AF - 43544N° 154
Village of Fridley, ldiinn.
IBUILDING PERMIT
Office of II9TSPECTOR OF BiJYLDINGS `
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Owner �" ��� ��y'�a„ • '' ,. ���
Architect Fridley, Minn., � d� � �, 19�
Builder ���:.*'�+w�lt.
j�� � � LOCATION OF BUILDING
No. Street —�,}�#,z Part of Lot
Lot Block Addition or Sub-Division
��'�CRIPT��?J �F B�TILDING
Frontg� �� Depth �''�- � Iieight � n Stories�""i�..�' Manner of Construction � F`��`'�`�``"�
!` �� '
To be used as �T �� �.�""'�"�� `��"'�-�� � To be completed �°3:��(��' � Estimated Cost � '�� �'� `
if fi ..,... . . ' x '4 #.' l, t �° d .i'� i� +� yq
Permit is hereby granted to ��'�"����- "+��e� to �,d�, '�:��"' !i
the building � described in the above s.tatement. Thia permit is granted
upon the express condition that th a erson to whom it is granted, and his agents, employees and workmen, in all
the work done in, around and upon said building, or any part thereof, shall conform in ali reapects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildinga
within the city limits, and thia permit may be revoked at any time upon violation of any of the provisions of said
ordinancea. - �y� � r�
��
� "�",� "''� ��"'�, . inspector of Buildings.
AGREEMENT AND SWORIV STATEI�IENT
In consideration of the issue �nd delivery to me by the Insgector of Buildings of Fridley of ;
the above permit, I hereby agree to do the proposed work in accorda�nce with the description
above set forth and according to the provisions of the ordinances of Friclley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
� _ � �� ..-��� ,
Subscribed .and sworn to before me at Fridley, Minnesota, this �
day of_ ��.�, : ,4.D. 19�. �'� �-� � � ,�,.�.:�
_ ��'
` ����e �� �r���e�, 1bTi�.
��JgL��� P�R1��IT
I�T° 3 5 5
��C� �� �Ts����o� o� ��,T�a�v��
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O�vr.°r��� � :�m^���r+' �` W:..+
Architect a
�
Builcler .r"t�� s°°E`x. ,,.�:,,_ „
��� �.
Frid'_ey, Minn., � -"•'�° - , 19
�
�„3 9�' La��.�rc�N a� s�r�L���
��" No. �� Street ,� �r" '� � {`��` , -�� Part of Lot
,�.,�.».w��' � � .:F < r
'�" t� Lat Block ddition or uub-�ivision n ���,�� �'` ��` ��
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Front "�.�e�tb. .� . ZZeig�h� � �tofae.'—=` �bT �r.r_er o= Con�trkctian_� •" `- ..- `i"'- '~ --
a
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To be use�1 � s � ' To be con��lete� ' ^ { , � � r : �sta.mated Cos£ � '� r � , ;
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Perxnit is hereby granted to to
M�''° the builaing�,,,r���'",�',+c�cg,•�--�--•-' described in the above statement. Thie permit is granted
' iapon the express condition that the person to whom it is ur�..nied, aad his agents, emgloyees and workmen, in a11
the work done in, around and upon,said huilding, or any gart thereof, shall conform in all respecta to the ordi-
; nances of Fridley, Minn., regarding the construction, alterati�n, maintena,nce, repair and moving of buildin�'s
within the city limits, and this permit may be revoked at any tisne upon violation of any of the provisions of said
ordinances.
{ x s ector of Buildings.
1�GR�EEI�ZF�TT 1-4.1°dD SVJ�3R1V STAT�1l��N'_�'
In consicleration o£ the issue and delivery to r�?.e k�y the Fn��eet.ar af T3�.�il.�in;u af �'ridl�y of
�he above; ,�ermit, I hereb,y agree to do the proposed �x�c�rk in <,.ccor�7.2nep vai.th the c�escription
above set fa�cth and accord'ang to the provisions of #?�.� o5°dina,nce� �f �'ri��ey, and, kae�n� first �a�ly
sworn, I hereby state and say that the facts stai;ed F�y t;._e a.nd con�ained in t�ie above. germ�t �re
true as therein stated. '���; ,� � i
� �
�'r' �,,`�,�;�,,,y� y+, �'•
� �
Subscribed and sworn to before me at Fridley, Niir.newQta, this
, .
day of + A.D. 19 ;�
0
sus�ecT PER .
City of Fridley o 20159 '
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
' ` R
� � •
� • COMMUNITY DEVELOPMENT DIV.
' � �.-------�
r � � PROTECTIVE INSPECTION SEC. � j�, � a
� , -[ 6
i
, � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""'� � ,�� 612-571-3450 910-F15 10/17/89 / /
JOB ADDRESS 6399 Baker Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. N33 Of 14 Auditor's SLIb. #88 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Donald Sachs 6399 Baker Avenue N.E., Fridley 571-1145
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 AFCHITECT 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
C� NEW ❑ ADDITION � ALTEfiATION ❑ REPAIR ❑ MOVE C� REMOVE
8 DESCRIBE WOHK
Remove existing 20' x 20' Garage and Construct a 24' x 30' Garage
9 CHANGEOFUSEFROM TO
STIPUI.ATIONS
Provide a hard sur�ace driveway.
S�EPt'." " T'" !'�Rl1�IlTS R�C�UlRED F�R
��IIIIRIf ' _:; � ��4=�TiNG, �'��1���i[�9G AND SIGNS.
SEPARATE PERMI7S ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUII AND VOID IF WORK OR CONSTRUCTION ZONING SQ. F7. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS APP�ICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $10, 526 y�S. 26
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION. $�.ZF) .00
PLAN CHECK FEE TOTAL FEE
$131.26
iG ATUREOFCON' CTORO AUTHOF712EDAGENT iDn i WHEN PROPERLY V IDATED THIS IS YOUR PERMIT
f� r� g F �
c� ��,�-- �a i
S�GNATUFEOFOWNERIIFOWNEABUILDEAI IDATEI BLDG �NSP ATE
� � � Effective 5/1/88
� [ � R�-1 AND �2
�T� [ ] Buildiryg Permit Applicati�
�nstru�ti� Aaaress: _ e 3�t 9- l� /� K L� ,4 �l � n� . C
�� �'iP�i�: 111 �.2_. /� �1 D r 7�t3 S ,5 U B D� V S/ a N# �
owner rrame & Aaaress: � a N/� (� � � A �- F-( S �,et. �_ 15"'7 !- I t y 5
Contractor: �. #
Address:
Attach to thi.s application, a Oertificate of S�uvey of the
lot, with the pn�poEed aonstn�ctica� drawn on it t.o scale.
� :._ �• r •�- � i• •.� • s i:�
LIVIIJG ARF.�,: Zesx�th Wldth iieic�t Sq. F't.
C;AFt�GE AREA: I,�s�c�th �' _ Width 30 , Heic�t /o �'T� Sq. Ft.
D�CR ARF.A: Ierx�t-h Width Hgt/Grwnd Sq. Ft.
OT�t: �2e.yc v,E t-x fi c� 7`��..c "� a H G.0 o�n' X c�G> '
Corner Ir�t (y�) Znside Iat [� Ft. Yd Setback Side Yazd Setbacks
'IYpe of Cbnstruc�tion: Esti,mated Qost: $ �Q� S� ��
Approx. O��letion Date: �
� Driveway Width If New Openirig Is nesirea: �. S S
� � p W'dth + 6' See Back Page
L1ATE: �6 ���/f1 APP'LSCANr: _ b �.r�C . � ,�'! ,.�� 'ip1. � S% ( - / / �f .S
�tF� $ 1��.0��
State Sur�rharge $ .� •� i�
SAC Criarge $
Driveway ��,o�„i $
Park Fee $
Sewer Main Q�arge $
. v
S'I'IPCJIATIOrLS :
$ l � l, a
�'ITY DSE Q�Y
r�ee sci�edule an Reverse siae
$.5o/Sl,000 valuatian
$575 pet SAC Unit
Alt. "A" or Alt. "8" 11bwe
Fee Detetmined by F��qineerirg
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��
CITY OF FRIDLEY
Effective Date May 1, lggg
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRI6ERATION AND
' AIR CONDITIONING SYSTEMS AND DEVICES
FATE SCHEDULE
QESZDENiTIAL .
Furnace Shell and Duct Work,
Burnex' (A1so replacement furnace)
Gas Piping
(piping needed with new iurnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes�
All Others/Repairs and Alterations
18 of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1$ of Value of Appliance or Work
RATE TpTpiI,
$ 2�Qt00 $��
$ 10,00 $
$ 10,00 $
$ 10.00 $
$ 10.00 $
$
State Surcharge
TOTAL FEE
Reinspection Fee ($I5.00)
Rough insp.
Date
Final Insp. �✓�'"" �(/
Date �
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00�
PLUS $.50 STATE SURCHARGE
��� Job Address ��-/ % ����..�� � ��
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55932
City of Fridley
Tel. #571-3450
The undersigned hereby mak.es application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley. Minn. _ �� " �,3 . 19��
�R �n� �° ����5
KIND OF BUILDING
USED AS
$ TD BE COMPI,ETED ABOUT _��� �
ESTIMATED COST � � �j � ���
$ .50
OLD - NEW BUILDING PERMIT NO. PERMIT NO. ��+�� �
S ZL> • ` = . � ,
$
DESCRIPTION OF FUFtNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Watez, arm Air- o.
Trade Name ������ Size No. �nJ ��-a�T�.�JL� L���
-�
Capacity Sq. Ft. EDR g�7 �O gp
7bta1 Connected Load Kind of Fue2 L��, g Q�
,---
e
SURNER - Trade Name Size No.
t
Capacity Sq. Ft. EDR gT0 gp
----+�_
�pany �.f" /.,1A��f� ��dL/ �i" �
Signed By
Attach stack verifi.cation fouu with. replacanent furnace pesmits �h /���t=C�C./
*Air Conditioners can not be laced in side Tel. No. _ �,J
P yard without
written petmission fran adjoining neighbor.
SUBJECT - P E
City of Fridley 21322
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
i � ECEIPT NO.
� �
� `_______ COMMUNITY DEVELOPMENT DIV. 1/ � 9�
r �~ � PROTECTIVE INSPECTION SEC. �
� �
� , /'�'1 � CITV HALL FRIDLEV SS432 NUMBER REV. DATE PAGE Of APPROVED BV
�""�" ,'' 612-571-3450 910-Ft5 5/7/92 / /
JOB ADDRESS 6399 Baker. Ayenue NE
t LEGAL �OT NO. BIOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. N� 14 AllC�iS Sill�. #HH SHEET
2 PfiOPERTY OWNER MAII ADDRESS ZIP PHONE
Donald S:achs 6399 Ba,kex Ayenue NE 571�1145
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO.
S:�oe
4 ARCHITECT OR DESIGNEF MAIL ADDFiESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CL S OF WOf;K
O NEW C� ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Constxuct a 23`4" x 7�4« Deta,chsd_Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See not�,tions on plan# Smake. detectors must be added if not already
instalTed in dwelling.
������� , r��:�n r�' `
Before digging catl for S��',4RATE t�EFtMITS RE��.-. .� ��
alt utili#y locations , WiRtNG, NEAl'lNG, PLUivi'u�►'�:i i=:,vv $IGNS.
�-0002 � � , . + . • . . .
• , _ ...
R�QU1f�� �B� I.AW . , _
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITNIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PFOVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-/3�-3 $e66
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $33.QQ Fire SC $1..31.
PLAN CHECK FEE TOTAL FEE
� $34,97
si�N i R OFCONiRACTOFOR rHOaiZE GENt IDATEi WHE PROP�R � IDATED THIS IS YOUR PERMIT
�}.1/ ��-�s�.-�� " �/ �
;� � �� .� - ��-
�SiGNATUREOFOWNERIIFOWNERBU�LDER1 IDATEI � BI�DG �NSP�, f)qTE ��
NEW [ �
ADDN [ ]
ALTER [ )
CITY OF FRIDLEY
5INGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/ 1192
Construction Address: /� � �1 cC � � � � � �- � l/ ` / �i' r`-
Legal Description: �/ % i, o % / `( /�%s '� ��
Owner Name & Address: ,�o/�,� � ,U �5 q C %l S Tel. # ,� i / - / � �/ �
Contractor: ___�'� v� � e� MN LICENSE �
Address:
LIVING AREA:
GARAGE AREA:
DBCK AREA:
OTHER:
Tel. �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scaie.
DESCRIPTION OF IMPROYEMENT
Length Width Height
Length Width Height
; �T
Length o2 c3 `-i Width �7 ' �, ` � HgtlGround �o ��
Sq. Ft.
Sq. Ft.
sq. Ft. / 7
/
Comer Lot [] Inside Lot [) Ft. Yd Setback Side Yard Setbacks ��
Type of Construction: %J,� C r� 7�Y a y.�o �� Estimated Cost: $ �-3 %� —
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. b Ft = Ft x$ _$
� ; �r'' .
_/,_, ,, � � ,: l ,r� x : ;�� �-
DATE: �� 9�--- APPLICANT: � G�i'�J�r� �.��'�-�_ Tel. ,#� 7� �.r y 5
. � CITY `USE � -ONLY . . _ '
. . . . �; �,.
;; . , ,
Permit Fee S � � �
Fire Surcharge. $ l • 3 �
State Surcharge $ , �
SAC Charge $ """'"
License Surcharge $ �"`""°"'"
Driveway Escrow $ �
Park Fee $ �'''�
Sewer Main Charge $ _-�""
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth°%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Ait. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�
TOTAL $ k ,
/ ` y�
,������ • � �
STIPULATIONS: / °�
` ` ��.,��;.,��,, �,
..�e,. -�.�. .
BUILDING PERMIT FEE SCHEDULE
The Cluef Building Official shall, before issuing pemuts for the erection of any building or structure,
or for any addition to any existing building or structure, or for any alteration or repair to any existing
building or structure, upon application ffierefore, require the payment by the appiicant for such permit
of fees to the amount herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,U00,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additionat $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,Q00 or fraction thereof, to and including $100,000
$639. SO for first $100,0U0 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ci�rb Streets Only)
Altemate "A" : Removal and replacement of curb and gutter anly - Driveway width plus b feet times
$13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus b feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow
for proper review of the proposed structure and of the constiuction site.
A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has been
constructed will be required before proceeding with the framing.
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sue�ecT P tdfi-"— �
City of Fridley ` � � � � �
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
� �
, � O.
� ` .____ COMMUNITY DEVELOPMENT DIV, �n
r � y � PROTECTIVE INSPECTION SEC ��l
� � � �
1 _
' � �'��1 � CITY HALL FRIDIE� 55432 NUMBER �1EY DATE PAGE OF APPROVED Bv
� ----�.' `.�
612-571-3450 910-F15 11/9/94 � �
JOB ADDRESS
6399 Baker Avenue NE
1 LEGAI LOT NO. BLOCK TRACT OR ADDfT10N SEE ATTACHED
DESCR. N� 1[f Auditor's Sllb. ��88 SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHON€
Donald Sachs 6399 Baker Avenue NE 571-1145
3 CONTRACTOR MAIL ADDRESS Z�P PMONE UCENSE NO
Same
4 ARCHITECT OR DESIGNEFi MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADORESS ZIP PHONE UCENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
Cl NEW ❑ ADDITION ❑ ALTERATION p REPAIR ❑ MOVE O REMOVE
X
8 DESCRIBE WORK
Construct a 12' x 12' Shed
9 CHANGEOFUSEFROM TO
STfPULATIONS
Shed must be at least 3 feet from the side or back property lines and
off from any easement. Maximum height of shed is 14 feet. Shed must be securely
anchored to the ground by either putting it on a foundation or tieing it down with
anchor ties.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS AqE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR Alfi CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WOfiK OR CONSTRUCTION ZON�NG SQ. FT CU. FT.
AUTHORIZED iS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTFUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING
I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINEO THIS APPLICATION STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $5OO �.SO
WITH WHETHER SPECIFIED HEfiEIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE pERMiT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING con,- 15.00 Fire CS �.SO
STRUCTION OR THE PERFORMANCE Of CONSTRUCTION �
PLAN CHECK FEE TOTA� FEE
$16.00
SiGNnrURE OF CON't�nCTOa Oa n�rHOaiZED aGENr IDATEi WHEN PfiOPE VALIDATED THIS IS YOUR PERMIT
�, � �� y���
SiGNATUREOFOWNEAiIFOWNEABU�LDERi IDATE� B G�NSP ��FTE
NEW
ADDN
ALTER
[l
{]
[�
CITY OF FRIDLEY
SINGLE FE1►MILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 1/i/94
��S`'1"�
' — � -� � �
ConstructionAddress: �% � � C� '�-� T/ ( � �-�
Legal Description: � ?��- �
Owner Name & Address: ��/�//-a � /� 'J� � ( � � TeL # L S'% � -� / �� �
Contractor: <� � L %� MN LICENSE #
Address: � � �1 7 `— � �f���; /�__ �, Tel. � . � %/ /`�i� _--._.
Attach to this application, a Certificate of Survey of the
lot, 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 � Width Hgt/Gcound SQ. Ft.
OTHER: S�� �u� � 1' /Z � - �� IS . �
Corner Lot [ � znside Lot [) Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimat�ed Cost: $
Approx. Completion Date:
{Cost on Beck)
Driveway Curb Cut Width Neede.cl: Ft. + 6 Ft = Ft x�
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
T4TAL
APPLICANT:
� / 5� �ti
,
$ , i'rJ
$ 7�
$
$
$
S
$
$
C' f"'J
$ /�-
1! `!__ � !_
:� .
=$
Tel. #
Fee Schedule on Reverse Side
.QOl of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
F� Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS: �- • � -
,
sue�ecT PE
� City of Fridley 26 8 � 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� EIP
� �
� �
� ` COMMUNITY OEVELOPMENT DIV. , //
r � y � PROTECTIVE INSPECTION SEC. �7(p�
� �
`_--- �;�"';'; CITY HALL FRIDLE� 55�32 NUMBEP pEV DATE PAGE Of AGPROVED 8�
i �� 612-571-3450 910-Ft5 7/29/98 � �
JOB ADDRESS
6399 Baker AVE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. N Lot 14 Auditor's Subdivision ��88 SHEET
2 PROPER�Y OWNER MAIL ADQRESS 21P PHONE
Becky Suchs
3 CONTRACTOR MAIL ADORESS Z�P PHONE UCENSE NO.
Gates Roofin 4640 Ximines Ln P1 outh -
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK `
O NEW ❑ ADDITION ❑ ALTERATION �1 REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Reroof'house and ara e 22 S Tear-off
9 CHANGE OF USE PROM TO
STIPUl.AT10NS
Underlayment must comply with State Buidling Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD
SEPARATE PERMITS ARE REOUIqED FOR ELECTRICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWIG. UNITS OFFSTREET PARKING
I HEREBV CERTIFV THAT I HAVE READ ANO EXAMINED THIS APP�ICATION 1 STALIS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PAOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING TNIS TYPE OF WORK Wlll BE COMPLIED
WITH WHETHEF SPECIFIED MEREIN OFi NOT. THE GFiANTING OF A PERMIT $1834 �.92
DOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERfO ANCE OF CONSTRUCTION. �.59 . SO Fire SC � 1. H3
� _ PLAN CMECK FEE TOT EE
` 1 C� � License $5.0 7.25
SiGNATUAEOF pN' 10AOAAUTMOA�2EOAGENT IDATEi P OPE ALIDA E IS I$ V�U� M�T
7 '
S�GNATURE OF OWNEFl UF OWNER BU�LDEAI �DATE� BL �NSP qqTE
NEW
ADDN
ALTER
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ConstructionAddress: �;
I.egal Description: �
Owner Name & Address:
Contractor: �' �
Address: , �� �� a'rWi�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1 / 1 /98
��� �a
�� ��
/ Tel. #
MN LICENSE # G �q�
Tel. # SSO -CY� �13
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length . Width ` Hgt/Gr nd
.��� - , _S t �� ��
Sq. Ft.
Sq. Ft.
Sq. Ft.
� �
Construction Type: �tCw p�Y l�f -y'CJU / Estimated Cost: $ y l��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 7�" � APPLICANT: �G�G! �D�'p%� Tel. # j��`�6��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��.5�
$ - �-�
$ �
$
$ �: (� �
$
$
$
$
$
�'�. ���
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.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 [ ]
.
�_ oLtz�
CITY OF FRIDLEY INSPECTION DIV,
6431 University Ave NE
Fridley, MN 55432 .
572-3604 �
RATE SCHEDULE
APPLIf�ATiON FOR POWER PLANTS AND HEATING, CUOLING, VENTILATION,
REFRICiERATION AND AIR CONDITIONING SYSTEMS AND [)EVICES
Residential
Furnace Sheil and Duct Work, 8urner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditfoning — All Sizes �
Rate
$ 30.00 $
$ 10.00 $
$ 10.00 $
$ 10,00 $
$ 25.00 $
All Others/Repairs & Alteratlons (LIST ON BA�I�
1% of Value of Appliance or Work $
�-i��%z�c- ��� c°�� � �lu,�
Commercial/Industriai ✓��•�� CU�ti ��'��i
1.25% of Value of Appliance or Work $
State Surcharge
TOTALFEE
Effective On January 1, 1997
JOB ADDRESS_ � � �1 �'/ ���� �J�_�,�
The undersigned hereby makes application for a permit forthe work herein
TOTAL specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Buifding Division, and hereby declares that �II the facts and
representations stated in this application are true and correct.
�_ 3_ �� ,�ss�
$ .50
$ �5•�a
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AlR CONDITIONING PERMIT IS $25 00
PLUS THE $.50 S�ATE SURCHARGE
REINSPECTION FEE $42,00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property ow�er.
_ ____ __^.r,.,.
OWNER
BUILDING USED AS ����1�
�>
ESTIMATED C05T �v'7.S' PERMIT N0; �J;� j
DE�CRIPTION OF FURNACE AND OR BURNER
No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No,
B� HP EDR
Fuel Total Connected Load
Burner Trade Name
BTU
�
Size No.
EDR
a`_��'It���i� �-ii�P�i �±�K: �C t�f i� C;�C'�t�il"!t�,�li�ii� �;..
HEATING COMPANY �t9Yi ►AAa�_v„� . _
Signed
;�� �
��:: � ��..�� , i �
��y -_ �
Approved By �� Rough—In Date Final Uate
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPIACEMENT FURNACE ` ` -`
�C�c�.��" ��►ce�e� J�� ��IS��
Ci i Y l�F F t-ZIUI_Lti IN:�1Jt�, � ivfv utV
6431 University Ave NF
Fridley, MN 55432
(763) 572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
Water
Closet Urinal
PLUMBING FIXTURE RATES
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas'"
Gas Range`"
Gas Dryer"
Back Flow Preventer Required ()Yes () Nc
Type
Reinspection Fee $47.00/Hr
L-Iiectivc Un Jan 1, �u02
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
8ath Wash �rink. Floor Catch Auto. Gas Gas M�sc. :. Water Heater
Tub ' Shower Sink Tra FQUnt. Orain Basin > Washer A 1. ': Ran e Fi?ct. `= Gas Elec
NO. RATE TOTAL JOBADDRESS__t���-( ,l�;�Ql� ! ��iVt�/���_
�
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
.50
.� ♦
The undersigned hereby makes application for a permit for the work he�ein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
� - c� �" , 20�
• ��� �. . c_ �
Building Used As
Estimated Cost --��-- PERMIT NO. �� . ���
PLUMBING COMPANY_ ���� A�(��� +"� J� T_
SIGNED BY TEL NO.Lo��/- o�(oc!- �0�7 �
FAX # _ a - _ L/ cj
�� � -:.
Approved By���- )\ I�ough-4n Date Finat Date �/oZ Qj
�—
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS a20 00 !
PLUS THE a.50 STATE SURCHARGE
�COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A
*
COMMON VENT INFO ON BACK SIDE
Building MECHANICAL Perrnit Ivo.: - �
Inspections RESIDENTIAL APPLICATION Received BMA
763-572-3604 CITY OF FRIDLEY vat����d. 3 0 20 7
DATE �� D� YOUR E-MAIL ADDRESS � V` 1ta i,� d,.�J �N�1�t I I�d' •�c� tM
s��ADD�ss 63a k�,r .�., SSy3T�
THIS APPLICANT IS: ❑ OWNER $CONTRACTOR
PROPERTY NAME: r` J`R i l�yS
OWNER/ ADDRESS: �j a� �;�� �UG CITY 'F✓` � d` STATE�ZIP 5�-43
TENANT pHONE: �r!j — S1 (— l ��i S
CONTRACTOR COMPANY NAME: �S P� wtbt �. c'1-z `�' �� ✓�
SUBMIT A COPY OF CONTACT PERSON: +� rn, vv� o t� �
YOUR STATE STATE LICENSE # d 1/� 'rt I� EXP DATE �n • I'C
LICENSE WITH ADDRESS:_a c,,v,�elnln CITY S% C�c.�x, STATE�ZIP �l0 a
APPLICATION pHONE C�a "��-�lS� FAX ��7 `7�S I` �� S�
PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW �REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK � oww cr-e �wd. u� wn La,GP� ���
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) c
Equipment Installed MFG: !i�v)� MODEL: l � SepJ �, �V� SIZFIBN
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBT[I
A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
— _
# � ;i.� .
_ . _ - �' .� . ,� . ��n ,�,. .. � _....
Permit Fee $ . Number of fixtures @$1 U.00 x$10.00 =$
Surcharge � .50 Number �f :ixtu:es @ $15.OQ x $15.00 = $
TOTAL DUE $ Number of fixtures @$25.00 '. x$25.00 =$ • o0
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Tota1= $ • 5�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building 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 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 11 work hich re � ires •eview and approval of plans.
SIGNANRE OF APPLICANT � PRINT NAME � Ya w�J�4 wio H,f DATE SI <<I I0 7
� � �a . ,
=x �: ;,, � - � � :� . :� �.. � .
, , . , � ��a.
a�w z
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977