiTS RF.OiJIRF.D FOR WORK OTHER THAN DESCRIBED ABOVE.
54.00
1.50
0.75
5.00
61.25
NEW
ADDN
ALTER
() C1TY OF FRfDLEY Effective 4/1/2004
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BU{LDING PERMIT APPLICATION
. ,�C�C `� C�lo���
Construction Address:
��
Legal Description:
Owner Name & Address: _ �� +� �� � L C — ='J �.�� Tel. � � i
Contractor� ��`Yl�� � l,(1 �-. MN LICENSE #�C'�2 � `�J U1 �
LIVING AREA:
GARAGE AREA:
DECK AREA:
QTHER:
Tel. #
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRlPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width � Height Sq. Ft.
Length Width HgUGround Sq. Ft
iS�a . �
Construction Type:�� ��� ��,�� �� Estimated Cost: �
.� -
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ^ ^�'� APPUCANT: Tel. #��3 � l 1- �I 13�
Call (763) 572-3604 for Pecmit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will caN
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 ,
� �����
$ "-'
$ �� �D
$ �S
$
$ � �'C;.
$
$
$
$
$ ��/.�s-
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ )
STIPULATIONS:
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