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AF - 44131City of Fridley, l�iinn. BUILDING PERMIT N� 5625 Date: ..#.._.�!_.'_.r!'"��.."."""�._....___._... � Ov�mer: �,�!�i�a� uflder _ _ *�....�...._�...�. Adciress ...__.____.._._..____...._..._.._ ._......:._�._........_._..__._... Address .__..._____�._.__�_._.___._..�..._..�_� L CATfON OP BU L ING Na �,�.y"�-{i�+rStreet .��ir�' �.�e-..�..�s P of Lot .._._.._ . Lot ._,...,�r�..� Block .._.___...� _._....._..._....:... ddition or Sub-Divisiic�._. . �T.' . � . ,�t � �_ Corner Lot ._.._..._.�...._.:..�. Inaide Lot ._.._.. ..._...__._._ Setback ..�� _._._ Sideyard -f�::. •.l.+�! Sewer Elevatia� _.___.._..._..___._.__._._..�_._...__...._._.......___.. Foundation �:levation _.__._........ .__..._.. x DESCRIPTION OF BUILDING . To vaea , � _._� Front _. �; DePth� � Height �W Sq. Ft. �.�, Cu. P`t. 1..�. t _...�. Depth y��..� eight ._,�' Sq. F`t. .,1� Cu. i't. �. . � . Type o nstruction .__ Est, C'osi��"...��.�.:.-.. be Completed .__w__._�......__...._:. ,:. , , .,,,' . In consideration of the issuance to me of a permit to construct the build�g deacribed .abave I agt�ee to �o the proposed work in accordarice with the descrfption �bove set for� and in compliance with . a�1 provida�s +o! ordinances of the dty of Fridley. ,• ' +�s-. ___..._ ' , Ea consideration of ttle payment of a fee oP $a��..�._.: �._.., permit is hereby grantEd to to construet the building or addition as described above. This perm3t is �graated upon �he express con�iition that the person to whom it is granted and his agents, employeea and vvorkinen, in 1111,w+osrlc done in, around and upon said building� or any part thereof, sha�l coffic�rm in atl respects ta ,t�e � Ct' Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of within the dty ]irnits and thia permit may be revokeci at any time upon violati of any o�' the provit�ns t'� ' QTt�I18I10ES. � � � ��"� � . , B� � NOTICE: � This p�n�at dws uot eov�r du �on�ruetien, hut�Natten for w�ina► pWapbiny. aaie b�Nin�, �wr er wahr. M ww' N sM tM buildi� insp�efor for s�p�rata p�nnits �o� t6� it�m�. . , . �4 � � _ � �-�� . 0 APPLICATION FOR BUILDSNG PERMIT CITY OF FRIDLEY, MINNESOTA � � r - - - - �i .� _. ✓_ r�r .�/ • ' �,,f'/ � i Address Address LOCATION OF BUILDTNG No. ..S' �� .s v of Lot Lot H1ock Addition or Subdivision �� Corner Lot Tnside Lot Setback,,,,,,,,r,,,�„�,Side-Yard SEVdER ELEVATION FOUNDATION �LEVATION Applicant attach to this form Certificate of 3urvey of Zot and proposed building location. - To be used asa DESCRIPTION OF BUILDING � � , � Sq. Ft. Cu. Ft. Front--L�Depth,�% � ____Height '- �� ,� Sq. Ft. Cu. Ft. Type of Construction Estimated-�Cost To be Completed � _ _ - w � ��r� . . The undersigned hereby makas application for a permit �or the work herein specified, agreeing to do all work in strict accordance with � the City of Fridley Ordinances and ruling o� the Department of Suild- ings, and hereby declares that all the facts and representations stated in this application are true and correct. , DATE � ./% �— / � — �P/ SIC�TATtTRE X��1-iLz,• �� L�t c� M, � •,� "`� --� �..,�.�.�..� (�Schedule of Fee Coets can be found on the Reverse Side). � , ,, � . . . . ,. • r� LJ C� City of Fridley, Minn. BUILDING PERMIT Date: OCTOBER 20, 1966 �o 3s �li � 9063 Owner: _WILLIAM .SNIZTH �.____._._......._..__._.__.___.___ Builder _.._.._._DERKSEN.:BUILDERS-,.---INC�----.._.._.---...._..__ Address ...�zS_0..�:SL��T.._�T....._1�I.�.�...._.-�--�-�--�----...-----.._. Address _.--�---�--77_05.---�E.1.��---A�E--N�--_E._....__.---- FRIDLEY. MINNESOTA 55421 MINNEAPO�LIS, MiNNESOTA 55432 LOCATION OF BUILDING No. ..---525.0._._...... Street .....__BIICH�ftAN__STREET---N-•—� E'�---�----��----------------.-.. Part of Lot •-------•----•-•--•--•-•----_.._.._-----•---••-----_._._..�_ Lot •---._....z �._. 1...---••-----__......_ Addition or Sub-Division _...._...._MARIAN.. HILLS._.___.._...__. __. _. __.r_ ............__ Block .-------_........•--.•-- .. . • - CornerLot ----.-----.--•-•-•---,•----- Inside Lot -------•---.----X•---•---.--------. Setback ...._......._.--•.---•---._...._..--- Sideyard ......._..__..._......__..._.._......._....._..__.._...... Sewer Elevation •------•...._._---•••---•--.----•--._..._......._..---•--•---._.._ .............--•----- Foundation Elevation .--.---•----_...__......----_. . _._. __......____..._..__._..� DESCRIPTION OF BUILDING To be Used as: ADDN. TO GAR. 10 22 . 9 220 2,200 .___......_.....___.___.__..........••---._._ Front _..._........_..---. Depth _.---.._..._...._.. Height .....- ............._.. S9. Ft. _...----..._._._ Cu. Ft _.._._ _ _.--- ............._..._..._.._.............._......_ Front -----_......_._.. Depth _.••--------..._.. Height ....._.............__ S9. Ft. _..--•.._...._. Cu. F� ._._..___._ Zj�pe of Construction ....._--•---•--F''.�ME.----._...._.._..__. Es� Cost ••----....�1,�400._00.--•-..--- To be Completed •--•._..._.._...__.__..._.�..._.._._ In consideration of the issuance to me of a permit to co ct the buildin , escribed abov , I agree, to do th� proposed work in accordance with the description above e forth and in mp ' wi all provi ' ns of ordinances of the city of Fridley. � In consideration of the payment of a fee of $...4 . 00 � permit is hereby granted to__.._DERKSEN �� BUILDERS, INC. . to construct the building or addition as described above. This pezmit 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 o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked a t any time upon violation of any of the provisions of said ordinancea CLARENCE BELISLE � B�� r NOTICE: 'Ihis psnnh doa not eowr th� eonstruction, inshllafion for widng, pbmbing, gas h�atin�, aw�� or wa1�r. B� wn to sN fho Buildiag Insp�eto� for s�puats p�rmils foe th� ihms. �`� �j -1 APP'LICATION FOR BUILDING PERMIT CITY OF FRIDL�Y, MINNESOTA OWNER' S NAME ,C�i�1 � � BUILDE f � C- �� f � � -t—. ADDRESS�� C-'' ,f � ADDRESS � G � � �� - LOCATION OF BUILDING N0, `� �- 5 C' STREET // CC ��tLct�ir -. � PART OF LOT LOT�„_��_BLOCK f ADDITION OR SUBDIVISION �� / CORNER LOT INSIDE LO't�SETBACK SIDE-YARD �C?' r`� % SEWER ELEVATION FOUNDATION EiEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; �'�GC-c� 4�� '-� �f��'` Front C% Depth�� Height � Sq. Ft. ,��G Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost_�' :i��#.p �� , F �r /'�� . d To 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct� DATE C7 `2� SIGNATURE ,� , (Schedule of ee Costs can be found on the Reverse Side�. U ` - • . , .�' .:�.., .M':: ��:� .� ��-�+�� `"� � �.; �,�' ° - a. . dw�.4. �.�. w�ws+�.,..:a ��m,�i�. iYUUu . . . � • • . .. .. . ,....,. .m.. ...�......a�.,...,�,�.., »µ........�...._ � , ... ...... � � . ....._..._�_........._ , aa.,;,,.r7 ' ,.�. ... _ u,�.. . . _. . � .. . +. ..� ,. . ... . . . .. . . _.. . . � .. . .. . � ��' , v _ . _ � _ .. _ .__ _._._�..�:__,.._. _..__---- . �-.�� . ' ' °,.,..` ....� .,..,�..... _._ � _ � � _ �.,, , . _ —�: _ ___ _ - - - , ___ , - k. : : _ — � - _ �; . . . _. .. - _ -._ __. � - - - --- ,__,.____ � �° S��+anstrom �ons t . Ca . 120-74 . ..--_ - -. � ^: Or .2105 � a � _� „ _ ► �. L:. ��i � "��' o i�i uwD suRV�roR H[GIiTER6D UND[R LAW� OP iTAT[ OF MINN[fpTA LICiN1E0 iY ORDINANC� OR CITY OR MINN[A►OL�i � 361a EAST SSTH STREET PA. 4-46B1 ! �utbcpor'g QLertdficatc Z 5^. � ..._-� �'�� ,� � ' .�. /33, yZ. � Z 'f„ ' ------, � . �'� c\ a� � �S � 'J �' yZ2 � � � � / �. 5 � f `,�. � y1 � � 3S s��, e. i=�a �3. y3 b� � � ° = .�"° � � ip. 1 HERiBY CERTIFY THAT THG ABOV6 It A TRU[ AND pp12RCCT PLAT OR A SURVgIf Of �Ot 22 �lock ],, hiarrion iiills . i � `� 1 � �. �; � � � � � � � N � V i� �Q ► �� .;� t ,, .� I AS fl1PVCYCO YY Y< THI�i. :��'��' ?`� . M .'�'� �e�. .:..:-�� ... -•..:.:.. .. .. . . . .. .. . , � . . j . ...uw...r:».r-aiM�� VRmPoti,��n9Y•P N V�pik--1 w ... .s.v:...x.. ,. . � . � y s, ....aa'+w � . , . . � ,. . . �•<�'.s pyn..�-�� .. � ' .A . .. �. a �° � . s a + �� . ...n�,a;,_.:,. .. .<,. . . . w.� ... "• � e> o .: �. _, r�w,+sx�� . __..��t4tYt i>.•.S..v� `� ,,.....,-.7-�v.iia'.ii� ', . .. ...�s� ,,,.... City of Fridley App�icafiion for P"h�mbing and Gas Fitting Penn3it Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK � � �'`o �� Number, Kind and Locatiaa of •Fixtures Location . yr1 yJ� yj N N � Z + t WATER HTR. �"' < � = N Y Z K � Z = Z = W <o = �m Zue z �< ?� 3 g< �u! �`Z �a �Z 7Z oc < c �� O x �� c� a a f N GAS ELEC. 3� � n� m v� 3`- oLL N LLO Sm <3 (9< C9Sa (9O Base i lst � 2nd 3rd 4th • Fnture Conaeetioa Openiags * New Fixtuse, �id Opesiings PARTIAL RATE SCHEDULE / Sewes Cesspool PLUMBING FIXTURE RATES: NO. RATE TOTAL Number PYxtures ... .... .. .. .... ...... .—lA— x $1.50 $ y. U U Future �xture Opening ................ x 1.20 $ New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTi� ......—�� x 2.00 $ d. 0 U New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures ..........................�L— x $1.50 $—,�=v Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTiT . ............. x 2.00 � REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL F'EE $, �'a �`� City of Fridley: � � / � �� . The undersigned hereby makes application for a permit for Lhe work herei specified, agreeing to do all work in strict accordance with the City Ordinancs and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application are true and correct. Owner Kind of Building ` Used as To be compieted about � /�! �-;- � Estimated Cost, $ %7 2 � � Old Ne . Building Permit No. �5 ��-� PeImit No. �' �� ROUC3H FIN az zM . Signed sy Business Phone No. '" � � -- Applic.t�tion �or Power Plants dnd 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 & Duct Work to 120,Q00 BTIT . . . . . . . . . . . . each add. 60,000 BT[J ....................... Replacement of Furnace .......:..............:...... Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . R.epairs & Alterations each add. $500.00 . . ... . .. . . .. . . � 8.00 $� 2.00 � 5.00 $ 5.00 $ 2.50 $ 3TEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . 8.00 $ Furnace Shell & Lin�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 e- � U GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ '� "' GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ...................... x $1.50 $� Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU . . . . . . . . . . , x 2.00 $ AIR CONDITIONING �, FAN HEATING SY3TEM See Fee Schedule VENTILATING SY3TEM $ ALTERATIONS & REPAIRS TOTAL FEE $ � � ROUGH FINAL Dept. of Bldgs. Phone 3U 4-7470 * ---•--- �� 7 C� � � � 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 d orrect. Fiidley, Minn. / � , 196 � Owner i��t�.—�/ - /'1 nn . Kind of Building Used as (L To be completed about �� ti'r°'� �� Estimated Cost, $ �� Old—New. Building Permit No. ��1� �'S Permit No. d DE$CRIPTiON OF WORK HEATING or POWER PI�ANTS--Steam, Hot Water, Warm Air—No. �/`' . Trade Name Size No. �OU �� Capacity �9 �� Sq. Ft. E. .R. BTiJ H.P. Total Connected Load Kind o! Fuel BURNER — Trade Nam Size No.�� Capacity-L�t-c` " d Sq. Ft. E.D.R. BTU H.P. (REMARKS—OVER) �w'�e e z 2M �J �e i , � I' ' ��-. �� _t! �. / . L..�/�✓�/��L 1" � � � ' � ' _ 4 Sa�aly5�� _ i � �� -�- CITY OF FRID� EY INSPcCTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, N1N 55432 �4PPLICATIOfV FOFt POWER PLANTS AND HEATlP�G, COOLlhiG, VEN7ILATIfJN, 0�2-3604 REFRIGERATION AND AIR CONDiTIONINca S`(S7EiVIS AND DEVICES RAi'E SCHEDULE Residential - ' Furnace Shel! and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) :_ Gas Range Gas Qryer *Air Canditioning — All Sizes All Others/Repairs & Alterations (LfST ON BACf� 1°io of Value of Appiiance ar Work Com merciat/I ndustrial 1.25% of Value of Appliance or Work Rate $ 30,00 $ i 0.00 $10.00 TOTAI. � 3�.� $ $ $10.00 $ $ 25.00 w - - $ $ State Surcharge TOTAk FEE F, �� 3b " DEPENDABL HEATING COMPANY MINIMUM FEE FOR ANY H�ATING/COOLING/VENTILATION �-, � 2g RAP(ps gp�L�VARp , REFRIGERATION/AIR CONDITtONiNG FERMtT IS �25.00 Sig�ed 8y,�� N RAPIOS� ��o PLUS THE .50 STATE SURCHARGE I� �� Approved By Rough—In Date Final Date � FILL OUT BACK SIDE F STACK VERIFICATION ON REPLACEMENT FURNAC�E JOB ADDRE5S 5a 5 C� �� Q � The undersigned hereby rnakes application for a permit for the vvork herein specifietl agree+ng to do all work in strict accordance with the City Codes a�d rulings of the Buiiding Division, and•hereby deciares that ail the facts and representations s#ated in tiiis application are true and correct. �j �_� .. ,19g$ OWNER BU1LDiNG USED AS � ESTIMATED COST � � � � � PERMIT NO. ��.C�� DESCRIPTICIN OF FURNACE AND OA BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name (� c,�(�.✓ Size No. � BTU '� �(�/�U HP EDR Fuel C� �1 �SC�--�--Total Connected Load 11 C�DL7 Bumer Trade Name Size No. BTU HP EDR REINSPECTION FEE $42.00/Hr *Air Condi�i�ners can not be placed in a side yard without written permission from adjoining property �wner, . � . . . t - . r : ,.: . _. . .. .... . _, . : . _ . .-:. � � . . . , . _ �HIMNEY AN STACK VERIFICATION The undersigned hereby verifies that ttte existing chimney or stack: 1. Has been carefully examined Yes (�No () 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all cunent Code requirements for size and total BTU's connected b Ha� ta�al neai�rig $1 U'S Of %S� p p , , All other BTU's �� TOTAL BTU's � p f,,Q � p 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: � �• •� :- � �� 2'� � _ G'o�� HEATING CO: Signed By: Date: Yes ( vr No ( ) Yes ( ) No (c� Yes (� No ( ) i'�es (�%j No ( ) Yes ( ) No � Yes (�' No ( ) --3' �� _ � �_ .T`� SuBJECT City of Fridley AT TNE TOP OF TME TWINS g � I L D I N G P E R M I T r S : � ; v___.__ COMMUNITV OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. i � . � � �"'1 � CITY NALI FfiIOLE� 35�32 NUMBEN �"'"'�� ,�' 612-571-3450 910-F15 �oe nooRess 5250 B ch na 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION oesca. 22 1 Mari an H' 11 � 2 PROPERTY OWNER MAIL AODFiESS Glen Weaver-Lanq J CON7RACTOR MAIL ADDRESS � 5 ENGINEER OR DESIGNER MAIL AOORESS MAtL ADORESS REV D�TE 5/17/99 21P 21P PAGE OF � � 29474 RECEIPT NO. p` (�3O�1 AVPROVED BY SEE ATTACMED SHEET PHONE 4-0757 PMONE IICENSE NO PHONE LICENSE NO. PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CIASS OF WOHK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside and windows (8 windows & 1 door) 9 CHANGE Of USE FROM STIPULATIONS TO Call for building wrap inspection before covering. Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. TYPE OF CONST. SEPARATE PERMITS ARE REOUIRED FOR ELECTHICAL, PLUMBING. MEATING. VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL ANO VOIO If WORK OFi CONS7RUCTION ZONING AUTHORIZEO IS NOT COMMENCED W�THIN 60 OAYS. OR IF CONSTRUCTION OA WORK IS SUSPENDED OR ABANOONEO FOR A PEiiIOD Of 120 DAYS AT ANY TIME AFTER WOpK IS COMMENCED. NO DWLG. UNI7S I HEREBY CEFTIf V THAT I HAVE REAO AND EXAMINEO THI$ APPLICATIpN ANO KNOW TME SAME TO BE TRUE AND COpRECT. ALl PROVISIONS O: LAWS VA UATION AND ORDINANCES GOVEiiNING TMIS TYPE OF WORK WILI BE COMPLIED WITM WHETHEA SPECIFIEO HEREIN Op NOT. THE GRANTING OF A PERMIT $ 976 DOES NOT PRESUME TO GIVE AUTMOAITY TO VIOLATE OR CANCEL THE PERMITfEE PROVISIONS OF ANY OTHEi; STATE OR LOCAL LAW REGULATING CON- $97 � 25 STRUCTION OR TME PERfOfiMANCE OF CONSTRUCTION PLAN CNECK FEE OFCON'AACTOQO AUTMOQIIEDAGENT ID�lEr ) OWNEQ��F QW I�OERi � A� . f' OCCUPANCYGROUP IOCCUPANCVlOAO SQ. fT CU FT OfFSTREET PARKING STA��S GARAGES SURTAX $1.98 SAC CNARGE Fir SC $3.97 TOi F;¢E � .�� L VALIOAT � IS IS�QUR P IT v'' - �,�tE NEW [ ] ADDN ALTER Effective 5/14/99 ( ] CITY OF FRIDLEY [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUII,DING PERNIIT APPLICATION Construction Address: ��'� ��C� �,� � � Legal Description: �a G'� p^�� p Owner Name & Address:�,� U�^��( —�� Tel. # S�-( '��5� Contractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length Driveway Curb Cut Width Needed: DATE:� f Q Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: DESCRIPTION OF IMPROVEMENT Width Width Width Ft. + 6 Ft = Tel. # Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. ;�n� a...\ �,c�-� � v � Estimated Cost: $ �� ( , Ft x $ _$ $ C' ,o2S�� $ '�% $ l, 9 $ $ $ $ $ $ D .02 6 $ CITY USE ONLY Fee Schedule on Reverse Side Tel. # ��.� --�� .001 of Pernut Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Detemuned by Engineering Agreement Necessary [ ] Not Necessary [ ] �� SUBJECT � .. � . � . � c�ty of Fr�a��y AT TME TOP OF TNE TWINS � u� L D I�� P E R M I T r � � ,�s�r � ; y ��. COMMUNf7Y DEVELOP�ENT DIV. ��o�� r � � PROTECTIVE INSPECTION SEC. � � �l �� 1� CITV MALL fRIOLE� 55132 NUMBER AEV D�TE v�GE 0: L�.��J \.�I.�' �.J . . . 612-571-3450 910-F15 9/17/O1 / / ioe nooRess 5250 Buchanan Street NE � 1 IEGAL LOT NO. BLOCK TRACT OR ADOITION DESCR. 22 1 Marian Hills Addition 2 PROPERTY OWNEFi MAIL AODRESS Glen Weaver-Lang 5250 Buchanan Street NE 3 CONTRACTOR MAILADORESS Same a AACHITECT OR DESIGNER MAIL AOORESS 5 ENGINEER MAtL iIP ZIP 21P PERMIT.NO. 32166 �� / AGPNOVEO BY SEE ATTACHEO SNEET PMpNE 763-574-0757 PHONE IICENSE NO PHONE LICENSE NO. LICENSE NO 6 USE OF BUILOING Residential 7 CLASS OF WOFiK � NEW O ADDITION � ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Install egress window 9 CHANGE Of USE FROM STIPUlAT10NS Window to meet State requirements for egress windows. SEPARA7E PERMITS ARE REQUIRED FOR ELECTRICAI. PIUMBING, NEATING. "� v• vv..v• VENTI�ATING OR AIF CONDITIONING. - � � � � THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONING AUTMOAIZED IS NOT COMMENCED WITMIN 60 DAYS. OR IF CONSTpUCTION Y OR WORK IS SUSPENDED OR ABANQONEO FOR A PERIOD OF 120 OAY$ A7 ANY TIME AFTER WORK IS COMMENCED ' NO DWLG. UNITS I MEFiEBV CERTIFY THAT I HAVE REAO ANO E%AMINEO THIS APPLICA71pN 1 AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PqOVISIONS Of �AWS VALUATION AND OROINANCES GOVERNING TMIS TVPE Of WORK WILI B� COMPLIED $3OO WITH WHETMER SPECIFIED MEREIN OR NOT TME GRANTING OF A PERMIT OOES NO7 PRESUME 70 GIVE AU7HORITV TO VlOLATE OR CANCEI TME pEFMITfEE PROVISIONS OF ANY OTMER STATE OR LOCAI LAW REGULATING CON- STRUCTION OA THE PERfORMANCE OF CONSTRUCTION �Z,3.SQ ^ eTUpEOFCON'a CTOQOAAUTMOA�ZEOeGENT IOAT�� Q�- ��K}IO . a��t OwaEA Bw�DEq �d �E� � ' � � UPANCVGROUP OCCUPANCVLOAD FT CU iT. OFFS7REET PARKING STALLS GARAGES SURTAX $.50 SAC CHARGE Fire SC $.30 10iA�FEE ,�24.30 LIOIyT�/D T►+�S 1�14fjUF7 P M1� �-Y : . �iafE N� [ l Effective 1/1/2001 ADDN [] , CiTY OF FRIDLEY (763) 572-3604 Bfdg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �.�� , �(� �� 4�1� Legal Description: Owner Name 8� Address: � c.h�'1d�ei.'# �-7 h��S7 L1 ' �� Contractor: �--� v MN LICENSE # Address TeL # LIVING AREA: 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 Sq. Ft. GARAGE A�REA: Length Width Height DECK AREA: OTHER: Length Width Hgt/Ground Sq. Ft. Sq. Ft. Construction Type: Estimated Cost: $ O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$_ DATE: '"� I APPLICANT: Tel. # �� LI —�� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ o�J � SD Fee Schedule on Reverse Side— $ � ;�C7 .001 of Permit Valuation (1/10th%) $ � S� $.50/$1,000 Valuation $ $1150 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 [ ] $ ��%�3l>