AF - 46117•
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City of Fridley, Minn.
BUILDING PERMIT N� s 6 2�
Date: _._. ./..__. �.�� � "'.�...�Q...�_....._..._.......____- � C_� � zL�
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Owner: _...1�_: . _ . _::: . ��''.1!�L Builder
Address....._......._:..._._....__..____.._...._._....�..._..._._.._..........._...._...._--•-••••-•---_. Address _.._.._..._..____....._ ............._...-•---._..-----._.......__._.._.._._._.._._.._.__�.
�I�,,.% � �����:-�E_..CA OP UILDING
No. . ._.. ..----. .._._. .. Street ....._ ..:' �. _ - -=1 ......................-.._. P , of Lot ....._...---._...._.._._..._..__.__.._....
._._
Lot _... ......__..._ Block .----------- .. Addition or Sub-Division . .. . .._.. _ _. .._:.._.._
�..._. �---... _.._. . _ .
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Corner Lot ------__-.._.._.__._ Inside Lot ....._........-���'---.... Setback ..----o..7•x.�`..---�..--•...... Si yard .....__.._l.___.`...___._..._.___.___�._....
Sewer Elevation _.._......_____..._...__...__..._._..._.._.._._..._.._--_-----------_ Foundation Elevation
DESCRIPTION OF BUILDING
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. _ : ... .. Front �_6�1._. DePth ,p�.,�_..-_. Height . r,,,E-.....�.�..._.. Sq. F� ��SJ_� Cu. Ft�.�.�7 �
__._...__..__._.__._..._.....__.._._ Front ._.._.._..__ Depth _..._._..._. __ 'ght � S4. FL. _.___..____.. Cu. F�
. . Hes ._.._.......... _.._..._..._.�.
Type of Construction _.� e���+.� y G -______ r'!�'�... Est, Cost ��....�.��!'�C.r'G�......_........ To be Completed _...__._.�_._...:._..�__�
In consideration of the issuance to me of a permit to construct the building described above, I
th� proposed work in accordance with the description above set mpli with all
ordinances of the city of Fridley.
.,
to do
ns of
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Ea consfderation of the payment of a fee oP $-��{,,c.--...._.....-•---, Permit is hereby grauted to._.__.�____
.. to constxuct 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, 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 af
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bufldings
within the dty limits and this permit may be revoked a t ac�y time upon violation of any of the provisiona of said
ordinancea � /1
Building Inspector
NOTICE:
1Ms p�rmh dou not eowr th� eonshueNoe, in�ailMion fer wieiny. plumbing, gas h�afin�, swv�r or wabr. 8� sun to sN
fh� BuiWiog InspKio� for s�p�rah p�emits fo� fh� iNms.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRZDL�Y, MINNESO'PA
OWNER'S NAME BUiLDER
ADDRESS ADDI�i'sSS
LOCATION OF BU I
No. �� f// Street Part of Lot
Lo� � B1ock 2 Additioa or Subdfvision
Coraer Lot Inside Lot Setback Side-Yard
_._.� .___�._,_.
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this fora► Two Certificates of Survey of Lot anci proposed build-
ing location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Aeight
Sq. Ft. Cu. Ft.
Type of Construction Sstimated Cost
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do ail work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
,
DATE 3 SIGNATURE � � �
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(9chedule of Fee Costs caa be found oa the Reverse $ide). /
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Lond Plonnin9 6B7'S-N,�hwoy =LS N.E.
Land Survecf�ixJ MinrnenPn/s32,
Soils Testin9 EN G l NEE R{ N G, I N C. Minn�esnfo
Ciwl fr Afunicipol SUnset4-6066
E,�ineeriny En9ineers � Survec�o�s
cer�ts�icafe o� sutve Fo� � .�., �� y , . �� .; , r� � � �=.
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l htnebr� cerfi�'y fhot �ihis is o h�t a�d aovr�cf �tpr•esenfo!'�an o�'a su�ru, �'1/iie d�a�nab�+es �'�'k �beMr aEsc�v6dd �aad, a►'�d
o�'flr /acafio� o�'o/l bwAdin9s , tl rreon , aadd/ risib/i axroochartnfs ,�!'wx), �rn ar a� sad /and. As surrryed 6tJ nk fl�CS -°brc�
`� �r''"`' A��"��n' SUBURBAN ENG/NEERING, INC.
L-n �neers 6� Sur►cyors
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Application �or Power Plants and Heerting. 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 & I?uct Work to 120,000 BTIT . . . . . . . . . . . .
each add. 60,000 BT[T . . . ....... . .. ... .. .. .. .
Replacement oP �rnace .............................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . .. . .. . . . . . . .
8.00 $
2.00 �
5.00 $
5.00 $
2.50 $
3TEAM o: HOT WATER SY$TEM
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 $ � 6 • Vv
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 SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $,% d��
ROUGH
FINAL
Dept. of Bldgs. Phone 3U 4-7470
LOCBtion ! J / / / J �C:! `C' �! � IV � �
City oi 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 ail the fac s
and representations stated in this application are true and correct.
.,t_ ��
Fridley, Minn. ��.�? ` � 5 , 1
Owner — 'S
Kind of Building __���1�14V!'1 �
Used as _ �� �` L � w°�
To be completed about
Estimated Cost, $
\ �_��
Old—New. Building Permit No. ���v Permit No. � ,6
DESCRIPTION OF WORK
HEATING or POWER PLANZS�team, Hot Water, Warm Air—No.
Trade Name Size No,
Capacity Sq. Ft. E.D.R. BTU H.P.
Total Connected Load Kind of Fue�
BURNER — Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTU H.P.
(REMARKS—OVER)
a��.� sM
Signe K�R 1 �� �� �
By
Business P No. � �J � � / � Z
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
� (i
Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . �..�' 8.00 $ � � -�
Replacement of Furnace ...........................:. 5.00 �
Repairs & Alterations--up to $500.Q0 . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . 2.5U $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BT(T . . . . . . . . . . . .
each add. 60,Q00 BTU .......................
Replacement oP Fiirnace .............................
Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .
8.00 $
2.00 ;
5.00 $
5.00 $
2.50 $
STEAM o: HOT WATER $YSTEM
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 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 $
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ..... ............... x $1.50 $
Additional Fixtures . ............... x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.04 $
AIR CONDITIONING a
FAN HEATING 3YSTEM See Fee Schedule
VENTILATING SYSTEM �
ALTERATION3 8c REPAIRS TOTAL FEE � ��
ROUGH
FINAL
Depi. of Bldgs. Phone $U 4-7470
LocBlion � �.�� i� % � Q S -f . N , � �
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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.
�idley, Minn. �� �� 3 19 �
.
Owner � �
�
Kind of Building
Used as _
To be completed about ' �
Estimated Cost, $ Z ��
Old—New. Building Permit No. _ Permit No. � C—`
DEBCRIPTION OF WORK
HEATING or POWER PI.ANTS-�team, Hot Water, Warm Air—No.
Trade Name ��� - Size No.
Capacity'��" Sq. Ft. E.D.R. ��. d � 6 BTLT H.P.
Total Connected LoadS,E} �,�.� ,-�s ?3 3� Kind of Fuel /V�v �. � a s.
BURNEft — Trade Name Size No
Capacity Sq. Ft. E.D.R. BTfJ H.p,
(REMARKS-OVER)
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Signed � . W . � X ���' ` ,
By C� . � 11. _
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Business Phone No-�� ,.�}— �� � �
City of Fridley
App�ication for P'lun�bing and Gas Fitting Perntit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK � �` ? p �J�L � �� y, �
Number, Kind and Location of Fixtures Location cJ � d� /V
� N
IA 1[
O < � ? � Z � } Z
� 3 c�i � � � � � 3 � a
Base '
lst °d
2nd
3rd
4th
' Future Conaectfon Openings
* New Fixtuse, Old Openiags
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- � .U1 = � I .W , • � � .:�.
� z U z O x �- .(9 .
� gc t�� '<3 c`�< �� �
Connected
PARTIAL RATE SCHEDULE
Y `W�lTER . H7R, �
..+,. �� `, ...
F N GAS ELEC.
3ewer �
Cesspool (�
PLIIMBING FIXTURE RATES: NO. RATE TOTAi.
Number Fixtures . . . . . . . . . . . . . . . . . . . . . �� x $1.50 $ • � 6
Future Fixture Opening ................ x 120 $
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin . . . x 3.25 $
Water Heater (Up ta 200,000 BTU) . . . . . . °� x 2.00 $ �• �
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
I lst 3 Fixtures .........................._...�_ x$1.50 $� 'L �? '"
Additional Fixtures .................... x .50 �
Gas Range to 200,000 BTiJ . ......... ... . x 2.00 �
, REPAIRS & ALTERATIONS—Refer 2o Code
Description ......................................... $
TOTAL F'EE $��!
Clty Of Fi1�Cj';
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 faci
and representations stated in this application are true and conect.
Fridley, Minn.� � - � , 1��
Owner �� /T � �� S
Kind of Building ,/7 fs' J�}/%') �
i / �
Used as � W�iL- L/ li/�
To be completed about
Estimated Cost, $ _
Old—New. Building Permit No. ���_ Permit No. � �"��
Signecl/��l1, �4 / S�1 T'o'YV ����____, l T��
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By
Business P ne No. �� y�� a� 6 �"
ROUGH 9 � � � �
FINAL
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Pl.�azr:bing rixtux'e Rate:;: i10. R.ATE TQTAI.
lvurc�:eer 1?ixtures l x$2.00 $ �?. C� U
Futixre Fi�tures x $1.50
T•,ew �'ixtur��-01d C,�nen. x $1.50 ,
C� t i:l? ��i, � i Il X� 3.% S .+_�.
w�r:� z�,�a���-��,000 a�o _ X $s.00 _
Gs'ound R.:n Olr� I%1d.g. _�� x$3.25
�lec. Wa.t�r Heater � x $2.00
Gas T'itt:i���2�:�ees •
15 �. 3�; X �u:��� X$z . ao
l�dditional Fixtures x $ .75 _
Gas P.ange-"199, �00 BTiT x$5.OG ��,
R��i�°s & /�l.teratia�s
� See
Pe�cription: �p�Q
S �ate Stz.rcharge
To��, r�E
.50
$ �. S7�
The undezsi�;ned l�ereby r�akes applicatio7� ior a permit
lor tt�e �aori� �i��rein spec:[.iied, agreeing t:o do all worlc
ii� strict accoxdr�rzce wi.t�� tlze Citv Ordinances and rulin
of t'lie nerar.rm�r�t- of B�ia.�di.ngs, and hereby declare �liat
aIl tlzc facLs a�i<: r�p�es�ntations stated in thi.s
�zpplication a_,`�� txtic �i�;3 cozrec�.
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sue�ECr P
c�ty of Fridley 25 306 ��
AT THE TOP OF THE TWINS g � I L D I N G P E R M i T
i ` RECEIPT NO.
COMMUNITY DEVELOPMENT DIV. �� �`
r � V � PROTECTWE INSPECTION SEC. �'J�
� � �
� � �"'1 � CITY HALL FFIDLE� SS13Z NUMBER REV DATE PAGE Of AOPROVEO BY
�"°'�" �'' 612-571-3450 910-F15 7/24/97 � �
JOB ADORESS 7579-81 Able Street NE
t LEGAI �OT NO. BLOCK TRACT OR AODITION SEE ATTACHEO
OESCR. 2 2 Nagel's Woodlands SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PMONE
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
a ARCHI7ECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Duplex
7 CLASS OF WORK
�] NEW ❑ ADDITION � ALTERATION ❑ 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.
W�Rl�IMG
Before digging cati for
ail utility iocations
454-0002
REQUIREU BY LAW
SEPARATE PERMITS REQUlR�ED FOR
WIRING, HEATING, PLUMBING AND S�GNS.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 WOfiK IS SUSPENOED OR ABANDONED FOR A PERIOO OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTFEET PARKING
I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED THIS APPLICATION 2' STA��S GAHAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
WN H WHETHER SPECIF ED HEREIN'OR NOTOTHE GRANTING OF AOPERMIDT �8�949 ��F.47
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEI THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- �149.75 Fire SC �H.95
UCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
�� � License SC $5.00 $168.17
si ATUAEOFCON"RACTOAOAAUTMORiZEDAGENT IDATEi HEN PROPERLV V IDATEO THI$ IS VOUR PERMIT
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Consti�uctionAddress: �
Legal Description: �
Owner Name & Address:
Contractor: � n �° �
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CI'I'Y OF rRIDLEY
SINGLE FAMILY ANU DUPI,CXES R-1 AND R-2
BUILDING PLRMI"I' APPLICATION
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Tel_ #
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' - 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
Length Width Height
L,ength oZ `� Width c� a, Height
�ng� Width Hgt/Ground
. Tel. # 7�Y��2u3
y�
Sq. Ft.
Sq. Ft. Y�y
Sq. Ft_
Construction Type: �l� �,��zQ :.:��.,�,,.,,� Estimated Cost: $ �, LDc� <<>�� ,� ��,�/�
,
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ _$
DATE: Z - � �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcliarge
Driveway Lscrow
Erosion Control
Park Pee
Sewer Main Charge
1'O' 1 ��� ! ,
ti�l�ll'f �1.���1�1( )\�ti�
APPLICANT: G� �� ��� Tel. #�7 S Y� 6 t Y�
CITY USE ONLY
�
$ L� % Fee Schedule on Reverse Side
$ �� .001 of Permit Valuation (1/lOth%)
$ y� �7 $.50/$1,000 Valuation
� $950 per SAC Unit
� `S� � $5.00 (State Licensed Residential Contractors)
� Alt. "A" or Alt. "I3" Above
� $450.00 Conservation Plan Review
� I=ee Deterinined by Engineering
� __ Agreement I�tecessary [ J Not Necessary [ �
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� SUBJECT P .
City of Fridley 6 7 9 8
AT THE TOP OF THE TWINS g� I L D I N G P E R M I T
r
� � IPT NO.
� �' COMMUNITV DEVELOPMENT DIV. � //.
' j v __���_, /JI%/7 � /
r � � PROTECTIVE INSPECTION SEC. f J �r
l---- �;/'�',.j CITY HALL FRIDLE� SS4$2 NUMBER REV OATE PAGE Of APPROVED BY
i " 612-571-3450 9t0-Ft5 7/23(9$ � �
�oe nooaess 75�9-81 Able St NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED,
DESCR. 2 2 Na el's WOOCI13I1CIS SHEET
2 PROPERTV OWNER MAII ADORESS ZIP PHONE
Able Pro ert Mana ement 9920 Zilla St -
3 CON7FACTOR MAIL AODRESS ZIP PMONE UCENSE NO.
Onwer
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 �ESCFIBE WORK
Reroof 22 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code. .
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEf;M1T BECOMES NULL ANO VOID IF WORK OR CQNSTRUCTION ZONING SO. FT. CU. FT.
AUTHOFI2ED IS NOT GOMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIfV THAT 1 HAVE REAO ANQ EXAMINEO THIS APPLICATION 2 STAILS GAFiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GfiANTING OF A PERMIT $1834.80 �.9Z
DOES NOT PRESUME TO GIVE AUTHOfi1TV TO VIOLATE OR CANCEI THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY O HER STATE OR �OCA� LAW REGULATtNG CON• --•
STRUCT OR THE P FO CE C RUCTION. �59..rj� Fire cJCi �1.g3
�`
PLAN GHECKFEE TpTAIFEE
License SC $5.00 $67.25
SiGNATUPEOFCON'AACTOAORAUTHOR�ZEDAGENT {DATE� WHEN PROPEFiLV IDATED THIS IS YOUA PERMIT
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S�GNAiURE OF OWNER U� OWNER BUiLDER� IDATE� �(� �7f5P qpiE
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NEW
ADDN
ALTER
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ��7� --- � % ����-S%-/J��-� �
�
Legal Description:
Owner Name & Address: �� �,�Q,/�� /�1�,�C��-- r Tel. #
Contractor: �,�i�% MN LICENSE #
,
Address: � �7C� � l �- �- � ��D��i�'J✓�J ��S � Tel. #
Attach to this application, a Certiiicate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE �AREA:
DECK AREA:
OTHER:
Construction Type:
Length
Length
Driveway Curb Cut Width Needed
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
,
DESCRIPTION OF IMPROVEMENT
r�
APPLICANT:
$ .
$ 3
$ • �''�
$
$ �� �
$
$
$
$
$ 2 +�
Width Height -
Width Height
Width Hgt/Ground
� �� � l>�3y�
Effective 1 / 1/98
Sq. Ft.
Sq. Ft.
Sq. Ft.
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/f � � �
Estimated Cost: $ ���
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _$
Tel. #
CITY USE ONLY
Fee Schedule on Reverse Side
001 of Permit Valuation (1ilOth%)
$.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 [ ]
�
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CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 l+'AX: (763) 571-112f7
__' \\\
PERMIT N : 2004-01264 j
�'
DATE ISSUED: 08/06/2004
ADDRESS : 7581 ABLE ST NE
PIN : 123024220019
LEGAL DESC : NAGELS WOODLANDS
: LOT 2 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
TRENDY ROOFING SONS INC (20027543)
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 wark 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 worl�
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
regukai�' nstruction or the performance of construction.
Appii�ar�"� � Date
Bldg Insp
0
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
54.00
1.50
0.75
5.00
61.25
NEW
ADDN
ALTER
�� CITY OF FRIDLEY Effective 4/1/2004
�� 6431 University Ave NE, Fridiey, MN 55432 (763) 572-3604 Bidg Insp
�� SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDiNG PERMIT APPUCATION � , , j � ��
1
Construction Address:
Legal Description:
Owner Name & Address:
C'.nnfrac:tnr� T�^f��f'v
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C�� • ` /
�ak �-� v.�. 42��
Tel.
_ ����
MN LICENSE #
55 �1�!\ Tel. � iEi 3 ,�,�
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRfPTION OF {MPROVEMENT
LIVING AREA: Length Width Height _ Sq. Ft.
GARAGE AREA: Length _ �Nidth � Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
QTHER:
� S 1 ��� .IsOO • `'1'�
^ n� �� �stimated Cost: $ n t\ v- �
Construction Type�,� 'i��� �: • � a
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: � � . Tel # 1 �� _]�l -���
Call (T63) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
C1TY USE ONLY -
P�rmit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
��
$ �'7, Da Fee Schedule on Reverse Side
$ -- 65% of Permit Fee
$ %, ,SG` .001 of Permit Valuation (1/10th%)
$ � �� $.50/$1,000 Valuation
$ $1350 per SAC Unit
$ � . ��() $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "6" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary ( ] Not Necessary [ ]
$ (�����ZS✓ STIPULATIONS:
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REVI
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Building PLUMBING
Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-�OG-�� / / ��� EFFECTIVE 2-19-09
DATE i:' (o ! O� r —
SITE ADDRESS 7.�(jO
THIS APPL[CANT (S:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
PERMIT TYPE
TYPE OF WORK:
�OWNER
NAME: �U I �
ADDRESS: ?S�
PHONE: �
NAME:
STATE LICENSE #
STATE BOND q
ADDRESS:
PHONE
�SINGLE FAMILY
❑ NEW
Permit No.:
Received By: /�
Dat���dJUN _ 9 2�
YOUR E-MAtL ADDRESS �-s uf G(J Sr/1�.. G C� i'YI
/V C i (- 'C ( .�% �i �� � � N �r�C3 `L
OCONTRACTOR
1L�
lol�
O TWO FAMILY
� L� �
Y �/L CITY �� I �%L C��
3��2
EXPDATE
EXP DATE
CITY
FAX
❑ TOWNHOUSE
�REPLACEMENT
AT�/vGIP S��I3
ATE ZIP
DETAILED DESCRIPTION OF WORK /�� �G � ��� � L ✓ � �i� � /�lJ eP �
S7 � c� e-r ��- ccJ ,� T e 2 1�I � TE �2
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MIN(MUM FEE
$35.SQ
BATH SINK/LAV FLOOR DRAINS SHbWER WATER PIPING
_ BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER (�
_ CLOTHES WASHER KITCHEN SINK WATER CLOSE'i' BACKFLOW PREV. $1 )
_ DISHWASHER _ LAUNDRY TRAY WATER HEA"I'ER ($35) FOR IRRIGATION
_ WATER METER _OTHER
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PRUCESSED
I hereby apply for a plumbing 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 f r a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the e I wor hich requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME t' •�< <�a t N��2 DATE ��i � �
City of Fridley
Suilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977