AF - 43217City of Fridley
Appiicatioe for Plumbing cmd Gas Fitfing Permit
Dept. of Bldgs. Phone 560-3
DESCRIPTION OF WORK
Number, Kind and Locaiion of Fixtures
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O <� � � � � Z �S° zQ = J o� <� �7 <° 7� �a
� ; 7 N 3 H O LL N LL � V m< 3 C9 �d (9 z C9 O
Base ( �
lst ( j �
2nd _
3rd
4th
• F�r� ����A �run� I Coruiected with
* New Fixture, Otd Opesuags
PARTIAL RATE SCHEDULE
WATER HTR.
• •
F N GAS EI.EC.
Sewer �
Cesspool j�
PLIIMSING FIXTURE RATES: NO. RATE TOTAL
/� 00
Number Fixtures . . . . . . . . . . . . . . . . . . . . . . —1�L x $2.00 $ / a ,
Future Fixture Opening . . . . . . . . . . . . . . . . x $1.5Q $
New Fixture Old Opening . . . . . . . . . . . . . . x $1.50 $
Catch Basin .... ................. x $3.25 $
Water Heater (Up to 99,000 BTIT) . . . . . . x $3.00 $
New Ground Run Old Bldg. . . . . . . . . . . . . � x $3.25 $
Electric Water Heater s $2.00 $
GA3 FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .......................... x $2.00 $
Additional Fixtures . . . . . . . . . . . . . . . . . . . . x $ .75 $
Gas Range to 199,000 BTU . . . . . . . . . . . . . . x $5.00 $
REPAIRS 8c ALTERATIONS—Refer to Code
Description ................................................$
00
TOTAL FEE $�—
City of Fridley:
�
� ,
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
anfl ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn. // / /
.
Owner �/��2=�:�-�","' �„
_ � � ,
Kind of Building -
Used as � �
To be completed about .L� � � /� �
���
Estimated Cost, $ � � �
1� �
Old—ATew. Building Pexmit No. Permit No. ��� �
Signe f '=���-�� ^
By��/ ��g 1GCX � �y! {9'
Business Phone No `%T � �� - � � � �
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53-8�-s915.51
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City of Fridley
�►PP�icafion I�or Plu�nbMq and Gas Fitii�q hn�it
Dapt. of Bldy�. Phon� 5�0-3450 --
DESCRiPTiON OF WOAlC 631 N E Dover St
Alumb�r, Kiad and Locatioa oi Fix3ures I'0����
U�' • • WATEN MT�.
;� � 3� � � �� o�, � ��j3� �� u� u� u$
� _ � � `� 7 W I N GAS ELEG.
Base � ns
i�
2nd
3rd
4th
� - -Fuxur� Cona�elioa Op�ni:tps
+ N�w Fixtur�, Old Op�aieWs
PARTIAL RAT� SCHEDULE
�•= O
CNSpool (�]
PLIIMBING FIXTURE RATE3: NO. R1�TE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . x �2.00 E
F�ature Fixture Opening . . . . . . . . . . . x 51.50 $ _
New Fixture Old Opening . . . . . . . . . . , x 51.50 E--
Catch Basin . . . . . . . . . . . . . . . . . . . . x �3.25 �
Water Heater 'Up to 99,OOf? BTIJ> •••• x 53.00 i
New Ground Run Old Bldg. . . . . . . . . X 53.25 $
Electric Wat�r H�a4r . . . . . . . . . . . . . . : =2.00 =
GAS FITTING FEES: NO. R11TE TOTAL
lst 3 Fixtures . . . • . • • . • • . . • . • . x �200 ;
Additional Flxtures . . . . . . . .... . . . . . x : .?b #
Gas Ran�e to 199.000 BTU ..,.. ....... x ab.04 i
Gas Pryer 1 5.00
REPAIRS ic ALTEAATIOM6—R�f�s !o Cod�
Descriptlon . . . . . . . . . . ... . . . . . ..... . . . ... . . ... ... . ... . �
Z.oT,U., n'x� 00
�
City of FYidley:
The undersigned hereby makes application for a permit for the vroak herei
specified, agreeing to do all work in strict accordance with the Cit� Qrdinance
and ruling oi the Department of Buildings, and hereby declares that al1 the fact
and representations stated in this application are true and correct
10-27-70
Fridley, biinn 19_
E Brickson
Owner
frame
Kind of Building
res
Used as
11-1-70
To be completed about
Estimated Cost, a 1'0•��
OId--New. Building Permit '� drmit l� .6 °� �
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By C _ c � � - -- . .
Business Phune No.
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City of Fridley "���� _ 15 6 8�
AT THE TOP OF THE TWINS g U 1 L D I N G P E R M I T
f
� �
, � CEIPT .
� • COMMUNITY DEVELOPMENT DIV.
� `.: ------ � � �6�
r � � PROTECTIVE INSPECTION SEC.
�
1 � �
� � �'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�"""��� ,�� 612-571-3450 910-F15
4/28/80 � �
JOB ADDRESS 631 Dover Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. C�—% V Riverview Heights SHEET
2 PROPERTYOWNER MAI�ADDRESS ZIP PHONE
Einar G. Erickson 631 Dover Street N.E. 784-8312
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res identi.al
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
x
8 DESCRIBE WOFK
Reroof house
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED 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. N0. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTfNG OF A PERM17 S73O y�. SO
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. S%. SO
PLAN CHECKFEE TOTALfEE
�8. OQ
sic TUFEOFCON' ACTO RAUTHORI E�AGENT �onTei WHEN PROPERLY ALIDATED THIS iS vOUR PERMIT
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SiGNATUREOFOWNERUfOWNERBUILDERi IDATEI BLDG iNSP DP7E
CI7Y OF f�R I DLf_ Y •
/�f?{'(..�C/1'1'I0.1 i�Of� f;ES�l�)L:ia��1ltL riUlLl)II�G ['ERi•1ITS
. (fde�-r, /alter:�tions, /�dditions, or• Repairs)
� Ot�f �dC iZ : ���w� � �c���'���..C�°z""
AQDRESS: _� � / '����c.- �'
TCL �t0: � ��— �3/?�
. �-�,
BUI LDElt : .
�1DL)It�SS: •
'tCL (��0:
Cons�;ruction Locai:ion
. 5��� ��a :� 3 r ST��T: ,� �-�
LOT: �- S', �-� I3J�OCK.: V ADDITION: ��f:�li�i� /��
Corner I,ot: %b Insicle Lot: i�� SetbacY>: �� Sideyards ��1��' 6�f�-� 7
ApplicanL- attach to t.tiis form t-�ao Certiiicates of Suxvey of lot and
proposed buildi.nc, location drawn oxi certifi_cates to scale.
DESCRIPTIO(r' OF CO�v'STRUCTIO�!
� rront: Depth :
��� Squa��e Feet: ~ Cubi� I'cet:
?�ront:
Deptlz :
H eight:
Height:
Square� reet: Cubic Feet:
�7 ��
Type Of COY1Struct�.on: ����'L� ' Estimated Cost: $�/ U
�b �3e Ck�mpleted:
Fro�sed Drivewa� Wic�th I� New Opening Is llesi.red:
� Alt. A Alt. B
$ $ ______�_
aEE REVEF�SE SIDE OF SHEET
��ie undez:sig�ied hereby makes application icz° z permit f_or the 4�o�-k hei:ein sp�:cified,
agreei_ng to do a1.1 �ti=ork in strict accordance �•�ith t2ie Cit.y of T'ridley Ordinances and
ruliiigs o.� tlie Depaztr,lent af 23uil.cli.ngs, anc;. liere}�y declares i.liat all the �act:s and
rep,:esei7t:atioiis st.ated in i�his ap��lication ar_e t1_ue ana corxect.
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DATE: SIGN�1�li7'.L•': `1���� �'''` 1�"�""�� •
Stipulations:
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. $
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CI�IY OF
FRiDLEY
FRiD�EY MUNIClPAL CENTER • 6431 UNlVERS[TY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
September 8, 1993
Ms. Tichy
3242 Hayes Street N.E.
Minneapolis, MN 55418
Subject: 631 Dover Street N.E., Fridley, MN .
Dear Ms. Tichy:
The above-referenced property is zoned R-1, Single Family Dwelling.
The property is located in the Zone A of the flood zone, wliich is
considered to be areas of 100-year flood. The Community Panel
number is 270013 0003 B, dated March 2, 1981.
If you have any further questions regarding this property, please
contact me at 572-3593.
Sincerely,
Michele McPherson, BLA
Planning Assistant
MM/dn
C-93-216
sue�etr PER
City of Fridley 313 3 5�
AT THE TOP OF TME TWINS B U I L D� N� P E R M� T
r
; � RECEIPT NO.
� ; y ����� COMMUNITV DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. Q
i .
� � �"'1 • CITY NAIL FRIOIE� SS��2 NUMBER pEV O�TE PAGE Of � vROvED Br
�----�•' ,•' 612-571-3450 9�0-F15 8/22/00 � �
J08 ADDRESS 631 Dover Street NE
1 LEGAL �OT NO. BLOCK TqACT OR AODITION SEE ATTACHED
oescR. 4, 7 V Riverview Heights SHEET
2 PROPERTY OWNER MAI� AODRESS ZIP PMONE
Denise Sward 631 Dover Street NE 763-780-9622
3 CONTHACTOR MAIL AODRESS 21P PMONE LICENSE NO
Same
d ARCHITECT OR OESIGNER MAI� ADORESS ZIP PHONE I.ICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
ReSidential
7 CLASS OF WORK
O NEW O AD�ITION ❑ AITERATION C� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House
9 CHANGEOFUSEFROM TO
STIPUTATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST OCCUPANCV GROUP OCCUPANCY �OAO
SEPARATE PERMITS ARE FiEOUIRED FOR ELECTiiICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONtNG
THIS PERMIT BECOMES NUIL ANO VOIO IF WORK OR CONSTRUCTION ZONING SO. FT CU fT
AUTMORIZED IS NOT COMMENCED NJITHIN 60 DAYS. Oii IF CONS7RUCTION
OR WORK IS SUSPENDED OR ABANOONEO fOR A PERI00 OF 120 OAYS AT
ANV TIME AfTER WOi;K tS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING
1 MEREBY CERTIFV THAT I MAVE REAO AND EXAMINED THIS APPIICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTAI(
ANp ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMP�IED @
WITH WMETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT W 1 f 738 �. H7
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL TME pERMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUTATING coN- �63. LS Fire SC �1.74
STRUCTION OR TF1E PERFORMANCE OF CONSTRUCTION
P�AN CMECK FEE TOTAL FEE
65.76
S�GNATUQEO�CON'AACtOAOp�UTHOp�ZEOoGENT iD�iEi F�E PROP VALIDAT D THIS I UR PERMIT
� %�Ji1�e r �' �� -Gt'� l� y �
5� i niUFEO�OWaEQ�� OWNEABU�LOERi iD�iE� � Bl0 �h5� - ���Tt
NEW [j
ADDN []
ALTER [ ]
Effective 1/1/2000
CITY OF FRIDLEY (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: !/ /jl�
Legal Description: /��� [/ l � y ?
Owner Name & Address: ,�j�� �U�,Yi1� Tel. # 7l�3 • 7�d- 1l�� �
Contractor: MN LICENSE #
Address: Tel. #
LIVING 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 Sq. Ft.
�S' 1 �'38
Construction Type: ��Q��!,���� Estimated Cost: $ /�.. �' y.
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _�
DATE: ��: � APPLICANT: , c� �� Tel. # 7�,3 - 7�O' 9���
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ �r �� Fee Schedule on Reverse Side
Fire Surcharge $ , � .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ VS� �(t/
.. , • -