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AF - 40650City of Fridley, 1Vlinn. BUILL�ING PERR�liiIT N° 5411 Date: �`'��,� `"' L�' � Owner: !��j�� Builder �_.___. �. Address _. Address �',. �-T �* CATIO. Uii.DBiVG No. � Street .� ✓� +' Part of Lot �� Lot _.... __ Block Adc7ition or Sub-Division ..—_�� Coraer Lot ..._ Inside Lot �"""� Setback ��_ Sideyard � Sewer IIevation �.. .� Foundation Elevation DESCRIPTION OF BUILDING To � v�a � �` r f y Front �� DePth ��Height �j� Sq. F� l�� Cu. Ft�S�� Fro Depth Height t�Sq. Ft. ._.._� Cu. I+'t. 7.'ype of Construction --.�."�...�`. Esi. C� ��.��;�!'.�.�--_'i o be Completed ...� In conslderation oP the isauance to me of a permit to construct the. building described above, I agree to do the proposed work in accordance with the descrlption above set forth and in compliance with all provisions of ordinaaces of the dty of Frldiey. � `In consideration of the payment of a fee of $.�.�� , permit is hereby granted to ' to construct the building or addition as described above. Thia permit is granted upon the express crondition that the person to whom it is granted and his agents, employees and worlmien, in all work done in, around and upon said building, or any part thereof, shall con%rin in all respects to the ordinances of Fridley� Minnesota regarding location, construction, alteration, maintenance, repair and mov3ag of buildinga within the dty limits and this permit may be revoked at any time upon vi� of any of the provisions of said ordinauaes. ��°``+, .� �F'► � Bwlldin� Ina�ctor NOTIC� This permit does eot eevsr �6s eonshudioe, iestalleHon for vriring, plum6feg, eas heating, sev�rer or wetea ee sare to aee the Buildieg leapeetor for aoparate �rmha for fhese items. r�'� 4 i.c', _ � y, +5 --y-r� . f - ��. �F . _ �— K . '�, f �. 'r �PPLICgTION FOR BIIILDING P.E�MI'r CITY OF FRIDLEY, MINNESOTA OWtie1' � 8 1V8ID8 �� / ' � �` � Buil$8T �+ddrese �� '� � � � � a Address � LQCATIOIV OF BIIILDING � j �� /L !�-d`� PO. / � ,__ S'l'.r@A'ti ,�, ..c�ta-Cet P8I''t Of LO -+��% � � �!'C Lot .�� Block � 7 Addition or Subdivision Corner Lot ___,+ aide Lot� Setbaak /�� 3ide-Yard /`S'— 3� ELEVITTON FOUNDATION ELEVATION �pplicant e,ttach to this form Certificate of Sureey of Lot and proposed buildin� location. To be ueed as: n A9 p�� DESCRZPTION OF BIITLDING Sq. Ft. Cu. F�t. Froat� Depth Aeight �. Ft. Cu. Ft. T'ype of Construction ._,_,_, Estimated Ccat ��Cl�� d`� �"" To be Complet� The undersigned hereby makes application for a permit for the work herein speQif3ed, a�reeia� to do a17. work in at�rict a.ccordance with the City ardiaanees and ruting of the Depa,rtment of Builci3.iigs, and hereby declares that all the facte and representation� stated in thi.s epplication ere true and correct. (A Schsdule of Fee Costs can be fouad on the Reverse Side.) ri P � ,. r� / \ � � � y A I• BIIIL�ING PERMIT F�E SCHEDIIIE Sectign a. '1`he Inspector of Buildings shall, before issuing any permit for the �r�et3oa of ariy building or structure, or for an�r addition to any existing bu31d- ing or atructure, or for any alterations or repairs to any exiating building or atructure, upon applicat3on therefor, require the payment by the applicant for suoh permit of fees to the amount herein bel.ow aet forth and in the meriner herein prov3derl ta�wit: 2.1. For ang suah permit for the erection of an�t fire-proof building, other thau a garage, warehouse, factor� or grain elevator, or for the erection of any fire- proof addition, for simi).ar occupanc�r, to any existing building shall be at the r�te of �l.LFO for each one thousand cubic feet, or fraction thereof, in such cubicsl contenta. 2.2. For any such permit for the erect3on of any fireproof garage, warehouse, factory or grain elevator, ar for the erection of ang fireproof addition, for aimilar occupancy, to ang exiating building sh�l.l be at the rate of �1.25 for each one thousa,nd cub3c feet, classified as "fireproof'� by Section 502 of the M3nneapolia Building Code. HOUSE.S 2.3. For an9 auch parmit for the than e garage, warehouae, factory addition, for simia.ar occupancy, each one thousand cubic feet. GAft_.___AGES erection of ar�r non-fireproof building other or gra3n elevator, or any nor�-fireproof to any existing buildfng. Permit $1.� for 2.1�. For an3► such permit for the erection of any nor�fireproof garage, warehouse, factary or grain elevator, or for the erection of ang norr-fireproof addition, for s3milar occupancy, to an� exist3ng building or far �ach auch building or addition. Ninet9 Cents for each one thousand cub3c feet or fraction thereof, in the cubical con�ents thereof with a minimum of �4.00. For the purpose of computing fses for building permits the cubicel contenta of e�y building or addition to a uniform height�tYirou�hout by multiplying the grovnd area covered from a point s3x (6) 3nchea below the f`loor 13ne of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 for each Five Iiundred Dollars (�500.00), or f`raction thereof in the cost of al.l proposed work. � 2.6. In no case shall the fee charged for a.ny permit �,s set forth in Section 2 be less than $4.00. - s r'1 P'�1 _1 � ,_ � t ; t t A 1 j\ �,\ ; � � - ' . ' � ,� l� � -= � EGAN, FI ELD & NOWAK � `� ��" ° � .�, , S U R V E�Y O R S ._ ___ ,�-�r _ �� ,�� E. � `"� `�, - � ' � ° � s �. °-.r,.=_ r _ �-.. . . _ . _ _ .. �°� ' � �� ig m¢� � �t�r� � I� 149 WEST IAKE ETREET '�' �"� � `' MfNNEAVOl15 8, MINN. \ ' � ,ESf�B�4`1�. 18)I � {!'I '�,. � �f P�N � . i v �, _ � ;i � � -�, ' 'I , CERTIFICATE OF SVRYEY � i � For E3. & M. I NC. � � � � - � � ---- 9�$ � -- -> . ''�,%�:� `'� / l � I i . �(, I _ � � I' L�.��_ ' �� I o i � � , -- eV,��t� /ine o� �he ��;c��fa �� f'e'� v f' Lo� /9 � � �; � i � 'R°� — , 30 0• a` ' ��° R� �J �` � ° � , � � +,^;� . � - � ; z � ' = 9 ' � ; �Y � � z ' �+J � �' � ,° ► � tn , o,.�,r 3' -�-� � ? , o; � 9�, o - -- - . ,� ,� �! o`�� j: '� � c � a� � c�" ,'' � Y �' ' ' � � i ! � �. � � '�' , � �_ ' I � � I 1. _ . __ � -'`� — 3?r.�— � --_ � w �•,, �� — a _ I77.1 — — � ; ,v.F� � � � ' , � F �vi/oir�° � � DESCR1PTIaN; THB SOUTH 9O FEET OF LOT IJ�.REV18E0 AUOITOR�B SU801V181FJN Np� TT� ANOKA COUNTr� MIAINEBATA. SG►�e : I " - 50' , � � �-�,•� _ � � � � _ We hereby cert�fy that this is a true end correet• Fepresentation of a survey of the bounderies of the Iand above described and of the locatio�n of�-a-I-I� bui Iding� if any, thereon, and all visible encroachments, if any, from or on said land. Dated thi s Z�eT day of OcTOaER � 19�, EGAN, F I ELD b NOWAK i - F - � Survevors � �-- - - a -� , ��- � bY : �,: -= '-. � F i 4 e �No 23G6 Book No; 1534 - 21 - � E� � a � H I 0 � :°. �� N � 0 � � � a p to � O � x � � M � � � � r o � � � � x z x � rn � 4� O � m � x �� a�o� � � `-�� o � �� m � � � � N � y w a�. � � � W � �wk� � � �i � � C+1 o � � �� a � . o � °o � : a� : : � : : x „ ,e sa o N � °c o Q � <n r» �n � 0 o � r bo � eb i � � �t � 0 o m � � � n ... � � � ��{ V 4 m 4 0 � �n \ � � b � � w � � � � � � oe N � � � 0 0 0 0 0 0 � � � 0 0 sn �` �° s O r 00 W z °c � `�° � w oa �"' �� m �� o � y O � � � . � � W • �: �. � � � � � P M, � y � 0 0 � � � � o � z � � � 9 � � � °x M 0 � �: �� -� �� i �i � a � � � � � n M aa `D fD x w N � .'s�' „�,� 0 0° � � � �e � R° R° �b �� 0 0 0 0 � � o � � �- � y ; � a� . . � � � � o � : : � � : : � : N � � � 0 0 0 °o � �' � �� 0 � � � � m cp a � � � � c� � I� o �e m � 0 � O � 0 � � g �- �7 � ro � � � �. �. � ,,, � � � �� '�� ''' o p� � � � � �� °. � p' : m a' � � • y O a � : G � �n � ' . CJ p $ O O � o . . . m o s ' : � � � � N � o °o o °o °o � �n � R� p, � tmA � h�y � � � , � m � � b � b � � �. �; �� R° R° � � y x � `. � � �"'�, � o � � �� , b � o a � � � �,�. . � . . e�ii ,°o : : O � . . OQ . . G . . . � � � � � en o 0 0 0 0 0 0 � � O E" C C 'a � aa� � �� H �m oa � � �� •� � d°° �� .b o ��o � � pp�`4 �� 0 �.y �O'1 �i' � �5'€� R1�M� w� , a��'i � p. � p �m ao H y �� @ �.�� a�r� ��NM �� Qe ►7 H � ��i fp �. � r�n �. O � D � D r � � m H _ m C m b ro M bo � M � a � � V O � � • � � �� 3 � ; � � � ,a _ 3' i0 `��. � � �� A � e� i � ~ �� 70 � . O�. � �.�� / � � ' NAME � jHTG . CON7R . [ADDRES � FL. � _ROOM LENGTH � WIDTH WIN OWS DOORS-CRACKAGE ANO AREA N0. WIDTM HEIGHT No. OF LINEAL FT AREA LIQITS OF CRACK SQ. FT, � �a �o /�1%I�T—�_ T �, HEIGHT BTU OATE NAME d� "9' � � `� B ADDRESS � � FL. �J � ROOM LENGTH �� WIDTH �� HEI WIfdD WS AND DOORS-CRACKAGE SND AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK SQ. FT COEF.I BTU INFILTRATION O O Q� INFILTRATION � Q� GLASS � �� GLASS Q D E)IP. WALL EXP. WALL NET EXP. WALL - � NET EXP. WALL �o �O � CEILING CEILIN(i � FLOOR FLOOR TOTAL BTU. � o' TOTAL BTU. � � � FL � ROOM LENGTH � WIDTH �,3 HEIGHT � � FL. ROOM LEN�TH �/ WIDTH � HEIGHT� WIN OWS A DOORS•CRACKAGE AI�D AREA WIN OWS AND DOORS•CRACKAGE AND AREA N0, wIDTN HEIGHT N0. OF LINEAL FT. AREA N0. OF LINEAL FT. AREA LIGHTS OF CRACK SQ. FT. N0. WIDTH HEIGHT LIGHTS OF CRACK S0. FT. � / / /6 � � _i„ .,.� . ._ i .... COEF. BTU. COEF. BTU. INFILTRATION 9 � /) �� /f � INFILTRATION Q � GLASS � EXP. WALL � NET EXP. WALL �Q a � CEILING � �D rJ CO FLOOR TOTAL BTU. ' SID � FL. _ ROOM LENGTH ��, WI_DTH .�� HE_I_GHT_ __ WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK SO.FT. _ � _ �� /� �. � _�O GlAS3 EXP. WALL NEt EXP. WALL CEILING FLOOR TOTAL BTU. � � : FL. �� _ ROOM __LENGTH W I_DTH _- HE I(�i WtND WS ANb DOORS-CRACKAGE ND AREA N0. INIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK S0. FT. COEF. BTU. COEF. BTU. INfILTRATION / a . INFIITRATION � � � GlASS � � GLASS d �b �iJ� €XP. wALL EXV. WALI � NET EXP. WALL �O � O NET ExP. WALL � ID ��,�Q CEILING o CEILING Q G' FLOOR FLOOR TOTAL BTU. � p TOTAL BTU. �o � Q TOTAL BTU. HEAT LOSS � D OTAL E.D.R. STEAM TOTAL SQ. FT. H.W. ')"�Z d HEAT I P!G UN I T e ^ � � NAME �� HTG . CONT�R . pDDRESS � FL. RO LENGTH �Q WIDTH /� HEI WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTN HEIGHT No. OF LINEAL FT AREA LIGHTS OF CRApC SQ. FT l :�3a? � o �. i 7 i� INfILTRATION GLASS EXP. WAIL NET EXP. WALL CEILING COEF.I BTU �� FLOOR TOTAL BTU. FL. _ OM LEN�TH WIDTH o HEIGHT WIN OWS AND D00 •CRAC�tAGE AND AREA IYO. MIDTH MEIGHT N0. 9F LINEAL FT. AREA LIGH7S OF CRACK S0. FT. DATE NAME �y � . � 9-� / � � B ADDRESS�� .�� FL. OOM LENGT � WIDTH � HEIGHTd% WIMD S ANO ORS-CRACKAGE ND AREA N0. BIIDTH NEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK S0. FT COEF.I BTU INFILTRATION GLASS � EXP. NALL � NET EXP. WALI � CEILIN6 FLOOR 6� �30 TOTAL BTU. D FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA N0. W�OTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK SO. FT. 8 � /� COEF. BTU. COEF. BTU. INFIl7RAtI0N v o INFILTRATION GLASS � � GLASS EXP. WALL EXP. WALL IYET EXP. NALL ��O � v NET EXP. WALL CEILING • CEILING FLOOR � FLOOR TOTAL BTU. `� �� TOTAL BTU. FL. ROOM LENGTH � WIDTH HEIGHT � FL. ROOM LENGTH WIDTH HEIGHT � WINDOWS AND DOORS•CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND'AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK S0. FT. LIqiTS OF CRACK SO.FT. INFILTRATION GlASS EXP. wALL NET EXP. NALL CEILING FLOOR TOTAL 9TU. TOTAL BTU. HEAT LOSS HEAT 1 fVG UN I T COEF BTU. I O . INFILTRATION o GLASS EXp. iALL Q NET EXP. YALL CEILING �j� / v FLOOR p TOTAL BTU. TOTAL E.D.R. STEAM TOTAL SQ. FT. H.W. BTU. � ��:� ��r City of Fridley, Minn. N° �`� 2� BUILDING PERMIT � August 30, 1967 Date: � �\ p�r; Nor,man Long g��. Miles Const . Address 7315 East River Road Ad� 4500 No�th Lyndale LOCATION OF BUILDING No. 7315 g�t East River Road part of I�ot � S. 90'L .19glock Addition or Sub-Div9sion .._.._Aud , Subd .�77 Coraer Lot _ Inaide Lot S.etback — Sideyard Sewer IIevation _..— Foundal3on IIevation DESCRIPTION OF BUILDING To be Used as: Garage �nt 24' �p� 24' g�g�t 10' gq, r-t,576 �, � 5760 Front Depth I�eight Sq. Ft Cu. F't, Type of Conatruction Frame �� $1900.00 To be Completed In consideration oP the isauance to me of a permit to construct the bwllding described above I agree to do the proposed work ffi accordance with the description above set forth and comp ance with afl provis4ons oP ordtnancxa of the dty of Fridley. „,�/ I�� `�� Q ��t ° �� In cwnsideration of the payment of a fee of $-2 �.�_., permit fs hereby gra�ited to 1Kiles Constiuction to cronatruct the building or addition as described almve. Thiapermf t is granted upon the express �ndition that thepe�on to whom it is graated and his agents, employees anc� worl�nen, 9a all work dane in, around and upon seid building, or any part thereo� sl�all conform Yn all respecte to the ordinanc�s oE Frldley, Minnesota regardi�g location, conatrucl3on, altera.tion, meiatenance, repair and moving of builtlin$e within the dty limita and this permit may be revoited at any t�ime upam violat[oa of aay of the provl�lona og seid ordinancea �i _ _x_.; _ � h . � �... _ �_ : � . � • � ; . - � � Nonce� ihb psrmit dea aof eewr 1hs eans�dion, t�falladoa h� wiAnO, plumblee, ea huNeg, s�w�r er w�hr. B� wn 10 sN t6a Buildtu8 lespseto� to� »� �nrmhs for t6as h�. A�� : :i:C:�'�'�.fi:a ^�3 T3?J�'i,D �iIG r ; �� l.T Ci.'� �D� I�,t.t:i��:��; Ti�1�;1; SC?'A OWN�' R� S NAI�1F. ��jNI. 1�-4� �-C� Ii G. RTJs_� •�iR �/ (� C� �Z S%li ADDRESS � 3 r�s �� ! � V�Z Zc:� AD�i'.ESS ys O� /J. � Y�✓L�y� � � LOCA9:T.ON Or BUII,B��iG � rI0 /3 r� � ST1wE� �_ Z-t i/� jZ- � p � NoTc.-� � S`Dr . _ E1RT 0 LOT °� ov � ��r�l �ju' LOT o� �-o� ��i BLOCK ADJIT'tON OR SU13Di:VISiON j'� v tQ �-E o�-S �? 7Z ;3 ° -�' �o Y•�, €d�� e - . ' �� CORNER LOT INSiDE LOT.�SE1'BACY. a�- �-� v� s� SIDE�YAF.D � SE4,TER ELEVA'�IO;I FOUI�A'LIOW ET,EVATION y�� S I�� Applicant aCtach to this form Two Cextificates of Survey of Lot and praposed building location dra�ti*n on these Certificates. DESCRIPT�C;Z OF BUILDING - To Be Usgd As :;:_ _ . . . � � r i �� ,, ,� �° � , _ _ . - _ - .. C� � �� i-- � Front � `f Depth 2 � HeighC ` � � "m � � Sq. Ft . �"_ %� Cu. Ft . `� � r`�, ��.� � Front Depth Height _. • Sq. Ft. Cu. Ft. ,�� °° Type of Construction ��"��-�- Estiu�ated Cost �� Q' � � To Be Completed ��-� / oB�- `l3.E-�Q�� Tha uadersigned hereby makes a�►plication for a permit for the work herzin specified, agreeing to do all work in strict accordance cvith the City of Frid?ey Ordir.ances and rulin�s of the Degartmsnt of Eui�di��s, an3 hereby declares that alI the tacts and representations at2ted in this app�ication aYe t e and correct. _ �>�es�:+� l��-v -" , . DATE �S .� 2- � � — � � SIGNAT`URE (Schedul.e of Fee Costs can be found on the Reverse Sid2). • :�'.�;�', (�� ✓�..,_._`a�A i � V .. . • � ^ �"� / 1 BUII�DING PEF.t•I1T FEE SCHEDULE SECTIOi1 2, The Inspector of Buildings shall, before issuin� permits for the erection of any bui_lding of structure, or for any addition to any existing buildi.ng;or structure, or for any alteration or repairs to any existing buildin� or structure, upon appl.i_calion therefore, require the pay�nent by the applicant � for such permit of fees to the amount h�rein below set forth and in the manner . herein provided to-wit; � 0 Ur.iform Buildin� Code: Type 1;2, & 4- $1.75 for each one thousand cubic f2et, or fractiot� thereof, in such cubical contents. Typ� 3� 5-$1.50 for each one thousand cubic feete 0 For the purpose uf computino fees �for buildino permits, the cubical cont�nts of any building or addition to a unifarm hei�ht throughout by multipluing the ground area covered from a poicit six (6) inches beloc�� the floor line of the basecient or celZar to the average height of the upper surface or to �the averaae height of the roof surface of the main gabl.� of a�pitched roof. . For repairs or alterations to ar. existing structure, the fee snall be at the rate of $3.00 per Each Five Hundred Dollars ($500.00) o� fraction thereof in the cost of all proposed worke - In no case sha11 the fee charged for any�permit as set forth in Section 2 be less than $5.00. � , �TSSSD Connection Charges based on 1.ocation- Area 1 or 2. -< - � (,� �..� ��-'` . � 1 �— �� , �` �:, f e � V � - / � l� � � � ^ ..f.� .r� • � ' _ 1 � '-�- s� � H ;x H � � � 'o z � 0 C'� � � � ea � x � 0 � • � b � ►. � � � r �f � � � � h � 'i1 Q � A� I�C fp�1 � � � � r► ?7 f► W � M Gl N O r1 ? �0 � f� ►n z o` o s"' � w� �-�' ��.°� o a m� ro �e � r o ��-. b' M►Fi n � �aa� �°o M � m�� o ° � � �t m � K ] r�i � 1 0 � � ' "x'� °o � �O � cMis W r�+ � a Ri � ef o N °o � a a �� e o� ►- �o m � a n• o o � M N � � �p�.., � � � W ►� ."O A � h O � � N �-�-• (► 'J O IO � � � � � • � . .� . , m . cn c-� x rn z c o r- • rn N N N lJ� o°o fq �p N tN O o N V U 0 t'q� S• � O � ec x x x x ae x x x x x x !�' tA N tA N 1A Y N i/1 N N fN O !r W ' M t1� V O UI V1 Nf N W 0 0 0 ' o 0 0 00 0 0 0 0 •� 0 0 0 0 0 0 00 0 0 0 0 � ` _� ifl N N fq T/1 f/► fA N fA Vl N N a -H r ►9 _ C'�p C' ?J ` H t�� m � ro � �o � �� H � 6� � ,� 0 � � ro • � �- � � n � ►' Stoclea : � -''. a n. �`> r � ° z � Closeta � Urinals h m � � Sath 11ibs h � � � H34�tIS O a ] �Sinks � � '� � Wash Traps y Y. ,y Drinkinq '° � ' Fountains $t10WPSS � Floor Dr. � catch � Basins o Aut�atic p' Washer E � Gas Appl. , Misc. Fixt S a� Gas Ranqe K E �° K Other m � w a rr r t�o M A � � H � G C � � � � � �° � o � � H � y (� H y d � b o c � y U S � � w � y � r �a g z �"'� o � � •° o `i w , �p I'I O O (�D � ' �' � � � � � � i / � Z ` �z 'v n y �" � o c� .o \1 �"/� � e� f�'• ' �� ' 1 � �°'n � :_'�bp� b°' MM F�� M ,b n ►�-rM-c cnt°n3� p` mw a.�'�a �� a t�n �o a O m n m m � ° � `q ��w°� � m o n m � co �o o n � m H O 'C � I-� �l � � N x m �t t� �iy . .� moo�' p' r a M' 7C •b . fn � � 1a+ � G F� F+ � p�� Q �� /� O. 01 01 ' Q � � y M R rt W M- O ~i 1�0 � R M `� 0 �p b � O P � vN-� a o � f° � -� o � � � ' OD ' O n A O . � r pr ►t � � � � : . n � rn- � � � �� X • I a ��M � "� . w � r� c� n m� m ae x n m a o m� � w m m° �°. n 9 m rp► ra. o°m a,�r s m � �p � C� '��C D ta► hl M 1��+ p Ct r�n w m � M Oi � • �O 1p �1 F► A O M o i7 hl f► p C M• M O af A• m �p r 1+� C � m� m r�. m° a r° °m m° °� m a � ��, M� m iO M. o a °~ s°m �v~i /a► SO M 'C W K � . N �'� R7 ti 8 G b W p � m � Q � e� G Q � M h �y s �.O m b � a w y ' r► o m a tn � y � � � r a hl W H tQ ql N f/1 fA fN N N A N M N t� m r r N7 O O Y1 �t UI IJ� lJ� N1 Y1 A F+ W 1,11 • . . . . . . . . . O o O O O O O O O p NI y� p O O O O O O O O O O O O p �o e- � r. z G� 's7 .. c �e° y m � � m � O r 1�1 � y i17 �� N N N f/l N N W M N fl/ �D N N � y� `�' .°j p+� Ca` � � � '`9 '17 � N N � � 3 N � o �1 y� :D� C+7 ►C ��n m ri �� b t+l � Fi ° m N r 0 0 0 �0 y� t+ � � H � V �, . M C'� � �� _\ � � � � � � w � � �. � �� '�_ I � �7 � � � i G1 � � � �0 � , � � � I � � C � y �v v� � � i° h �' �' Storiea r», �0 5r a a K � e ' � � Closets ,� � orinais �' g � sath �s m � �'=� r Basins d o `�� < Sinka �"`1 Wash Trays � j, Dsinkinq �a �' FOUnt81nS Showera �, r ' _ Fioor nra� _�.� Catch � � � Hasina � Auta�atic E - � Washer � cas a�i. Misc. Fixt m � Gas Panqe �Rp M N Othe! �� ' � M � H � i � � M � � � � \r S 7 � ►3 f] O f0 I+� 1p mO�o� ~�ew M k F+� � Mrf f�! f• ►�•. G t�i+ M H � � p, � r K1 7 W W M W W� a�°n"� o�'"' � � � � h m �o � � � fp � M � �� g�' � � °�"� m �n ~ m � �r �°e � a FO`, n p� � � � Gr� µ � 7 h K � M � � m � � \ Oi � � M 1 ��a �� rg�� o � r7h �� w5 � aK�� I 8�w� 8 ° K �' ��r e� ,� a � r a "'� O Z � O 70 � E �' 3 - � �� O a T Z d T � � � a ty N r R1 T � �.. � Gf � m• � t r � f a` s : r � a . sue�ecT PERMIT N . City of Fridley � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� r � � COMMUNITY DEVELOPMENT DIV. RECEIP ' j V _"'�', r � � PROTECTIVE INSPECTION SEC. � /r�/� � � �� T � � �'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED Br �----� • •�' 612-571-3450 910-F15 7/9/96 � � JOB ADDRESS 7315 East River Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 19 Revised Auditor's Sub. 4�'77 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pat Doherty 7315 East River Rd NE 571-5815 3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO D& D Home Improvement Inc 7401 Central Ave NE, Fridley MN 55432 784-7543 4840 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE UCENSE NO- 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C7 ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOHK Reroof House & Garage (22 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Buiidin.g Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIFiED FOR ELECTRICAL. PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. 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 CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SUFTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `P 1 s H LS �. 91 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISI OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUC ON THE PERFORMANCE OF ONSTRUCTION. �59. SO Fire SC � I.. SZ � PLAN CHECK FEE TOTAL FEE License SC $5.00 $67.23 S�GNATU�7E O CON7RAC10A OA A.UTHORIZED AGENT ID TEI WHEN PAOPER VAL�TED THIS IS YO� � RMIT SiGNATUAE OF OWNEA iIF OWNEA BU�LDEAi IOATEI Bl G�NSP �O �_/ rrEw ADDN ALTER C] [l [] ConstructionAddress: Legal Description: Owner Name & Address: Effective 3/1/96 CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 Building Permit Application _ Tel. # ��,,,�° �� Contractor: _ D& D Home Improvement , I nc MN LICENSE � Q R 4 n Address: 7401 Central Ave NE Fridley, MN 55432 Tel. # 784=7543 Attach to tlus application, a Certificate of Survey of the lot, with the proposed constiv�tion drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot [ Ft. Yd Setback Side Yard Setbacks Type of Construction: �� — �C/,�� '� � Estimated Cost: $ /�f � Approx. Completion Date: � 4 � . �/�11°�'� �� „� ,� ��'� .(Cost on Back) Driveway Cur t Width Needed: Ft. + t= Ft x$ _$ DATE: APPLICANT: Tel. !� �� "�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ �� S L� $ /- c�� $ �� $ $ � C�C� $ $ $ CITY USE ONLY Fee Schedule on Reverse Side .�1 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plaa Review Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ (a . � d e � SuBJECT City of Fridley � � �� 7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r S � RECEIPT NO. � ' COMMUNITY DEVELOPMENT DIV r `�------ . �o �� PROTECTIVE INSPECTION SEC i � i � � � �'�'1 � CITY HALL FRIDLE� 55432 NUMBEN REV DATE PAGE OF APPROVED BY �"""� � �'J 612-571-3450 910-F15 5/2/97 / / JOB ADDRESS 7315 East River Rd NE t IEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCF. Pt 19 Revised Auditor1 s Subv �%77 SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Pat Doherty 7315 East River Road NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Standard Water Control 5337 Lakeland Ave N Cr stal MN 55429 537-4849 1522 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Install drain tile 9 CHANGE OF USE FROM TO STIPULATIONS TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD 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 AUTHOfi12ED IS NOT COMMENCED WITHIN 60 DAYS, Oii 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 THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED � 1�'�OO �. SS WITH WHETHER SPECIFIED HEREIN OR NOT. 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 cow- �54. OO Fire SC � 1.�IO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. \,� PLAN CHECK FEE TOTAL FEE �X License SC $5.00 $61.55 � SIGNA7UREOF ON'RACTOAORAUTHOPIZEDAGENT �DATEi NEN PqOPERLY V DATED THIS IS YOUR PERMIT � � � S�GNnTURE OF OWNEa ��v OWNEA BURDER� �DATEi " B�DG NSV qaiE NEW ADDN ALTER (1 (l/ l i� CITY OF �RiDC.EY S[N�►1.E F�IL�' AND DUPi.E3�ES R-1 AND d�-2 Building Permit Application ConstrucdonAddress: Fji �� Lega1 Description: Eftective 1/1/95 Owner iVame & Addres�: J Z {�i i� � T le .# �5� Contractor: �� (� ��,��',�� I�D MN LICENSE #� �� Address: �i� `� � � % � VP I �� 1 � �ii'UP, � � �Yt�� w"�o��.� Tel. # �c�°.� 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. Length Length Leagth DESCRIPTION OF IMPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft Comer Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Ty� of Construction: ►� ,� f' Estimated Cost: $ i"�%�� •� �� Approx. Completion Daxe: � (Cost on Back) Driveway Curb Cut Width Ne�ded: Ft. + 6 t= Ft x$ _$ DATE: �-� � 9 � APPLICANT: � Tel. � Pennit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park F� Sewer Main Charge TOTAL $ �� $ l, �l� $ . aS $ $ �. DU $ $ $ $ .— � i. SS CITY USE ONLY Fee Schedule on Reverse Side .001 of Pertriit Valuation (1/lOth%) $.so�$1,(�o valuation $850 per SAC Unit $5.� (State Licensed Residentiai Contractors) Alt. "A" or Alt "B" Abave $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not N�essary [ ] STIPULATIONS: ' � .D �� -- � ,� , �� , 2 `�% .� — �' 1tU11_I�ING ri:Kn��-�- ��r�, sc�ir_i>�Ir_r_ '�'h�: (;I�i�f tiuilclin}; Utticial st�all, tx;forc iss��ing permits for tt�e crcction of any huilding or titniciurc, „r tur any a�iciitic�n tu any cxititir�g buiWir�}; or sttucturc, or for any altcr�tion or rcpair to any cxistin}; t>uililing ur s�ructure, u�r� anplication iherefore, rec�uire tfie payment by tF�e applican[ for sucti Permit c>1 l�c:t tc� thc; amt>unt hcrcin I�clow sct ti�rih and in thc ��ianner l�crcin provi�lc:ci to-�vil_ "l'O"CAL VALU�� 1 to $500 $501 to $Z,000 $2,001 t4 �25,000 $25;001 to �50,000 $50,001 to �100,000 $100,001 to $500,000 $500,001 to $1,000,000 $ i , OD0,001 and up rri:.s $l5 (Minimum Fce is $15 plus sUrcharge) $15 for fust $500 p[us $2 for each additional $i00 or fraction thereof, to and including $2,000 - $45 for fi�st $2,000 plus $9 for �each additionat $1;000 or fraction thereof, to and including $25,000 ' - $252 for first $25,000 plus $6_SO for each additional $1;000 or fraction th�oof, to_ aud iriclading $50,000 -- $41450 for first �50,000 plus $4_SO for each additional $1,000 or fraction the,roof, to and including $lIX},000 $63950 for �rst -$100,� plus- $3S0 for each additional� � $1,000 or frac�ion dte�eof, to and including -$500,000 � $2039.50 for the 5rst $5�,000 plus �3 for each additiion,al $1,000 or fradion thereof, to and inciudiug $1,OOO,QQO �3539_SO for the fust $1,000,000 plus $2 for each additional �1,000 or fraction t�ereof - DRIVEWAY DEPRESS[ON ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and re�lacement of cutfi and gutt� only - Driveway width plus 6 feet times �13_50. Alternate °I3": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Dciveway width plus 6 feet times $15_75. VLRlF[CA"CION OF FOUNDAT[OIY Permits for cor�st�uction will be issued a minimum of 24 hours from the time of application to allow for pro�cr rcvicw of tt�e proposui stn�cturc and of the co�struction site_ - A Lctitic;:ite of Survey of t��e lo[, showing the iocation of ttte founciation once it has it has t�ecn constructe�i will bc �equirul f�ef<�re proceeding with the framing_ �.. CITY OF FRIDLEY PERMIT NO.: 2004-02202 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/30/2004 � ' (763) 572-3604 FAX: (763) 571-1287 �DDRESS : 7315 E RIVER RD NE � � � � � PIN : 103024140004 LEGAL DESC : UNAVAILABLE : LOT BLOCK , PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIREPLACE VALUATION : $ 0.00 NOTE: INSTALLING A NEW FIRE PLACE # A/C UNITS 0 # FURNACES 1 APPLICANT FURNACE SHELL/DUCT WORK 35.00 NYAMBU LINUS M& MAGHANGA D W GAS PIPING FEE 10.00 7315 E RIVER RD NE FIRE SURCHARGE 0.00 FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 0.50 AIR CONDITIONING FEE 0.00 TOTAL 45.50 PAID WITH CHECK # 2289 OWNER NYAMBU LINUS M& MAGHANGA D W 7315 E RIVER RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This pemut becomes null and void if work or construction 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 l�ow the same to be true and correct. All provisions of laws and ordinances governing this type of work 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 loc law regul ' ig cons ction or the performance of cons cti . Ap licant Date Bldg Ins Da �`'( �- SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 O N � � 0�4 � O v m � � � m � O � O n � N m Z � v \J � O Z '� m m � � 0 0 \ s O � :i7 -� 0 D r � m m � °'"'�,' N � c � � m ma m � � j N 3 U' c ° � o � � � c N N � D o� o � b � 3 0 � � o �i � �C � � c o � � ai oWi �� c � 0 � � � � � � 0 , � v 0 � 0 c � � v � m _n � d v m � � � m � � _ Z Cii � � � � � � : � a � � i c =+i ' � 7 n. i � N d ; �°+mq i � �• � . � � I 'W�.� ' c o � a o � �_�: �� .o—; � <: o � � N � , •o .i > > ;i y 7 � � �a , �: � � � -.�� a o i �G � � a � �� : 1 f . co �. ; N 3 . � � � n* � , p� n i . ? � i � O • .,, a . � c� i N N i i ? o D � • o � ; � < m � � 1 "� m m � m o � tt'Du, F� � Ul -�p O � o � � o � � ' � o .°_Y, O , N � N aa �� rt °—' o o � .� � .° � o -- � :N 0 . -� * D O � a � 0 � OR D N N G� Ol � v m � . �, � ,cNi� o °o °o � � � �W � N � o� a N Z N fD _ 'O N � � o �W;� m � a � m = Z � N rt mo'a C 7 N � � I,y m � _ � � ,� 7 c� 7 � � N ,� rt � N � a � 0 d = a o m � � � o'..�i o ' ` � 3 D _: � N N � m � m � 07 � • � � � ma Z N � C � N m �'I N v � � y - . � � c�' �i � N � VI 0 � � a � � cD � V• � 3 � � N � � � �. c ° 1 C 7 � m� � O � W � � m R� D m � n 2 m v � r 0 o c�"�i� T 0 0 o I� 0 0 0 � � � , � �' I� �� W � a D � Oq v N O a � � � � m -, � � � \ -o � m � � � z O ^ � '� A n a G1 � � � � w Z �' O � � N. -n � � � � ? N < � � � � Z m � � � W C � � r �' v_ N � � Z � '0 m --�-I 0 Z � � m � �'I 'G � .r � D m ,,.� ,-ni °z z° o n � z � v o a� � m � � °D O � o Z � m � -I � � � � Z Z (.� z v � � 2 �� -� rn Z � � � � � � � Z 0 � � � � � � rn m � Z � � �m � O ` �6 Z .� . .� N O O � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION -� When replacina an existins� furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the cuRent codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installinu a new ventina svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's spec�cations. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed coRectly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes ( ) No ( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat ' Total Appliances Tdal Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) ,�HEATING CO: Si�n?d By: Date : PLUMBiNG RESIIDEhITUAL APPLICATIOId Ciiy of Fridley , r�� _ i i �+ _ a��J, • .��,—. �-:�,: _ r WOTE: IF PROPERTY 13 NOT OWNER/OCCUPIED- A LICENSED CONTRI�CTOR �AUST OBTAt�I THE PER�91T. DATE '/� c9 I� b � YOUR E-NWI. ADDRESS __-- SIT� ADDRES3 ""`I.� � S �� F/� n J THE APPi.ICAN't �s: (pRCLE �I� - OWNER <. DAfTRACTOR -- �_ t�E �A,,.1 � .— � a � ..J PROPERI'1f OWWERt p�RESS � � �:$_ F � � �iI> iL ,j � C� �'�� F�� " ; � ' PER1i1T 7YpE �to�� _ � � a -: 3 �, , _ � s � Y � Te�ry Oveiacker Pibg Inc � 1628 County H�►y 10 �.y Spring Lake Park, MN 55432 � (763) 572-8880 TYPE OF iA10RK � O NEIN C�TA� QESGRIPT{ON OF WQRK _ . s� �/" Zpa __ 5 S'+f 3 2� UCEAtiSE # `-� t N �F Pry� STATE Zp� FAX� % lo � - 57 2 - �� FAkAfl.Y �'iV�Tp FAdIB.Y �K REPU4CEMEiYT ' � � '�1�l�, � � F'EES ARE B�LSED ON S'�0.� PLR FQ(TURE, EXCEPT VYHfRE NOT�D FOCIURES: (�IIiCATE TOTAL NttdABER OF EACFQ ea�rti sw�rn.�v ��t nw�s SHOWER WATER PIP�1Q l� � __�A7HTtlB �AS PlPBdG (Meed C�►'L&�I SWIf�AII�G ROOL WATER 8CFTE�tER ($3S) CLOTf1ES WAS�lER la'I'CHEN SINFC WATER CLOSE7 6ACi�[.Ol� PREV. C�'1'vh DI.RiflatA� LAUNDRY'fRAY �WATEFt HTR (� FOR �ii1GAT10N VYATERlAETER OTHER Parmit �� $ 3�, d d MiNiMUM: $15.OQ ar 5% of �rost of the improvem�r�t whichever is Plan Revi�w Surchar�e TOTAL DUE � -- $ .S+D $ � � �� greater on work less tiian $�0 Make ch� ps�yeble to: CH,y of Fridtey ...w w ev� r+rruvs�� v�a rvaa I� TGRIp� i� �1►V ��RLdY YN � tl. 1'lC:�A��.�it� ��Y �Y � a P�b�9 �� 9e firat U�e 6� � ts � a� �urateC tl�at tl�e v� � t� !n � a� the or�nances and �s of 8te C�y af F�idley ar�d v�t)t the h� �ort Cod�: U�t 1 tmds�nd tl�)s � r�t a p�rrdi but o�dy an ap�icatian f� a�rmit � r�k Is rrot to sl�rt wlthout a penni� �t ihe t�ortc atID 6e in acmndantoe xrith ��ppraArer! �an &� N� c� of af! �Aarlc whid� r� review and approvat af pl�s. AWI� OF,4PFUC�wT �A C. l� � E K�.�7 .J � J%� e/ a fo DATE Pt� type ar print StGRfAI'URE OF APPUCAM 8434 UNIVESRY AVENUE NE. FRIDLEY,119�f Su432 �� . w Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received B� 763-572-3604 CITY OF FRIDLEY Date xec'c1: v� c7'7 DATE_ �- 5-�% YOUR E-MAIL ADDRESS _T� e 5�f'v 4-7�c.�� CJ C7�t7 `• L 0� SIT'E ADDRESS ' 1� i'� C� Z"� i=\Z ZJ,A� TI-IIS APPLICANT IS: ❑ OWNER �ANTRACTOR PROPERTY NAME: \ cA,r, �3 ac� r p5, OWNER/ ADDRESS: �� 1'� �• �`�1 �:: Zc� C�� \ CITY � r�� e��-c.�---� STATB''�va ZII' S� Z TENANT pHONE: lo i 2� a� ��_� � CONTRACTOR NAME; � A2� v�l.� C3 �t5o �- rt C - SUBMIT A COPY OF STATE LICENSE # � aej P� EXP DATE 1�-� 1- ZC� � YOUR STATE ADDRESS: 3��Je� t%-?��" S�- _CITY�L-5 STAT�`�w ZIP 5 S�t n� LICENSE WITH PHONE ,�� .'� SS�'Z o_e� Z _ FAX �o �2 %'at� `{ \`-t Z_ APPLICATION PERMIT TYPE ��GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: �EW 0 �p�CEMENT DETAILED DESCRIPTION OF WORK �g,-,�.�r �,1r�v.t -Gr�� C- �— � � 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 O v�`�x .OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVi� 1 BATH SINKILAV FLOOR DRAINS � SHOWER � WATER PIPMG BATHTUB GAS PIPING R�ocrrr�c�xs�) SWIMMING POOL _ WATER SOFTNER ($35) CLOTI-IES WASHER KITCHEN SINK i WATER CLOSET _BACKFLOW PREV. ($IS) DISHWASHER � LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATIOAI — WATER METER _ OTHER ,.. � �� - �, : , „� `h `��'-�`� �� , �� ? �� .,i c .. �� . �� , ��a�� n` = „ .. i��. 1_'' ., c,�.P. ��, �� - � M� Permit Fee $ Number of fixtures @$10.00 � x$10.00 =$ Surchar e .50 Number of fixtures @$I5.00 x$15.00 =$ TOTAL DiJE $ 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 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 work which requges review and approval of plans. SIGNATURE OF APPLICANT � � PRINT NAME �,c�s�a�n.� --� , � �✓ �� DATE � �'S �� r, N .: ... _ a. ,.'�_ �- �,. , . , ��:..... �. . _�.. „ a. ,1� w . �... � � � - `�`�� ' � ' � � `°°��u: City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977