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I ; �;;; :x . > 1 v � � ° i 7 � I I � .� 1 p) ., , pi � tA<.•+. �' n � ��; 1 � D - N o r � � : � � a, w w � � q � m , -n ;�. �: ;'rA` ;; �::; w � w � _ m fD m �' c� � � � rn n V A � N O. (J I �p O � � O p � < T Z �u � A � v W � N C fD Z Z m � n � O Z v < � m il < � O � � w � c w � � <o V sue�ecr P . �,� City of Fridley 2 6 6 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T P ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. [� / � � �: ---•- � (��(� r � � PROTECTIVE INSPECTION SEC. i ` � � /'�'1 � CITY FIALL FRIDLE� 55432 NUMBER REV DATE PAGE Of APPROVED BV �"'"� � �'� 612-571-3460 910-F15 7/14/98 � � 108 ADDRESS 6815 E. River Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. � 1 Ostman's ir d n SHEET 2 PFOPEFTY OWNER MAIL ADDflES$ ZIP PHONE Don We ler - 3 CONTRACTOf; MAIL ADDRESS Z�P PHONE UCENSE NO Nutzma.nn Bros Co - d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTEFiAT10N �] REPAIR p MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and ara e 27 S Tear-off 9 CHAN(iE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. riPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OFi AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION OR WOHK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I NEREBY CERTIFV THAT I HAVE FiEAD ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT 2251 1. 13 DOES NOT PRESUME TO GIVE AUTHOFiITY TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CHARGE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. %/{. ]S Fires SC Z. LS �PLAN CHECK FEE TOTAL FEE � icense 5.0 83.13 SIGNATURE CONTRACTORORAUTMORIZEDAGENT ID TEI EN ROP VALID T D TNIS IS�OUR PERM � �/ i /a/ .� S�GNATUREOFOWNERiiFOWNERBUILDER� iDATEi - � .NSD OFTE NEW ADDN ALTER L) [l [] ConstructionAddress: CI1'Y OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERNIIT APPLICATION ! %�v�,�- ��0 Effective 1/1/98 (o°�� I�a H Legal Description: Owner Name & Address: �� i(%i:�G P�_ Tel. #�%/ ��07� Contractor: /�/-�-ci`��rAn� �� •, MN LICENSE #�UG�'!�%�,� Address: J7 l�� rr� i(J vl� °—�� / Jrri6�r�✓ Tel. #�� R` 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 Length Width Length � Width Height Height Sq. Ft. Sq. Ft. �Sq. Ft. �,�t � E� Construction Type•. � /�I� Estimated Cost: $ ��s�� (Fee Schedule on Back) Driveway Curb Cut idth Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � � APPLICANT: Tel. # �d 7 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ %/. i � $ -� $ , � `� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $ $1000 per SAC Unit $ �. ��i� $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 [] $ �-� � , �_� 7' e � ` _ •�uiu�i3 a� q�inn �uTpaa�oid aio�aq pannba.z aq iiTns pa��nusuo� uaaq s�q �t s� at a�no uor3�puno3 a�i 3o uor��oi a� �utn�oqs `1oj aq� �o �anins 3o a3��3i�a� d •a�is uotl�nr�suo� aql 3o pu� ainl�nr�s pasodoid a�l 3o nnatnai iadoid io� naolle o� uop�iidd� �o auni aq� moz� sinou {,z �o mnuimiiu � pansst aq i�Cn� uot��n�suo� io3 situuad 1�TOI,L�'QI�Tf l03 30 l�iOI.L��I3I2I�A 'SL'Si$ sau� �aa3 9 snid �pina �En�anuQ - y�dap u�uc 9�1inn q��oidd� apim loo� £� ti�sut pu� ia�in� pu� qin� 3o auauia��idai puE �noLUa2I �uSu al�uali� 'OS"£I$ ��l laa3 9 snjd �ptm ��manuQ -�iuo iaun� puE q.zn� 30 luaLUa��ida� puu� i�notuag :ud„ a��ua�� (�jup s�aax�s qin� a�ai�uo�) A102i�S"3 I�iOISS�d�Q 1��A��ARiQ �oaiaql uot�� io ppp`j$ I�uotlippE ��a ao3 SL'Z$ snid ppp'ppp'i$ �sn� atp .�o� SZ'ZIOS$ 000`000`I$ ��Pni�ut pu� o� `3oaia� uoil�� io ppp`j$ i�aopipp8 q��a io3 SZ'1�$ Snid 000`QOS$ �sn,� a� io� SZ'L88Z$ OQO`OOS$ �utpnj�uT pu� oi `�oaia� uotl��i3 io 000`I$ j�uopippE ��Ea io3 00' S$ �Id 000`OOI $�sig io� SZ' L88$ 000 `00 i $ $�Pni�in pu� o� `�02I2i� IIOT��B.13 .IO � ` j $ I�uor�TPPE q��a io3 SZ'9$ Snid OQO`OS$ �sn,� ao3 SL'�LS$ 000`OS$ $mPni�� pB� o� `�oaaa� uop�� so 000`I$ i�a?�jPPE �I��a Io3 00'6$ Snid Q00`SZ$ isn3 io3 SL'6b£$ 000`SZ$ $�Pni�m puE ol `3oaiaql uori�� lo 000`i$ I�ontPP� u�� 03 OS'ZI$ �Id 000`Z$1�3 jo3 SZ'Z9$ 000`Z$ �utpni�ut pu� ol `3oaia�l uop��i� lo OOI$ i�ol�tpp� ��$a io3 SL'Z$ Snid OOS$1s.n,� io� iZ$ (a�n�q�ms snid i Z$ s� aa3 cununuiYlt) I Z$ S"333 dn pus I00`000` I$ 000`0(}0`I$ ol I00`OOS$ 0(?0`OOS$ ol I00`OOI$ 000`OOi$ o� t00`OS� 0(�`OS$ 01 I00`SZ$ 000`SZ$ ol I00`Z$ OQO`Z$ ol I05$ OOS$ ol i$ �fl'I�A 'IHZOZ :lim-o� paptnoid utaia� iauu�tu aql ut puE quo3 las moiaq uTaia� lunom� a� ol saa3 30 �tuuad ��ns io3 lue�Tidd� aqa �q luatu��d aql a.nnbai `aio�aia�l uot��tiddE nodn `ainl�rws .IO °IIIpIIAtI �III�SIX2 �iIE O� .IIEd2I IO IIOIjL'I2jj8 �iIL I03 .IU `ain��nAs io autp�nq �ur�snca �ue o1 uopipp� �uE l03 lo `aml�n.r�s io �utpimq �u� 3o uot��aia a� io3 siTUUad �umss� aio�aq ��s �1��0 �utPnnB 3ani� a�I.L �'Il1Q�H�S ��3 ZII�1i��d JI�IIQ'IIflg �/ � ` Y � � � �� s�� #_ 013� ' CITY OF FRIDLEY UTILITY RE�IUEST JobAddress:�� a t�.. �� vvL �u.�late:��(�LS� Owner: Legal �.ot i�w. e�ack atdn�on Description = Plumbing Co.:�P�f`I'y 14�P-a�aF].0 1�j� Master Lic. #� I 4 i agree to call for inspections after uncovering the damaged line, before arry repairs are made, an gain when t e repair is made but before recovering the line. X Signature: � l� INSPECTION FEE Water Line ❑ Sewer Line Repair� Relocation ❑ r� � Fee: Fee: Per Chapter 206, Fridley City Code 1 Total: Receipt # ° � INSPECTION RESULT Approved ❑ Denied � CommeMs Inspector: Date: White Copy—Inspection Dept. • Yellow Copy—Plumbing Co. • Herd Copy Water Dept. � CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 �631572-3604 FAX: (7631571-1287 ADDRESS : 6815 E RIVER RD NE PIN : 153024120012 LEGAL DESC : OSTMANS 1 ST ADD : LOT 7 BLOCK 1 PERMIT TYPE : SE9VER/WATER REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SEWER LINE REPAIR �� PERM NO.: 2004-00500 ` ) DATE ISSiTED: 04/14/2004 VALUATION . NOTE: CALL FOR INSPECTION AFTER UNCOVERING TI� LINE, BEFORE ANY REPAIRS ARE MADE, AND AGAIN WHEN TI� REPAIR IS MADE BUT BEFORE RECOVERING 'TI� LINE. SEWER LINE REPAIR IN REAR YARD. APPLICANT ANDERSON JERRY PLUMBING 9506 STANLEY AVE S BLOOMINGTON, NIN 55437- OWNER WEGLER DONALD E& LILLIAN E 6815 E RIVER RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construcrion 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 ttus type of worl� 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 re latin cQ�n � or e erformance of conshvction. Applicant/?��/o��G�p Date �'/-1 N^de Bldg Insp Date SEWER LINE REPAIlt/RELOCATION TOTAL PAID WITH CHECK # 12557 SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 40.00 40.00 � >uilding �_?lspections `�63-572-3604 �:�� 5 l a �b �� aDDxESS 8 / � 'I IIS A.PPLICANT IS: '2R0-i'ERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROFERTY TYPE PERMIT TYPE �rYrE oF woxx: BUILDING Permit No.: RESIDENTIAL APPLICATION Received By: � CITY OF FRII�LEY Dat��'D�:MAI� YOUR E-MAIL ADDRESS ��'u P S�� ! (' }.�I�.� S_ r� � d� U'L f' � � /1 /�� ❑ OWNER CieONTRACTOR e ca. � r � r 5 C'i�C � ut r IC Q� ctnr 631 S71 • q� � � N��— The Home Depot A.H.S. Inc. sTa,� Ltc 3200 Cobb Galleria Pkwy. .�wDx�ss: Atlanta, GA 30339 Pxor� '763-542-8826 ❑ SINGLE ❑ �,o FA License #20268257 QADDTfION ❑ GAR.AGE/SHEI ❑ BASIIvIENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWARNIIIQG PC ❑NEw n�ptau �ESCRIBE WORK BEING 'IZE OF IIvIPROVEMENT dUMBER OF SQUARES _ =ARAGES ROPOSED SIZE: 'ROPOSED HEIGHT: I�ANCE/REPAIlZ ❑ REMODELING 1SL,i�tloc.► �`cpI pti�htllr IDING ] Vinyl J AIuminum 7 O�er �'INDOWS �1 EXISTING OPENINGS C�s' �No !R FOR NEW OP�IINGS-DESCRIBE SIZE OF >PENING CHANGES & LENGTH ❑ HOUSE ONLY ❑ HOUSE 8c GARAGE ❑ ATTACHED GARAGE ❑ DEfACHED GARAGE C33afft O Trim fa-Fescis wn�mows itil'eol'rl, Z�v�.4 lbq�67� � A 1t n � b a( c�J /C`lO 1' ,J 0/LC S � S-�6�7 CITY STATE ZIP ❑ DRAIN TILE C�.B�'E�R 1?J/)Gi S WIDTH HEIGHT '7 200 y3� t� M.�n� � ��b S G t aE. BASEMENT REMODELING SUBNIIT: 1. Existing Floor Plan 2. Pmposed floor plan 3. List of structural members W be used Ft FOR NEW CONSTRUCTION INCLUDING DECKS, ,ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing shvctvres and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA,' (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION � /'S� a� S� 3 OCCUPANCY TYPE ' ermit Fee 'lan Review urcharge 'ire Surcharge ,icense Surcharge AC Charge :urb Gti.rt Escrow .rosion Control ark Fee ewer Main Charge 'otal Due $ � L 5,'�'S See Back Page for Fee Schedule $ 65% of Building Permit Fee $ %• (. � (.0005) times the total job valuation – Mini.mum $.50 $ � 5.�? S'� .001 x Permit Valuation (1/10%) $ S, b� $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) � $ o� 3•� 3 Make checks navable to: Citv of Fridlev Aitach THIS IS AN APPLICATION FOR A PERMff NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acl�owledge that the information above is complete and accurate; that the work will be in �nformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a srmit but only an application for a pemut and work is not to start without a permit; that the work will be in accordance with the approved lan. in the case of all work which requires revi andapproval o€plans. tJ :rNATtJRE OF APPLICANT 11�( � PRINT NqME // I�� S C� D I i� DATE S( I� D a �' `L Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Bui.lda.ng Official sha11, before issuing permits for the erection of any bui.ldin.g or .structure, or for any ad�.ition to a.ny es�isting buildi.ng or s#ructure, or for -any al�-�ration or repair to any existi.ng building or structure, upon application therefore, require the payment by the �pplicant for such perm.it of fees to the amount herein. below sei forth an.d in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.5.0 plus surcha=ge)- $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fractian, to and including $2,000 $2,001 to $25,000 $69.25 for l�` $2,000 plus $14 for each additional$1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $39125 for 1� $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for ea.ch additional $1,000 or fraction to and including$500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,OOO,Q00 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for constru.ction will be issued a minimum of 24 hours from the time of application io allow for proper review of proposed structure and of the construction site. A Certifica.te of Survey of the lot, showin.g the location of the existing foundation will be required. before proceedin.g with the franung. New Houses Onlv City of Fridley Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax.: 763-502-4977 Building Ins�ections 763-572-3604 DATE_ L— SITE ADDRESS _ Tutc aPPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUgMIT A COPY OF YOUR STATE LICENSE WIT�i eppT.iCATION PERMIT 'fYPE TYPE OF WORK: PLUMBING _. ._��.. . 1�ESIDENTIAL AP'PLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS ❑ OWNER '�1CONTRACTOR ,•� ADDRESS:, permit No. Received By: IV� Da�°�EP 4 ��,...... • l I `-' .cr v v STATE LICENSE # 651-365-1340 (Q EXP DA TTY STATE 7-� qDDRESS: 3670 Dodd Rd. ��uu agan, F�c PHONE �1NGLE FAMILI' ❑ NEW DETAILED DESCRIP'1`ION OF WORK p TWO FAMILY 0 TOWNHOUSE � REPLACE1vIENT R MS 16B.665 the permit fee is a minimum of $15.00 or 5°e% of�t�� eosft�u�p s° �5,��ho�ild refl ct onl�y the cost of labor ) PE improvement, installation or replacement of a residential fixtur , x .OS =,__—. Labor cost under $300 °$15.00. Labor cost between $300 toN $�.ao ER ofFIX aI'URE. EX� T NOTED. FiXTURES: (IN�iCATE TOTAL FOR PR07ECTS WE�RE IABOR EXCEEDS $500. FEES A1� B�ID SHOWER _`NATER PBING N(7MgER OF EACH BELOV� ��R D��S — S�G POOL WATER SOFTNER ($35) BATH SINKJI-AV G� PIPING (r�o c�"�►�''� — _BACKFLOW PREV. ($15) BATHTUB —�.C� g�{ W ATER CLOSEf FOR IRRIGATION CLOTHES WASHER VJf+TER HEATER i$35) _ OTI�R � _DISHWASHER ,_,LAUNDRYTRAY -�-WATERMEfER _ T � ,. . ,. , . _ �: . . .,.: . ,� � . Permit Fee TOTAL DUE $ – ,�, ; �,�,�'�A'� ` � � .� �� . . ,, � ,. .� . . ' es $10.00 ., x $10.00 = $__ I•Tumber of fixtur @ TTumber of fixtures (a� $15.00 x $I5.00 = $ — .50 N�ber of fixiures @ $35.00 x $35.00 = $_._ � State Surcharge = $.�?0 Tota1= $ TI-IIS IS AN APPLICATION FOR A PERMIT NOT VALID tJNTIT- PROCE�SID �� e work will be in I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; 'th the ordinances and codes of the City of Fridley and wiw � utM�e�� °a� W�==ryal b�� ordan�w �1 �e conformance wi not a permit but only an application for a permi t a n d w o r k i s n o t t o s t a rt a p p r o v e d p l an in the case of all work whi� requ��review and a'pproval of pl� Q� r��.LATE �f ��``° C) un ,C�' /`5 .,...,n.rr�.ielvtF �.�-� SIGNATURE �F APPLICANC City of Fridley Building Inspec4ions Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 3�7�`� �