AF - 44866�UILDING PERIVIIT
Village of �'ridley, l�'Iinn. N� 2� 2 8
Date /•� • ��. �.,; . �.'.';�.�r . . . . . . . . . . . . . . . . . . . . . .
�"J t�t
Owner. .......... Builder ...........................................
� ���.�'�"'?''"��,.'��
Address.�,..�;.,.r+a�..�... �� ........ Address .........................................
— �"d$d��
LOCATION OF BUILDIIVG
No. .s-� .. Street Part of Lot
i,,;�.3.�: � . .�-�,��rr'::�' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .
Lot ................ Block .....,.......... Addition or Sub-Division ................. .. ................
Corner Lot .;�. ....... Inside Lot ............ Setback ... .� Sideyard .,r. . ..............
f''" ��""1,�-�.' ;,�1� r�%�-�'`
DES�CFZIPTION OF BUELD{NG
To be Used as:
, . . . . . . Front * . . Depth . . . Eieight . . . . Sq. Ft. ,„. .� . . Cu. Ft.
R .� � ........
� l�'� , ft ^'t��� �-.'`� � `"wn�` W� ��, � - �.� � +..,�
� � � ` Y. . Front . . . . . . . Depth . . . . . Height . . . . . . Sq. Ft. f . . . . . . . Cu. Ft. . . . . . . . .
,
I k �� rE�` .; ��,� a .r
,� . �r,. �- � . 1 r '��. , c �, k �;�� y r- „� &.�. � r �_ ;
Type of Construc�ion .. ..... Est. Cost ,,..,: ... .. .... .. . To be Gompleted
. .. .. .
, .. .....
�
. . . d..
~�''%'+r� ` �?' �+ J � �, • � 'i°���� � . .� .
In consideration di the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliarice with all provisions of
ordinances of the village of �"ridley.
r .
,�-a
:�,: . . . .
In consideration of the payment of a fee of $.,. . . . . . , permit is hereby granted to . . . . . . . . . .. . �.
..... ...........
... to construct the buildin���Q�dition as described above. This � nted upon
_,..���"��di�ibn that the person to wham 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
F'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits anfl this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. . �,
..�FJ : .. '
-.. . . . .......... Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspeator for separate permits for these items.
---�
•
�
City of Fridley, Minn.
BUILDING PERMIT N° 3 3 9 4
Date: . . . t. -. . �. . � . -: �:�'. : . . . .
Owner�.......r . • ... .... Builder . .�.�. ,, .....................................
Address...(�.�.� .. ....... ......... ...... Address .............................................
LC�CATIOlV OF BUILDING
No. �`!. .� 7! . Street���.s4� . . . . . .. . . . . . . . . . . . . . . . . . . Part of Lot . . . . . .. . . . . . . . . . . . . . . . .
Lot j�. :r�". !.� . BYock . . . . .� . . . . . . . . . . Addition or Sub-Division . . .��.�.c . . . . . .
Corner Lot ............ Inside Lot ...� ..... Setback ............ Sideyard ...........................
DESCRIRTION O�' BU[LDING
To be Used as:
�t�f���.... � ont ....... Depth ........ Height ........ Sq. Ft. ........ Gti. F't. ........
.................... Front ........ Depth ......,. Height ........ Sq. Ft. ........ G�. Ft. ........
Type of Construction . . . . . . . . . . . . . . . . . . . �a� Cost. .0. , .��. . . .�'~. . . .�.° To be Completed . . . . . . . . . . . . . . . . . . .
.�� � � � ��X a e
��� � � 1 � " 6 �
,�" � ,�..� �� x � �
, .
%C' � � P'� ��..._ � � cs '� �
In consideration of tihe issuance to me of a permit to construct the building desribed above, I agree to do
tYi� proposed work in accordance with the descrIption above set forth and in compliance with all prpvisions of
ordinances of the city of Fridley. � �
.�. ............ ...... . ....
�/� �/ ��
In consideration of the payment of a fee o! $. y7...G.`�'�....., pernut is hereby granted to ...................
..... .. .. .. .. .. .. ... .. .. . to construct the building or addition as described above. This pezmit is granted upon
the express condition that the person to whoan it is granted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
J Fridley, Minnesota, regarding location, construction, alteration, maintenance, repair and moving of bufldings with-
in the city limits and this permit may be revoked at ar►y time upon violation of any of the provisions of said
ordinances. _
z-�m���—���
NOTICE:
This permit does not cover the construction, instailation or alteration for wi�i , binp, 9as heatinp,
sewer or water. Be sure to see the Building Inspector for separate permits for itema
}
City of Fridley
App�ication for P`lumbing and Gas Fitting Penrrrit
Dept. of Bldgs. Phone $U 4-7470
DESCRIPTION OF WORK ` � '� �, � �'
Number, Kind and Lxatian of Fixtures Locatio
y N � � N W Z � * WATER NTR.
•�G' �� z- x� �'� us!} Zz �Q°`z �z oxvt � � u! z
Q t� � �' '� Z Q dS � � = j� <~� j< Q a� Z < a F N GAS ELEC.
� ; � o f m Vl 3� o LL N LL o U m<$ C9 t U� Sn U O
Base i � � � �
lst
2nd _
3rd
4th
• Future Connection O�eain.gs
* New Fix3ure, Old Oper►ittgs
PARTIAL RATE SCHEDULE
Sewer �
Cesspool n
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . .— �'�' x $1.50 $ lo • U U
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 $ �
New Ground Run Old Bldg. . . . . . . v . . . � x 3.25 $ � • °'L 5
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .......................... x $1.50 $
Additional Fixtures . . . . . .. . .. .. . . . . . . . . x .50 $
Gas Range to 200,000 BTiJ ... . . . . .. . .. . . x 2.00 �
REPAIRS 8a ALTERATIONS—Refer to Code
Description ................................................$ ��
TOTAL FEE $
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 Bu'ldings, and hereby declares that all the fact
and representations stated in this a 'catio re true and corr
Z.,
Fridley ' n. � , 19 �
� ' t
Owner
Kind of Building
Used as `��'`r"� - � – �
To be completed about
Estimated Cost, $
Old— ew. Building Permit No. rmit No. `� 3���
Signe "
gy e
Business Phone No. �� ` ��
ROUGH
FINAL
az 2M
�
Application for Power Plants and Heerting. Cooling. Yentitation. Refrigerirtion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE T--O�
Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . . . . . . $10.00 �
Replacement of Furnace ............................. 6.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 6.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU . . . . . . . . . . . . $10.00 $
each add. 60,000 BTtJ .. ...... .. . .. ..... . . .. . 3.00 ;
Replacement of F�rnace ............................. 6.00 $�
Repairs & Alterations—up to $50�.00 . . . . . . . . . . . . . . . . . 6.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . .. . . 3.00 $
3TEAM ar HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . 3.00 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 3.00 $
OIL BURNER—to 3 gal, per hour . . . . . . . . . . . . . . . . . .. . . . . . 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $ �� � �
over 199,000 BTiJ See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
Ist 3 Fixtures ..................... �_ x$ 2,00 $�- 0�
Additional Fixtures . ..... ... x .7b $
Gas R,ange to 199,000 .. x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SY3TEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
�
See Fee Schedule
S
TOTAL FEE � /� , � �
Dept. of Bldgs. Phone 560-3450
Location � �.2 � �/_�...� i<.G��'��
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir.
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 ar true and correct. '
_ � ^ F�idley, Minn. �U , lg��
Owner
Kind of
Used as
To be completed about v�� �� T� ���CJ
Estimated Cost, $ �
Old New. Building Permit No. Permit No. .�,.33
DESCRIPTIOM OF WORK
HEATING or POWER NTS--Steam, Hot Water, Warm Air—No.
Trade Name� Size No. %���� � �
Capacity ��� � Sq. Ft. E.D.R. BTU �,Z d o a '�
Total Connected Load �� �l� Kind of Fue1 �(�-�/
BURNER — Trade NamP Size No.
Capacity Sq. F`t. E.D.R. BTU H.P.
(REMARKS-OVER)
42
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- �.r�i�� ,: � I��� � � E �
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HO SE HEATlNG TES7 RECORD
ADDRESS --�� APT. FLOOR CITY SUBUR�
OCCUPANT � �� OWNER
HEAT LOSS DATE HT INST. GAS C0. METER E#
SOLD BY INSTALLED BY
Eleetrical Work By Gas Line By �- " •
TYPE OF HEAT GA FA �HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE � MAKE OF BURNER
Model Modet
Serial SB 3�'oS"n.S' 9�' Max. BTU Rating
INPUT f6 ���n MAKE OF FURNACE
Model
T� CONTROLS �� �
THERM05TAT aL�., Heat Plug Venf Size
Valve y� KIND OF LINER SIZE �'r NONE
Limit ____LLL Draft Hood �' �, Regulator L�'�
Limi! Sstting �,� � Filters Size_--_t��s^ Number `
Fan Setting �l �, Q-'��d Chimney Location ide �� Outside
Pilot Type � Chimney Construetion
Pilot Make ,�—
Pilot Model p�� Smoke Bomb Wiring
Pilot Timing C5 �.lLo c� Draft t/� Test Tay �-----
L.W. Cut Off Door Pressure— Lighfing Insi. �'�
t � �
Prossure � Q Percent CO2 '� Date Tasted ���
)nput CFH Peresnt 02 � � Company Testing
i$taek Temp. Percent CO ^ d'� Name of Teater
Form 235
sue�ecr PERMIT .
City of Fridley 12665
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
f
; � CEIPT NO.
� `L _ COMMUi�11TY DEVELOPMENT DIV. � / � • %
r � � PROTECTIVE INSPECTION SEC.
��p� ��
1 �
1 i �
(4 � �� r"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF �APPROVED 8Y
""'� � ,'� 612-560-3450
910-F15 8 7 7 4 � 1�
JOB ADDRESS �,1011 Hau ert 6524 Anoka Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION S€E ATTACHED
oesca. 1,12 �.t 4 Oak Grove SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Arlon Haupert 6524 Anoka Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Franzen Construction Co 4250 5th Street NE
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE UCENSENO.
6 USE OF BUILDING
House addition 16 x 8
7 CLASS OF WORK
❑ NEW �7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
add 16 x 8 to existing house
9 CHANGE QF USE FROM TO
STIPULATIONS
'SEPER�TE PEft�M1TS REQIJ�REA FOR WIRING�
NEATING, PLUMBIN� AND StGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, W�Od f rame
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ: FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK 1S COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED �r
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT '+'4 / OOO 2
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTNER STATE OR �OCAL LAW REGULATING CON-
STRUCTIO THE PE ORMAN OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
�C./ ' ;
SIGNATUREOFCONTRACTORORAUTHORIZED EN IDarEt WHEN PROPERLY VAUDATED THIS IS YOUR PERMIT � �
. c�3 13
SiGNATURE OF OWNER UF OWNER BUILDERI IDATEI BLDG INSP ' � DAT
�
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITiON BUILDTNG PERMIT
CITY OF FRIDLEY, h1INNESOTA
OWNER'S NAME: �_BUILDER:� � �
ADDRESS : (OSd` �/ tl ���„�,ri� 7'!- t°i, ADDRESS : ?� o .S^� � �'f �-
NO:. (v,S�� STREET: � 1,�� � -
LOT: ,�-� � BLOCK: _� ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this foxm �too Certificates of Survey of Lot and proposed
building loca�ion drawn on these Certificates. �
E
iiESCRIPTION OF BUILDING
T�e Used ��/ •
� cYt1%O,-r / �
Front. (p Depth: Height:
Square Feet: �� Cubic Feet: ��� `�
Front: Depth: Height:
Square Feet; Cubic Feet:
/
�pe of Construction: �%L� � �✓�:t. m� Estimated Cost: $���, 0 a
To Be Completed: �/j� °— �-- � �/
The undersigned hereby ma.kes applica�ian for a permit for the work herein
specified, agreeing to do all work in st'rict accordance with the City of
Fridley Oxdinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
Z ��
AATE : � 2 SIGNATIJRE :
(See Reverse Side For Adclitional Information.) � � �
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sue�ecr PER .
City of Fridley ° 12949
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RE PT N0.
� • COMMUNITY DEVEIOPMENT DIV. ��
' � L: —
r � � PROTECTIVE INSPECTION SEC. `
1 �
�4 � /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
""'�' ,�� 612-560-3450
910-F15 5 19 75 � �
10B ADDRESS Arl on Haupert
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ��,12 4 Oak Grove Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Arlon Haupert 6524 Anoka Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
��rr��rt+ Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
�c7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construct 24 x 22 Ft. Garage
9 CHANGE QF USE FROM TO
STIPULATIONS � ���
i. Provide a hard surface Drive. ca111o�� ut`���
gefore digg�ng GAS Et�'
�EI.EPHONE - ELECSRI Y ��
RE{�u1RE� �
,�
SEPERAT� PER�;.i.�� REQ��li�Z�a FOR Ylti� r X�� .�o�,�P PQ�
HEAT�l�, �,U�S�NCa� A�1�2 Si.C��''s - ``�' o�� ���'
r r� �„�„o
S�Q K �' }
'��� �
��� `f
�f' ,.
TYPE OF CONST. OCCUP UP OCCUPANCY LOAD '
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, .0
VENTILATING OR AIR CONDITIONING. WOOd 1 Y�allie
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
OR WORKES SUSPENDOED ORNAB NDONED FORAA PEROD OFON OTDAYSOAT rJ2H S�ZHO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX ,
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3 �907. ZO �.9�J
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON, �O.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
11.95
� SI f�l REOFCONTRAGTOROR THORIZEDAGENT IDATEI EN PROPERLY ATED HI IS YOU ERMIT
• ; � 7 ��
i ATUREOFOWNERIIF WNERBUIL RI IDATEI BLDG WSP DATE � '
.. ., . . ' ' ^ /� � �. -. 4 r �
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APpLICATION FOR RESIDENTIAL, AI,7'ERATION,
OR AllllITION BUILDING PERMIT
CITY OF FRIDLE`I, b1INNESOTA
, .
�WNER'S NAME: BUILDER:
ADDRES S : �,��,�� ��z� ADDRES S :
NO : . �v�� � STREET • C�t`�z��l�v � °
LOT • � / . BLOCK • / Z- ADDITION • /%� ,�✓i'✓n'"�
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant att�ch to tris form '?iao Certificates of Survey of Lot and propos 3
building location drawn on these Certificates. �
DESCRIPTION OF BUILDING
To Be Used As:
� Front: ��Depth: � � Height: � �
Square Feet : S�-3� Cubic Feet : �� ��
Fxont: Depth: Height:
Square Feet; Cubic Feet:
1j�pe of Construction: _ �i'�� stitna.ted Cost: $ `�`QO ����
To Be Completed: ���sL� —
The undersigned hereby ma.kes applicativn for a permit for the work herein
specified, agreeing to do all woxk in stiict 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 : � SIGNATITRE • �'�-+�%"l/ �
(See Rev rse Side For Additional Information.) .
,l4- � ,u
� �� ,��� z� _
__.�• � ��s
l/
sue�ecr � P IT N .
City of Fridley 2 813 0
AT THE TOP OF TME TWINS g �� L D I N� P E R M i T
� - 572-3604
,� .
� • COMMUNITY QEVELOP�ENT OIV. � ! ^ �
r � � � PROTECTIVE INSPECTION SEC. �� ��
� � �"'1 � CITY MALL FRIDLE� 551J2 NUMBEA pEV O�TE P�GE Of •PVROVED Br
�"""'�" �'' 612-57�-3a50 s�aF�s 10/7/98 � �
JOB ADDRESS
6524 Anoka Street NE "
t LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 11, 12 4 Oak Grove Addition SNEET
2 PiiOPEFTY OWNEfi MAIL ADDFESS ZIP PMONE
Kath Hau ert - 1
3 CONTRACTOR MAIL AODRESS ZIP PNONE LICENSE NO
Ideal Roofin Inc. 1680 M -
d ARCHITECT OR DESIGNER MAIL ADOFESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL ADDfiESS ZIP PHONE LICENSE NO
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
p NEW O AODITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e 30 S Tear-off
9 CHANGEOfUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCV�OAp
SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, MEATING,
VENTI�ATING OR AIR CONDITIONING.
TNIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT CU fT
AUTHORiZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTHUCTION
OR WORK IS SUSPENDED OR ABANDONEO POi; A PERIOD Of 120 �AYS A7
ANV TIME AFTER WORK IS COMMENCED ' NO DWIG. UNITS OFfSTREET PARKING
1 MEREBV CERTIFV THAT I HAVE READ ANO E7(AMINEO TMIS APP�ICATtON STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS � VALUATION SURTA%
ANO OROINANCES GOVERNING THIS TVPE OF WORK WILI BE COMP�IEO
WITN WHETHER SPECIFIED MEREIN Of: NOT. THE GRANTING Of A PERMIT �LS71 �1. L9
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pERMIT FEE SAC CHARGE
PROVISIO �S OF ANY OTHEfi STATE OR IOCA� LAW REGUTATING CON-
STRUCTIO OR THE PERfORMANCE OP CONSTfiUCTION �%�i.75 Fire SC �2.5%
PI,AN CHECK FEE TOTAL FEE
C a ��:=1� License SC 5.00 83.61
S�GNATUQE O� CON"Fi(;i Op �UTNOQ�ZED �GENT iDATEi WMEN PqOPEAI� ALIDATED TNIS IS OUR PERMIT
y (/✓ 7
S�GNaTUAE O� OWNEQ��F OWtiEABUiIOEiii iDATE� Bl0 �hSP � ��<<E
, .
NEW [ ] Effective 1/1l98
ADDN ( ] CITY OF FRIDLEY
ALTER [] Sri�TGLE FAMILY AI�iD DUPLEXES R-1 AND R-2 b
BUILDING PERMIT APPLICATION �q �� ��
o �
� �
ConstructionAddress: �� Z..`-( � N o l� q 5 i.
Legal Description:
Owner Name & Address: K A IL, � i-� A ��¢�,,� � 5 Zy � NoK� s 1. Tel. # S� Z—�$� b
Contractor: ��►... � a.n� �- (� oo (= iN4 y�,! c. . MN LICENSE # 2 01 y-t 39 t
Address: (b$o M�ANzc�.,s Rd. �s r g�rL.,�su�t(�- MN �5337 Tel.# Y3S� 3061
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
,�THER:
Construction Type:
DESCRIPTION OF �IPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Driveway Curb Cut Width Needed
� � s �. S �.
Sq. Ft.
Sq. Ft.
Sq. Ft.
�---
� S
Estimated Cost: $ a� � �
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _$
2
DATE: 10 � 7%y g APPLICANT: � ti C--- Pc,.�-et�.�.,.a Tel. #� 3�- 3o io �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ /��%�.�
$ �- �7
$ �. o?g
$
$ S • DO
$
$
$
$
$ ��3 b /
CITY USE ONLY
Fee Schedule 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 .
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
' �� SuBJECT . � '
c;ty of Fridley 9253
AT TNE TOP OF THE TWINS g � f L D I N G P E R M I T
r
� �
� �
� ; L _____ COMMUNITY DEVELOPMENT DIV. /
r � � PROTECTIVE INSPEC710N SEC.
i �
� � �"'1 � CITY NALL FFIOLE� 55132 NUMBEN AEV D�TE PAGE OF �GPROVEO B�
�'""'�"� �'' 612-571-3450 9t0-Ft5 4/19/99 / /
JOB ADDRESS 6524 Anoka Street NE
t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oescA. 11,12 4 Oak Grove Addition SNEET
2 PROPEiiTY OWNER MAIL A,DDRESS ZIV PHONE
Kathleen Hau ert 6524 Anoka Street NE 572-9810
3 CON7RACTOR MAIL ADORESS ZIP PHONE LICENSE NO
Same
a ARCHITECT OR DESIGNER MAIL AOORESS 21P PHONE LICENSE NO.
5 ENGINEER MAII ADDfiE$S ZIP PNONE UCENSE NO
6 USE OF BUILDING
Residential
7 ClASS OF WORK
O NEW O ADDITION ❑ ALTERATIpN �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap inspection before covering.
?YPf OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FpR ELECTiiICAL. PLUM9ING, MEATING,
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID if WORK OR CONSTRUCTION ZONING S�. F� CU FT.
AUTHORIZED IS NOT COMMENCEO WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOfi A PERIOD OF 120 DAYS A7
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNI7S OFFSTREET PARKING
I MEREBV CERTIfV THAT 1 MAVE FEAD AND E7(AMIN�� TMIS APP�ICATION 1 STA��S GARAGES
ANO KNOW TME SAME TO BE TRUE AND COFiRECT. A�L PROVISIONS Of �AWS VALUATION SUfiTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMP�IED $3�000 �I.SO
WITH WHETMEfi SPECIFIEO MEREIN Ofi NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEqM17 fEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON• @'�(F.75 . Fire SC �3.00
STRUCTION OR TME PERfORMANCE Of CONSTRUCTION `I'
PLAN CMECKFEE TOTALFEE
$79.25
S�GNATUQE O� CON"AA(;TQfi OQ AUTMOA�ZEO �GENT �D�rE� WHEN PROPER � ALIOATED TMIS IS YOUQ PERMIT
�_ 1� -�i Gv, �/% -Zv-�q
S�GN4TUpE O� OWNEQ��� OW EABU�I i7i IdATE� BLD �NSP ' ���TF
NEW
ADDN
ALTER
[l
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Il
... , 'i� �.�? � ,. �
ConstructionAddress :
-Lega1 Description:
Owner Name & Ac
Contractor: �,�
Address: l!��
. : <�?
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
C
Effective 1/1/99
�
LIVING AREA: ,
�;-�: , ;.
GARAGE AREAs
DECK AREA:
OTHER: ;
�
u
MN LICENSE #
� �`� �i. # ( �I.�� = �� --�'$ �0
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 1MPROVEMENT
�J�ng� W idth Height
�ng� Width Height
Length
W idth Hgt/Ground
� �_,. �. �.-� �,n� Y� .Et �,�� v�i'P
Sq. Ft.
Sq. Ft.
Sq. Ft:
Construction Type: Estimated Cost: $_�,i � ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: `-t �
� q a,PrLicaivT• L� ��o�n� �rn� �'�,l � � — Tel. # �{o� 5�a -�gl C�
;; . , �
Permit Fee
Fire Surcharge
State Surcharge
SAC' Charge'
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ �� 2��
$� ,��
$ /�_ ��
�.$ �
$
$
$
$
$
"`TOTAL ` $ , �S
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 [ ]
L�UL1C�111g
Inspections
�63-572-3604
:�ATE � � ( � U l �l�
SiTE ADDRESS �p � � �:
THIS APPLICANT IS:
BUILDING
Permit No.:
RESIDENTIAL APPLICATION Received By: �
CITY OF FRIDLEY Date Rec'a: � �"��
YOUR E-MAIL ADDRESS K c� � a o� e l cI Q r �•0 %�'e S_ C V%i
E� o� 4 5-f. N' �
� OWNER C3COALTRACTOR
�'ROt ERTY OWNER/ N,�:�
TENANT ,�D�SS: G
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
�S
N,�.�E:_ RENEWAL By ANDERSEN
STATE LICE 1920 COUNTY RD. "C" WEST
.�DxESS:_ ROSEVILLE, MN 55113
PHONE 651-264-4777
o� F�, LICENSE #20130983
Q ADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ NEW
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
<,OOFING
NUMBER OF SQUARES _
�ARAGES
?ROPOSED SIZE:
?ROPOSED HEIGHT:
�IDING
❑ Vinyl
� Aluminum
❑ Other
Fl�( C� � C V STATE_ZIP S S Y��
o�A lG�t r 0.c S
�l a 4s- GUk7
CITY STATE ZIP
�RIES
7C��OWS
❑ DRAIN TILE
❑ OTHER
❑ SWIMMING POOL
❑ ADDITION
ANCE/REPAIl2 ❑ REMODELING
1 U�� n c(u � �c D I C, tt 1� � n in ,�
U
LENGTH WIDTH HEIGHT
❑ HOU3E ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GAR�IGE
OSoffit
� Trim
❑ Fascia
WINDOWS
IN EXISTING OPENINGS C�fts ONo LOCATION OF WINDOWS ���rh�n, hV►d1�j� !�!� �
OR FOR NEW OP£NINGS-DESCRIBE SIZE OF � D�
OPENING CHANGES &
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of slructural members to be used
Ft.
-,
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing shvctures
a�d proposed project.
2. Two sets of construction plans
3. Energy Calculations
TYPE OF WINDOW TO BE INSTALLED � NUMBER OF WINDOWS �� I
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $'S, S 5�i OCCUPANCY TYPE
?ermit Fee
Plan Review
Surcharge
r ire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
�,rosion Control
Park Fee
Sewer Main Charge
Total Due
� �a�. -�S"
$
$ �. S
- � �- � 3
$ �5 � (?C�
$
$
$
$
$
$ c� di,
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
tions
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�t,+ork which requ' s eview andapproval of plans.
SIGNATURE OF APPLICANT � PRINT NAME � � m SCI �t_�I-c_ _ DATE � Z' ' 2' �/' � 6.