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AF - 43213City of Fridley, Minn.. BUILDING PER.MIT N° 5584 Date: ._.. �` � `� . _:.�'._.._.._..__�! .___. � __._._.._ ._.w.___._..._ . , Owner: ._ . . ._. .r.��.__....,..._._. Builder _�_..�.. ...__.._.._._.._._.._....� Address.�._.._._._._.........w..__...__._....._.._.__.__._.._...._..__.___....._:_ Address _____.�_.._.._...__._.___..._.._..u_.._._..__ . � LOCATIO OF BUILDING No. _.��._.'.�._... S�treet . :��. ..I�._ _._. Part' I�t:;:..._....�._;:_.. _ __. _ _.._. _.. , . , : .A Lot „��,��Block _.._..��: _,�.._....__..._.._... Addition or Sub-DivIsi� Corner Lot ._.._...��.. Inside Lot _.._.._.._.._._.___.__.:.. Setback _ _.._ Sideyard _ �: ..� j�... Sewer Elevation _____.._..___...�..._..��..___.._.__.______.___._..._ Foundation IIevatian _._._._._.._._._.T_ bESCRIPYION OF BUILDING�� To �e Used '� Front �,�_. Depth �� Heighit �__ Sq. � ._ Cu: 1�'t. r ?� _._ _ ___ t � . Depth � Height ....� .. • F'i. ` Cu. Ft ' � . _. _ �. , Type of , truction ,,�. :.._. Est. Cos �,,:��._.:.. be Completed • � ,t _ . � ' . .. ' ) � A� . . � . � . ' ' . � . . : ', . . .. - . . .. � � . ., � .. �� , '. . .... . � . . ' . - . . • � J,.:�� ' . . . . . . � , . . . In consfderation of the issuance to rne of a permit to construct the b�iiding d�cril�d abave i a�+ee to do .the P�P�� work in accordance with the description above set forth and in complfan�ce with a�l pttaV�eionur iDt ordir►anc�s of the city of Fridley. �_._..._ In cansideration of the payment of a fee of $.: ...:._. . permit is hereby gi�aated to.� ' ....._. , _.�......_...__...____....__.._._____._..._ to c�struct the bwtldiag or addition as described above. This perri�it is gi'�ntied upo�� he express c�ndition that the person to whom it is granted and, his a.gents, etnpioyees and w�� ia ��r&' . done in, around and upon said builciing, or any part thereof, shall confora� in all respects to the' � of �'ridley, Mnu►esota regaz'ding location, constructio�f, slteration, maintenance, repafx� and maviAg t� withi� the city limits and this permit may be revoked at RnY time upan of anY o� the praviaia� cIE ordinaacea ,�:� NOTICE: ' 7his p�nnit dws not eowr �Iw eonsirudton, insfaRdkn foe wktns,..�lumMn�'gu 1�fin�, aw�r er waNr. M�at f� sM th� dufkling Insp�ero► for a�pKata p�emits for th�a iNn�. � �-:, ; � � a�4 � � y---,--_—"' ' ` �w„` a� _ ._ . � . . � � �,�� -� APPLICATION FOR HUIi�DING PERA�lIT CITY OF FRIDLEY, 1�iI'`'a�C^'r'n \ 4wner ` s N' Address i LOCATION OF BUILDII�'G No. �/Q Street , f,_Part of Lot � � Lot,�, '%-� j�,�� Block Addition or Subdivisio � / � Corner Lot,_�,,,_Znside Lot Setback�S�Side-Yard SEVdER ELEVATION �'OUNDATION ELEVATION Applicant attach to this form Certifcicate ofc Survey of Lot and proposed building location. DEBCRTPTION OF BUILDxNG To be used ase / � Front�,�_,Depth Height � Sq . Ft . �`� ��5 . Ft . �/��O , Front�� Depth a1' y- __ Height � Sq. Ft. Cu. Ft. y ` � �y Type of Construction---��, .r � Estimated Ca -��,1�� To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do al1 work in 5trict accordance with the City of Fridley Ordinances and ruling o� the Department of Build- ings� and hereby declares that all the facts and represen�ations stated in this application are true and correct. DATE -- �% "`-" G SIGNATURE C� . ., (Schedule of Fee Cd��can e�ound on the Reverse Side). r � � �f�S��Ci�C * -- ..__ .s�' ... City of Fridley App�ica�ian for P'luuntbing and Gas Fitting Perm�t Depf. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK /� }� r� y�� '/ C Number, Kind and Lxation of Fixtures Location— � c�L 1/�-! l`� 0 (�, N Y z '" z � , w^Tea "TR. � City of Fridlev: �p � �m � �< Z� i O< � �`� �^a z Z ++ ; l"� j o� � v� 3� o� w u'�. O tS �< 3 �U' �� p F N GAS ELEC. � Base � Ist % 2nd _ 3rd 4th ' Future Connection Openings Connected with * New Fixture, Old Openfngs I 3ewer � Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAi. Number FSixtures . . . . .. . ........ ....... `" x $1.50 $ � U � Future Fixture Opening ................ x 1.20 $ New F'ixture Old Opening . . . . . . . . . . . . . . x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTiT) . . . . . . —� x 2.06 $ � • � v New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL � /� � lst 3 Fixtures .......................... x $1.50 $ Additional Fixtures . . .. . ............. .. x .50 $ Gas Range to 200,000 BTiT .............. x 2.00 � REPAIRS & ALTERATIONS—Refer to Code Description ................................................$—T TOTAL FEE �O r� i� The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the I}epartment of Buildings, and hereby declares that all the faci and representations stated in this application are true and correct. Fridley, Minn. � Z' �� , 19� � Owner � ' �(�( l � � � � Kind of Buiiding � �✓ � � � Used as � E"-5 ' Ta be completed about �° °�' � � " Estimated Cost, Old—New. Building Permit ROUGH � G V 196 � FINAL az aM \-5 vT � Pg�m�t r —� r/ ned ��' � ` /��G�' gy C7.'7� 0 '' Business Phone No. S u�– ��.5� City of Fridley Application for P'lumbing and Gas �tting Perm�t Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK /�� _.. �v ��.,. Number, Kind and Lxaiian of Fixtures Localion �� n U' WATER HTR. �n �^ in a Z • • u+ ur"i � S N Z '^ x Y Y Z �c � Z U z O x (9 z �� 7 z�� 'o z g� g7 �7 <a 7�Z( 7a F N cns ELEC. ; 7 m VI 3 H O LL N LL O m ��S (J G (� 1' C� O ��I�i��ii��'r-�-�- /��;� �7�� :. - �� '% �i� �� ' � ■ ■ ■ ■ • ■ ■� � . ■ ■ .� . " � - _ � PARTIAL RATE SCHEDULE PLIIMBING FIXTURE RATES: NO. RATE TOTAL Number FixtuTes . . . . . . . . . . . . . . , . . . . . . x $1.50 $� Future Fixture Opening . . . . . . . . . . . . . . . x 1.20 $— New Fixture Old Opening . . . . . . . . . . . . . x 1.00 $ Catch Basin ... ...... ... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $ GAS FITTING FEES: � NO. RATE TOTAL lst 3 Fixtures .......................... Add3tional F3xtures .................... Gas Range to 200,000 BTLT . .. .. ....: .. .. x $1.50 $ x .5Q $ x 2.00 � REPAIRS Sc ALTERATIONS—Refer io Code Des�ription ................................................$ \ TOTAL FEE $�% .� '' � \ `\ �� \ City of Fiidley: � � , t� �`% .•��r�,,�� t�'� q,p f�� --; � —�. F- � � � ... �' O' .= � s.Y'J .�..� .-` f,� a�l.:. `bf3, �� / The undersigned hereby makes application for a perr�ri2�'f �_t�g$ �v�� herei. specified, agreeing to do all work in strict accordance with the ��'iiy Ordinance and ruling of the Department of Buildings, and hereby declares that all the iacl and representations stated in this appIication are true nd correct. Fridley, Minn. , 19�� r G�-�C� Owner "�� Kind af Building _� Used as � �" To be completed about Estimated Cost, Old-1\Tew. Build ROUGH FINAL 42 _ / S �/� �� " � t e _ \` ,; . p' � City of Fridley r AT T1N; TOP Q� TwE TwINa � 'i ` r rL-------; GOMMtJNITY OEV[L.O�M[NT OIV. � ' � MO'TECTIVR w'11�CTIpN ptK, �` � �--. ; prv �u►�� s��D�.Rr �Mt 4.....1`.� t.J i1�-s�0-3M0 Job Address bl0 N. E. Dover Street ner Robert A. Rutherford Contractor ;��NNEGASCO Kind of Building Comp etion Date a � r W � � W � i W I 3I<° u a�NVa s�� '1ddV 9Y•J �:�� •�s�w � i •6n�1 'MNIY21 � d I SNISV9) y H�1v�I a4 w Oo eN�vaal 3 � �oa,� 0 w�. Q � I saaMOHSI O'� �� 'tNnodl G d NNlala a �v QU�6Abtll hi H81/M � CHNISI � •NIfY� spnt M1Y� a'�rNirn �ruvM 53=8► -s-915.51 i��EGT PLU�IBI�Vr, PERf1IT QPPLI�ATI��J ss S �33 MARQUPTTE Use - Fr3me Res. stimate ost 1-28-75 io.00 i ; i II � r iI ___ _._�' � f , , ii f I ; � ; � ; Ij � � � � I_ �__�_ i �� I I - �I o `o w � � � I I I � I � f � ( ( � — � � � —� � I � .. .,� r�i � c�i � � , �� one -- __ ---- -- -- ..----_ _ _ -- ...— ----- iiPlumbing Fixture Rates: N0. RATE TOTAL ,! Number Fixtures x $2.00 �_ I� Future Fixtures I ; X $1.5� �' New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 �' Water Heater-99,000 BTU x $3.00 i � Ground Run Old Bldg. x 3.25 $ � Elec. Water Heater x $2.00 j Gas Fitting Faes: II ! lst 3 Fixtures x $2.00 � Additional Fixtures --^ x $ .75 I � Gas Range-199,000 BTU 1 x$5.00 5.00 ! Repairs & Alterations I ^ See + Description: Code IS tate Surcharge C�ass °'A'�' �t�r.cfiarge ,�0¢ . 50 I i TOTAL FEE $ S.S� !The undersigned hereby makea application for a permit �for the work herein specified� agreeing to do all work in strict accordance w ith the Ci.ty Ordinances and rulinF of the Depaxtment �of $uild�.nga�, and hereby declare that a1l�the facta and representatione etated in this a�plication are true and correct. '�/ o� o�. . �f �m.. /�-/ 7- 7,5��.� _ . Date ► . sue�ecr pER �� c�ty of Fridley � AT THE TOP OF THE TWINS g U I L D I N G P E R M i T � � ECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � ' ; .: ------ ��J3�i r � � PROTECTIVE INSPECTION SEC. � � i �4 � �'�'1 � CITY HALL FRIDLEY 55432 NUMBER � REV. DATE � PAGE OF APPROVED BY `•""�'� ,�� 612-560-3450 910-F15 10/8/76 � � JOB ADDRESS 610 .Dover Street N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 37-39 W Riverview Heights sHeer 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Rutherford 610 Dover Street N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEEA MAILADDRESS ZIP PHONE LICENSENO.. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION �J ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof Structure 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE �'ERMITS REQUiREp FpR WiRlN�, NEATIN�„ PI.UMg1N0 ANp SIGN�. � SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. ASpt13�.'t THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Of 120 DAYS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �$'�SO. O¢ y�. SO WITH WHETHER SPECIFIED HEREIN OA N07. THE GRANTING OF A PERMIT 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 PERFORMANCE OF CONSTRUCTION. �`%. SO PLAN CHECK FEE TOTA� FEE � yS8.0� SIGNATUREOFCONTRACTOR RA THOfiI AGENT Ioa7E� WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT %�Qa�� /d-S-?� �i f c�.n� �v-c4-7(„ . �. S GNATURE OP OWNERIIF OWNER BUILDEfiI IDATEI BLDG INSP DATE T-- C1TY UF f=fZIDLEY APPLICATION FOR f:cSl DEN'i`Z/1L &l ILDING PERMITS iNEI��, ALTER/aTIONS, ADDITIQf�S, 0 R REPAI RS) OWN�R' S Nt1r1E : RQQE�r C� u�HEl�I-�.R-D BUILDEI2: S/� M�' ADDIZ�SS: �ID p�vEl� 5T� I��•�� ADDRLSS: ��/y� TEL. I�O.. ��0-�l� � .��. No : i;� 1 D s�rrx :,�� 1 C,� s�, N, E_ LOT :��i 38i 3`i RLOCIC :` G{� ADDITIO:�' : //�E12 j/!�'L() f�/EG NT S CORNER LOT: INSIDE LOT: S�TBACY.: SIDLi'ARD: Applicant attach to this form �ao Certificates of Survey of Lot and proposed building location drawn on these Certificates. ll�SCRIPTIO�i OF BUILDI\`G To Be Used As: :E:,j��jOf ,�/OUSE Front: Squaxe Feet; Deptti : Cubic Feet: Height • Fxont: Depth: Height: Square Feet; Cubic Feet: r?s�H�LT Type of Construction: � Esti�nated Cost: $ %�D ,I�Q . �To Be Completed: //-/s� %� 7.'he undersi�ned hereby makes applicatinn for a permit for the work herein specified, agreeing to do all �ooxlc in s�'rict accordance ��ith the City of �ridley Ordinances and rulings ot the Department of Buildings, and hereby declaxes tliat all the facts and xeFresentations stated in this application ara true and correct. nt�T�, : /l� — � - 7 � • srcn�rur.� : � � � � (See Reverse Side Foz Acidition�ll Infoi-mation. ) � �, S-a r---� `-' Y •� r r sue�ecT P City of Fridley � 15 9 4 5 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ;, , � EIPT N • COMMUNITY DEVELOPMENT DIV. � � ti: ------� l l � r � � PROTECTIVE INSPECTION SEC. � � 1 - �,��'��; � CITY HALL FRIDLEY 55432 NUMBER i7EV. DATE PAGE OF APPROVED BY ` �� 1� '� 612-571-3450 910-F15 9/29/$0 � � JOB ADDRESS 610 Daver S't. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 37,38,39 W Rivervi.ew Hei hts SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Rutherfard 610 Dvver St . 86-01 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE �ICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK Fireplace 9 CHANGEQFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED �S NOT COMMENCED W17HIN 60 DAYS, OA IF CONS7AUCTlON 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 AND EXAMINED THIS APPLICATtON 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 � �jOO.00 •/5 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON- 9,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $9•75 SIGNATURE OF CON'FA OR OR AUTHORIZED AGENT IDATEI WHE ROPERLY A E T IS YOUR PERMIT , . � �� .� �� S NATUREOF WNEF( OWNER�BU�LDE �DArEY P D!•TE C�TY OF �itIDL..f;Y !t('!'{_It:/l'�?�'� ;�C1C; f;E�SI(;L:i�1�'II1L LUII.�)IiiG ('E�'J�TTS (tJf�►•r, J�� l:er��t�ions, /�dc(ii:i��ns, or Rc;�airs) � � �,� r ' � � II ADDRf:SS: Cs7)D .fk) U� .ST TC L h 0: '7 �(� � C'� / U Sp ulJI �.�if:i:: J C� YYl �? • AUURE:SS: � TEL IdO: ' � Cons�;rilct;on Location � . sTZU�x r�o : (p t� s2��Ef:m: _ �c� v� r2 SZ' - N•�. T,�7.` : ELOC'iC : nnnz�rxo� : Corner Lat: �� Insicle Lot: ScibacY.: Sideyards: l�p�licant attach to this £orm t-wo Certificates af Survey of lot and proposed building location drawn on c�rtificates to scale. DESCRIPTIOi� 0� CUi��ST"'JCTIO�d ` r - ' � I'ront: D� pJi: Iieight: , � Squa�e.Feet:^ Cubic Feet: . 0 r ront: Squar.e� F'e�t: Type oi Co.�struction : Dt�pttt : Height: Glibic I'eet- Estimated Cos �: $��_�Q . . 7b Fe Cbr,�pleted: � Alt. A Alt. B Prnposed Urive�•�ay �vidth lf New Opening Is Des:ised: $� $ , S�I: P.�VF:R:��' Si�E �fi 5HEET . 7.iie �xnc�e�_ sa.cned hereby make� appli�caticn £or a�erniii� i�cr the �:�ork herein specified, ac�rr:a��.ng to c.c� _all wor}: in stric� � r.corc�ance tazth tlie C�4y af J'ridle}l Orclin� nccs anci r.ulii��3s c�f L-}Ze �e��al'tnte:�t. of. 73tlilcii.t�c�s, and ]inreb�� declares that al)_ tl�e fzeLs and �:epresant-<:ti.�ns statcd iii L-his �.pk�lication are true anci correct. � r>,.�r: ��7� � 9 /�'� sxcN��,:�r�.: ;�t:.Lj�11��1L:101�5: . � ��-w:k� 9. vc� . U . . T-x � ��' � � - ��,� � . �_ ._ ; 0 n SUBJECT c�ty of Fridley 2 0 3 9 5 , , AT THE TOP OF THE TWINS g �! L D I N G P E R M I T RECEiPT r � � � `L_�� COMMUNITY DEVE�OPMENT DiV. � �� 1 � � PROTECTIVE INSPECTION SEC. � � r 1 � � HEV. DATE PAGE OF APPROVEO BV � �"'1 � CITY HALL FRIDLE� 55432 NUMBER �""'� � ,�� 612-571-3450 910-F15 5/30/�0 / � J08 ADDRESS 610 Dover S'treet NRE, 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 37^39 W' Riverview Heights SHEET 2 PROPERTY OWNER MAII ADDRESS ZIP PHONE Bob Rutlisrfprd 610 Do�er S'treet N,E, 786-0106 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. S�me. 4 AFiCMITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDHESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Res identia,l 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION �1 REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroo� Attachsd Gara e(� S' ares 9 CHANGE OF USE FROM TO STIPULATIONS On all ner� mofs or teac•pffs and repla�ement roofs, State Cade re4,uires, lh�� Z taxers of �5 tb. fett,. , mopped together,, � ins�ali�� M a poi�tt 24 inches up from exteriar. �l� li�►e: or tMe use of othe�' approved underl�yS+�ent :memgr,ane, . TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTHEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TAUE AND CORHECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORpINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4OO $. �JO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $1rj.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIGNATUFlEOFCON'RACTORORAUTHOA�ZEDA ENT IDATEI WHEN P�'OPERLY V tDATED THIS IS YOUR PERMIT � ' � 9 l •`�. SiGN TURE OF OWN R F OWNEA BUIL RI ATEI �� BLDG� WSP �aT � [ ) Effective 1/1/90 A� [ ] R-1 AND R-2 �'� [� Building F�exmit Application Construction Address: �/D //�� t� P/' S� Lega1 �escription: �% . _ ��, 3 °% ,� owner Name & Address: ��j �u e 7�`{2r �rc.l Tel. # 7�6-a�o� cbntractor: 7'�'�"�___=��-�-�'��-w --- Tel. # ,��D 3L�/� �__�_� ,_ _ n __�1 �' P,ddress: - - ----- ---- • .� �s�,. ,< <...�-�%��_ . .j-�.�_�-="��0 � LIVIl�IG AREA: GAI2AGE ARF,A; DDCR AREA: OTF�It: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D�SG'RIPTIO�J OF II�T�VE'�MENr T pm'th Width Height Sq. Ft. Lesx�th Width ��_ Height �Q � Sq. Ft. �Q � Length Windth Hgt/Ground Sq. Ft. �Q.s�/ o�� A>Uc� H'P �o.o � r� ,4��i�o S�' .S�11 Corner Iot [1� Inside Lpt [] Ft. Yd Setback Side Ya�i Setbaaks Z�pe of Construction: 2(�oc� r Estimated Cost: $ '�OD ..... Approx. Ocm�letion Date: ,��erZ�P /� • .�..�_. � - . - •.- . �- _. , . _- . -.. - . . . ,� '' �� .,:.:�.. L«!,�,�.. � - � - . %r / �I► , r% /,, � !��1' 1 •1 I � P�rn�it Fee $ �� /-� U C� State Surchan�e $ .,� SAC Clzarge $ Driveway Escrow $ Park Fee $ Sewer Main C�arge $ . �• s�rz�TTOrrs: $ /� . SZ�+ Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" AUove Fee Determined bY �9��J Agreement Neoessary [ ) Not Neoessary [ ] ..- aun�ec� City of Fridley � AT THE TOP OF THE TWINS g � I L D I N G P E R M I T � � � � � • COMMUNITY OEVELOPMENT OIY. � ; V ��.� , . . � r � � PR07ECTIVE INSPECTION SEC. 1 � � � i"'1 � CITY NALL FRIOIE� 55132 NvMBEP �'""�" ,'' 612-571-3450 910-Ft5 108 ADDRESS �V@T • 610 ,D��(r�� Street NE t LEGAL LOT NO. BIOCK TRACT OR AODITION DESCii. 3'� � 38 � 39 W Riverview HeiQht 2 PROPERTY OWNER MAIL A�pRES$ Robert Rutherford 3 CON7RACTOR MAIL ADORESS Owner a ARCMITECT OR DESIGNEF MAIL AOORESS 5 ENGINEER MAIL ADORESS 6 USE OF BUILOING Residential AEV DATE 10/12/99 ZIP ZIP ZIP PAGE O: � � 30383 ECEIP� T NO. �T �� PROVEO 8V SEE ATTACHED SHEET PHONE i-0106 PMONE IICENSE NO PHONE LICENSE NO. PHONE LICENSE NO 7 CLASS OF WORK O NEW � ADDITION � ALTERATION 7g REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (24 Sq) Tear-off 9 CHANGE Of USE fROM STIPULATIONS TO Underlaymenfi must comply with the State Building Code. TYPE OF CC SEPARATE PEfiMITS ARE REOUIFEO fOR ELECTRICA�, PLUMBING, NEATING. VENTILATING OR AIR CONOITIONING. � � THIS PERMIT BECOMES NULL AND VOID If WORK Op CONSTpUCTION ZONING AUTMORIZED IS NOT COMMENCED Vy1THIN 60 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED FOii A PER100 Of 120 DAYS A7 ANY TIME AFTER WORK IS COMMENCED. NO DWIG I MEFEBY CERTIFV THAT I HAVE READ ANO E7fAMINEO THIS APPLICA710N ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VA�UATION AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPUED W17M WHE7NER SPEC1f1E0 MEAEIN Oii NOT. TME GRANTING OF A PERMIT �2098 OOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEI TME pEqMITiEE PROVISIONS OF ANY OTHER STATE Oii LOCAL LAW REGUTATING CON- STRUCTION OR THE PERFOfiMANCE Of CONSTRUCTION $S3. ZS S�GNyiylaE OF CON OWHEQ� �iZED AGENi iD�iE� � !o-!a _�,� a� �O�iE� PANCVGROUP OCCUPANCvLOAO SO. S7A�L5 Y VAL CU FT. OfFSTFEET PARKING GARAGES SURTAX $1.05 SAC CMAFiGE ire SC $2.10 OTAL FEE 86.40 � D TH�S I��U= PE$f�A� , � ,� _ r��E . NEW [ ] ADDN ALTER c Effective 5/10/99 ( ] CITY OF FRIDLEY [] SINGLE FAMII�Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: f � � U� �! ,/V � Legal Description: �� 3� �� Owner Name & Ad ss: �pQ� f2T ��Q, �Ij /,�d Tel. # b/2 -- 7�6 — D!D fo Contractor: ��'� MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. o�x: � .f� � �-t2 � ftD�s�' � ��G �... Construction Type:�� p�'�' � QE �ppt Estimated Cost: $ --�� - Driveway C�Zrb Cut Width Needed: Ft. + 6 Ft = Ft x$ �� , _$ DAT'E: JD �'l o2—`t �j' APPLICANT: Tel. # 6!2 -%�'(� ��/O (o Pernut Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ C� � �' $ , l� $ �� U �-: $ $ $ $ $ $ � c��, �� CITY USE ONLY Fee Schedule on Reverse Side .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 Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Building MECHANICAL Perr�it No.: � - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D��'dJ! �� nn DATE �1 // ^ ls % YOUR E-MAIL ADDRESS SITE ADDRESS � f � �JDt��tZ S I. !V � THIS APPLICANT IS: ❑ OWNER BC�ONTRACTOR PROPERTY NAME: ^ e,e OWNER/ pDDRESS: `o IO �>pr� E'� �T ,ptl �r CITY �i2�'G( JP ,� STAT��[P TENANT PHONE:�G� �' �SG �� /OG CONTRACTOR COMPANY NAME: �' �' ��.. i2 Avr e � c� iC � T n� C SUBMIT A COPY OF CONTACT PERSON: �t�'1� � C'• /`l/Ln�2 � YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ,e,DDRESS• S 3�' n� s�l �° E� CTTY � rD; c�. or...� STATF��ZIP SS// Z APPLICATION pHONE � 5/ `%� �� O 5�% FAX PERMIT TYPE '�' °1"GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW L�'REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK t��yLDl1c.° Q' D�AC �i'v ��d �Ti'p.,t>�.� 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 £XCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) �i Equipment Installed MFG: �Qfti1 S/ IP.E�sd � MODEL: SIZE/BTU �7. �� MFG: ' MODEL: SIZE/BTU MFG: MODEL: SIZEBTU �p/C $25.00 FIREPLACE (GAS) $ I 5.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $]0.00 BOILER $35.00 FURNACE $35.00 GAS L1NIT HTR $]0.00 CHIMNEY LINER $10.00 GAS DRYER $t0.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENT[LATOR $I5.00 � �� Permit Fee Y$ �_. Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ ,�� . Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ TH1S 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 des of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an icatio or a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the e of a rk ch re ' s review and approval of plans. SIGNATURE OF APPL ° PRINT NAME�v �++� �V�. a� � DATE �� 7 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �uii�in� lnspe�tions %��-�%?-��3�4 76 �-��-=�9i? F��i DAT� � l � l �(7'� SITL ADDRESS �J THIS APPLICANT 1S P120PERTY O�,�VNEIt/ TENA1�tT CONT1tACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF 1NSURANC� PERNXIT TYPE TYPE OF WORK: ❑ OWNEP �'':� �� : �� /C1 �j�j�'� �.L �'�l� `.� _��.:��..� �'1�J= '�IT U ;��'� � � ��;�� .FFECTTV� 1-t-OS C YOUR L-NIAIL .�DDRESS NAML-: I� �i �T I� �J(L.�',i��r� ADDRESS: tDI�V pUV� ��" %I � CITY PHONE: �'�'�i� �blo' �(p1O NAME �IV�Y �l'�'� �I�Aii9it.�ifrl.ln �. STATE LICENSE # P°rinit No.: Rec°�vedmB��: Date�� u�: � 'ATL��%ZIP rJsy�2 E.YP DATE �..,�-•—°— STATE BOND � GXP DATL '� '""`�� ADDRESS: g7i�b M,�f,l✓1 S'� j�f �#'� CITY �Nl� STATE�i [_ZIP �✓r "Z PHONE �'1�''�'�5�� ZI �I %� Ft�X � v 77 - 3S� 25� SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW DETAILED DESCRIPTION OF WORK [�REPLACEMENT �� PER MS 16B.665 the permit fae is a minimum of �15.00 or 5% of the total cost up to �500.00, whichever is g�eater, for the irnprovement,, installation or repiacement 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 = plus .50 surchazge OR FOR PROJECTS Wf�RE LABOR EXCEEDS $500, FEES ARE BASED ON $] 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV�. MINIMUM FEE � 15.50. BATH SINK/LAV ' FLOORDRAINS SHOWER WATERPIPING BATiiTUB GAS PIPING (NEED QTY LIC) SWIMMING POOL WATER SOFTNEB ($35) CLOTI�S WASHER KITCHEN SINK WATER CLOSET $ACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY � �WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee TOTAL DUE (MINIMUM $15.� � Number of fixtures @ $10.00 x $10.00 = $ .50 Number of fixtures (c_,� � 15.00 x$15.00 =� $ OR Number of fixtures @�35.00 � x$�5.00 =$ 5•�� State Surcharge = $ .50 (MINIMUM �15.�0) Total = � " • b`D THIS IS AN APPLICATION FORA PERM[T-NOT VALID UNTIL PROCESSED [ hereby apply for a plumbing permit and I acicnowledge that the information above is complete and accurate; that the work will be in conformanc� with the ordinances and codes of'the Citv of Fridlev and with the Minnesota Construction Codes: that I Lmderstand this is not a permit but oniy an app(ication For a permit nnd wori: is not to starc �Nithout a permit on site: that the �-vorl: will be in accordance �:vith the approved nlan � the case of all �.vork �.vhich reauires review and approval of pians. SIGiaATUP�L OC' i .'�I�PROVGD 131' ��,�nnL. iU� �/�-� G�� oAT� � J! D � 3AT1" ;'! L: _�,L'•�ETr": .�`��.'�R: _T� �riZ?viITS .'_RE ?E7i:IR�.t': �:f?R Bl.i'TILDINIi_ L'i,�':: ;"R1C:`:L _�i��D �:'1Ei�;� � [vTC: :L. :vOR['L �:�-T ��x �� ..;ffiIe�� iia�in� ��s�e��oa�s :��a�"��t �=�_ � .;:i��e:�i�,� -1�e:1u� ,��. ��;dle, _:�ii,� :�-�_ -�:- :-:�,ii1 --• �?�-�i)=-- .