AF - 38042City of Fridley, Minn.
BUILDING PE�T N.� 5282 �
�
Date: •�: +,,. . �� ,,,.A• ,� � � .
F ;i � �;i
�
Ovvaer: ���—�'� {� �'� � Builder — _:._.. --.�
Address __.._ Address '� -�' � �
A� � LO�A ON O� BUILDIIVG �
No. _�� Street ���'`� � �..,re_�_____ Part o Lqt
Lot �_.....__ Block .— _ Addition or Sub-Division ._ --±_-_.,-^_..� a�����
..� .
Corner Lot ._.._._. Inside Lot !�'.-"� Setback x�°� � Sideyard __..� �.—.��..y..
Sewer IIevat3on _._..__._...__.__ ._ Founda.tfion IIevation
DESCRIPTION OF BUILDING
To v�a �• � .
�!1 �' r� � � a� �rr�
,r ° ,' . Front �� Depth • s� - Height - � Sq. Ft, ;(" ✓ " Cu. Ft ' �
� � ,,r� ,
Froni �""'�:�"" Depth � Height .�� Sq. F� �,�Cu. F't. �
� A ��
Type of truction ��.��� Fast �.� '��� —. To be Completed �
In consideration oP the issuance to me of a permit to construct the building descrihed above, I agree to do
the proposed work in accordance with the description above set forth aad in compliance with all provisions of
ordinances oE the dty of Fridley.
,.
,�
.,,
In consideration of the payment oP a fee of $��F "'"�r , permit is hereby granted to
�,,,t.�.--___..
to construct the building or additioa as described above. This permit is granted upon
the express candition that the �rson to whom it is gra.nted and lus 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
Frfdley, 119:innesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits aad this permit may be revoked at any Lime upon violation of any of the provisions of said
ordinances.
,�='�'� ��� ...,; f.�_ ;::..�`'''f
'',�..—,�,� �--� �� auil�fng Inspector
NOTICE:
Thb permlf does not eover ths eonstrueHan, ieshllstion 4or wiring, plumbing, gas heating, aewe� o� water. 9e aure to see
flu Building 6upestar for separate permits for thess ham�.
�., 4 ,r,,.
- �"--a f- J.� ' � _ , . ., �
,
OWri9TB �9
AtI.C2T@88
No.
0
1PPLICATION FOR BUILDiNG PERMIT
CITY OF FRTDLEY, M�NNE.SOTR
�i / �
�,�.rl// �
Iaot �� B].o
y /� �. Pert of t , —
i � _�
tion or Sub.Div.
Corner Lot Inaide Lot,_,�Set Back �.� Side-Yard fG� `�
SEWER. ELEVATION Ft)UNDATION ELEVATION _,.._,_
Applic�xit attach to th3s fo�m Certificate of Survey of Lvt and proposed building
loca.tion.
DESCRIPi'ION OF BUILDTNG
To be ed as: �
R Front � Depth _��' Height
- —�-- - —
Sq. Ft. �� �'� Cu. Ft. l
Fta
Z�rpe of
To be
� �o
�
ted Gost � � B
�
The undersigned hereby �nakes application for a permit for the work hereiri specified,
agreeing to do a11 work in-strict accordance with the City Ord3nances and ru].ing of
the Department of Bixi.ldings, and hereby decl tha.t all the facts and represents-
tions stated in thi.s applicat3on are truo �nd co ct. ��� '
�
(� Schedule oP Fee costa can be found
�
.e.� � . - -
the Reverse 5ide.)
�
. • = �
80ILDING PERMIT i�E SCI�DULE
Section 2. The Inspeator of Buildinga shall, before issu3ng an�r perm3t
for the erecstion bf any builoling or etru.cture, or for any addition t,o
an�r exiating buildin� or structure, or for an�► alterations or repe.irs
to.any existing building or structure,.upoa application therefor� require
the pa3►ment by the applicant for such perm3.t of fees to the amount herein
beiow set forth �nd in the manner herein provided to-wit:
2.1. For any such perm3.t for the erection of an� fire-proof building,.other
th�:n a�arage, warehouse, faatory or grain elevator, or for the erect�On of
an3r fireproof addition, fo� s3.mi.lar occupancy, to sny sxisting bLtildia�
shal]. be at the rate of .$1.40 for ea,ch one thousand cubic feet, or fraction
thereof, in such cubic�l contents.
2.2. For an�r auch permit for the erection of any fireprooF garage� were-
hous�, factory or grain elevator; or for the erection of eny f'ireproof
addition, for simil.ax occup�nncy, to any existing building aha11 be at the
rate oi' $1.2� for each one thousand cubic feet, c7.a.ssified �s "f3reproof!� .
by Section 502 of the Minneapolis Building Code.
OIIS
2.3. For �.ny suah permit for the erection of �ny
other thsxi a garage, warehouse, factory or grain
fireproof addition, for simil.ar occupancy� to any
Permit �1.00 for each one thousand cubic feet.
GARAGE3
nor�fireproof building
elevator, ar any non-
existirig bu3lding.
2,4. For ar�y such perinit for the erection of any �on-fireproof gara�Q�
werehouse, factory or grain eleeator, or fo� the ereetion of any non-
firepraof sddition, for similer occupanc�, to arr�� exiating buildin�
for each such building or add�ltion. Ninety Cents for each one thous�p,d
cubic feet or fraction thereof, in the cubicel contents thereof with�a
min3.mum of $4.00. � � •
. �.
;�
For the purpose of computing fees for building permits the cub3cal'-�:ot�tents
of any building or addition to a un3.form height throughout by multiplyf;ng
the ground axea covered from a point aix.(6) inches below the floor line of
the basement or cellar to the average beight of the upper surface or t:o the
average height of the roof eurface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing etrueture, the fee ahail be
at the rate of �3.00 for each Five Hundred Dolla�,s ($500.00), or fraction
thereof in the cost of all proposed work.
2.6. In no case ahal]. the fee charged for any permit ae set forth in
Sect3s�n2- be less than �L,..00.
� �
` � _� .-°�
P� _
�
MINDER ENGINEERING CO.,INC�.
ENGI NEERS AND SURVEYORS
LANO BuRVEY�NO 301L' TE8TINC3
CIVIL d, MUNIGIPAL ENdINEERIN(i LANO PI.ANNINO
6418-56T" AVENUE N.
MINNEAPOLIS 2T, M►NN.
KE T- 3(n37
,, �C ��'�i II � 0�C� ��i �� 1� I� �S �� �'`II! �
�°,�,1_ , �
✓
P���°������
�
��
�
1
������.
�
C!zarc,
.�--
(0..
1
a,y�
Kl
�
�`� �r f �J � .
—�oo —
—�._
, �
---�°- ----� I
R ���
t �`i
��
�„� ,..�
, ���
. I � i=,
�� �-
� ,,
� ,�
s .� �
r ' ` ��
�
�Y ��:�lRi��F � U7/11Tj' ��iaC'����.j�.J
— i —�
�°
1_.. �a � ��, �'� �.� � ��. �.f ,��'o
�I<I Sa _ _ ,
���' a � ."' ~" � �' ..:r' �` �.-� d ;,� 'rr � '�,
���r�r �'' :a,l ,
� Qc� n c ie� %rcr�
� S ,' /� �� �'
WE HERE6Y CERTIFY THAT THIS IS A TRUE AN� CORRECT REPRESENTATIOtJ OF A SURVEY OF THE BOUNVARIES OF 7HE
�AND ABOYE �ESCRICiED AN� OF7HE IOGATION OF ALL BUllD1NGS, IF At�SY, TNEREON, At�1D ALL VISt6LE ENCROACHMENTS,
IF ANY, FROM OR oN SAIO LAND. _ ----
` - -_ - t�i Pd-Ej�Ef� = E�i-Gtid-E��td�--C"v.;�'I�� ._ -- -
pATED 7M15 DNY OF �'/!-�r'''' -�" --� I�.D.1`15 4
.� En1G1NBF,� ANp SURV�_y�ORS
�
^ b`( ;�"/��`` �-�-�-`�:.- � -' -�``�`��'�
- — — � ' — — — -
�
� s
�
��y
G �
�. RP
��
o�
p �
: w
. 7i
:Y
' M
. h
: o
: a
. m
0 '
� .
� �
Q
N
�
�
�
�
�
r "�'1
� � �
� W (�
����
s� � �
� � .
O •
O � ;
O .
o .
o . •
� . .
� . .
0
pC >C 9�
� �� �
°o q o �
� �
� a
1�
�
�
0
tro'
�
z� � z� z x
fD m � `� 61
� y �' $ � a� �
� �,�� � �
�� ��� y
�r, " : o � � �
P �i � O y �
R1��'''
¢ � : � �- : �
�
� o : �' � :
¢ 0 � � .
C4 0 . . . .
� Gd : : : :
: � : : : :
� O
p� p4 C4 i� i� D4
W � w r f+ � '.d
� p C�7� O O P �
� tfs tss t� �
N � fH
� � ��
@ � �
0
A
x
V �
�
�
�
D
�
i
�
m
H
n
_
m
C
r
m
� � � p, p � �1
� w
x ^� �
�� �
...e A �
� �
0 m
�� ��
� � �
� � �
��
m
� M
❑❑ � I
� � ° � �
� �, � �
l�D Fp � tn h�fi y
0
�. �
�
� � � .
¢ �•
� � � �
� �
� I
.. = ;
� � 1 �' �
������ �
r , �`
�� \
� � ��,
�� �
o � �r
a `� �
�. \ r
��'��
WATER
a.osers
URINAIS
enrti
��
9AS�N5
SINKS
WPSH
rRnrs
DRINK.
FOUNT.
sHwas.
ROOR
DRAINS
UTCFi
BASINS
nuro
w�e
GAS
APPL
GA5
RANGE
GAS
OPENINGS
+� s
z •
� �
A
m
� p
��� �aa�"
� ►�,y
.� �: �, �
y � � �
�o�� �
�. � � �
� ���y! � V � �
y H O �
��m� O y
W �
� � ��
�� � �
►� ��o�.
��
� � ��ro �
� �b
�
�� �m
p ` �' o
/ � p, o d
�N �°��y �
� w
�v� ��
A
�. �, � �.
� � � y
. ��:�
�. � �
��o
m ���
�
� �� �
�
m
M �
n A
aro
aM
� x
� �
p �
�. �
M �
�
m
�
'0
�
�i
�
�
� �
� �
� Q
� �
' T
d a �-
m �
� � �
�.
� ��
0 �
W �
1� �
���
�
�
T
3
a
�
I
0
�
�
�+ r��� � � °
4� � y x n "7 b7 � w�
,��' .. � � 5 rs �
x O H y : y � � .+ �.' � � a.
W n � C �y � � n � fD � Ca N
c
dM � y I N O
� � �i x � � � W � w O � 0
���� o �w m y o y w �c J�
o � y o � m �: �
� o 0
o � o � �
W p � . 0 �' y � �I
� � � � y � x �
. . ��'�.`°
: : : : �: ��,
. . . ; Fs� ; y ;
��° . . . . � . . .
g : : : : � � : :
. . . . � : . .
a � � � : �: : :
�
H
� � I I I ;
x
„ea„o
� � �
� O O p � O
i'fl {� iA � il,1
G7
� �y O
� r
�
N
�
�
00
5'
�
a
p ".
� -
0
f�
�.
1 � `` 4/
c
� °-} i .�,
��
i
. � � �
��� �O�o� �� �o.���S
� � � b � � b �
n N �• � � ` � � � C• � � �
� � `� us �
� � Q �i �i° �p � � � R° R° p � �i
: � � � � o p��' �p� � �(p � o � �
� � �y � � � ^ F_ m w � � �
� � � � o � � � o o � � ?0
o� �� �
. � � � � o Q � � � � �
� � . pd o� . �
� $ �' a s' : � o p, d : :
� � : . ~ � o :
. ,� .
, �-� : : o � Q : :
� C'� p . � 0 Op O . .
O
i� o: �. ; � g: : :
� � . : : : : ; :
i � : f : ' : : : : :
� . .: ....
C71 N N OD CD
O O O O O
bi {fl 4J! tA' {fl
� o w � �
� � m
�. �
� � � � �
� n y -
� �, � �
m d� � �
z �
� � �
CA *
� � �
�7
P� � � �� �
=f, 1�9 � � �
�' O
-� o x
� � M
�� m �
� _� � �
��.°°�(�,
� � � O �
1�� f� +r'- Z
�1 � —
�
0
b �-'
���N� N����
O O O O O O O O Q �
{i! <A � PA �A
�
�
� �p ' .
O � o y O
a � � � � �
fD h O � � y
� � b �� �
O ' � � ���
��. � � ��
�- �' w � ��
� �
� �. _� r�
� � ,, ; �
� '� � ' �
, �
O � h�
�
;�
G� �� , �
� ����
, �.
� ;� I
� �
� � .
� �
rt
O
1
�
m
y A
a.a� �
►!y�� r+ � F��b
���'� �
�°�� �
p�
�.*�.� ..
y v �
��o
b
����
�
p��`C
e� �
0
� �° �
� �5'€�
� � �.b
���� ,
�
�a�p
p' �, o
�M y
����
�
¢A��.�
G � ��
���y
����
G�o
���
� .�
��
� S� 5'
v
�
�
D
'�''
�
�
�
m
N
_
m
C
m
d
»
M
�
�
�
�
a
�
�
0
�.,
h
�
�
.
�
_ �
��
�
�I
� �
� ..�
._
�
�
�N
� •
h
a .�A
��
v<
e. �
��
�
70
i.
�
�
d
��
CRONSTROMS HTG. & AIR COND.� INC. �ob Nam �� �
D-56 ��0 Exaelslo� Boule�ard, Mtnneapolts 16, Minn. � a
z6 B■A'1' LOSS CALCYLA?IONB ^_� �, 1obAddre
Weatherstrips A.S.H.V.E, Coastruction Na I Ins ation
Guide
Windows I Doors Reference Out. WaU Iat. Wall Ceiling Roof F1oor I Kind How Applied
Yes—No Yes—No 19_
Fl.�" Room � Length �°— Width �''�- Height ,✓' °-° Fl. •u,,�= Room Length � Width/ •�- Hei
Windows a Doors—Crackage and Area Windows an Doors—�Crackage and Area
Width Helght No. ot Llneal !. Area Width Halght No. ot Llneal LA Area
No. ot pane o[ a Iighte ot crack eq. ft. No. of pane o[ pane llghte oL crack eQ. tt.
�� �/
,v ,o' � ts AP �. �' � �� f ``Z �
� � 2� �- ,j � �
Coef. Btu Coef.
Infiltration � � � g' � In6ltration � � �
Glass � � ,� �,--�
Eap. wall
Net exp. wall r' :� rr t`e, ° g� @ P.�o ,/ �,+�
�e
Int. wall
Ceiling ��' �, ;j j,�
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ina. W.A. L,eader area
t �.� ,�, �,� R�m � �� /� - w�a� -
Windows an Doora—Cracicage and Area
Wld h Helgdt No. ot Liaeal ft Area
No. ot pane o[ vane liehts oL crack ea. tk
In6ltration � ��-
Glaaa �`°�
Eap. waA
Net exp. wall • �'- - �.�/� � �' j��
Inc. wau
Ceiling � ` �
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ina. W.A. L.eader ana
�. � � _ -a . R�� � �� � P Width f ;{ �
Windows and Doora—Crackage and Area
Wldth Hefg4t No. ot Llaeal tt. Ares
No. of yane ot paae Ilghte ot cracB eQ. tt.
r
o ti
�v �
� .� �
�� � �
Coe
Infiltratioa �'
Glaaa � �
Exp. wall
Net eap. wall � � � lm X. ° � = �a ' � . e�' f I�
Int. wall � �{ , � :
Ceiling � '
Floor
Tbtal Btu.
Required aq. ft. E.D.R. or sq. iaa. W.A. Leader ana
�I
��
� �
'�C�
Btu
i � '�
�
� ��
��cy
t
� ��
� Cdaas
Eap. wall - -
Net eap. wall . � = � �,�s -
� Int. wall
Ceiling �' S��! 2�
Floor;,�
Total Btu.
�
Btu
��
�- s �
.�
�
Required sq. k. E.D.R. or aq. ins. WA. Leader area
Fl. ,� � Room I l.ength Widt6 ,�,�°" ---Height �
Windows and D�ra—Crackage and Area
Wldth Helg6t o. o! L/neal Lt. Area v�e ��
No. ot pane of Dane 1 ghCS ot crack eQ. [L !�
�.,_'` %� � � / ,�- � ;+� d
- '� i� �
�.�
c�f. -� s�
In6ltratioa � �- „�°',�'` g' �P
Glaaa
Eap. wall
Net eap. M
Int. wall
Ceiling
Floor
Total Btu.
k' =`��_
x ��
Required sq. it. E.D.R. or aq. ins. W.A. Lea�der area
Fl.� ' Room I t�engthe%�}`.� Width ,i
Windowa and Doora—Crackage and Area
Wldt6 Helght No. of Lfneal ft. Area
No. ot yane of.pane tlghts o! crack ep. !Q
L•� � ►� ,�. � ,�'
°�� �c� � d � t �..
�
In61tra6on
Glasa
Esp. waD
1Vet eap. wal� ?��' a„�'_� E-
Int. wall
Ceiling � . �
Floor
Total Btu.
�
�`� �
.�° i �t;
Coef. Btu
� �
,�� � �
�� / a e"`�
k. E.D.R. or aq. ins. WA. I.eader area
� .
CRONSTROMS HTG. & AIR COND.� INC. Job Name �� i�E
D-S6 ��0 Eueebior Boulevard, Minneapolls 16, Mlnn. � �
ze H�AT L03� CALCYLA'ilONS �, ;,� Job Addre
A.s.�.v.E, (
Weatherstrips Guide �Aatruction No.
Windows I Doors Reference Out. Wall Int. WaU Ceiling Roof Floor I Kind
Yes—No Yes—No 19_
Fl. Room � Length !�� Width Height Fl.� Room � 1
Windows and Doors—Crackage and Area Windows and Doors—Cr+
�Vidth Helght No. ot Lineal f. Ares Width Hetght No,
No. ot pane o[ Dane IlBhte o[ crack eq. Lt. No. of pane ot pane tlB�
� L3
� �
� �� ! �
Coef. Btu
In5ltration Y° � �° � Inhltration
Glaas ` S�% �� C.lasa
Exp. wall Eup. wall
Net ex wall `' • � .,� � � � c7 `�
P• � ` 3 ,� Net eap. wall
Int. wall In� wall
Ceiling ,+'�i►' �, j '�£► `� � � Ceiling
Floor ��r
Total tu. %► Total Bcu.
Required sq. ft. E.D.R. or aq. ina. W.A. L.eader area Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl . .� oom � Length /:... Width� Height �,� Room I I.ength Width
Wiadows and Doora—Crackage aad Area Windows and Doora—Crackage and Area
Wtdth Helght No. o! L1nea1 Lt. Area Wldth Seight No. o! Ltneal tt. Area
No. ot Dane ot pane lighte ot crack eQ. it No. ot Dane ot pane I16bte ot crack s4. tt
i ,� � � f �'� o
��-�''� � �-
R
ns�at�on
How Applied
:h Width Height
� and Area
Ltneal tt Area
of crack eQ. it.
Coef. Btu
Coef. � �. Btu
1a61tration e'p
Glaaa '
Eup. wall
Nec eap. wall � �� �' � — �
Inc. wau
Ceiling i , (p a( � J
Floor
Total tu.
Required sq. fG E.D.R. or aq. ins. W.A. L.eader area
r�. ,�� R�m ���� /_ w�a�, °
Windows and Doora—Crackage and Area
Width Helgh! No. oL L1nea1 tt. Ares
No. of Dgne ot Dape Ilghts ot craek sq. f!.
Btu
Inhltration
Glaaa
Eap. waU
Net eap. wall
Int. wall
Ceiling �!
Floor
Tbtal Btu.
aq. ft. E.D.R..or aq. iaa. W.A. l.eader area
t�
i�
In6ltration
C.laaa
�p. Weu
Net eap. wall
Int. wall
Ceiling
Floor
'fotal Btw
Required aq. h E.D.R. or sq. ms. W.A. Leader area
Fl.� tt�m ���� w�a� H��h�
I Windowa and Doora—Crackage and Area
Wfdth Hefght No, of Lineal t� Ares
I No. of pane ot.pane tlahts ot crack p. iG
Infiltration
C.lasa
Eup. wall
Net eap. wall
Inw wall
Ceiling
Floor
1'otal Btu.
Requued u�. k. E.D.R. or aq. ins. WA. L.eader area
Btu
SUBJECT P :
City of Fridley o 19533 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � IPT NO.
� • COMMUNITY DEVELOPMENT DIV. ��� ��
i �V �
r � � PROTECTIVE INSPECTION SEC.
1 = �
� �"�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""'� � �'� 612-571-3450 910-F15 6/14/88 / /
108 ADDRESS 118 Craig i�iay N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ],Q 2 Pearson's Cx. ai.gway Estates SHEET
2 PROPERTYOWNER MAIIADDRESS ZIP PHONE
Margaret Hendley 118 Craig Way N.E. 571-2757
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LIGENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Resident%al
7 CLASS OF WORK
0 NEW 0 ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroo� Hous.e & Garage (.30 Squares)
9 CHANOE OF USE FROM TO
STIPULATIONS
Roof c�n Y�e 2nd layer but not 3xd. Install ridged galvanized valleys.
On all new roofs ar tear-offs and repiacement roofs.
State Code requires that 2 iayers of I5 Ib. �ett.
mopped together. be installed tQ a point 24 inches
up from eicteriar u�al{ line, or the use of othe[
. appr�ved underlayment membrane,
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ ANO 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 WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S1 �SOO $• 75
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $3S.QO
LAN CHECK FEE TOTAL FEE
$35.75
SIGNATUREOFCONTRACTOROR UTHOR12ED GENT �DnTEi . WHEN PROPERLY V DATED THIS IS YOUR PERMI
Si-� �NERtlFOVNERBUILDER� _� IDATEI � BLDG WSP s1 �' r/A Ar°i
� []
A�N [ ]
ALTER [ ]
�nstruction Address
r �� Desscriptian:_
City of F'ridley
R-1 AI�ID R-2
Building Penait Appl ication
0
EEfective 5/L88
Owner N�ne & Address: T�. �� `%/'o� 7�S %
(bmractor : _ �t� t S� �
Tp1. #
Address:
Attach to this appl ication, a Certif i�cate af Sluvey of the
lat, with the proposoed oonstructi� drawn on it to scale.
� � �• �� �; •;� �• • • � ��,
LIVING 1�i: r,enqth , wiath Height st�. Ft.
c�RACE �: r,enyth width eeight st�. Ft. �
DE(�t �: �ngth width Hc�t/Gro�a 9q. I�t.
�@� t°S -�'i. 2�j�- �'j s4� ��. C�
Gbrner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
�ipe a� �nstruction: Fstimateol Cost: S lsC�O, 4 c�
.r,;_
AppL'Olc. COmpl G't1011 Date : y� ''7' .
~. i, r '��`j., I 'r° i
�°�� +:- ,. � eY.t� A Alt� B
Proposed Driveway Wic7th If � New,9�,.Opening`'�� sDesired: � S
�:.�� ���- �� �Width + 6' See Back Page
,
., r ':.;.,, ' ,.'r- �.;
/� r. �
� � � l 1 � �J (J ' v y ° n
APPLICAIJP � 'j :�,; ,:.' Tel. � ��
:
• ; . �. , ., ,,t, .: ...
CQY � . BSE � (�bY�
Pe=mit F�ee S 3�� �v F�ee Schedule on Reverse Side
State Surdiarge S •� 5.50/$1,000 Valuation
SAC Q�arge $ 5550 per SAC Unit
Driveway Escrav S Al.t. '�," or Al� '�" Ab�ve
Park F�ee S l�e Determi.ned by E�gineering
Sewer 1�lain Qiarge Agreeaent Neoessary I l Na�t Neaessary []
�AL � ��� � J
31'IPULI�I�:
m
=:��. � �. ' ���vl�l ;�� `M:1�;�. )
The Chief Building Official shall, before issuing permits for the erection of any
building or �ructure, or for any additi� to any existing building or structure, or for
any alteration or repair to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set for�h and in the manrier herein provic]ed to-wit:
�TAL VALUE
�1 to 5500
5501 to $2,000
S2, 001 to $25, 000
$25,001 to 550,000
550,001 to 5100,000
5100,001 to $500,000
��
S15 Q�iinim�n Fee is S15 plus surcharge )
S15 for first 5500 plus S2 for each addi.tional 5100 or f raction
thereof, to and including $2,000
S45 for f irst $2, 000 plus $9 for each additional S1, 000 or
fraction thereof, to and including 525,000
$252 for first �25,000 plus 56.50 for each additional 51,000 or
f raction thereof, to and incluc]ing P 550, 000
5414.50 for first $50,000 plus �4.50 for each additional 51,000
or fraction thereof, to and including 5100,000
5639.50 for first �100,000 plus 53.50 for each additiona7. 51,000
or fracti� thereof, to and including 5500,000
5500,001 to �1,000,000 SZ039.50 for the first 5500,000 plus S3 for each additional
. 51,000 or fraction thereof, to and including $1,000,000
51,000,001 a�d up �3539.50 for the first 51,000,000 plus S2 for each additional
$1,000 or fraction thereof �
D�V� D RF_�GTAN FQf`Rf?�1
(Concrete Curb Streets Only)
Alternate °A": Renaval and replaoement a� curb and gutter only - Driveway width plus 6
feet times 513.50.
Alternate "B": Renwal and replaoement of airb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times �15.75.
/�+; ' : M • � • ' a�:U� �.: ���
Permits for c�nstruction will be issued a minimum of 24 hours f rom the time of
application to allav for proper review of the proposed structure and of the o�nstruction
site.
A Certificate of &uvey of the lot, shawing the locati� of the foimdation once it has
been a�onstrt�ted will be required before proceeding with the fra�ning.
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
CITY OF FRIDLEY PERMI��O.: 2 o4-d o04 � ,�' !
6431 UNIVERSII'Y AVENUE NE �_ ----.-_ °-_-f �,
FRIDLEY, MN 55432 DATE I5SUED: 04/01/2004 �� �
�631572-3604 FAX: (7631571-1287
: 118 CRAIG WAY NE
: 103024120054
: PEARSONS CRAIGWAY ESTATES
: LOT 10 BLOCK 2
: BUII.,DING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
VALUATION : $ 450.00
NOTE: PER SECTION 1402, 1997 UNIFORM BUII.,DING CODE, REQUIRES THAT A WEATI�R RESISTIVE BARR�R BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT TI� INTERIOR WALL COVERING. EXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN TI� SIDING IS AN
APPROVED WEATI�R BARRIER. VINYL SIDING IS NOT A WEATI�RPROOF COVERING UNLESS TI�
MANUFACTURER STATES THIS IN TI�IR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. RESIDE NORTH SIDE OF HOUSE ONLY
APPLICANT
CIARDELLI THEODORE J& KARI H
118 CRAIG WAY NE
FRIDLEY, MN 55432
OWNER
CIARDELLI THEODORE J& KARI H
118 CRAIG WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
applicarion and lmow 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 othe state or local law
regulating construc ' o pe - f construction.
'Applic Dat � —��—�/
�: � � !��_�1L y � 1� �- �
BUII,DING PERMIT FEE
FIltE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
23.50
0.45
0.50
24.45
NEW []
ADDN []
ALTER [ ]
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �/ � � �'�i �
� � l''/ ��
� i� 3 �
Effective 4/ /2004
(763) 572-3604 Bldg Insp �� �
(763) 571-1287 Fax �
oD�...� .
� �
Legal Description: � � �
Ovmer Name & Address L � � i ✓ Tei. # �� �� � �a2 -°� � ��
Contractor. MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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.
Length �� Width Height Sq. Ft.
Length Width � Hgt/Ground/' i Sq. Ft
.�.
" ' �
Construction Type: / � Estimated Cost: $ �/ �Q
Driveway Curb Cut Width Needed: _
DATE: �- -�/' `"C� ��►PPLICANT:
�3%C7
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� ��, S?�
$ �---�
$ � ��
$ �
$
$
$
$
$
$
$
��.��`�
CITY USE ONLY -
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 Consenration Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
BUII.DING PERMIT FEE SCHEDULE
The Cluef Building Official shall, before issuing permits for the ere�tion 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 therefore, require the payment by the applicant 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,�1 to $50,�
$50,001 to $100,0�
$100,001 to $500,000
$SOO,QOl to $1,000,0�
$1,0�,�1 and up
I���.y
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,�
$69.25 for first $2,000 plus $14.00 for each additional$1,000
or fraction thereof, to and including $25,OQ0
$391.25 for first $25,0� plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0�
$643.75 for first $50,000 plus $7.00 for ea.ch additional
$1,� or fraction thereof, to and including $100,000
$993.75 for first $1W,000 plus $5.60 for each additional
$1,� or fraction thereof, to and including $500,0�
$3,233.75 for the first $500,�0 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1, �0,000
$5,608.75 for the first $1,(�O,Q00 plus $3.15 for each additional
$1,�0 or fraction thereof
CURB CUT ESCROW
(Concrete Gbrb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Ceraficate of Survey of the lot, showing the location of the existing foundation will be required. before
proceeding with the framing. New Houses Onlv
�
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CON5TRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57Z-36U4 FAX:
: 118 CRAIG WAY NE
: 103024120054
: PEARSONS CRAIGWAY ESTATES
: LOT 10 BLOCK 2
: BUILDING
: RESIDENTIAL
: ADDITION/ALTERATION
571-1287
PERNIIT NO.: 2004-02173
DATE ISSUED: 11/24/2004
VALUATION : $ 1,000.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILIT'Y LOCATIONS.
PROVID� SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF T'HE DWELLING PER R317 OF TI�
2000 INTERNATIONAL RESIDENTIAL CODE.
APPLICANT
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
1 .C7�'/�7
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
applicarion and l�ow 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
regul c�ionsor the p•fg mance of construc on.
Appi1Ca11t o �� Date �`� �/ d
Bldg Insp.
BUII,DING PERMIT FEE
PLAN CHECK FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
PAID WITH CHECK # 8157
SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
38.75
25.19
1.00
0.50
65.44
NEW [J
ADDN [)
A�TER [ ]
GITY OF FRIDLL-Y tttecuve 4i u�uu4
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
. �
onstruction Address: / �' � C r' d � � ��� ��' �
egal Description:
Owner Name 8 Address: � � 2- Tel. #/� �,1P�'���2-
Contractor. MN LICENSE #
Address:� �% � C� y` ��R� �llL�7 r���l.�� � 3-�7�� �'�
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
�
DESCRIPTION OF IMPROVEMENT �
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
� (' r l' L�r,n��-J
_ �l2.Pli,.� ld( �Z' fl % -�'� �i� i�, f a.L �'"/�
/
Construction Type: � Estimated Cost: $� �l� .U�
,
Driveway Curb Cut dth Needed: Ft + 6 Ft = Ft x
DATE: � � �' I APPLICAN . �
$ _
#7l�-�>�-���`�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ ��
$� .5,� lg _
$��� .
$ , 6C�
$
.$
$
$
$
$
i �
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 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits 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 b�ilding or
structure, upon applicadon therefore, require the payment by the applicant 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
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $1Q0 or
fraction thereof, to and including $2,000 a
69.25 for first $2 000 lus $14.00 for each additional $1,000
$Z,001 to $25,000 $ � p
or fraction thereof, to and including $25,�
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $5�,000
$500,001 to $1,000,000
$1,000,001 and up
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each addidonal
$1,�0 or fracdon thereof, to and including $100,0�
$993.75 for first $1�,000 plus $5.60 for each additional
$1,0� or fraction thereof, to and including $5�,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,�0,000 plus $3.15 for each additional
$1,000 or fracdon thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Pernuts for construcdon will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
�
NEW [ j CITY UF FRIDLL-Y tr�ecuve 4i�rzuu4
ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
AI�TER � j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5T1-1287 Fax
BUILDING PERMIT APPLICATION
,
Construction Address:
Legal Description:
Owner Name 8 Address: Tel. #
Contractor. MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
O'6HER:
v2 �GU�'�
Construction Ty�
Attach to this application, a Certificate of Survey of the
bt, with the proposed constn.�ction drawn on it to scale.
,
DESCRIPTION OF IMPROVEMENT '
Length Width Height Sq. Ft
Length Width
Length Width
e�a�/�
Height Sq. Ft
Hgt/Ground Sq. Ft .�
wf w �"
�Po ��.,_ _ �rr�1- �� / �
Estimated Cost: $
_ ,
. �-.� ;�
aX� r^�, �rs, ,�r s�q/�h�, �-��.���� ��d��
Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$
DATE: APPLICANT: Tel. #
� ..
i� "
Call (T63) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Pennit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 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 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ J Not Necessary [ J
$ STIPULATIONS:
BUII.DING PERMIT FEE SCHEDULE
The Chief Building O�cial shall, before issuing permits 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 b�ilding br
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000 a
69.25 for first $2 �0 lus $14.00 for each addidonal $1,0�
$2,001 to $25,000 $ � p
or fracdon thereof, to and including $25,000
$25,001 to $50,000
$SO,DOl to $100,000
$100,001 to $5�,000
$500,001 to $1,000,000
$1,000,001 and up
$391.25 for first $25,Q00 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0(?0
$643.75 for first $50,004 plus $7.00 for each addidonal
$1,000 or fracdon thereof, to and including $100,000
>
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $5�,(�0
$3,233.75 for the fust $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,�0,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
-.
. t •
,r
�
�J�
%'
�
� ��
� ��
- „ r�
S !� �
� au�S�— �
=���� ��'D��-
`� �' ��s��
_ /<��, ���1a�Y�.
/��� �s ���
�'
�/l ��� ����? .� d'�/ � �
� l"
��� _
� � - �/� ������
� �
�R �E ED��t_
��� CDMd
�
S
3 .��
� ������i,
/� �a. T
� �� �
1a1���
��
�0
�t
1�
�
v��
� ,����� �a����
�� � �
5 �
►
�•�
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 N'AX:
ADDRESS : 118 CRAIG WAY NE
PIN : 103024120054
LEGAL DESC : PEARSONS CRAIGWAY ESTATES
: LOT 10 BLOCK 2
571-1"L�7
PERMIT NO.: 2004-02199
DATE ISSUED: 11/30/2004
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE.
# 0-100 AMP CIRCUITS 5
APPLICANT
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
OWNER
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after 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 work
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
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
STATE SURCHARGE, ELEC FLAT
ELEC CIRCUIT FEE (0-100 AMPS)
ELECTRIC FORM FEE
TOTAL
PAID WITH CHECK # 5397
R6��i
S�YAKA"1�� Yr:KMI"1�5 K�(1U11�U FUK WUKK OTHER THAN DESCRIBED ABOVE.
0.50
30.00
1.00
31.50
,
ORDER FOR PAYMEI�ii NO: G� �` � �/? �����
Z — ,,`Z�� � c�,�i 9 % �Ri�R FOR �i4YlOfEIVT`'
Installer of Wiring /-* `7 � / L — � ��/ c� / Z
edOccupan Job °z �� .
PropertyAddr�s l��'
Date
C�.d i�
Permit No. %-3 � % `�.3".�
O Additlonal rough-in tnapecNon was required.
❑ No acc�a - scheduled inspech�.
O Fee shoRage - see computatlon.
�d Reinspectlon Tee.
Fee Computation:
P � '� ���'
Date Flled
Zlp �� i� �f� �
� � �
Please retum this ordq r�r chec�c in the amount of �� aayable to the city/
township by (date) ( /
Inspector C �-� ° Telephone �f� �1�- ,��%� �-
RETURNTHIS ORDER WRH PAYMENTTOTHE CITY/TOWNSHIP WHERETHE JOB IS LOCATED. RC-02
?
,
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�63) 572-3604 FAX: (763 571-1287
PERMIT NO.: 2004-02200
DATE ISSUED: 11/30/2004
ADDRESS : 118 CRAIG WAY NE
� �� �
PIN : 103024120054 '
LEGAL DESC : PEARSONS CRAIGWAY ESTATES
: LOT 10 BLpCK 2
PERMIT T'YPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
OWNER
KHADIJAH RIOPELLE&HALIL AYYILDIZ
118 CRAIG WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORI�T STATEMENT
1'his permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and lrnow 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
regulating construction or the perfo ce of construction.
Applicant � � i Date
Bldg
0
3
0
# GAS RANGES
VALUE (FOR MINIMUM CALC)
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 5397
< < �
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
0
0
0
300
0.00
30.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.50
30.50
�
�n
. �
W
C
�
�
Z
7I7
�
D
r
r
ao
m
�
�
O
v
m
v
�
m
�
C
�
n
�
m
n
�
Z
cn
D
Z
v
D
�
r
m
�
.D
�
�
m
�
�
o �
D �
r m
�
m
m
�
�
� •
� o
,
D
-o
'Q
<
m
n
�
�
0
c
�
�
�
v
.�-►
N
T
�
N
v
�
m
��m
N r �
�
\O�
2 c�
°, m =
oCi � �
�
� Z c�D
o v�
-�oo
�.�o
m m=
o "o �
�D
��
-� �
�v
rD-
-�
m
�
z
�
v����� � m n�i W c0°u � m
���' �' m m m 3� � g m°" �
� � v � -, � � � � � � � .o -r�
� 2 = � � W
� � � � � rt � � 7 � j �p fD
� � � � � '<; � �. � w
� � � cc � d � Z
m cfl
� ��� � `°
� N �� � � �
� � �. � �
� � � � c
� m �
c
m
�
�
m ��
�
I � I I I I I I I I I I I�
� ������������
� � � w w w � � � � � j �
cn oo���+0000000
0 0 0 0 0 0 0 0 0 0 o c o
0 0 0 0 0 0 0 0 0 0 0 0 0
�
� �
� C
z �
m W
v Z
� �
c�
0
�
D
. � .-Zf
m
r
z
O
�
�
.�
�
m
�
�
m
v
�
0
�
'0
m
�
�
�
z
O
W
C
v
Z
G)
c
�
m
v
�
z
m
�
n
m
1
7
a
N
O
�
Q- n N
� � c
�
� � m
N � �
°-�, m �
�"s N
�p � a
�
W 0 N
Q- °- �
� v �
v��
�� m
a,; °��., �,
> > �
C) .y-rt $
ac'�i
� a1 O
N �
� � O'
�
N
Q fll
n � N
�' � �
m
� � rt
�
-«
� � �
°�' m �
N n N
� � O
� � �
� � m
N N (p
�
-o
r
C
W
Z
�
�
C
z
m
�
�
m
�
�.
�
m
�
O
D
r
�
O
W
f \
�(� ,�
-V
N
�
wQ- ��"' �
N
cn '_� c O
W Z N �
� � � �
_.°�,"'p,��
„N�v
� Zm
� m�
v Z
� �
� �
, m
� �
� O
Z
C
�
m
rt
<'
m
a
�
N
0
.°p
+ b
: a}ea :�g pau6ig
�O� JNllt/3H
( ) oN
aq���saa :SNOI1H2131�d
acL(1 ui �a�aweiQ � y�Bua� }} �y6iaH ao��auuo� �uaA £# �u�i�ddy
acu(1 w �a�aweiQ �} y�6ua� }� �y6iaH �o��auuo� �uan Z# a�uei�ddy
ad�l ui �a}aweia �} y�6ua� }} �y6iaH �o}�auuo� �uan �# a�uei�ddy
say�ui �a�aweiQ �y6iaH �uan acl�(1 �ua� uowwo�
}ndul n38 I��l sa�uei�ddy I��ol
�eN �o pa�sissy ue� �ndu� �18 ad�l E# �uei�ddy
�eN �o pa�sissy ue� �ndul (119 ad�l Z# �uei�ddy
}eN �o pa;sissy ue� �ndul f118 ad�(1 �# a�uei�ddy
uoi;eu�o;u� �o;�auuo� �uan pue;uan uowwo��azig pue a J, a�uei� d
( ) sa� �sapo� �ua.un� �ad se �(�a�e�edas
pa�uan pue �uan uowwo� ay� wa� panowa� uaaq sey a�uei�dde ue
�a}}� �(���a�o� pa��e�sui pue pazis s�o}�auuo� �uan pue �uan uowwo� ay} ��
() oN () sa� � •sa�uei�dde }}eap �e�n�eu pue pa�sisse ue} �o� sa�qel 6w�u�n
� a��wn� �e�}ua� � tio6a�e� yWy�-y�y apn��ui saop siyl •suoi�e��}i�ads
�s,�a�n��e�nuew pue sapo� �ua�n� ay� s�aaw pue �(�qwasse pa}si� e si }i
}ey� sa�}uan �(qa�ay pau6is�apun ay� 'wa;s s ui;uan nnau e ui���sui uayjN
( ) oN ( ) SaJI
( ) oN ( ) Sa�l
( ) oN
( ) oN
( ) oN
•suoi�e��i�ads s,�a�n��e�nuew pue sapo� �ua�n� ay} �aaw o;
pa��e�sw pue pazis aq ��inn �i �ie uoi;snqwo� nnau e ��e;sui o� pa�mba� uayM
�
�suoi�e��i�ads s,�aan��e}nuew pue
sapo� �uaLn� ay� �aaw o� pa��e�sui pue pazis si �ie uoi;snqwo� u�s�xa a�,
( ) sa� �sa�uei�dde }�eap �e�n�eu pue pa�sisse
ue� �o� sa�qel 6ui�uan a�ewn� �e�;ua� �/(�o6a�e� yWy�-y�y apn��ui
saqp siyl •suoi���i�ads s,�a�n��e�nuew pue sapa� }ua.un� ay� s�aaw pue
�(�qwasse pa;si� e si �iun �uawa�e�da� ay� �ey� sa�}uan os�e pau6is�apun ayl
O sa� �uQi�euiuua; pue snnoq�a �o �aqwnu 'y;6ua� `6wzis 6uipn��ui suoi�e���ads
�a�n}�e�nu�w pue sapo� �ua.�n� ��e s�aaw pue �nd/�i�se�d si wa�s�(s 6w�uan ayl
_
() sa� �pa�inba� aaaynn paddo�sa��} pue pa}�oddns �(�a�n�as si pue
'suoi��ru}sqo 'uoi�e�oua}ap '�sru wa� aa�� si pue pawwexa uaaq sey 6w�uan
ay� }ey} sa�uan �(qaaay pau6isaapun ay} `a�eu�n� u�sixa ue ui�e� aa uayM
NOIld�I�Rl3A?Jlb N011,Sf18W0� aNH 2101�3NN0� 1N3A �1N3A NOWWO�
SlI1,Na3d 3�NHI�ddt� JNIN�1f18 �3(1� 1N3W3�tild32! a0� A�3131dW0� NI °l�l�
a