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AF - 45602City of Fridley, Minn.. BUILDING PERMIT N� 5350 Date: ___.T __`�J...; Y' �''"�._`..� I____.____ �� / � Owner: �.p��"}2.----5.��...�-e.��-�--f�_�ss�_ Builder €��� .._ .. . � -tt��e%.�....�y..�IG�i,�..jy[... Address __.._._......_.._.__.._...___._....._. � . ......-.........__........_....__..... Address _..._....---�.__._._......_...._..__._. . _. ��� � CATaON O UILDING No. ... _ . Street 1_..... P of Lot ....,_........._. _. _ � .....—.._..---....._..._. ^ Lot -.-.....�.�.!__._ Block __._..._._. .. Addition or Sub-Division .� �� ---.._. ._. _.../t�-s2.t._-- Corner Lot ....._._..._._.._ Inside Lot _..___%sE�._.__ Setback _.�y�2 M-.--. Side ard . / �'R � . y ......I-�_.._..._...----�---___ Sewer Elevahon To Used � _.�f ��(,� Foundation Elevation DESCRIPTION OF BUILDING Front _;f"'�.�._.... Depth ��.^'.�{x..._,_ Height >!!.CTs_F.._. Sq. Ft r�°s��.�.�..�Cu. Ftf� .f�.:.�"L,! -�-. ... .`�� P � Height ..._ Sq F't. . _ _ _.. Cu. FG . . _...� Front ......._.. De th ._ � Type of Constauction �'� .. ,� � +%t �e�x�� �i �� w�r�"'r-i-�^�7RS.� -�-.. Est. Cd'st �,,,�;f;,��".�' � t�E Completed ._..._...._ ............. In conaideration of the iasuance to me of a. pernilt 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 provisions of ordinances of the city of FYidley. � . � In caa�sideration of the payment of a fee oP� permit is hereb �+��-J�- —..__, y grantea to_..____�_ to constnyct the buildi or addition as described above. This permit is granted upon the exPrnss ca�ndition that the person to whom it i�s �anted and his agents, employees and workmen, in ai] work done in, around and upon said building, or any Part thereof, shall cqnform in all respects to the ordinancea of ��IeY� Mwnesota re8�`ding location, construction, �lteration, maintenence, repair and movuig of buildinga �� a�l' 1�its 8°d this Pei'mit may be revoked at aqv time upon vioiytion of any of the provisions of said Buildin8 Inspector NOTICE: T6is parmif dwr not wver fl�� wnchuction. i�rapNion for wiring, PIum61nB. 9y 6eaffng� zeM.or or wahr. Bs wn fo w 1M building ImpsROr for sepueM permk� for 1Lesa ifemt, 4 .�_�. � � `... APPLICATION FO�t BIIILDING PSR1+II.�' CITY �' FRIDIEY, MINNESQTA Owner' a Na� GU/A�L /�� Huilder Address %D iN OF .-- v No. / y Street �� Xit.�–� ��1�Part of Lot Lot� �— Block 6ddition or Subdivision ��A�.%!'f5� � � - Corner Lot Inaide I,ot �� Setback_�_Side–Yard ��� SE��i. ELEVATION FOU1�D&SION ELEYATION ipplicant attach to thia form Certificate of Survey of Lot and proposed building location. To� uaed �aj� � DFSCRIPTION OF BUII�DING �1• ��� /� .`' i Front Depth Height Sq. Ft. Cu. Ft. Type of Construction ���, Estimated Co �,� ���� To be Completed The undersigned hereby makes application for a permit for the work herein apecified, agreain8 to do all work in atrict accordance with the City Ordinanaea and ruling oY the Depertmeat of Buildinga� and hereby declarea that he faots and repreaentations atated in this application are true and correct. nn� �' .� �L � % � RT�NATTiRit �� r�,l� � __ _ _ (A Schedule of Fee Coste can be found on the Reverse � , o r . ��t� . n . � � • y 0. � � � l � � '�o .i � � A tL a o s U � � •� � 0 � !C � O o 3e o� o "' a� W �, a� a 7 z � �Qa �� d 3� � v�� ��r�.� o�ffi� w w a+ �� U � � 3v�'� �'aa, � �F w � .�m G u'� W s�� � � �' a � �2 a W q � W y' H � % F 3 � � � A � �.� v � � �C � w ���% �' �v� ���� � v b � O� o ���� U °��'' � � � W < g 7 � � w z • . 59NIN3d0 r� 3'JNVa SY9 1dM r� aaHSVm SNISYB SNIVLp � � v h` � ` 0 � �' i z � Q � � � a N � V` � � � z° :a � I � W � � � � m b � � C � N J � °' pj R U Fj o �d B d N o � ° � z O � � P � v ] E ri O B � � � U 'su,�ws iNnod lNrod � � u�� HSVM 51NI5 � SNKVE 7qQ� Ow SBfLL i �+ O Hlva 4 � r� s srvNian �j � � aaivM m saua{g � � a '° w � x W ti N M V •'% W J^ J � W U � W Q � J Q � a V i n O a � p F O V F tn en an w w �e o o �n o in vi N M O N (4 H .ti .i M N C�i � x x x K x x z°�� I ��- � o � G °o �o � Q N b F �a�' °� � '" � O � P+ � � � � � y � e�'6 w� x� x Q � � � � V q 3 �zt�zUgz � � z w � F us w re q�' � � °o, �[ � CC x x x °z � � � � 0 �o �o 0 � N � � � � N x Q a w O w �' � � ��a3 R � h q � w W � F ro U M w pC � � 4� x � F� � � � u � � a w � v� � � e .� i� �� � � N � � �� � .� � \ � � � O � � 1 � � W U N W � < � a yu�: ��" �° � ��� "o��� .. � ' �gb ��bQ �'�a� o�,c � M � z�a`d o ,y � ���� Ay � �y G °i' � FQ'�a .+�C'� � w �°g°5 Y �y� � C W L �Y� b '�w °" a� ��do � �mov � � m y vv'a � ���� �� U «, �a m � I � � 8 8 8 8 �O eG �O dJ N g : � � � � b � ' a � a��a � o0 � W a � � �'�o�� � � Q � � ��a�a � W ^ n �? � � a a a �! 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OATE vAGE OF APPRpVEO BY i 612-571-3450 9i0-Fi5 5/10/83 � � �oe aooRess 1410 Glacier Lane N.E. 1 LEGAL �OTNO. BLOCK TRACTORADDITION SEEATTACHEO DESCR. � 2 4� � Innsbruck lst Addition SHEET 2 PROPERTVOWNER � MAILADDRESS ZIP PHONE Pau1 8erg 1410 Glacier Lane N.E. 571-4521 3 CONTRACTOR MAILAD�RESS Z�P PHONE LICENSENO. Same a ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADORESS ZIP PHONE LICENSENO. 6 USE OP BUILDING � Residential 7 CLASSOFWORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE .. X 8 DESCRIBEWORN � Reroof Dwellin 9 CHANGEOFUSEFROM TO � STI ULATIONS Roof can be 2nd layer lut not 3rd. Install galvanized valleys, SEPARATEPERMITSARERE�UIRE�FORELECTRICAL,PWMBING,MEATING, TVPEOFCONST.� OCCUPANCYGROUP OCCUPANCYLOAO VENTILATING OR AIR CONDITIONING. � TNIS PERMIT BECOMES NULL AND VOID � 1F WORK OR CONSTRUCTION ZONING � SO. FT. - CU. FT. AUTMORIZED IS NOT COMMENCED WITHW�60 DAYS, OR IF CONSTNUCTION ��OR WORK IS SUSPENDED OR ABANDONED FOR A PER�OD OF 120 DAYS AT � �� ANV TIME AFTER WORK IS COMMENGER � � NO. DWLG. UNITS OfFSTREET PAPKING I NEFEBV CERTIiV THAT I MAVE READ� AND EXAMINEO THIS APPLICATION ,' STALLS GARAGES ANDKNOWTHESAMETOBETRUEANOCOHREGT.AILPROVISIONSOFLAWS yp�UATION SURTA% AND OFDINANCES GOVERNING TMIS iYPE OF WORK WILL BE COMPLIEO �`SOO S.SO �WITH WHETHER SPECIPIEO NEREIN OR NOT. TME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOflITY TO VIOLATE OR CANCEI TNE pERMITFEE SNCCHARGE PROVISIONS OF ANV OTHEP STATE OR LOCAL lAW REGULATING CON- $'],S. OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � � � PLANCHECNFEE TOTALFEE� $15.50 5� OicOrviRnCro OAnUT 2EOAGENi �DniEi � N.'HV�J PROPERU' LIDATEO THIS IS VOUR PERMIT �..�.Q, .5 =/D� �3 ��o i NATUREOFOWNER WNER fLOER! i0ATE1 BLDG �NSP PiE c�Tr or Faio�.cr �=f�°t1�� "°9. 1, 198] APPLICATIQ� i0R RCSiDCNTl11L lUlLDlilG PLRNfITS (Nc�r. Alterations. Itdditions. or RepairsJ ON►�ER: ADDP,ESS: � �� �o: �7�— SL.s~-z / . . srx�r «o: /�/ d srn�r: g���� dUIIDER: ' . ADDRLSS: TEL f�0: wr: �— si.oac: � �anirsaei: — Cozner Lot: inciac Lot: Cetbaak: 5ideyezds: 11p�]ieant ait�eh to Ll�is foae fsro Certifie�tes of S1�rvey of lot �nd pzoposed building locatian drawn on oeztifie�tes to seele. DESCRIPTJOit OF COHSTP.UCTIOH mnt: Depth: Neiqht: iquare Faets Wbie Feet: Fzont: DeptA� iquare Fest: Qabie Peet: 7ype oi Cbrstruetionc ,Q�' YD Ee CDr..plcteE: � HeiqAts S -� op istimateE Cost: t �J d4 � J►lt. I► 7►It. 8 Yroposed Drivc�+ay i�idtA If NCV Opening ie Desized: _' j 6EC RiVER;E S7D'c OF SNf�T �s,� �e�siQ��a n�r�vY makcs applieation foz a per�cit fcz thr �,ork rercin speeificd, •greeirg to do,all vozk in striet •ceozdsnee with the City of Fridley Ozdi��ances e»d rulin9s of the Del>ulanmi of Duildings, and TrscDy dec7a:es t?u�t �ll the faets nnd zcpzeanftaticas stated ir� this Appli L�11Ei ��� � O � SI(1�IA1Vli ttipulationst � fS� o� � .sa � � r R 3 C R � � O > � W Z � g F Z � � N Z U J O� U o t3 Q Z �n H � W� _ } 0 � 4 Z F Z Z � ¢�u O O Q a p O a � Z O� ¢ U � a � a� � � Z Q a N Z 2 j N } Q T p � N � � Z � c � O � m ���' N U ti u^i � 'V .� : �� • � n' l� � � ��a _ �� � �a� � to� y U "' � m°" � C� r m �s-• w - UM o �� �;�o -� 3 Y o d N � Q. C v t6 R � � a � U y .� y C U � � o � n � '� � v c (� U '� m � '1 Q N � N Q = � V ,�-� � s � Q Y O � � � � �i O N 1` � y Y V R ' .Q � � C t U � O � N � L � � � 1 -O r � � _ c a m c rn m o L° R .�-� m � `o � 3 � a' ai L? U C > d N . p`, �N�� o V ' J � � I � 1 O � L � � m � o° o °o, °C o 0 0 N � � vs vi f» i d C 7 m 1Y � � � 3 0 � a � C � N � � U W y ic m � � ¢ 0 ��a d U R C 7 N C t � � m 2 rn c a a � � m � u ¢ � (J jD � z r � K w a R �r � 0 = O p Z W � � � � � � , �� � � � o � � r � w � � � �I � a _ d m Q c 1 t � 7 6 s �� I �� ' l �- �- ¢ r- U w z � � � � �J� z a �JI w g � � c� a �� O >. c� w d � @� � m -�o z Q = Z �\ i z � O � p N � I F- N O � I-- �� N �� Q � 2 m 41 Z F- � LL. ffl C� 2 fn Q � I � I O u> t� 0 0 0 0 V) M Z 0 � N � � Q I T C O � v U a � � I 1 � � �n cA vH � a m z 0 � � Y J � �3 N C O 0 � y U a� � Q m �;- Q n O N ; � j � o s� a '� Y 3 O U p C � � � R C � � � � � 'v a> £ � O � U N W r w � w � � � � a � O H W LL Z � F-- U w a � z W Z O Z O Q U � � W i Y Q N � W O U !i� a W Z � � � � Y Z � w �- t� � Q � J J a W W 2 � 0 L 3 -o - � a � � o '� r �� � a 0 � Q. U Oi f3 G fl- C �O � o '� C � � U C �y O C � m o € r o °' U � a`�t ,wr.....,e� .s � � � � � sua�cGr �- . � � . � . � PER . City of Fridley 018 5 � �"�E'°°°f'�E'W'NS gUiLDiNG PERMIT Na r � � � ��� COMMUNITY DE�EIOPMENT DIY. . / f � � PROTECTIVE INSPECTION SEC. . �� � KJ � � /'�9 � CITY NALL FRIDLE� SSta2 NUwBER RE'/ D�TE o�GE OF �IiNOVEO !r �----�' ••� 612-571-3450 9t0.Ft5 9/8/99 / / J08 ADORESS 1410 Glacier Lane NE � � � 1 LEGAL LOTNO. BLOCK TRACTORADOITION SEEATTACMED DESLR. 2 4� � Innsbruck lst Addition. s"EET t PROPEPTYOWNER MAILAD09E5$� 21P PNONE Roger Gri£fis 571-4036 J CONTRACTOF MAILAOONE55 Z1°55337 PHONE LICENSENO American B1dg. Contractors Inc. 12247 Nicollet Ave S Burnsville 707-6959 20169383 � ARCNITEC70RDESIGNER MAILADDNESS � ZIP PMONE UCENSENO. 5 ENGINEER MAIUDORE55 . 21V VXONE LICENSENO 8 USE OF BUILDING Residential � cuss o� wonK ❑ NEW ❑ ADDITION D ALTERATIpN. �[ pEPAIR O MOVE � iiEMOVE B �ESCFIBEWORK Reroof house and ara e 23 S Tear-o£f 9 CHANGE OF USE FROM TO STIPULATIONS . Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPnNCV�OnO SEPARATE PERMITSPRE FEOUIREO FOF ELECTRICFL, PLUMBING, HEATING. VENTIUTING OR AIR CONOITIONING. � � THIS PERMIT BECOMES NULI 4N0 �O�O IF WORK OF CONSTRUCTION zONING SO. FT CU. FT. AVTMORIZED IS NOT COMMENCED N(�THIN 80 OAYS. OR IF CpNSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOR 4 PERIOD OF 12p DAY$ AT � ANY TIME AFTER WOAN IS COMMENCED. NO. OW4G. UNITS OFF57REEi GARKING 1 NEAEBV CERTIFV THA7 1 HAYE fiEAO I1ND EXAMINEO THIS APPLIC�TION STA��S GARAGES .CN01(NOW THE SAME TO BE TRUE ANDCORNECT. ALL PROVISION50� �AWS yq�upTION $URTA% nND OR�INANCES GOYERNING THIS TVPE OF WOAK WILL BE COMPLIED � �, WITM WMETMER SPEQFIED HEREIN OA NOT. THE GRAN7ING OF A 7ERMIT ZOlO I.OI OOES NpT PRESUME TO GIVE AUTMORITY TO VIOLATE OR C�NCEI TME pERMITFEE � S�CLMA E �qOV1510N5 O� ANY OTMER STATE OA LOWL lAW REGUL�TING CON� � STRUCTIpN OR TME �EAFORMANC£ OF LONSTRUCTION � $ `Lrj . � � pLAN GHECN fE TOT l E N t�RE ONCO n •U*N EO�GENi iO�lE� NEN R V IOA TNIS IS U 7 T < SG�+aipqtO�OwnEa��iOWNEaBw�OEPi iO�TEi B� �aSP' ��tt NEWj'T"` � 4� Effecdve 5/10/99 ADDN [ ] CTTY OF FRIDLEY ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII..DING PERMIT APPLICATION Construcdon Address: ��//l� /.-�i,� c i`P.r_ � rv� 1��'�� �� I.egal Descripdon: Owner Name & Address: e q*,� �-,��' G�, � s Tel. # S%/- t/ 0 3 L Contractor: MN LICENSE #� o/ b g 3 P3 Address: /22�/7 � c��(a� iT�c S. Tel. # 7 a 7-� ss F Attach to this application, a Certificate of Survey of the lot, with the proposed construcdon drawn on it to scale. 1 ' I' I 1 1 I' t•/_ �1 ►Yi LIVING AREA: Length Width Height- Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground _ Sq. Ft. OTHER: �-3 s �� Construction Type: �f ^� o u/� Estimated Cost: $ �___ Driveway C�ub G�t Width Needed: �Ft. + 6 Ft =_Ft x$ _$ DATE: 9' - 3-Q y APPLICANT: �����,�¢C-, y��_ Tel. # Q/�=� 7� t-- Pemut Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ ���as� $ .d/ $ , D/ $ $� $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (i/lOth%) $.50/$1,000 Valuation $1050 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 [ ] $ �.`�`�' 0 0 O N C l0 � C � > U � W N � W a :� z � LL N � 0 Z Q C7 Z m � J a � � LL Z O H V J a a a � 0 Z O U L 3. 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Q O 1 ` A Q '\ \ 6 a o C Z ¢ c F LL m O C r rn 'o � m m � � W o Z a C9 m a° � Z O � � J Q � V Q (Cp R� d 4 = W `o � � N O a. 7 ^' O � �o� N Z o LL ¢ 3 C � l0 �W7 .0 = O o- � � ��� � Q � � N �1 N U 7 � � � W ❑ � Y Q m z � � 2 F z � z O � � O U � � W J m Q H � Z � ¢ O � � z O U w � U --? w � w W � a J W � � H Q � a W m J S � . � Q � y 7 m � O U Building Inspections 763-572-3604 763-502-4977 FAX SI7'P ADDRESS _�' THIS APPI.ICANT IS: PROPERTY OWNERI TENANT CONTRACTOR SUBMTT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERMIT 1'YPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER COMPANYNAME: CONTACTPERSON: STATE UCENSE # PHONE DETAILED DESCRIPTION OF ADDRESS FAMILY ❑ TWO FAMILY ❑ REPLACEMENT ❑ TOWNHOUSE ❑ ALTERATION/REMODEL ATE 'LIP ATE_71P FEES ARE BASED ON SI0.00 PER FIXTURE XCEPT WHERE NOTED. F[XTURES: QNDICATE T TAL NUMBER OF EACH BELOW) Fquipmentlnstalled MFG:��Q�� MODEL:(�1,�� SIZEBTU �JQ��YYZ —. v7°._ _ NC $25.00 AIR TO A[R EXCHANGEHR SIS BOILER $35.00 CH�MNEY LiNER $]0.00 MFG: MODEL: MFG MODEL�. FIREPLACE(GAS)SI5.00 FIREPLACE(WOOD)$35.00 FURNACE$35.00 GAS DRYER $10.00 SIZEBTU SIZEBTU RANGE/OVEN $10.00 GAS GRiLL $10.00 UNIT HTR $10.00 �� HEATER $35.00 THIS IS AN APPLICATION F02 A PERMIT-NOT VALID UNTIL PROCESSEP 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 [he ordinances and wdes of the City of Fridley and with the Minnesota Construction Codes; tha[ 1 understand [his is not a permit but only an lication for a permit and work is not [o start without a permit that [he work will be in accordaoce with the approved plan in the cas o I work which requires review and app ov s. Q �� SIGNATURE OP APPLiCAN ` � T NAME � � � DATE � � "V� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977