AF - 46121•
•
•
Date:
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City of Fridley, Minn..
BUILDING PERMIT N� s s 2 s
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.���t _ . ..:__� ' _..._... _ _....... . " . Builder _. __ ...._. �... ......._ ............._............._............_......_.___.�.__.._.
Address_..._......_:..._......._..._...__.._......_.__.._...__...__.._..._._...._...._..._......_.._. Address
TIO , F BUIL ING
No. ���.,..�.r Street ..-_-•. ......_.._-- ----...._ � •---- _.._1..... -- -f- ..:,,!_-.... P f t .............. .___._......____._._._..----. . _._.
Lot _..._.,�_...._......._...._ Block .___.._.._....�----•---•-•-•--------- Addition or Sub-Division _.. .... .._..._. �
...__.. _._.. . -- - _ ..._...._ ..._..._
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Corner Lot _.__............_......_ Inside Lot •---•--���•----- Setback ...��......--•--.... Sideyard ........•-•�D..._.._.__�...___.__..__..�._
Sewer Elevation .__......_.____..._..•--•.__..._......__._..___.._......_.._-••----_ Foundation Elevation
DESCRIPTION OF BUILDING
T U :
// �r s /,�
. .... . _. ... ... Front _..(�.lC.�.�. Depth ...�� Height _..� .. Sq. Ft. / �� Cu. Ft�..�.�_..�7 v
....._.._.._._.___..._._.._..._..__....... Fron --.___.........__ Depth _...__ � f�eight ....._.....�.�, Sq. Ft. ___...._._.
. Cu. F� _._.
Type of Construction -•����`��•'•�:�`.c.�•-.. Est. Cost p` U. ��To be Completed ....._...__......_._._________._
•-•-..._ .... ---•-:L.��.F��.._.......
In cotisideration of the issuance to me of a permit to construct the building
th� proposed work in accordance with the description abo � se��
ordinances of the city of Fridley.
�
! above, I agree to do
with all/picovisions of
pv
In co�sideration of the payment of a fee of _ ��_., permit is hereby grauted 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, 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 buildings
wi'thin the city ]imits and this permit may be revoked at any time upon violatioa of any of the provisions of said
ordinancea /1 �. ,, r1
Building Inspector
NOTICE:
This p�nnff dou not eowr 1h� eonstweNon. iiuhilaHon fer vririny. phimbing, gas h�atiny. s�w�� or wN�r. 8� wn to sN
th� Buildiag In�p�etor for �p�rai� p�emils for th� ibms.
#
V �
A�P'LICATION FOR BUILDING PERMIT
GIZY OF FRYDLEY, MINNESOTA
OWNER'S NAME BUiLDER
ADDRESS ADDRESS
N
LocA�cox oF aua. xc
t
No. �`� �� Street Part of Lot
Lot r Block Addition or Subdivision
Corner Lot Inside I,ot Setback Side Yard
SEWER BLEVATION FUUNDATION SLBVATION
Applicant attach to this foron Two CerCificates of Survey of Lot aad proposed build-
ing location drawa oa these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Frout Depth Height
Sq, Ft. Cu. Ft.
Bront Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
Tb be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Departmeat of $uildiugs, an8 hereby declares that all the Facts and
represeneatioas stated in this applicatiou sre true aad correct.
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DATE � � � SIGNATURE l � /
(Schedule of Fee Costs can be found on the 1�E�ve�tse Side . ��L � ��
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Land Surveyin9 Minr�oPo%s 32,
SoilsTestin9 EN G I NEE R I N G, I N C. ��°f°
Civil b tilunicipo/ S(/nset4-6066
E,�meerm9 E/�9ineers � Surveyo�s
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l htrrby urfi�'y f/wt Ihis �s a Irur av� �cf ���resenfofion o�'a su^vttf y�'lfir ba�r►abriies �'�fr �b+ir obr�►b�d laid, e'�d
o�'�!Z /ocafion o�'all bvildin9s ,1�rrPa� , and d/ r�sib✓e axrnodimtnfs , ifmxf ,�rn ar a� ssid /and. As wrvty�d t� mr ih5 - abrf
`� �� A�D �' SUBURBAN ENGINEERING, INC.
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City of Fridfey
Apptic�tion for Plumbing emd C�as Fitfing Penrtit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK Cj a 9� ��� � �� �I �
Number, Kind and Locatian of Fixtures Locahon �
�n U' WATER HTR.
N
N �
F� x� `� '� xyt Zz ��Z �Z aw � � W • w
;� � �� � in 3 t�°C- O� u=i � o V m< 3 C7'J G�U' �(�9 p i N GAS EIEC.
Base
lst
2nd
3rd
4th _ _
• Fuiu:e Connaciion Operuags
* New Fixture, Old Openings
PARTIAL RATE SCHEDULE
�
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- ��� � � , 1�
C3wner �� � J � � V '1 �i2 S
� , '
Kind of Building .�`'_L.�m C�
3ewer � Used as �W�/ N�
Cesspool �
Ta be completed about _
PLIIMBING FIXTURE RATE3: NO. RATE 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 ta 200,000 BTCT) . . . . . . � x 2.00 $ �' �
New Ground R,un Old Bldg . . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
� lst 3 Fixtures . . . . . . . . . . . . . . . . . . . . . . . . . . � x $1.50 $�
�, Additional Fixtures .................... x .5U $
Gas Range to 200,OOQ BTLl . .. . . . .. .. . .. . x 2.00 �
, REPAIR3 8c ALTERATIONS—Refes Yo Code
� Description ....... $
........................................
, TOTAL F'EE $��,�--":�—
Estimated Cost, $
Old-1�Tew. Building Permit No. ����� Permit No.��
Signe � �.� � � � T �
By
Business Ph ne o. l� y� ��%� y'
ROUGH � � �� ! �
FINAL
42
. �
Application for Power Plants and Heating. Cooling, Ventila�ion. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: •' ` . . . .."�tA.�E .. �,T1�T, _'��"•
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 1?A,OOQ BTLT . . . . . . . . . . . .
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 $
3TEAM or HOT WA1'ER 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 $ f � • Uv
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ...................... x $1.50 $
Additional Fixtures . ............... x .50 $
Gas R.ange to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING �
FAN HEATING 3YST8M See Fee Schedule
VENTILATING SY3TEM $
ALTERATIONS & REPAIRS TOTAL FEE $ /'�D. �
ROUGH
FIN
Depi. oi Bldgs. Phoae SU 4-7470
LocBtion �� / � �L � � ✓ � , �.-
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. �,��'J G - � _,' 19��
Owner � � ��� 1� �� �'�S
Kind of Building / �/'��rn �
Used as _ ��%� �Lt W °�
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No. °Z
DESCRIPTION OF WORK
AEATING or POWEit PLANT5�team, Hot Water, Warm Air—No.
Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTL1 H.P.
Total Connected Load Kind ot FueL
BURNER — Trade Name Size Na
Capacity Sq. Ft. E.D.R. BTfJ H.P.
(REMARKS-OVER)
��p42 'jM
Signe � `� �
By -
Business Phone . � y �'�� J � �
Application f�or Power Plams and Heal�ing. Cooling. Yentilation� Refrigeration and
Air Conditioning Systems and Devices
PARTfAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOT 6 G
Furnace Shell & Duct Work . . . . . . . ... .. . . ... . . .. ..�,?r 8.00 ��—
Replacement of Furnace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. �500.OU . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTLT . . . . . . . . . . . .
each add. 60,000 BTIT . . ........... . .. ... . .. .
Replacement oP F�rnace .:...........................
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 $
Fumace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR 5team . . . . . . . . . . . . . . . . . . . . . . 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 tup 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.OQ $
AIR CONDITIONING �,
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM �
6a
ALTERATIONS & REPAIRS TOTAL FEE -�
ROUGH
FINAL
Depi. oi Bldgs. Phoae $U 5-7470
Loc8tion � � � J ' ��' � � Q S � . %�%. 4. �.
♦
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. , 19 6 �
Owner �� ' � � � ��(�,.
Kind of Building �.�I
Used as ---��
To be compieted about
Estimated Cost, $
Old—New. Building Permit No. �� �� Permit No. ��-�
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—Na
Trade Name� � Size No.
Capacity
Sq. F't. E.D.R. BTU H.P.
Total Connected Load�„� a�- �� 3 q Kind oi Fue� �� �, ��� S".
BURNER — Trade N
Size No
Capacity Sq. Ft. E.D.R. BTU H.P.
Signe
By (� c�•-� �
��<z sM Business Phone No- �,� � � � ``� S/ -�
(REMARKS-OVER)
� SuBJECT 0• -"
City of Fridley 2 5 3 0 5�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� ` RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
r � V • � PROTECTIVE INSPECTION SEC. �� �
� �
� � �"'1 � CITY HALL FRIDLEV 55432 NUMBER tiEV OATE PAGE Oi APPROVEO BY
�----�: �.' 612-571-3450 9t0-F�5 7/24/97 � �
JOB ADDRESS 7595-97 Able Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 1 2 Nagel's Woodlands SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
ABLE PROPERTY MANAGEMENT 9920 Zilla St NW, Coon Ra ids Mn 55433 754-0743
3 CON7RACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
Kozitza Construction 9175 Isanti St Blaine MN 55449 786-3625 2650
d ARCHITECT OR DESIGNER MAIL ADOFESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII AODRESS ZIP PNONE LICENSE NO.
6 USE OF BUILDING
Duplex
7 CLASS OF WORK
a NEW O ADDITION O ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOFK
Construct a ZZ' x 22' Detached Gara e
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on p1an. Provide a hard surface driveway.
Variance on rear yard setback approved by Appeals Commission on 8/14/96.
WARM{�
Before digg�ng c�fl for
alt utility Joca#ions
454-0002
SEPARATE PERMI"fS REQUIRED FOR REQ�-%�RED BY LAW
WIRING, HEATING, PLUMBING AND StGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE f;E�UIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID 1F WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITMIN 60 DAYS, Ofi IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PER100 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION 2 STALLS GARAGE$
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUAT10N SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEiiE1N OR NOT. THE GRANTING OF A pERM1T �8� 949 ��F. �F%
DOES NOT PFESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEFMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- �149.75 Fire SC �H.9S
ST CTION OR THE PERFOFMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
"�� � License SC $5.00 $168.17
NnT EOPCONTRA�T0�70AAUTHOA4EOAGENT IDATEi WHEN PROPEFIV IDATED THIS IS VOUR PERMIT
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S�GNATUREOfOWNERiIFOWNERBWLDERI IDATEI " �' � '
BLOG NSP ��4TE
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AD�)i�
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Const►�uctionAddress: �
Legal llescription: � �
Owner Name & Address:
Contractor.
Address:-- ,
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
crrY oc FRivLrY
SINGLL FAMILY AND DUPLEXES R-1 AND EZ-2
BUILDING PLRMIT APPLICATION
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`_t �,/.�i�i�,�(.4� �
L:ffcctivc Ut/97
�������
; ���2.. ���.�. - �%`����.1..0-�-:� Tel. # � S� y- � Z �[3
�
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u.� �F rU�- � a ��/ j�j1 % t�tS� MN LICENSE #
3 � �!' %SY �_�-1 �> i �, J-i - � ����� r_ . Tel. # 7J`7��i2�(3
Attach to this application, a Certificate of Survey o�th��
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlViPROVEMENT
�ng� Width Height
�n� 02 � Width b2 a Height
�ng� Width Hgt/Ground
Sq. Ft.
Sq. Ft. ��.
Sq. Ft.
Construction Type: � �,L,r� ���,,,,,,� Estimated Cost: $ �S, LOc� � nU � �C
. .
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ -$
DATE: 7- 1� APPLICANT: �,';�J Tel. #�7 ;� Y� 6 7 4! 3
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Lscrow
Erosion Control
Park l�cc
Sewer Main Cliarge
�('�)'1�,1I
5�1�11't �1.-��1�1( �:A�.�:
CITY USE ONLY
$ -� Fee Schedule on Reverse Side
� �� .001 of Permit Valuation (1llOth%)
� . $.50/$1,000 Valuation
� $950 per SAC Unit
� 'SL � $5.00 (State Licensed Residential Contractors)
� Alt. "A" or Alt. "I3" Above
� $450.00 Conservation Plan Review
� Fee Detennined by Engineering
� Agreement Necessary [ ) Not Necessary ( ]
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SUBJECT P
City of Fridley 6 7 9 2
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
�
; ` RECEIPT NO.
� ` _���_ COMMUNITV DEVELOPMENT DIV.
r � V � PROTECTIVE INSPECTION SEC. ��
� .
i_--- �;����;'� CITY NALL FRIDLE� SS132 NUMBEp REV OATE PAGE OF APPROVEO BV
i J\ 612-571-3450 910-F15 7/23/98 / /
JOB ADDRESS
7595-97 Able St NE
1 IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. 1 2 Na 21 � S Woodlands SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Able Pro Man
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO.
Able Pro n 55433 754-
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUIIDING
'd n
7 CLASS OF WOFiK
O NEW O ADDITION O ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REQUtRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OF; AIR CONDITIONING. `
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFE9Y CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION SUiiTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIEO HEREIN OR NOT. TFIE GRANTING OF A PERMIT 1834. HO . 9Z
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- v,��
STRUC OR THE PE FORMANCE OF COMSTRUCTION. �rj9.,rj� Fire SCt�u�X �1.83
PLAN CHECK fEE TOTAL FEE
License SC 5.00 67.25
S�GNATUREOf CON� ACTOAORAU RIZEDAGENT IDATEI yy�N-PflO�RLY LIDATED THIS IS YOUR PERMIT
�„/I �- 2 y-�9�
SiGNATUAE OF OWNEAi�F OWNEA BU�LDER� IOATEI BlD �NSP �iFTE
NEW
ADDN
ALTER
[)
[l
[l
CITY OF FRIDLEY
SINGLE FAMILY A1�ID DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1 / 1 /98
����
��
ConstructionAddress: �,��,5 � � 1����5� !��,
Legal Description:
Owner Name & Address: ,�.gG�j�'�Q� � ��' �. Tel. #
Contractor: �� MN LICENSE #
Address: ����� �%��'� sT� - X����l��--� , Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'rION OF IlVIPROVEMENT
LIVL�TG AREA: Length Width Height
GARAGE -AREA: Length Width Height
DECK AREA: Len th Width Hgt/Ground
OTI3ER: / . ��.�:� ���5� :Y �C 7� 7� `
Construction Type:
Driveway Curb Cut Width Needed:
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surchar.ge
Driveway Escrow
Erosion Control
Park F�e
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT:
Sq. Ft.
Sq. Ft.
Sq. Ft.
� �
Estimated Cost: $ /� ��"�
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _$
CITY USE ONLY
Tel. #
$'� Fee Schedule on Reverse Side
� ' � .001 of Permit Valuation (1/lOth%)
$ L% $.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 [ ]
$�g-!�
, .
�
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 r'AX: (7631571-12tf7
— ---�
PERMIT O.: 2004-0126
DATE ISSUED: 08/06/2004
ADDRESS : ?597 ABLE ST NE
PIN : 123024220018
LEGAL DESC : NAGELS WOODLANDS
: LOT 1 BLOCK 2
PERMTT TYPE : BUILDING
PROPERTY TYPE : DUPLEXES
CONSTRUCTION TYPE : WINDOWIDOOR 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 wark 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
reg� ' cons�tion or the performance of construction.
AI�I�11�.Q11L Date ; ,
�-����� �' "' �
i � • � 1r�i-f
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
SEPARATB PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
54.00
1.50
0.75
5.00
61.25
NE1N [ ]
ADDN (]
ALTER [ )
J
Construction Address: �
Legal Description:
Owner Name & Address:
Contractor.� l `� �
Aririress� r� � � �.o. �
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg lnsp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPL1CATlON ���� j { ?��� ��
�
q -� _ � � °� S �Q
���� �.�~ <
� i
.� �ea �., �v �N1�.��� �M T
�.�� 425a
Tel.
�
MN UCENSE # Uo' 3
�S `�'� Te�. #-1 b3 S 9I � 9``� 33
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length _ Width Height Sq. Ft.
GARAGE AREA: Length , Width � Height Sq. Ft.
DECK AREA: Length ` W�dth HgUGround Sq. Ft.
�THER:
S'S �.\"� S.4O• p3' c�.�,
Construction Type:�q,��.9--� �► � �a �� � �stimated Cost: , -
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _ _$.
DATE: % " � " � � APPLICANT: Tel. # ,�� 5 \�'�� �3�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-128 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 Esccow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL .
$ �� �'C�
� �_____'
$ /: ��
$ • ,�.,
$
� �-�"t�
$
$
$
$
$ ���
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 Conseniation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
.,
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��oo-� � o�S� '�0 13���T'c,�. a� �r w:�aovJ
�'c � a,v� � �,+�`� o� '1� 12 w � �� � � � ° .�
-.� RQ�,�. o�a w,,na�� . �. �a� ���� �� �
�eeQQ-1 �� W ;�a�
Building
rnspec�zons
7. b3-572-360�
AA� f [� i Y_ � ��
S,ITE ADDRBSS �% S�.
THIS APPLICANT IS:
OWNE�t/
TENAN'�'
SUBIvIIi' A COPY OF
YOUR STATE
LIC£NSE WfII-I
APP�.TCATION
PERMTT 'X'YPE
TYPE OF WORK:
, � MT CHA�.NICAL perniit No.: �U - a �,
�2E'�SIDEI�T'IAL APl'LICATIQ� ��ived By: �
�
�Y�� �� �R�L�� Date Rec'd: 6' ���'
_ YOUR F.�MAIL ADDRESS
O OWPtER �(CONi'RACTOR
�
COMPA2�fY NAN�E:_
CONTAGT PERSON:
STA't� L3CENSE �!_
PHONE��,^ �--� '���` �) r FAX
�SINCrT.E FANlJL'Y � TWO �A,1vU1-Y
0 NEW �REPLACEM�NT
DETAILED D�SCRIPTiON OF WOR]S
CITX Y�/1 ���.�� l.3 � tN STATE �Z�P�
�XP DA'I� _
{-�;�. c�r�r
�_ �'1 ,
p TpWIdHOUSE
p ALTERATION/tZEMODEL
S(�
p�R MS 16B.665 the permit fet i.s a minimuzn of $15.00 or 5'/0 of the totat cost ag to SSOO.OQ, whichever is grcater, f�r the
improvement, instatlation or repiacement o� a r�sidential ftxture, excludiz�g the fixtures. {',Chis should reflect only the cost of Iabor }
�abor cost tutder $300 =$15.00. Laboi• cost between $300 to $SUO = cost of labor x.OS =
FOR PROJECTS WF�RE [ABOit EXCEEDS S500, k�FS ARE $ASED ON SI0.00 P6R FIXTURE, �'XCEPT WHER� NO'�EU• FDC7'URF.S: (AiD1C?+TE TOTAL
NUMBER OP �ACH BELO� SIZ�/BTU
Eqnipment lnstatled , MFG: MODEL: S1ZE/�TU ��
Iv�FG: �_ MODEI.: ��
MFG:
MObEL: „_. SIZFBTU _—.------
A/C SZ5_00 �„FIltEPI.ACE (GAS) 515.00 GAS itANGFIOVEDi S10.00
�pIR TO AiR F,3tCHANG6ER S15 F1R�7LACE (W�D) S35,00 _I�W GAS GRTI.L S10.00
80II.�R 535-00 ��URNACE 535.00 ;,,_CxAS UNiT HTR 510.00
I�HINWEX LINER SI0.00 �CAS DRY£R $10.00 POOL HfiATER 535.00
„r�r-r wnQK s� n nn �S�AS �'iPiNG 510.00 _Vk,�iTILATOR S15.40
���
Permit Fee
Surcharge
TOTAL DUE
.�..�., �.:-•-• ._ �._.__......_._.�_..._ _ _ _ _ _
$ Nnmbe�r �f fixtzues aQ �10A0 �' $10.00 =
� � .50 Number of fixtures (� $15.b0 x �15.00 = S
� __,_� Number of �'ixtures @ $25.00 x $25.40 = $
Numbex of fixtures aQ $35.00 � x$35,00 =$�
Siate Surcharge = S 50
Total � $�
TH1S IS AN f#PPI.ICATION �OR A pERMIT NOT VAL1D UNTIL PROCESSSD
I hereby apply for a bui�din� permit a�ad I acknowledgc that the inf�rmation above is c�mple'ta and accurate; t11at �he work wila be in
conforuxauce with the ordinances a�td todes of the City of Fridley and with the Minnesota�Gonshuction Codes; thaz i understand this is
not a permit but only an application for a permit and work is not to start without a pernut; that tt�e work will be in aCCOrd�nce with the
approved plan in the case of work which requires review and approval of s. �
SICrNATt]RE O� APFLIC � PRINC N ° * - � J'il`7/ � �� ��DATE ���I � �� �
Cxty of Fridley
Building �r�spections ��partn�e�t
643I Universxty Avenue N�, Fridley, MN SS432
763-572-3604