AF - 42438City of Fridle�, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
��; December 26. 1972
�e�. Dareel A. Farr Development Co. g�der Same
gdaress 5901 Brook�n Bou levard Address _ Same
� - .
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LOCATION OF BUILDING
Na - 5506 S�t East._�,varian Pass�N„�E,�....__.......----------. Part of Lot
Lot - � Biock _.��._....._ _.__._. Addition or Sub-Division _ Innsbruck. North T,. H.. 3rd Addition
Corner Lot ..� _._._. Tnside Lot _.__��____....._. Setback _..__._____.�__.._._ Sideyard .___.___._._._ _..__
,$ewer IIevation _. _ Foundation Elevation ___..:...___._
DESCRIPTION OF BUILDING
To be vsed as: 1200'
Townhouse __ �nt 24 �_ Depth 24' � Height ..26 �__.._. Sq. Ft. _.._600' ��,� 15� 600'
__ Garag� _.._ Front 10�. Depth ?2 � Height ._10 �.__.__ Sq. Ft. _.__231' Cu. Ft 2310'
Type of Construction �Aar1.._FramP Es� Cost .�.$2.Q*Q1Q___.W..__.___ To be Compieted __.1..__��x
Stipulations: `
.� ss-�� �
In consideration of the issuance to me of a permit to construct the buiiding described above, I agree to do
the proposed work in accordance with the description above and in compliance wi all provisions o!
Ordinances of the city of Fridley.
10.01 Sta Surcharge
In consideration of the payment of a fee of $_._3.$.....Q.9_�.__., permit is hereby granted to Darrel A. Farr Devel .
_ to construct the building or addition as described above. This permit is granted ttpo�t
the express condition that the person to whom it is granted and his agents, employees and workmen, in atl work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiIIgS
y�t'�,thui'�th�� city limits and this permit may be revoked a t any time upon violation,pf any of the provisions oE safd
/ �
��/���.Ill�.r��� . � � � y�.�y .,
NOTICE:
This psrmit does nof eove� the eonstrucfion, installation fo� wiring, plumbing, gas heafing, sewer or water. 8� sur� to sa�
ths Building Inspecto� for separate permits for these items.
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�I�PLICATION F0� RI:SIDENI'IAL, AL`�'i;RA�'ION,
OR AllllITIOi�' BUILDING ���jl'T'
CITY OF FRIDLEY, tiIINNESOTa
Oi�Li�t' S NA.� :��Y-rP/ �? F�ra� /,%ta�`/,�. �o. BUTLD�: SQ/'++ �
r�DD�ESS :�'90/ .C�rom9t0y» 1L3/v�l. AD�R�SS • S Ar��
ND'. .SS��O STREEi• .EQ.T31 ,(�tdlJ�'s�i�?mr /ds�SS
I.�"b ; � $LGtCK o 9 ADDiTION :..�I�HJ�J.�' wt� /i�Or�is %i�%�• 3=°I �t�rdi T�[! �9
Cfi�'T'� L�: �TdSID,� LCiT: � SEi'B;A��: SiDr,Y,I'A�.TtD:___��_,�,_„_
�p�? ivant ��tach to this foa�z �o C�ytifi�ate� o� Su.r�� of LoL and pro�ose�
puilding loc�tion drawn o� �h�s� Ce�tificat�s. �
➢ESCRIPTIO�I OF BUILDII4'G
do B� Us�d As : .
�frC1.�'✓ r�s' �%t.��' �. A ? Ori � : .�: "� , �.n. 8 p �.�! " �'.+L � �� ° �. jil i . ��' _
��d�
Squa�e �'���: l��Ca Cubic �'pe�. /s. fn��D
�'°�cavs��� • �Aont: /�'l.�' ��pth: ,Z•�' x�i�� �: ♦o'
�
Squax� �'�z�; �.3/ Cubic �'��e�: .�3/O
s;�Pa ot ��nst�uction: �lid:�e� �I°'.�oa+��. �s?�i=_,a��d ���!� � $ �� //�.Ofl�,.
�o �� �c�mol�t�ed: 8�/.r'� 7•3
sn� un�1�:r;.�i5a2d 'n�x�b� ��'�.�s applica�i� foz a pv:rrai�. :�� a�'i-Y.wor?�c h:=_;�;!T,
s��cifi��, :��:_Qina Lo �o �all zaoY'.. in a�'.���� a�coada��� wi�:°� �} Ci�� or
� rid'.�y flw,c�-t:�.cw� ard �,�1�!r�� of ��z� L�a?���:�t o:t PuI.1�:�nUs, �z�� h�:.�:��y
cl�clax�:� ii��� all �h� ��c�� �nri ��pres�nL:�tions s:.at�tid iY: �zzi.� applica�''.�n
=ar� t�iz znd cozr�c�.
A; �'.�'d. . .����t � �Z S Lnx1� .iJ�'.�. ,
(,:,-�7 ??<�y�rai� Side ;or A:idi���.,-i.a'! 3niors:atior.)
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560-3450
��� o � ��dC�
� �
ANOKA CQUI�TY
6431 UNIVERStTY AVENUE NE Jazivary 31, 1975 FRiDLEY, N1tNNESOT'ra 55432
Mr. James I�ondon ' �
Darrel A. Farr.� Dev�loprent Carp. „.
2810 Caunty Road 10 . __.
Brooklyn Center, Minne 55430 - '. � -
Re: Status of Permits for Six.Quad Units �
Dear Mr. London: •
The Cit.y of Fridley still/recogr�izes the buildinq permits for 5501, SSO'3,
5505, 5507 & 5502, 5504, 5506; 5508 & 5509, 5511, 5513, 5515 & 5510, 5512, 5514,
5516 & 5520, 5522, 5524, 5526 & 5532, 5534, 5536, 5530 East Bavarian Pass N.E.
, as being valid, ho��ever, if work is no� recammenced on or before May 31, 1975,
we will consider those not wor?�ed on as void. Tney will not be renewable after
the May 3ist date and new permits would have to be taken out for any new starts.
_ .
If you have any questions with reference to this matter, please call me
at 560-3450. �
DGC/mh
CC: Dick Sobiech
Jerry Boardr,ian
Si.ncerely,
DARREL G. CLARK
Community Development Adm.
u
SUBJECT P E . �
City of Fridley ° 15026
AT THE TOP OF THE TWINS g U I L D I N G P E R M 1 T
r
� � NO.
� 1 L__���_ COMMUNITY DEVELOPMENT DIV. �� O 3/
4 6
r � � PROTECTIVE INSPECTION SEC. / 3 3
1 �
�4 , /'�'1 � CITY HALL FRIDIEV 55432 NUMBER REV. DATE � PAGE OF APPAOVED BY
""'� � ��� 612-560-3450
910-F15 11/17/78 � �
JOB ADDRESS 5506 East Ba.varian Pass N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 9 Innsbruck North. Townh�ouse 3rd sHEeT
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Darrel A. Farr Develo�nent 7296 North.72nd Lane, Mpls., NIN 560-8110
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICEIV$ENO.
6 USE OF BUI�DING
Residential
7 C�ASS OF WORK
f� NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 26' To�nrnhouse and a 12' x 22' Garage
9 CHANGE Qf USE FROM � TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Fraane
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION (6L� + 264 15, 760 Total
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
WN H WHETHER SPECIF ED EREINIOR NOTOTHE GRANTING OF AO EFiMIDT �g$ $23,126 $11. S%
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATiNG CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $63.04 $400.00
PIQN CHECKFEE TOTALFEE
$15.76 49 .37
SIGNATUREOFCONifiACTORORAUTHORI2EDAGENT IDATEI ♦ �A/H PROPERL V D THI IS YOUR PERMIT
�
SiGNATURE OF OWNER UF OWNER BUILDERI I�ATEI BLDG. WSP � DAT
„ APPLICATION FOR RESIDEN7IAL BUILDING PERI�IITS�
�.CNEW, ALTERATIONS, ADDITIO�JS, OR REPAIRS) .
O� ,7ER: �� �-� �-� �� F� �Jn��n�n�^✓r.c..� BUILDER:� -�r4.�t y .
�
Addxes s : �l � Q t� �J s, i � � ri � .? � Address : �A � i c l��1: ,� , . �r.:--�/ , �
s t �”
' Tel. 2Jo.: `ln�"Y/!�>
i�fl- = � Street: t (� '
�it _ c.'-r- k: Y.t _� 1it �, d rt .vt _�;,,. �.r _r .� �
�r: _ ` � BLOCK: _ � fiDDITION: _ .� � �-1 � rQ .
CO�'v-ER LOT: . INSIDE IAT: ✓ SLTBACiC: SIDEYAitDS: _
App2icant attach to this form 'itao Certificates of Survey of Lot and pro�-�.osed ��
- building location drawn on these Certi�icates. �
. .
- � � - DESCRI P7I ON OF BUI LDI NG � � - . - - �
Tcs Be Used As : � - . : ' -
�c v,� � n(,[�i �'ront: _ a� Depth c a.� Height- -
- Square Feet: _ �� Cubzc Feet: /� , i(o �
. . .. r ,• .� . _ � .
� . . . . � . - - - � - . . . � I . . .
Front: _ a. � Depth: /Z– � Height: _
� Square Feet: Cubic�Feet:�
`ij'p° of Construction: �,('n��,� �j���, e � �stzmated Cost: � ��1C} -
_, �_�_ 9
�
, -ib Be Completed: % 1'' _
'--r� -�^—^ /�i-1 t . A A2t . �3
—______._
" Proposed I7riveway Width If New Openinq Is Desired $� $ -.
. (SEE RE�TER.SE SIDE OF SHEET}
T'�ze undersigned hereby r,►akes application £or a permit for`the ��ork herein
specified, agreeing to do all �3ork in stri.ct accordance with the Ci.ty of
Fridley Ordinances and rulings of the Department o£ Bui:ldi.ngs, anc� hereby
ceclares that.all the facts and representations stated in this appiication
are t�:ue and correct_ See reverse side for additional in�ormation. :
DA�E_ �! IS � � 5IGNATUF2E: �' �J _
Stipulations: � .
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GEO. SEDGWICK HTG. & AIR COND. CO. Y '"
OUSE HEATING TEST RECORD �
- .���rre��' � r.:
, —____---�� ' CITY � �
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ADDRESS OWNER
OCCUPANT '
DATE' HTG. INST. ' • ,: ; : � ' ; 4�
HEAT LOSS�� . - , INSTALLED BY ' . . ` : ,-- , _ ,� _ �y'
SOLD BY Gas Line BY ' OTHER .
Electrical Work By 4� . HW_ STEAM SPACE HTR. —UNIT HTR.
TYPE OF HEAT GA_ FA_. CONVERSION
GAS DESIGN
MAKE OF BURNER q
MAKE Model �'
Model - Max. BTU Rating
Serial MAKE OF FURNACE
INPUT Model
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__ CONTROLS Vent Size �
Heat Plug S�ZE�—NONE_--.—
THERMOS;TAT---- ; KIND OF LIN�R �
, ;.. ° .....: Regulator R
Valve , � •, Draft Hood ` � r
Limit Filters Size Nurl�ber .
Limit Setting Chimney Location Inside--------
putside I
Fan Setting `�Chimney Construction
Pilot Type � _., ��';.
f' 4'� Wiring
Pilot �4ake gmoke Bomb '' �"
Pilot Model __ Draft Test Tag
. ,_
-
Pilot Timing Lighting Inst.
Door Pressure
L.W. Cut Off Date Tested ' � `
. �,. , ,� , r : �" ;
Percent CO .--=--------- "- �~
Pressure 2 , Company Testing �� .' � , ; 4 , : '�-�
Input CFH � Percent �Z =---- Name of Tester
� � � , :,.�
Stack Temp. = - Percent CO ----- •
_.�._: �,. -.�.�...yF T-��'rT p�" ..� �.. � � �- t4��... _._ ._.._._.._..._
_'`
Form 235 l _ _ .� _.., _.. . � �
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_ _.. . - ni� �-- •.� ' " '
_ _., —•-- t--�- —� �.
sua�ecT PERMIT NO.
Ci�y of Fridley T � �; � � ;
AT THE TOP OF THE TWINS gU I L D I N G P E R M I
; � RECEIPT NO.
, � �Y.k�
� ' COMMUNITY OEVEIOPMENT DIV.
� �4_�'���'�
1 � � PROTECTIVE INSPECTION SEC.
i �
�
� � � AEV DATE PAGE �F APVROVED BV
' �""� � CITY HAI.L FRIDLE� 55432 NUMBEA
�'-"'�' �'' 612-57 t-3450 910-F15 3/ 18 /94 � �
JOB ADDRESS +�
5505 5505 5507 55 6
t LEGAL LOT N0. BIOGK TRACT OR ADDITION SEE ATTACHED
SHEET
DESCR. 1, 2, 3, 4 22 Innsbruck Nor
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Various
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Gittleman Cons r '
d ARCHITECT OR OESIGNER MAIL ADORESS ZIP ON l SE NO.
5 ENGINEER MAI�ADDRESS ZIP PHONE IICENSENO
6 USE OF BUILDING
Townhouse Ga a e
� CIASS OF WORK
O NEW O ADOITION ❑ ALTERATION � REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside
9 CHANGEOFUSEFROM T�
STlPULATIONS
TYPE OF CONST. OCCUPANCY GfiOUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL; PLUMBING, HEATING,
VENTIIATING OR AIFi CONDITIONING.
TMIS PERMIT BECOMES NULL AND VOID �F WORK OR CONSTFiUCT{ON ZpNING SQ. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAKS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS RT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ ANO, EXAMINED TH�S APPLICATION STALLS GARAGES
ANO KNOW THE SAME-TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAlUAT10N SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIFIED HEflE�N OR NOT. THE GRANTING OF A PERMIT �3 � 4OO � I.%O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMtTFEE SACCHARGE
PROVISIONS OF ANY OTHER $TATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONST�2UCTION. �63. OO Fire SC 3. �FO
PLAN CHECK fEE TOTAI FEE
License SC $5.00 73.10
S�GNATUREOFCON�AACTOF70RAUTHORIZEDAGENT ioATE� WHEN PROPER V LIDATED TH1S IS YOUR PERMIT
� 3-�I-��
S�GNnTUREO�OWNEA��FOWNERBU�LDER� iDATE� BIOG � 5� ��°rE
, sue�cc�. , P Q.1_
City of Fridley 30859
, ` AT TNE TOP OF TME TWINS g � I L D i N G P E R M I T REC O.
�
� ; y � COMMUNITY OEVEIOPMENT OIY. � � ��
r ` � � � PROTECTIVE INSPECTION SEC.
� . .
� _ �'�'1 � CITY MALL FRIOLE� SSI$2 NuMlEl1 NEV O�TE ��GE O: APVROVEO !v
�""� � �'' 612-571-3450 9t0-Ft5 4/26/00 / /
�oe�ooRESS 5502, 5504, 5506, 5508 East Bavarian Pass NE
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACMEO
oescR. 1-4 9 Innsbruck North Townhouse 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDiiES$ ZIP PHONE
Various
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
North Central Builders Inc 7401 42 ave N, New Hope, MN 55427-1219 3763
• ARCHITECT Ofi DESIGNER MAIL AODRESS ZtP PHONE LICENSE NO.
(763) 533-6168
S ENGINEER MAI� ADORE55 Z�? PHONE IICENSE NO
8 . USE Of BUIIDING
Townhouse Building
7 CLASS Of WORK
` O NEW ❑ ADOITION ❑ ALTERATION �7 REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reside & trim townhouse building
9 CHANGEOFUSEFROM T�
STIPULATIONS
Call for building wrap inspection before covering.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE flEOUIREO fOR ELECTRICAL, PIUMBING. HEATING,
VENTILATING OR AIR CONOITION�NG.
THIS PERMIT BECOMES NUIL ANO VOIO IF WORK OR CONSTRUCTION IONING SQ. FT CU. fT.
AUTMORIZEO IS NOT COMMENGED WITHIN 60 OAYS. OR IF CONSTRUC710N
OR WORK IS SUSPENDED OR ABANpONEO fOR A PERtOD OF 120 OAVS AT
ANV TIME AFTEfi WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARNING
I HEREBY CERTIfV TNAT 1 MAVE REA� AND E%AMINEO THIS APPLICATION �F STALLS GARAGES
AND KNOW TME SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS Of �AWS yALUATION SURTAX
ANO OFiO1NANCES GOVERNING TMIS TVPE Of WORK WI�L BE COMPLIED r
WITH WME7MER SPECIFIEO MEREIN Oii NOT. THE GRANTING OF A PERMIT �18 � 797 � 9.40
OOES NOT PFiESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL 7ME pEqMIT FEE SAC CHARGE
PROVISIONS Oi ANY OTMER STATE OR LOCAL LAW REGULATING CON•
STRUCTION OR TME PER fiMANGE Of CONSTRUCTION �3O% . ZS Fire SC � IH . HO
PLAN CHECK FEE TOTAL FEE
�2 -� Lice $5.0 340.45
S�GN�TUpE O� C09 • CTOp Op �U Op�2E0 �GENr IOATE� EN OP ALIOA TMIS IS VO MI �
%�
�r�i
$�GN�iuQE O� Owtifp ��� OWNEp BU40fp� �OAfE� INj� �i��f
�����
� SuB�ECT PER
c�ty of Fridley 31096
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
; � RECEIPT NO.
� ; � _ COMMUNITY DEVELOPMENT DIV. �
r � � � PROTECTIVE INSPECTION SEC. Q� g
� S ,
� /'��1 � CITY NALL fR10LE� 55�32 NUMBEN pEV DATE PAGE OF APPROVED 8�
�.__.Jl: '•� 612-571-3450 9t0-F15
6 27/00 � �
JOB AODRESS 5506,08,�, East Bavarian Pass
1 LEGA� �OT N0. BLOCK TRACT OR AODITION SEE ATTACHEO
oescR. 1-4 9 Innsbruck North Townhouse 3rd Addition SHEET
2 PROPERTY OWNER MAII ADORESS 21P PMONE
Innsbruck Townhome Association 651-224-5482
3 CON7RACTOR MML ADORESS ZIP PHONE UCENSE NO
Garlock-French Roofing Corp. 2301 E. 25th St., Mpls., MN 55406 612-722-7129 00001423
a ARCHITECT OR DESIGNER MAIL AO�RESS ZIP PMONE �ICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PMONE IICENSE NO
6 USE OF BUILDING
Residential
� CLASS OF WORK
O NEW O AODITION ❑ ALTERATION L�] REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof Townhouse Building (Tear Off)
9 CHANGE Of USE FfiOM TO
STIPULATIONS
ihiderlayment must comply with the State Building Code.
�rm�t Inspection Cards
�lili Be Mailed
'�i� Homeowner To Post
TVPEOfCONST. OCCUPANCYGROUP OCCUPANCvIOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, P�UMBING. MEATING.
VENTILATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULI AND VOID IF WORK OFi CONS7RUCTION 20NING SO. fT CU FT.
AUTMORIZED IS NOT COMMENCED WITHIN 60 OAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONEO fOR A PER100 Of 120 OAYS A7
ANV TIME AFTEii WORK IS COMMENCED. NO OWIG. UNITS OFFSTREE7 PARKING
1 MEREBY CERTIFV THAT 1 HAVE REAO AND EXAMINEO TMIS APP�ICATION 4 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VALUATION SURTAX
WI M WHENMER SPECIF ED EFEIN'OR NOTOTNE GRAN7ING OF AO ERMIOT �12�O6g.69 �C.00)
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE Ofi CANCEL THE pEpMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI lAW REGULATING CON-
STRUCTION OR TNE PERfORMANCE OF CONSTRUCTION �223.ZS �12.13
PLAN GMEGK F TOTAL FEE
241.44
S�GNATUAE O� CON�PA(;TOQ Op AUTMOAl2ED AGEN1 iD�tE� ME PROP ALIOATE THIS IS VOUR PERMI�
� �
S�GNSTUQE O� OWNEp��� OwNEABW�DEQ� iD�tEi OG �ti5� O�rE
NEW
ADDN
ALTER
[ ] CITY OF FRIDLEY
[ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
�.� 3�oy�
Effective 1/12000
612�72�604 Bidg Insp
Construction Address: ��� � �, b�S I i� � I a ��UI,U" � � P�� . . . . . - .
Legai Description:
Owner Name & Address l I(1 �15���- I lX.ill"��nOM� �SSL1Gi (�.'�'�fnei. # l�5 i- aa u- SN�i �
Contra�tor: � C— � Ln!'ii� �• MN LICENSE # LY�DI �a3
Ar�rirPSS• ��n) G�S't �� .�-�1(�� YI � I.�_ /V1 N SS�1o�Te�. #�0��- %o�a�_l�� G'j
Attach to this application, a Ce�tificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF III�lPROVEMENT
LNING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height _ Sq. Ft
DECK AREA: Length Width Hgt/G�ound Sq. Ft.
OTHER:
Construction Type: � � Y� Estimated Cost: $ ( �.� b�P � • ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE:��� APPLICANT: u� .t���,�� Tel.# ��a-�aa-��a�
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in application
Permit Fee $�� ��S Fee Schedule on Reverse Side
Fire Surcharge $ /o� � �3 . .001 of Permit Valuation (1/10th%)
State Surcharge $ l �0�0 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1100 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 j]
$ �7`����
^ �-� � �'�
� �� ` 6
CITY OF FRIDLEY iNSPECTION DIV.
6431 Universihr Ave NE
Fridley, MN 55432
572-3604
PLUMBING FIXTURE RATES:
APPLICATION FOR PLUMBiNG AND GAS FiTT6NG PERMIT
MARK NUMBER OF FlXTURES TO BE INSTALLED ON EACH
NO. RATE
New Fixtures
Old Opening, New Fixture
Beer Dispenser
B{ow Off Basin
Catch Sasin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas" �_
Gas Range"
Gas Dryer"
Back Flow Preventer Required ()Yes () No
Type
$ 7_00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$1"5.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATlONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
TOTAL
'��
$,20. 50
€ffective On May 10, 1999
�"�C�� �,�1�c (����-�y�' �`
JOB ADDRESS _ ST I Y� %� J QUvI��� ���4t�
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance wifh the city codes
and rufings of the Building Division, and hereby dectares that all the facts
and representafions stated in f.his application are true and correct.
l6`Z � ��,?
SHAFFNER, NAPJCY
5506 EAST BAVARIAN NORTHEAST
Owner FRIDLEY, MN 55432
— (763)572-3722
Building Used As.
Estimated Cost � �QC � PERMIT NO. ( � ��"/ `�
.
PLUMBING COMPANY �,�Q ����� �L-(i�'����C?
SIGNED BY� _ TEL NO_ ��2 UZ7� �Q33
Approved By � Rough-In Date Final Date '�-2-f;
"*COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.
Minnesota Department of Labor and Industry
443 Lafayette Road North
St. Paul, MM 55155-4342
- Phone: (651) 284-5064
TTY/MRS: (651) 297-4198
www.electricity.state. mn.us
Contractor Re uest for Electrical tns
Dat Rough-In Inspection Required?
,���1 �� Contractor Must Schedule All Rou h-In
Address of Inspection — Street
Name
— Indude Area
#ion — 4ne famif Dwelfin /Assc
Yes S�ngle Inspedion Other Than Rough-In:
:dions Contrador Must Schedule All Final Insp
�l�/os
Ready Now
Wili Schedule
�ltt�� �ET1�kGEA�I,E I�t`f �AI��E
• ' Y%
Contractor Name Contractor Mailing Address
KATH ELECTRfC 3096 RICE STREET / LlTTLE CANADa, MN 55113
Contractor Tefephone Number Contractor E-mail Address Electrical Utility
(651) 484-3325 keithwilliams@kathfuel.com
tra�or Aut4io " Signature Contractor License Number Job/Project Contact Qerson
CAOQ980 KE4TH WlLLIAMS
Fee Calculation
New Home or Associated Structure Existing Home/Structure Remodel or Addition
New D�velling ServicelPower Supply 0— 400 ampere �$35
New Dwelling Service/Power Supp{y 401 — 800 ampere (� $60
New Dwelling Feeders/Circuits '
U to 30 Feeders/Circuits - $100
IVow Hnma — Mnm than 30 Feedwrc/C:irrl�its (in addition to
Detached Garage or Other Associated Structure
New 5ervice/Povuer Supply 0— 400 ampere �$35
New Feeders/Circuits ( ) (d� $6 Each
Other (Speciiv)
fVew Service/Poarer Supply
New Service/Power Supply
0 — 400 ampere (� �35
401 — 800 ampere (d3 $60
$6 Each or 16 to 3(
— Mwe Than 30 Feei
tsUuto200A(�$E
( ) Feeders/Circuits � $2 Each j
Detached Garage or Other Associated Structure
New ServicelPaiver Suppty 0— 400 ampere �$35
a
New/E�dended Feeders/Circuits ( ) (� $6 Each
Reconnected Feeders/Circufts ( ) (� $2 Each
Tot81 (the fee calculated above or $35 multiplied Total (the fee calculated above or $35 mu�iplied
by the number of required inspection trips, by the rtumber of requir� inspection trips, i��, 50
whichever is greate� whichever is gr+eater) ��
Requests for Efectrical Inspection (REq with a fee of 5250 or less explre 12 months from the filing date. The co�rtractor must have the work completed within
the 12 month period or submit another REI that includes the inspectan fee for the uncompleted work. Inspection fees do not carty over Trom one REI to
_
another.
A service charge oi �30 w111 be add�l fo� all dishonored checks.
I hereby certmy thai I inspectea tne
Rough — In Inspection(s)
This materiat cart be
TDD (6b1) 297-4198.
different forms,
on the dates stated:
Date
as large print, Brail� or on a tape. To request, call
or
Building
Inspections
763-572-3604
SITB ADDRESS ��
TEIIS APPLICANf IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
❑ OWNER
NAME:
ADDRESS:
PHONE:
Permit No.
� �M `.
Received , .��_',a____
�
Date Rec' d: . � �''>,,
COMPANY NAME:_S � 1 1-t T1 Y� L./
CONTACT PERSON: }� IT�I W I L I. I���?
STATE LICENSE # ��' EXP DATE
ADDRESS: �OQiO IV GE �� ___ CTTY � 17TL�i I�I�D�STATFi��IP � I �.3
PHONE
SINGLE FAMII.Y
❑ NEW
DETAILED DESCRIPTION OF WORK
FAX
❑ TWO FAIv1II.Y Q TOWNHOUSF
❑ ALTERATION/REMODEL
PER MS 16B.665 the pernut fee is a minimum of $15.00 or 5% of the total cost up to $500.00, wluchever 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.05 =
FOR PROJECTS Wfi�RE LABOR EXCEEDS $500, FEES ARE BASED ON $] 0.00 PER FIXTCTRE, EXCEPT WEIERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELO� A
Equipment Installed MFG: ���� MODEL: �gl�TQO�Q SIZEBTU 0�
MFG: MODEL: S�ZEBTU
MFG: MODEL: SIZEBTU
A/C $25.00 _FII2EPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRII.L $10.00
_BOII,ER $35.00 �FURNACE $35.00 ,GAS UNIT HTR $10.00
CHIIvINEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 �VENTII,ATOR $15.00
Permit Fee $ ._� Number of fixtures @$10.00 x$10.00 =$
Surcharge .50 Number of firctures @$15.00 x$15.00 =$
TOTAL DUE $ .�Q Number of fixtures @$25.00 x$25.00 =$
. Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Tota1= $ �'��`
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understa.nd this is
not a permit but only an app ' ation for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case work which e ires review and approval of plans.
SIGNATURE OF APPLIC ""� ! PRiNT NAME��� DATE � I� N
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977