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AF - 41889• Date: _..._..Ju�_.30,�_.1968_ Owner: Warren Palm � • City of Fridley, Minn. BUILDING PERMIT Builder _.. S ame Address ....._._..._6421. East_Riyer _Road...._...._..---......_.._ Address � �r�� , f� �3'� �� 0 9851 No. .-----..6421 Lot..___..._.._... Corner Lot Sewer Elevatian LOCATION OF BUILDING East River Road ---------------------_..... Part of Lot ....._.---._..__.._.__..__._._._._..._... Street ._..---....._....__........._.--�----._...._.._.__...-�----------�----- . Block _-------------••-•---••---.._-•---•--.._.._. Addition or Sub-Division ..----------_.___....._.____.__.____.__...._......._.._.._...._ ..._........ Inside Lot -------------•-•---.•------•---------- Setba.ek ....._.._.._........----------.... Sideyard _._....._�..._____._.r._._._.....___._.... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: � --- ---.Garage.._. .....---.... Front __3_� � ..._ Depth ...� 24_�..._. Height --------.10 �.. Sq. F� __�.��.._ Cu. Ft �200 � •_--.._.._....---•._.._.._...........__......_ Front __.___......_..__ Depth _..__---------_ IIeight ....._.......-•----_ Sq. Ft. _.._..._...._ Cu. Ft. ___......_...� Type of Constxuction _...__k'.ram2_..._....._......_...---- Es� Cost _......._�2.�.000.........._........ To be Completed _..._._.._..�_.__._......._._.._ In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all pro�visions o! ordinances of the city of Fridley. _.� ��.�'�-�-�, In consfderation of the payment of a fee of $....._...11 . 00_, _ permit is hereby granted to..._.. Warren Palm •--•-• � ....._._.._......_.._.._..__....._.:..__.__...._..... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildinga within the city limits and this permit may be revoked a t ar�y time upon violation of aqy of ti�e provisians of said ordinances. '� � � Clarence Belis NOTICE: This permh doa no1 wwr th� aonstruetion, inst�llation fer wfring, plumbins, g�s h�aMn9, aw�r or wN�r. d� wn M tN tho Buildiag Insp�eto� for s�pant� p�rmits for fh�p fNms. n + • „ n APPLICAT�O�I FOR BUZLD.T.NC.� PERI✓�T CI^!Y OF FRSDLEY, MIYiNESQTA OWNER `S NAME_��i+.� ��s, i�� .Bt�LDER . �; r� `�R�SS. �C �� .�DDRESS : r � .� .=�.��,�.�. �� ____ _. � - � ' �i : . ' .. . . . . . , " ; - . . • . . . . ' . . . . .i , . . : � . :.:." � LOCA�ION' nF BiJ�LDII4G ` . . , �.� _ .. ..., ., . N4. C� �j�--� STRE�T �`�^�2�� _ . LOT BLOCK �UDII�IOP1 OR Si�aiDiVI�I0b1 - . . . - . a � � . � . .:� . . • , . _. . . � .. . CORii�A I�OT. ; �° �NS;IbB LOT: :' � � SE�BACI�___,_�_,_,�,SI1��YARD _.,_-____r... SEG?FR E7,r.VAT.ION Tt3P OF FOOTiN� Applicant attach to chia form Two Certificates of Survey of_.Lot and proposed building Yaeatirmi� dr�wri 'on t�ie�e�}�is�tificat�s: ' ' `' _ . , ,_ . _ . . , - e . :.� � �:r, : �� ,:� . . . . _ . . _ �' � . •� = �' : . - DBSCP�'PTI�ON� OF S.Jx�I'AT�' ; .: : . , .. ^? ... ,. ._ ` i .. . . . . a . ' ., . . To Be� Used � As� .. .. . . .� . ' . _ . . , . . _ � �� _ Front . `�' � � Depth�� Height;_ (�Z! , '.�': ;.� i. . a�.: . . �. . _ . � t . . ; � , Squ,a'�� feeC `�' � �Z v � . Cubic Feet `7 Z o 0 Froat Depth Hei�ht , � . - i . 'i::it . . . - • _' . ' Square feet • • _Cubic Feet �� Type.�f Cans�ru�tion� ' ' > � �- " s, �'�°'�" � Estima�ed Cost '� �. r To Be Completed / ,.- - /,� � - ��,.� ` �____��` The uadersigned hereby makes appiicatioa for a permit for the work herein specified, agreeing to do all work in striet accordance with the City of Fridley Ordinances and rulin�s of Che Department of Buiidings, and ttereby declares thae all the facts and represeatatioas stated in this applicatiott are true and correct. DATE _?/`3 �/ G' P _ ,_SIGNATi1RE��,. _ .. (Schedule of Fee Costs caa be f�und on t e Reverse Side). �d� �� ti� ��" � i' Iv� � �D � � � r � /��l C� �'/ 4/ ��! G� 6 �C �^' Ci �y � �� d % o �=- _ � e� �e � � � , ��-� � � r- � � �'= �2 -, �. � � .� ` '' J � � �� . � } � +k � - . � � � - �. � � I� 7 J � � � ' _ ' �.��v� _----��. • Fridl , F City Manager � R City of Fridley �. � 643]. University Avenue N.E. M Fridley, Minnesota 55421 SUBJECT: Possible Health Ha2ard � � DATE: 10-28-64 FOLD% Unsati.sfactory Septic Tank�-�- W. , 6421 East River Road Northeast O. Palm PLEASE REPLY TO -� SIGNED NL�. Earl P. Wagner, City Manager y o r ey Tnvesti�;ation ret�e�lec this co?��laint to be unjustifie�. Probably a cra r.?t ca 11_ . DATE � L- 7- 64 � SIGNED J� me s k� . Hen�y SEND WHITE AND PINK COPIES WITH CARBONS INTACT. PINK COPY IS RETURNED WITH REPIY. SUBJECT RIWIT�.„.,.e, __ City of Fridley �' AT THE TOP OF THE TWINS � • 13413 ; ` BU ILDING PERMI R � ` COMMUi�11TY DEVELOPMENT DIV. r � y � PROTECTIVE INSPECTION SEC. ��Q � � �l � /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY s��'� � ,�� 6t2-560-3450 910-F15 3/19/76 � % JOB ADDRESS 6421 East River R,�ad N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACIiED oescR. 34,35 Auditor's SLlb. #23 SHEET 2 PROPERTY OWNEF MAIL ADDRESS ZIP PHONE Warren Palm 6421 East River Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WOFK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 13' x l2' Addition to dwelli.ng 9 CHANGE QF USE FROM TO STIPULATIONS Call in v�rindow sizes in addition so energy calculations can be made. S�PERATE PERMITS RE(�UiREp �OR 1�iII�iNG, HEATING, PLUMBING AND SlGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC�I FY'dICI@ 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 R.1 156 31.iO 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 VAWATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S2 i OOO �Sl.. OO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU�ATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S�-2.00 ' PLAN CHECK FEE TOTAL FEE $13.00 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT (DATEI H �q/�� Y VALIDATED THIS IS YOUR PERMIT / X�'��U ER O OWN�IIF WN�BU�IDEf±i �^�DATE� � B� iNSPr��ZC/L/ 3-I�9E !/�` � O DG • '• . Jtl'1'LZGr'i t 1UI`� 1•U1C 1CL•:�111L'�ti 1 11�1�.� 1�L i i.:�� i,.v�� . . � OR AllllITTON. BUILllI`'G P�I2DITT , � � . ' CZTY 01� FRIDI.EY, hiINNESOTII • .' . , • . , .. . , • . . . � . . OS,'t1�Tt � S NI1Ti� : /�i�% ..�i-,��.�� BUILll�I'. • � �� . • . � � ADDIt�S S � �� ADDR�SS : ��,1 �'�'L/�� . . � • � !�i UE t�, l�i� � N0 :�� ', �la 1 STREET • /�i� l . � .1 /, :� %Ox : �� S �3LOCi:'�_..___.--- ADD�TIOn �-C C�E GC �� l _ �� 3 ----- �� . � ' . . . � ,i GOR1��R LCT : INS �DL LOT : X SEi.'�ACY.: ___ SIDLi'EII:D: .� =i . '� . • ' . • . #i • . . . - ,� 1�pplicanC a�tach �o this for:n Tc��o Certific�tes. �f Surve .of LoC an�.propased . �� buildir.g lacation di�iwn on these Cextificutes. � . . , ��. � • .� . . . . . i: � • ' • • • � '�' . ' . . . . . • . . . , `, . . . t: . � �DESCRIPTION OF BUILDING . � � - _; ' � � ' • s , , i. " To Be Used As : . . . � ` . . . � ��i�� S�•_ f 16� I� n� Fxon� : / 3 � D�pth : � /o? ! Height : �C � , . • . Square Feet: � Cubi.c.Feet: � • Front:� Depth. . Height• - �.. . � Squaxe Feet; Cubx.c Feet: ' ; � � ��pe oi �Construction: �._,L��C'G�� i�'-f-1 �n�-`� �stimated Cost: $ �, C`OCl ---`� . Ta �3e C�mpleCed: :� /�1Cs�S . • The undexsigned hereby makes application� for a permit for the woxk herea.n speei�ied, abreein� to do all worlc a.n stzict accordance taitli the Cit}• of - � �xi.cilc� Ordi.nances and i-ulin�s oi tiie Department of Fui.ldings, and hexeby declares that aIl the iacts and represen�at�ions st�ted in tliis application �xe true and corrccC. � � ..� ' • � � . . ' . • . ' • I�TE: ��- � �- ui !o SIGNf:T[lR.�: G`� ��,,� � �� • (See I�everse Sidc For Addition�Z Infoxination. )' ' . � . • � ./�_�C � . . ' � . . � ,� _ . �. � �.U�� , , � . � � •. . • . - . , . : �C � � . � � � .�,l�-L • . . . �� '.' • . . . . . . ' � � � . � � . • . . . . . . . _ .. . �'�"�'� ., � � ' ,J ` . � � � � .` `�.,,;�' \ v �'� � ; � � �� t � � � � � `� � ~�� `;- 4: i� �� , ,� 3 ti � � _� c � '� � _ �d�� , ` J �" �� `� �,c , �� r---�-----.. - � /J,' 1 , � / /' j, j, �' � � ,/ � ; i �' � � �� . � Sd` 1 � � � �a � � � � ,� U �, --t ::��- � '"�- ; o � a�. 0 � � �� . � � �. : � .� � li "- � 1- - t- �-.1 Q Cf1 � c'_ v' � �� :�I -� o �s d-, �n ° 2 �� .� � �`-� � �� '� c�� d -_.1 � �, -� � � � � l� 0 r----� � 4 ! F ; i ` 1 - i � i i t \ ; � � j i , � � �—.__ � 0 � . � i�[ � `4�+ 11 4 � � i� 4 �. � � � ; � .--- - - __ _ t _ - --- �--_-- --- - ; � : , Q � ' � � �� , = � � , , ; i � __.1 3 Q .�.� a 0 , , ., : . � . j � . . � - . � �� - .. i . � � _ 'l�� - + � . 1 . . �+�� . \ � � � ' �� , ; � ' . `°-` � �, � ' �, , � 1 �- , � � � ; ' �i , � � c�� d � � =. � , � '�. I R � � t . i � � I , ,.�_------------- __-----�`..------- __--_.� _-------___ 1_ _ ----- --- -- _. _. - -- ._ ----------�-- -- - --- - --- --- ---- - -�-------- i � �' I � ( I i � � ' _ __ � ---_-, _ =-_ -' � . L._._ '� _ _ ___ __""_ '."� '_."_'_�"'_�_'_-_ ___" __' "_ _ ..-__... _.__ ..� _ _.. . � � .' _�. __-'..."_. _.. .... . -� ._. _,__. _... ..__._'-"'_'-'- _- _-._ . "_�_ �_._.. r___�___ � � , ,� ' ; �, �� ` � .�. I - -- __ - _ _ --- --- ___ _ --- _ ,..____�.�_-_�-- _ _ _.__ -- -- - - --- � �1 ��` _ � - �_- - _ __ __-- _. .- - - = _ _ -- _ _ � --- . IJ Y� r ;. . . . 1 `` V � 1 � C `� � <_ ;�� ; -s---�- � � _ _ _ _ _ ___ _ - _ _ _ _ . _ _ _ , , �> , , + _ �� __ _�.._; � � . � �i�� iG��y � � « � r-a�� ,h . . . ,��`�t,��3�!°i:iCTi4 ��Sa ��f.:atc:;:si� � �� '.:�.; J b!9;ai� ��e:'•i: � • .,, _..._.._....__ Dopt. of B:dpa. �ono S:�•3SS0 D�3C?IPTIO?� GF VIOI;:: �,,fy� •_�� 2iva:`.u-. `:�i� ar.d I,o-cr!icn o! F!�!�.:-es L � I�IR Y ';, � � ., r :� � gZ,�z�a� � � 0 1 � ��CS = I� � " i�l � �'`< � ' `�� 7 ` 7 �4 N j} � � S G � ��Y -,c . , o`u < t�� 'u a jV V E3�2 ' �„ � � I , � �. , I ��1 3rd S :`, � • - Cc�.:.;,t::� v7iY:n • �'u �:o Ccn.: :.:•.:: a Cr,�::�"- ; %{iv ��:'1:D. ��d �i"'y4II:^•� P�P.TIAt, RATE 5�HEDULE VWATfq �+TM. m e ► N ��S 4�tC. J�'W'�7 Q CC.^.%�GOl n : L�SSIi7C F;:CTJF'.i. RATES: it0. �?ATE Td.Ai. N�,:zt,6er F�x:ures . . . . . . . . . . . .. . . . � x S?.��. S , G�d Fl�lure F�xtuse n,�cning . . • • • • • • • • • � x $1'� $ • "' 1ew Fix:ure Ot,�i Oyening. •.• •••• •• . x 51.50 $_:__. Catc?� B.;<_in ......... ........... x S%.25 $ Watcr iieater 'Up to 99.004 �i'Uf• ••• ._. x e3 G? 5 -' :�ew G:ound Run Old B:dg. ... r.. .. _ x;3.25 S --- E:�ctrtt Yl�:�r Y.�atar . . . . . . . . . . . . . . s ��.CJ � sIS iZTTI4G FEr3: ' ?i0. RfTi T.OT�.L • !st 3 Fix:ures • • • • • • • • • • • • • • • • x 52.C.� � -- ! �,d��L{CII81 FiXll1l'Q$ • • • . • • ...• . • . . • -.----- X J .i� � . Cu R:L.£e to 1�3.OG� H;V ....... ...• , x S5.00 .�i -- City of FZ-idlcy:. � r .C`� :� �� . ; � ��c.Q � The undersigr:ed hercby m.akes a�pilca�on for a permit !cr fhr vorY herti speeifi^d, a� ee:n� to do a1 «•e:k :n strict acco:�'ar..e with tre Ci� �:s-%�='� a.^.d niling of ihe 1}epa::r:>cr.t o! IIL:il�'nZs, and hereby decla:es ��at alI t-*:e 1.d and r�Dreser.tations siatc-d in Lh:s appllcat:� true a.r,d eo:'rect� . ,/�� ,', rYid?ey, b�ian �-�-"�-f _'�--' 19� Owr.er • � � • ' Kind o2 E;:ildin; �; ��`'� �� -- � Used µs To be co:r,pleted abaut �- Esfimated C�s:, S `�� P.t�� :�,. �'�C�C� Oid—?v'ew. ilu:.ding Perr.iit h'o. — - • Sigr:ed f %� _ . � �.� E'�- �OUGH FI:7?4Z, 11 - / � `�_ � • . .50 State Su:ch�,z � °..:'?l::iS ic J�LTER�7.OM3--P.�:ez :o Codo • . Pe:,cri;. S on . . . . . . . . . . . . . . . . . . .. . . . . , .. . . . . . ... . . .. . .S � . ' . ' Z`O�i AI. FT'.:.F. $� . � Y . • • . �y • -- Businrss Yh�r.c .Io - . . ., w ��! �i^.n4"�.�-n..?� �.w.� �n�. {•...n �-^•- f`:r �!;-- Pit^ ^� �+�.+.t��-:y �,,JrW;'.+�'?,.-r*r�.� �)ee�•-.c-^-*✓` ,.�^/� �f ♦ Y+ i7'bw�l 7�i �..'4 kC�'v.:.i L -f.d i[.� Qc F,y„ �7'J�.�i \..�� ...:u�+.i►va:j �'�4«�s.v��a.0i�.ii��:I.�i:.0 •�� li�R^»/±..�nn ��" {Aw��%•l�r...T /'^,...w� 4�/i�..�.-s�� iu3 'V.'�""mt.�.un:tVi..iL� w�i�+:i.:a.t.:� �a:..e:�:3 WDVNe�V�..�� ' PA,�'�l�! [h° � iirktT� .�.��:ii.�C1� d��. GR11vi rY ;rAr"i�-Q A:r�',: 44:. i'� T:;�:t't.I. F� �c� Sfr1: i�z ✓� : �rork ... $IC.CO i Rr':�-^:►.^.t cf csr..s� �.p� � F.�;:a.-� l� Ai:�ra:.or.;-- u� ;o SSx.00 E�� S c�e�a:'S L: Ai:rfd::o-1 each add. t5Q0.C4 . 3(YJ � ��. � ��.1�t r-.�c �1:.-:.sre S.�ell Zc L�:et 71ork to i}O,L`��J BTU ..RIO� � c �� a4. eo,�^�J B'�'t: .. ... 3.cx� s� P.cystr-�:cr: of i ai-L:cc 6.�Y? 3 n^*,;�i-s & n`;e•atiors—L� to S5r?O.OQ 6.00 S �-:�.ai-: Gc Aitert�oris each ad3. 5�4.0� 3.00 S a'Z`-�;yS or t:0 i +fIAS�R £YSTi?� r.:~:�cr S^ei1 �c L:nes--to 4�0 sq. ti F.D� S:er.r.�t F1:rnace S:� }i & I_�nP-•:e 6S� sG St. �DR Fiot Water Eacn add :G�1 s�. ri Ei�ft S'cnm E��_h a��. 32C sq :t EDP. Hot :?ater �JIL 3�P.:��F.—:o 3 gaI. �cr hout ovez 3 gal. per hour—�ee Fee 5cfiedule GAS B7: ?ss,'R (u� :t� L"S.x.,^ B7U) a,•r Ic'?.C�J 3"'Ti J 3ae Foo R.chvdtlo G.13 FI't � I!iC �"VS: 240 RAi`r. T4TAL ' zo 200 S _ x .7b S--• -- zb 5.17� S State Surcharge . .50 $ f�om Fc� 5t�:�z+i�3r� ��. t' la�ft'� �� S:4.M •o . I O C'0 S. 3 A� � 3.0'J i _ 6.00 S. b.CO S lst 3 F.xtures Add,:ioaa! F'SztLres Cas FL-r.gz sa i.s`3.� ASR G�.�,.:T:QCI:;Gt F?..:�.:. r: _.'3G �Ts�...� �. . ^• �Z�. G v7�: �.� RLi�i'J.°ur3 3 T.EBh:it,3 F2^',..J^v:3 �-::,z, �'v?t. Os �,.)t� js. i "i:o:w �-�r:,'�i �... �.... � ��J �� ;� � �,. � . +. City o4 Frid:.^;: '1'hr ,:r.de:siq^c� hcreb� makes ap�licaao:� for a�rrr^It for L'�e a;ork '�e:�.� spec�fied aFr�.�c•;r.g f�i de ail �•ork en s;rict acco��?an:e w•i:� the Ci:7 Q:-C::�.:� ar,d tviir.g.o.° Ihe Deya:t:r�rnt of Fiu:;dir.et, an3 heceby dccL*::s L`��t z:l tbt f�� and r�Nr��s?ntatiu:�s statrd sn •.}�►s app�catien arr true a:fd co::eCt ' F�idlea�--'. �'�n ! � � _�„28 � i A t.. :, ,. _ ,) � ., (?wr. Pr Kind of Bui?din� ��C� �'� ' C� i�_�_'�'y��l � . .. ,1 � _ A n _ ' - . , Used a� , ��` �1 T� 1?c� completeri abou� ' Es'.imat?r3 Cos� S _ �v J • �Old--�New. $uildisig Perm;t I�o. -•-- -- — p•rmit PJo �:M-��:..=rsa�r oi ��:� HEATTNG or FO:��R F'�.P�NT='.r—�: tr;,.�-c. P.ct Fatrs, Wa.-rn f►ir—?:o 7'rade Name ' Sse No Capacity.�._---____ -- S�. P't %.D.R BTV H.P TotaI Connected I�:d Iit�3 cf �1.�t BUFtNER — iYa-�.,e N�me__ Sisr No CaL+acity Sq. 7rt�t. �.DR I3T'U � �? 0 _ s SL.w-�.� /�(% � l� .�L�'1 ' �3 . F'.ak;:-�t 's'�.�..� �� . ts�:maaxs...ov3xf � ' SUBJECT City of Fridley r��f � 2 6 5 3 ' , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T` No. r � � COMMUNITY DEVELOPMENT OIV. , /�� r � � � PFOTECTIVE INSPECTION SEC. LI � � i � � � /�"1 • CITY HALL FRIOLE� 55�32 NUMBER REV DATE PAGE Of APPROVED BV �----� • •�� 612-571-3450 910-Ft5 7/10/98 � � JOB ADDRESS 6421 East River Road NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3L► Revised Auditor's Sub. �1f23 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rose Palm 6421 East River Road NE 3 CONTFACTOR MAIL ADORESS ZIP PHONE LICENSE NO. Scharacon 16700 N hzllcrest Court, Eden Prairie MN 55436 949-8668 20103863 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE IICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION �l REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) Tear-off - 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCEO WITHIN 60 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HERE9Y CERTIFV THAT I HAVE REAO AND EXAMINEO THIS APPLICATION 1 STA��S GARAGES AND KNOW TNE SAME TO 8E TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUA710N SUfi7AX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEfiEIN OR NOT. THE GRANTING OF A pERM1T �2,168 �I.OH DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TNE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR IOCA� LAW REGULATING CON- $74.75 Fire SC y�2. i6 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTA� FEE c�``—�� -�C�" �,f License SC $5.00 $82.99 S�GNATUREOFC ACTOAOAAU ORtZEDAGENT IDATEI HEN PROPERIY IDATED 7HIS IS YOUR PERMIT � � �r S�GNaTUREOFOwNERiiFOWNERBUiIDERi � �DATE� B�OG SP q°iE �w [ ) Effective 1/1/98 ADDN [ ] ,�, CTTY.OF FRIDLEY .. ALTER [] SINGLE FAMILY -AND DUPLEXES R-1 AND R-2 ��J� � _ ,�:, BUILDING PERMIT APPLICATION , r��. 0�9 :, _ , � . � ConstructionAddress: C3 L%�I � ��' Q-cJ� � �- � � - � i, � y � Legal Description: Owner Name & Address: (� C�.�' � �� <+'t Tel. # Contractor: s�. �'-� � f�4 'C,c�►� MN LICENSE # 2 c�I o-3 6'�� ,_ Address: `b ��' � f-�� ( �G�' L J'�- C � �Of�v P,� � � r . � �"�`�'°`I'el. # 6�2 - �l y9 - ��' . ' Attach to this application, a Certificate of Survey of the � lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: ` Length Width Height DECK AREA: Length Wid;th Hgt/Ground OTHER: � � Sq. Ft. Sq. Ft. Sq. Ft. :, r�2 `CJ�� . ,� G Construction Type: `t� � �vo -'F' Estimated Cost: $ � j�'' � �.. . (Fee Schedule on Back) . Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: °�' -�o � `�� A,PPLICANT: �� N � � �- (�o �V TeL # `l Y9 � �_�-._ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ .�.,� Fee Schedule on Reverse Side $ � . t �c .001 of Permit Valuation (1/lOth%) $ ; C� $.50/$1,000 Valuation $ $1000 per SAC Unit � $ . G�Q $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 J $ �--��'` ' � SU8JEC7 City of Fridley 2 2 016 ' , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T RECEIPT . r � � � • COMMUNITY DEVELOPMENT DIV. , ; ,: ------, �S9�o r � � PROTECTIVE INSPECTION SEC. � � ( � /��1 � CITY HALL FRIDLEY 55432 NUMBER AEV. OATE PAGE Of APPROVED BV �.---�•� �•' 612-571-3450 9�0-Ft5 8/6/93 / / 10B AODRESS Fj[�2� East River Road NE 1 LEGAL �aT NO. BLOCK TRACT QR ADDITION SEE ATTACHED DESCR. 34 R2V. AL1C�. S11Y�. #23 SHEET 2 PROPERTY OWNER MAII. ADDRESS ZIP PHONE Warren Palm 6421 East River Road NE 574-1982 3 CONTRACTOF MAIL ADORESS ZIP PHONE LICENSE NO. American Remodeling 3700 Annapolis Ln #145, Plymouth MN 55447 553-0020 2406 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION C� REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit/Fascia 9 CHANGEQFUSEFROM TO STIPULATIONS ProVi.de adequate a.ttic ventilation. Provide smoke detectors as per UBC 1210 adjacent tn all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GiiOUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEAtING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING 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 OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S APPL�CATION �' STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALl PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $� 8QQ $�� WITH WHE7HER 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 LOCAL LAW REGULATING CON- $41.00 Fi_re SC $l, SO STRUCTION OR 7HE PERFOFiMANCE Of CONSTRUC710N. PLAN CHECKFEE TOTALFEE License SC $5,QQ $48.7Q S�GNATUAE OF CONTRACTOR OA AUTHOA�ZED AGENT IDATE� WNEN P' PERI ALIDATED THIS IS VOUR PERMIT � _ S�GNATURE OF OwNEa i�v OWNER BU��DER� � iDATE� �� Bl �i�TE NEw t l ADDN [ J ALTER [ J � �� Construction Address: � �� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Appli tion !p �,'Z/ �`l. i!J`�i 4l c� Et�ective 3/1/92 ��, . Legal Description: ( (' i -�}` �� , �,�. t c� � �.c_ E� �� Owner Name Address: ��/✓�"7 � Tel. �.,"��f�l ��iZ Contractor: �� L��' mo�� - MN LICENSE ��"� �v Aaa��-��"v-� �x �.g�� i��` �au� !� ��/l�7 Tel. � �� D�%�U Attach to this appiication, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPRaVEMENT LIVING AREA: I.ength Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width HgtlGround OTHER: Sq, Ft. 5q, Ft. Sq. Ft. Corner Lot j J Inside Lot [ J Ft Yd ac�ic _ Side Yard Setbacks Type of Constcuctio�—� D��°� �B- �' ��'�Q-- � Estimated Cost: �� Approx. Completion Date: • �4 ' (Cost on Back) Driveway Curb Cut Width Neede�: Ft. + b Ft = Ft x S =$ ��; ��:��e:� TeI. �a��OD� U " �Q 'g�' APPLICANT. �� DATE: � Permit Fee $ / ' �� Fire Surcharge $ � 4 State Surcharge $ � SAC Charge S License Surcharge $ • DD Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ �� -/ � STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Pennit Vatuation (1/ IOth9�) $.SO/$1,000 Valuation $700 per SAC Unit � $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [] Not Necessary [ 1 - - - �. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATtON FuR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572 3604 REFRlGERATION AND AIR CONDITIONING S STEMS AN C RATE SCHEDULE Residential i�Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer �*Air Conditioning • All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1%a of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTALFEF ; MINIMUM FEE FOR ANY HEATING/COOLING/VEI�TIL�TION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE RE�NSPECTfON FEE $47.00/Hr *Air Conditioners can not be placed in a side yard �vithout written permission from adjoining property owner. TOTAL � �C� �U $ Y D DEVI ES Effective On May 10, 1999 X� JOB ADDRESS� �� f�L`U�=�-- � ` ,� ,, OWNER_�/ � �S � ��/ L-��i BUILDING USED AS „�l/�✓!� L.�� Y�► � ` �`"� � �� ESTIMATED COST �.� �� PERMIT N0. 1��-��.� DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name��l��aw' � Size No. BTU �'�F��d HP EDR $� S' � U� Fuel Total Connected Load $ $ $ .5� � .�, J. . Sv Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Buil��ing Division, and rrereby declares that all the facts and representations stated in this application are�true and correct. HEATING Signed Approved By �ttarp 7d %!',ir Conditi�sl�;�c.j l��r, ,ral Av�. I',;� .t'i �h s. tvlN S��TE ._ . �, -�: ., Raugh•In Date Final Date' � �� Building PLUMBING Permit rto.: '� � % Inspections R]�SIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRl[DLEY Date Rec'd: '=:� Z��. DATE � ZZ O(o YOUR E-MAIL AbDRESS SITE ADDRESS iD 1 Z� �G�S'� ��V e� f"�� THIS A.PPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY Nq�: A ( c��c,v� OWNER/ ,e�DRESS: �e z �s� �Z�ve�- R`� CITY ^ cQ �Q STATE �Z TENANT pHONE: %�03 �7�{ — J �18 z CONTRACTOR Nqj,,�: � I�D A� � L �3 [�- SUBMIT A COPY OF STATE LICENSE il ��) 'Z�o ( EXP DATE i 2I 3� YOURSTATE ADDRESS: 2�y r+�-� 6C3 a CITY �e��}� STATE "�`ZIP�� LICENSE WITH pHONE 5�3�(� FAX (?�3� �53-a?c( 3 APPLICATION PERMIT TYPE �LSINGLE FAMILY ❑ TWO FAMILY O TOWNNOUSE TYPE OF WORK: ��'' d �p�CEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fae is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, instailation or replacement of a residential fixture, excluding the fixtures. (This should reflect on�y 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 EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIX'f[JRES: (INDICATE TOTAL NUMBER OF EACH BELOVI� BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING � cnruc�s�j SWIMMING POOL WATER SOFTNER ($35) _ CLOTHES WASHER KITCHEN S1NK WATER CLOSET � BACKFLAW PREV. ($IS) BISHWASHER _ LAUNDRY TR.AY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER 'z �,�x ��. �. ..� _...:._ �. . ._ ., , ...._ .� .... , . . n _.. . �: Permit Fee . $ ��.�� Number of fixtures @ $10.00 x $10.00 = $ Surchar e .50 Number of fixtures @$15.00 x$15.OU =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMI7'-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accwate; that the work wil] be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application 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 of all wor c wh' quires review and approval of plans. STGNATURE OF APPLICANT /��-- PRINT NAME G�� '�- ��"�-s� DATE (9 Z� d� ��b City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 PAX: 763-502-4977 763-572-3551 763-571-1287 fax WATER AND SEWER � PERMIT APPLICATION CITY OF FRIDLEY EFFECTIVE 6/9/09 APPLICTATION DATE: ��U �v 9 YOUR E-MAIL ADDRESS: THIS APPLICANT IS: ❑ OWNER [�(,�NT�A CTOR �(''� JOB ADDRESS: LP�,. Z..I � eA �/ �Llt �,�` �C.e,�-�„ NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: �,F�'O��A �.'"�.�� OWNERJ Petmit l�To.:.��'v 7_�� Received By: Da�d" 0� TENANT '`�D�SS:,� ��,,,,,,_o _ C[TY STATE; ZIP PHONE: CONTRACTOR N,�: r _ SUBMIT'A COPYOF YOUR STATE �DRESS. p�Z � LICENSE WITH PH01`1E`7G �+ I"'�S�S�� CELL PHONE: � APPLICATION STATE LIC # STATE BOND: EXP DA' : 1. 2. Please attach sketch showing curb line, utility line, buildfng, etc. with distances. PERMIT TYPE � SEWER CONNECTION PERMIT O WATER CONNECTI�N PERMIT ❑ WATER LINE REPAIR ❑ SEWER LINE REPAIR ❑ ADD STATE SURCHARGE ❑ SAC CHARGE @ $2000 = $50 $50 �o ��z��' $40 $.50 � c � � , 1 OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHLJT-OFF / wEExENDS & HOLtDaYS $125lHOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED . I hereby apply for a water or sewer (new connection or repair) permit and I acknowledge that the information above is complete and accurate; that the work will be in o ance with the ordinances and codes of the City of Fridley. I understand this is no� a pgrmit but only an applicarion for a pe or 's t s without a permit. � SIGNATURE OF APPLIC PRINT NAME`/ K► DATE: � �� APPROVED BY: DATE: COPY GIVEN :❑ TIL Y BILLING (only if new meter) 0 PUBLIC WORKS ❑. EN N RING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 ' 763-572-3551 - FAX: 763-571-1287 �� - � . � .. . ��'�� ----�,''l�t`�-`�� Z' , -� . .�' . . � � �� \ � �� _ �. � � �. - �-�:� ��.� , . � �/� . � � f � � __. � � �� , �� $ . � � �� ; � � i' -� � y __