AF - 46103��r
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sue�ecr � -� p . �
'� City of Fridley 1 ^ 2���
�� � ATTMETOPpFTHETW4NS BUILIrF1r `.� PE"�M�T� '
. , � . .. . EIPT N
� i y COMMUNITY DEVELOPMENT �IV. ��$��S'
r � �. � Pf70TECTIYE 1NSPECTION SEC. - �
�
� �� /"'� � CITY NALI FRIDLE� 55�32 NUMBER . REV. wTE �� -� vAGE Of APanoYEO BY
ti.---�'� '' euaeaa�so sio-F�e 7i19/73 i I
-ioe nopaess 680 Glencoe Street N.E.
�� 1 �LEGAI , �tOTNO. BLOCK TRACTOFADDITIDN � � �SEEA7TACMED
oESCR:- 33 - 36 T Biverview Heights Additian sHeEr
2 PROFEEiT/DWNER MAILA�ORESS - LP PH�NE ���
IleGardner Conetruction 7950 East Biver Road N6.. 786-L220
�':3� CANTRACTOR MAILADDFESS ZIP PHONE� LICENSENO.
� � SuBBR�' .. � . . .
4 AACHITECTORDESIGNER MAILADDRESS �. ZIP �. PHONE LICENSENO.
,5�£NGINEEF � - MAILADDRESS � � � ZIP PHONE LICENSENO.
s useoeau��a�+c �idential
��- € SILASS-OF WORK �
NEW ❑ ADDITION � ❑ ALTERATION ❑ REPAIR � ❑ � MOVE ❑ REMOVE
a: oescn�eewaaK Gonstruct 35' x 2G' Dwelling and 22' s 24' 6arage
� � 9 GHANG60{USfrFHOM� � TO
sriPUln'r�oNS p=�,�ge a hard surface driveway. Pravide a verifying survey be£ore
cqppin�, Contractor to infoxm buper in writing on flood area. Grade
aet At �24.b'. Core fill and xod to footing;everg 8' around block
foundation: Prcrvide waterproofing, '� mason cement, as per attached
aheet, on b8semeht walls with bl�ek g poly. Pravide gate valne on
pente= autleC. Grade at top of i�F�baa�nent floor 820.6'.
WATSR 8=tii �EFiBR-I,OCATIONS: See attached list.
SEPERATE PERMITS REQUIRED FOR WIRIfVG,
NEATiNG, PLUAABING AND SiGNS.
SEPARATEPERMITS ARE REQUIRED FOfl ELECTRICAL, PLUMBING, HEATING, TMPEOF CANST. OCCUPANCY GRWP OCCUPANCV LOAD
VENTI�ATING OH AIR COND�TIONING: � � � WOOd FTB�E
THIS PEHMIT�.BECOMES NULL AND�VOIq iF.WORK OR.CONSTRUCTION ZONING � SQ.PT. CU.FT.
AUSHORIZED IS NOT COMMENCED WtTHIN 80 DFi'S, DBIF CON3TqUCT1�N .
- OR WORK IS SUSPENDED QR ABANpONE6� FDA A�.PE�i0.�B i1F 12U'DAYS AT . ���F ��� �LP 9Z�Y TOt81 .
�ANY TIME AFTER WORK IS ��MEN'�D , -�'= � `� "y6 LNNLG. UNITS OFFSTREET PARKING
�! MEREBY CERTIPY TNAF 1 HAVE AEhp AND EXAMINED TM5 APPIICATION, : i � � STALLS ��� � GAF9AGES
ANO.KNOWTHESAMETQBETRUEAND�CORRECT.ALLPROVISIDNSOFLAWS YALUATION �- � " SURTAX - �� � . � . .
� AND ORDINANCES GOVERN�NB TMIS TYPE OF WORK WILL BE��COMP418D �'j�7 SaS.L�TZ �- S.%6 � �
� � W4TM WHETHER SPEpF1ED HEREIN OR�.NOT. THE GRANTING OF� A PEPMIT.. �� � �
-DOES NOT PRESUME TO GIVE A� HOR15Y t0 YIOLATE OR GANCEt TNE RERMlTFEE ��- '�.�, SACCHARGE �
'PROVISIONS Of ANV OTME ST E OR LOCAL lAW REGUtATING CON�-� $43•�;. 275.�
�STHUGt�QN'OR�T � M CEflF�CONSTfiUCTION.
PLAN CHECK FEE � TOTAL FEE -
, �.:.. -,..�..�.: ,.� .. . _. . . . .'. . . _
- 326.76 � c
I N�T� ORG ACiORORHUiMORIZEDAGENT ' IOATEI yyHEN PROFERIV VA 7HI$ IS i^OUR PER�01T �
'y1'... . . . t /.
SIGNATUflEOFOWNEH11fOWNER�BWLDEAI � � !�AiEI BLUG iNSP f]AiE.
€,_ � � . .. ..., _ . ; a�5 : _ ; . , x.,� ..
.. ; - -r : . _ _ _
WILLIA ` BARLSON. RRES. - � �����TE Q� �R� � � � � � ;�
1fOtASTREE'f _ �"" '�`�`�`� i�
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9�i FIEREBY CBRI'y�Y THAT TNt 1S A 1'g�E AND QQRRECT REPRESENTATfGN . - •�
bF: A 4URVEY OF TN�.'�Rpt)NDARf 5 OF' �M�._t,'AI�D-,ABOYE DESCR4EED AND OF ;
TNE lOCA7tON OF ALl Bii ING �')F ANY* Th�R�ON� AND ALL VISIBLE '
� £NCROACMMENTS� IF ANY+ FR ON SAtlA Y.ANDa AS SURYCYED BY t!S
THlS 3RD DAY�OF JULY# 19��•
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APpLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNLR'S NAME: k J e�2 ✓`NC�r �p�Wl$UILDER
ADDRSSS: � g SZJ �/� t��e.r �� ADDRESS
NO;.�ZS STREET
�
LOT:.j3-�4�.SS-36BLOCK: / ADDITION: UI�CI c �lVi�
CORNER LOT: INSIDE LOT:X SETBACK: J� SIDEYARD:
Applicant attach to this form 1t,ro Certificates o£ Survev of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Ueed As:
�*.J Front: '��y _�p�: ��Height: °'� e �
Square Feet• Cubic Feet• /�� y�1 ^ ��
1r�` n �� � � r�
,.,, � Front • . � Depth: .7 � � Height •_ / fi ` +�
Square Feet; 5�, Cubic Feet•_ ti ? �"�
Type of Conatruction; (,(J oOPjj /���¢,K.� Estimated Cost�_$ ���: y� ?
r---
To Se Completed:
The undersigned hereby makes application for a permit for the work herein
epecified� agreeing to do all work in sttict accordance with the City of
Fridley Ordixtancea and rulinga of the Deparqnent of Buildinge, and hexeby
declarea that all the facts and representations stated in this application
are true and coxrect
11ATE: / SZGNATI7RE: �
� j c� r-- -e _.o� {�� .,�t
(See Reverse Side For Additionai Information,)
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City of Fridley
RTTHETOPOFTMETWINS g�ILDING PERMIT
�
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• COMMUNITY DEVELOPMENT OIV_
i r y_ """'
r � � PROTEC7IVE INSPECTION SEC.
1
i_--_�' /"';,, CITV HA�L FRIDIE� 554�2 NUMBER AEY. D/TE
i � b12-571-3450 910-F75 4/1
JOB ADDHESS 680 Glencoe Street N.E,
1 LEGAL ��T NO. BLOCK TRACT OR AODITION
oesca. 33-36� T Rive2view Heights AdditiOn
2 PROPERTYOWNER MAILADDRESS �
Rob ert Johnson 680 Glencoe Street N.E,
3 CONTRACTOR � MAIL ADDRESS
AMRE 3700 Annapolis Lane, Plymouth, MN 55441
< ARCHITECTORDESIGNEF MAILADDRESS
MAIL A�ORESS
7/87 I � �
ZIP
787^5036
I _18886
R IPT NO.
��6�
AGPROVEO BY
SEEAT7ACHED
SHEET
UCENSENO.
LICENSE NO.
PHONE LICENSE NO.
Residential
7 CLAS80F WORK
❑ NEW C� ADOITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B UESCRI9EWORK
Construct a 12� x 20' Deck
9 CMANGEOFUSEFPOM
`STIPUTATIONS
See notations on plan for �ooting sizes
SEPARAI'�' pF�M�S REQ��RED FOFY
WIR(NG, HEAT1tiG. PLUM6lNG AND SlGNS.
SEPARATE PEHMITS ARE REOUIHED FOR ELECTRICAL, PLUMBING. HEA7ING,
YENTILATING OR AIR CONDITIONING. �
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAY5, OR IF CONSTRUCTIDN
OR WORK IS SU5PENDED OA ABANDONED FOF A PEAIOD 0�12p OAYS AT
ANY TIME AFTER WORK IS COMMENCED. �
I HEREBY CERTIFV THAT 1 HAVE REAO AND EXAMINED THIS APPLICATION
AN� KNOW TNE SAME TO BE TRUE AND CONRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPLIEO
WITH WMETHER SPECIFIE� HEREIN OR NOi, THE GRANTIryG OF A PERMIT
OOES NOT PRESUME i0 GIVE AUTHORITV TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$�iRUCTION OR THE PERFORMANCE 0: CONSTRUCTION.
51GNAiURE
WARi�$x��
t3�fwe di88�8 ca11 I� ,;iatiEs
FF.LEPHONE - ELEC7AlC-� g�,
�Qi1���fl $i i.�rrllr
Si,dso
ITFEE
$28�00
CNECK FEI
$ %-�0
STq�LS
CU. FT.
$,83
$3 5, 83
LOAD
N� i 7 City of Fridley Effeetive 4/1/86
ADDN. [ ] R-1 AND R-2
pLTER. [ ] Suilding Permit Application
Construction Address: ��0 G 1 �P YVC � �p �- /(' � .
Legal Description:
Oaner Name & Address: � l D±D PY` j- `�y h ru c., y� Tel .��% JGG3(p
Contractor• I�YYl'(�'� ' Tel. # S 5 3 Q��(�
Address:�'L�D CSL v� n m�n I� c 1,! � 1 C� I'v� n�'1 �r� `(Y� ✓U s s�u 1
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draWn on it to scale.
DESCRIPTIOH OF IMPROVEMENT
LIVING AREA: Length Midth Height Sq. Ft.
GARACE AREA: Length Width Height Sq. Ft.
DECR AREA: Length \�-- Width � n Hgt/GrounQ� �3 » Sq. Ft. �- y�
OTHER:
02�� •r{� : � 6 fo�.?s+
Corner Lot [] Inside Lot [ J Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: a�7��
Approx. Completion Date: �\�—� i ���• Q G
Alt. A Alt H
Proposed Driveuay Width If Nex Opening Is Desired: E �
See Back Page for Explanation
DATE: `i-�y-g%
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sexer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: �� �"QO Tel
CITY OSE OHI.Y .
E� Fee Schedule on Reverse Side
$ 7QV 25i of Building Permit Fee
� - 0 3 $.50/�1,000 Valuation
a 5525 per SAC Unit
a
S
S �J�. 83
,�F',� Faan.►� Siz�.s
Fee Determined by Engineering
e 5s3 cx�� �
Agreement Necessary [ ] Not Necessary [ )
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t��ilG°�C� D[�C�a C�O�niPlQNnI�I
A Sesrs Authodzed Co�lncto�
, Addendum to Contract
Customer Name: � • ate: �"� '� 1 Page: �
Job Addreas: ��� •�� Sf i� f F�,'1f� shh ��y�Z
Job Ph.����83! wis Work Ph :'?g6 ��7� Mar Work Ph.:
i�,�ek so�a0cauon.: ,1
rn.• e..�� �� �Nt Ionp �n0 is 7o pwj�et aut..�.la�i. Th� O�ck is to W aupportW by—�-PO=4
�nA./�Joo1M. 7M footvt �n to G Nt 9Q to 36 flieDW Otlow pqM surt�ew TM Ckky un0�ntructuro i� to w
� 4a10 �ntl 2�c1 I�mlMbd DNm� wMCfl will eoMUt ol � nouw pl�tr. tront pl�q. OirON W�m�. eitl� d�nEs,Yna crou
� �OfNa E�c� M�m b 10 h�w p�Iv�NZW streu p1�W pnaseA In �t Dot� �ntlt uW on� unteroE. T�e unOSfstructur�
M�m� �n W De wt wit� tM erown a1M u0� TM �ouw pMt� isto De fulanetl ta in� �ous� usinp 3/8 inch by I incn and
9/B Inch Dy 8 ine� zlnc pl�iW I�p bolb. T�� �" ap� an t W tDacW 2l" on osnhr �iM tMB" I�ps an to De sDace018"
on unqr. T�� Wckinp O�tam It to w 1 yp�. Ths 2x� Axkinp DwrCS�n to Ea apaced with a 1�B
Incn to 1/� InCn Onin�p� p�p MtwNn bMrdt. All IumDSr is to bY /00% pfeeaure tr6�te0, num Wr ons grade. SEARS
BEST WOOD w�kh carNn � tory yur noo-prornW w�rnnty �painst O�m�qa by tarmilea. rot �ntl decry.
R.Illrt s .cnlcauo�u:
TRADITIONAL: Pwb �nU pott wpports �n b ba 2Y�, 8ttW /n0 DofleA wiM �/8 inch laq DoNe. Rrilinp cap is to
E� 981nchn abow tli� MCk IloOr. Bopom rtll it to W 1 1/2 inchat from MCk NOOr. Milin9 Cktqa �ro to bs2x2
NC �ro �CSC approx• � 1/2 MClip.
CROSSBUCN: Pwq �nA pott wppoM u� to W 2r1, flnW �ntl boltsA with 3/H ine� Isp bol4. Miling qp i� to
D� 3e It�ChN a00w tM MUC 1bM. Botlom nil f� to Ds 21J2 ine�s� abow tM Gek floor. TM Mro midON nilf an
to W esnt�rW WtwNn fM toP �� �nom nih. RaUinq erpu W�cq aro to W tx4.
FULLVIEW: PwltanGpastsuppon�antoW2sl.IfttW�nObolte0wit�9/Binen4q0oltaFailinpuDittobe38
Ine�w ahow iM GeY Iloor. Bottom rall Is 10 b� 21/J incMs �bow Ne Osck Noor. T�� two mi00N r�ila are lo ba
untarM betw�en tM top �nC bottom nNS.
_ CONTEMPORARY: Po�UanApoatwpport�antuW2al.11ttW�nCboltWwltAS/BMtDMpbol».Railin0upit
to M 3! IneMt �OOw tM Mek Iloor. R�illny plek�q u�to b�2# mit�rW wiM �4b tHpra�cut on lop a�d bouom
ot Ne0 pleklt �n0 �n �p�u0 �OW�. � 1M ine�u. TM bonom nll I� W M 1//2 ineh�t above tne Cack Iloa.
LOWBOV: Pwt�anApwrwpporU�ntoWYa{,flttW�nAOOIfWwltn9/BlnefilapDOlb.Therailinpcapi�toW
72 InePp aEOw tM Gck floor. TM 6otfom nll b to M 1 1/2 IneMs �DOVS the deck Iloor.
LowOOy FuINNw StyN Is a h�w two 2a1 pk�e�.
LowboY Tndltlo�W StyN b to �we tnONloMI �tyN plGket �p�eotl �PProa.1 1/2" apart.
` LowDOY �nbmponry SryN b to �as eonbmponry eryle plektl spard +POrox. /'1/2" aparl.
DECOHATIYE: PoW�nOpwlwppor4u�toW2x1,11nWanObdtWwit�3/81nc�I�pGOIts.Rai�ingcs0ia2x�
�nA b 9! IncMa �bow tM Wdc Boor. RNl�l�h a�to W ma0e 1x8,TM bottom rul plate is to be s 2a� and is 1 L2
Inenw �bow tM Gek tloor. (j[) ��jj((]p�jj'('(�j
_ WCOr�tIW Typ� A: IMnO eut E�contiw Oa1pnW ixE N�b. A' I{' �� C/�(' D�
_ O�eontlw Typ� B: Ii�nO wt A�eontlw WYpnW la6 sl�p. � I I11 � 1(1! ""'
_ Wwrspw Ty� G: H�na cw d�eonn.� aW9na la6 wte. II II
D�eondw Typ� D: Stnlaht eut Ww t� witn t!2 lu� pw Mtw�sn. [�r� Ly�
PRIVACY: Pwb an0 pWt wpport� rn to Us 2uI, HpW �nA Ddtetl wltP 9/b ineh I�p bolta. R�linq cap ia to Oe 6
f�N �DOw 1M A�ck tloor. MorizonW to0. mldGb �nG Eottom IWp�r itHp� to ba 2:I.
_ 7M TrWiNOnN Prlv�ey nil with sbtlpM e�t N W�p�eMO to tM lop �ntl Oottan pl�tq. SI�U an to N apacW
Ippfox. 1/2 Inc� ap�rt.
� 2.2 Tn0ltloml Ptiv�cy nil wiM strNpM cut plebb a�eMO to tM top md Ootlom platas. Piekata rn to 6�
sWeW �PProx. Y Inel�u aWrt.
_ �x8 Co�Umporary Vrlr�ey rdl wlt� �V�ipM eut sht� tl4cM0 to t�a Wp n1i pb4t en0 to the hce of t�e
UIIdM�fYC�YI� p�fl111MM. $I�b \f� f0 b� �Q�ClC �QQlGiL 1('1 MC11N ip{fl�
_ 2:2 Conbmponry Prlwey nU witM miqrW eut piewb �tl�eMG to 1M top rell pNtei and to the hce ol tM
unGntruetun p�Am�br. PIeYNS �n to D� ap�eW �PDrox. Y IneNU �p�rt.
�Y• L�ndlnQ Ana w�lkwav�pselnuuon.:
E-2 GLIDE STAIRWAY: TM sutrw�y wDPOn strinpm ere to bs 2x10's. The riu per stsp it to bs 8 ineMS sn0
ths 1rs�G I� to be Y 1/I lnenn w1qr. E�eh VNA U to bs wpportad Oy a 2M2 mlterodenaat.T�s railinp isto consisf
of 2x� poate, two ant�r nils, top reil �nC nil uD� As apDroprlats, a sleirway pW �8lnchu (38 i�eMS fa 31ea1
w10e abin) Cy 18 t/2 Inc1�N wlll M Nt �1 tn� Wp of tPe sU+rs. StNrwray� wsr 8 fwt f� Mwnion ue to De
��uPPa� Dy 2 addltb�ul 2x�wppoR pwU pMeW mi0-w�y In Me stOn �lo�q Wt� 1/� winA bracinp.
TWOLEVELS7AIRCASE: Shlrcawbtotonaiatoflaml�atMplyWOOAtitlnp�rs�NNOncentx.T�erearelo
�� E� ��fNW(S1/i'ANwItA1{//2't/NEICOMIf�In00f2XBWdT�bt�qManCihrOBfeGasfatlYxlDlats.
TM toUl w10th oi �IrcW� �n to d .
SINOLE STEPDOWN PADS: TM rb� lor f�� suptlown pW 1s to W.9 1/2`.5 1/Y" .8" .ot�er. . T�s
_ IsnpM of th� �t�pCOwn p�d I� to W . SUpOOwn pWs an W eooNSt of p�Hmetsr �pion rritn tArae
ne�wd 2x1 sl�q. Tot�l tr�a0 �IZe Is to W 7� 1/2".
CqRNERSUIRCASE: St�irqaistos�tap�inq�eorn�rwinpontlwk.Stairceaelstoeonsisto�2■l0atdngers
_ wiM�4z6kiek0asrANlh�WaaofsaChtrs�O.Th�NwpertrnAlstoOeBinchesandlhetre�tlistoEe9inc�ea.
LANDING Th� Imdinq I� to ba wpportW by_M�t(sy antl too4r(y. TM und�Mructun, Oacklnp antl
_ n1Unq b to bs tM wm� n �p�eifistl in t�s Osck �nd nilinp �aCtions.
WALKWAY: TM wNkray slzs i� fo W �Nt lOnp �nE Is to p�oj�Gt out � fHt. The walkWay is to G
_ eonnOdetl tolhs m�Vn tlsck �nd �s lo As supportetl Cy_�IOOtan. The untlentrueture. Eeckinp, an0 nilinp is
to M 1t1e ume u apecitiaG ie lM tleek w0 nillnp s�eUOns.
ACIOTM
i
�
�
�ne� Deck, Addendum Contlnued
� (CMdc a wY��M �nd Inelau Nu) �
^�MiNwr WeM�y� _�On Orou�d irN bwt (N.C.) �wm TrN1i�
—�� WI� 2SJMIYny Bwk B�nM _Wlndow TrNk�
�iwa an swr nw �ov.� e�ok e«�on �wwm_sml•—.1
_c+.e. ceq�� �io r.a. ___ov.� w..w u s.
� M� 9m� J1W T�OM ___L�tliu Und�nklrt
JMa1rWuW YW�br BoR �un TnNM �CIwW Mnd U 8.
O•YIIIOWM PIYIIM BOIt �pJ�ctlM:�� �POd QWMb
!n� 6UnOMw Gek �nA w L�Mlna e'_. ___
ei^•• ry�t (q �nA FooMr p) FNt of ExV� MWnp
f�tom Cu11Na Worlc
-JJWIb 1UIM IiolOUlllp WOOwr � _YOduln b W CupOin atl
� Y.w liaonmp raaa« ___Moauw wc uau+e v..
�an !I=MiY tNO. W Mod. ouq_� _Ndnnp�
� FW M (9q• F4�a _ON�r
T�ar Out an0 E�ew�wn:ConMOtor b!YW Nwy: Yr • Na
JMmow ExIMYip WooO Wok JIpW 64wn�ry/ConcnWFluh
M��----wol.��w'._
�aw ArNnp�, Iloof, w �-^�wtlon (MOUn: �
_Mmow fa1MMy ConorM� BbPV�OMY ^"�r'
WIM�P�q�ENv,
'NOTE M�Iqr IM old pnatun (IA.. ob WCY, ConorN� �tooP, Ne.) b I�km down �n0 �ny unlor�n Gmp�
IsAMWWfWNIC11MMlNnw000.0/�CkWOfONpyWmYONryPoIIalU.ulA/OfOtMfN r�lYOfkM�t11MW
W nptlnd ONon tlr n�w A�ek e�n W hrt�INd. nwn vr��� M WGtIaW eMry� m�N � 1
'NOTE: It 1M nloe�y,y� of utllity IInM, m�br�, �te. b nsew�ry tM cuNOm�r aqress to Es ra�ponNble lu IM
Waluon.l wNS. lLHJ�(cwtomsr Inniu)
iu�l�l lrot�nlam r�tl Wwnw d p�elc (InduA� laratlon of �ouw, Mu ol tl�elc. NwNlon. uW IouUOn of tll
.00a.ur� .pa7oqjt.uenoe.)
E�w.uon�_ 1 l
Mor@onW Sbrtlnp Polnt (HSP) tindar doo� �,.,_
VMical SLrUeY Point N8P1 . �w__r_ _
� D
�WWUy P�nnl� -Na� /7 Cwton�e IMWI) �urNdle o
WIMnn�r..:, � 6-E�� Own�r:
Dalr � 1 �' Own�r.
Dlnetlom b JoOe (Gh� M�in Cros� 81raU)
G 9� �— �o as�a n. /-o G'l �coe 1'o..lce L...
�,�»
City of Fridley
ATTNETOPOFTMETWINS g�ILDING PERM{
;,
� �
' COMMUNITY DEVELOPMENi DIV.
� j V__.����'
r � � pROTEGTIVE INSPEGTION SEC.
1
� � /"'1 � CITV H�LL FRIDLEV SSA32 NUMBEP � aEV
�""'�'� �'' 612-571-3450 9i0-F�5
JOB ADDNESS 680 Glencoe Street NE
1 LEGAI �OTNO. BLOCK TRACTORADDITION
oesca. 33-36 T Rivexview Heights
2 PROPERTYOWNER MAILADORESS
Bd� Johnson 680 Glencoe Street NE
3 CONTRnCTOR MAILADOFESS
A1lstar Construction 3315 N Hwy 100, Mpls.
a APCHITECTORDESIGNER . MAILADDRESS
-�S].dP.Rtidl
RerooE House
�
' 21479
CEIPT NO.
�/<f yD,�.
pF �>vAO�'ED Bv
�
SEEA7TALHEO
SMEET
IONE
784-5036
IONE LICENSE NO.
25 3247
1pNE LICENSE NO.
IONE LICENSENO.
❑ NEW ❑ AODITION O ALTERATION �� REPAiR ❑ MOVE ❑ REMOVE
9 CHANGEOPUSEFROM
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTHtCAI, PIUMBING, NEATING.
VENTILATING ON AIR CONDITIONING.
THIS PERMIT BECOMES� NULL AND VO�O IF WORK OR CONSTPUCTION
AUTMORI2E� IS NOT GOMMENCED W�TNIN BO OAYS, OR IF CON57RUCTION
OR WORK IS SUSPENDED OH ABANDONED FOfl A PERI00 OF 720 DAVS AT
ANV TIME AFTER WONN IS COMMENCED. �
I NEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS APPLICATION
ANO KNOW TNE SAME TO 8E TRUE AND CORRECT. ALL PROViS10N5 Of LAWS
AND ORDINANCES GO�EFNING TNIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT
DOES N07 PRESUME TO GIVE AU7MORITY TO VIOLATE OA CANCEL THE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW FEGULATING CON-
STqUCTION OF THE GERFOFMANf.�E OF CONSTAUCTION.
OF
1 � STALLS
ilUAT10N
$1,219
:RMIiFEE
$31,00
LAN GHECK FEE
License SC $5.00
$. 61
ACCHARGE
Eire SC $1.22
OTALFEE
$37.83
NEW [ j
ADDN [ j
AL1'ER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Pennit Application
Comstruction Address: �..$O G��Yne �-
Legal Description:
Effective 3/1/92
Owner Name & Address: ����,v� � Tel. # 7$'`�— S�Ce
Contractor: iqll�'f'nr �rX/1��TLiL+�-LoVI MN LICENSE # ��}�
Address:,�T�iS i.� i�t�l, �D� — YY1��S Tel. #�93-53�5
Attach to this application, a Certificate of Survey of the
lot, with the proposed coactrucflon drawn on it to scale.
LIVING AREA: Lettgth
GARAGE AREA: Length
DfiCK ARfiA: Length
OTHER:
DBSCRIPTION OF IMPROVEMENT
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground _ Sq. Ft.
Corn� Lot [] Inside Lot [ j (F�t. Yd �S,etback Side Yard Sdbacks
Type of Construction:Tc�ir'�%�1�(ZY1t- �'�OIJ�e�d' Estimated Cost: ��J�r�S=�
Approx. Completion Date: �� 2. /�� �! Ud
(Cost on Back)
Driveway Curb Cut Width Nceded: _Ft. + b Ft =_Ft x$ _$
�, • w ... � �
�
� --y � y<< f -
� — -
C�-Y3���Y��I:1 �i'1
Permit Fee $ -�� ��� Fee Schedule on Reverse Side
Fire Surcharge $ /. �� .001 of Permit Valuation (1/lOth%)
State Surcharge $ . G,! $.50/51,000 Valuation
SAC Charge $ 5700 per SAC Unit
License Surcharge $ �•�%C� $5.00 (State Liceased Residential Contractorsj
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Pazk Fee � Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
���517�.T11
STIPULAT[ONS:
$ -��),c?3
Building
Inspections
763-572-3604
SITE ADDRESS (GL�
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAII, ADDRESS
THIS APPLICANT IS: ❑ OWNER L�ONTRACTOR
T'ENANT nDnxFSS C crrv.
PHONE: �Jb3"J'r�IO"�`"/�G
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
STATE LICENSE
1
PERMIT TYPE u nuui i,vrv .� ��..v+�
� ❑ BASEMEN'I FINISH �ROOF
❑ DECK O SIDING
0
DESCRIBE WORK BEING DONE:
SIZE OF
OF SQiJARFS ��
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHS:
SIDIN
O Vinyl
❑ Aluminum
❑ Other
� HOUSE & GARAGE
❑ ATTAC}�D GARAGE
❑ DETACHED GARAGE
❑SD�C
❑ Trim
❑ Fucia
WINDOWS
iN 6XISTING OPEIQINGS OYes ONo LDCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES .@
TVPF, OF WINDOW TO BE P]STALLED NUMBER OF V
ALL FEES ARE BASED ON VALUA'
� � 93 c�SING
Plan Review
Fire Surchazge
Surcharge
Licease Surchazge
SAC Charge
Curb C�t Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Due
$
$
$
Permit No.:
Received
Date Rec
� ur.
EXP DATE
PO� CITY /g'N�l�� STATE_ZIP
❑ DRAA1 TILE
❑ OTHER
HEIGHT
BASEMENT REMODELA]G SUBMI7'�
l. ExistmgFloorPlan
2. Proposed floor plan
3. List otswcNal members to be used
Ft.
FORNEW CONSIRUCTION iNCLUDING DECKS,
ADDITIONS & PORCHES S[1BMIT�
I. Si[e Plan/Survey showing the ezisting sWCTUres
and proposed project.
2. Two Sets of construcuw� plans
3. Energy Calculations
TG THE COST OF LABOR AND MA
FEE SCHEDULE)
See Back Page foc Fee Schedule
65% of Building Pemut Fee
.001 times the total job valuation
.0005 x Peimit Valuation Minimum $.50
$5.00 (State Licensed Residential Con4actors)
$I550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservarion Plan Review
Fee Detemvned by Engineering
Agreement necessazy ( ) Non Necessary ( )
Make checks oava6le to: Citv af Fridlev Attac
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTll, PROCESSED
I hereby apply for a building pemut and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; ttiat I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work w c requires re /eYY�� d pprovai of plans. `�,�.
SIGNATURE OF APPLICANT D.f.iA� �J`�� PRINT NAME1'�%��S �//N c� DATE I���
From:
Building
Inspections
763-572-3604
763-502-4977 FAX
vnrt /U'%,b �
SITEAllURE'.SS 1
TH1$ AYYLICANT IS:
OWNER!
TENANT
SUBMIT A COPY OF
YOURSTATE
LICENSE WR'H
APPLICA7'ION
PERMIT TYPE
TYPE OE WORK:
�f Fridley To: 8128252303 Page: 4!5 Date: 8/102009 4:00:44 PM
MECHANICAL Pe'1"'t N`
RESIDENTIAL APPLICATION Recei�ed
CITY OF F�2IDLEY D��'
YOUR E-MAIL AUURESS
� ,l n C D �, �?�Lt,L���
❑OWN�R �yreurvTliACTOIi
NAMt: �JD �
puuiteSS /� ✓/ �
PHONt: I�" �/1 � D !
COMPANYNAMt: /�
CONTACTPyE�R��S1,OyN�: I1G�L��DnILFaG pI
STATHLICE4QSEr� ry,)f/�b / _EX
PHONE r —
INGLE FAMILY ❑ T0.'O FAMILI'
❑NEW �I -PLACEMENT
DETAILBD DESCRIPTION OF WORK
FAX �//rii� X'.�.
❑ TOV✓NHOUSE
❑ ALTERATIONiHEM011EL
in4 � Com
ATF:[[�/¢IP ��J s �f/ /
F�E5 ARE BASED UV St0.00 PER FIX"fUliE, EXCEP"t" W HERE VO"fED. pIX'I'UkES: (IVDICA'f6 "1'OTAL VUNBN;R Op gACH BELOW)
tquipment Installed �'if(�N[¢ MYG: _�Q� MODtL: �/� d f� SIL.EBTU �� GiiU
q'Ih EaA1� Mrr,: 'Z (A� nnoueL: _l�ffX �d,�(y s�t�aru .Z �'1
A/C $25.00
Alli70 Alli E7(CHANGEtR $ IS
BOILtR $35.00
CHIMNtY L]NEB$10.00
MFG: MODEL:
YI BEPLACE (GAS) j I5.00
YIREPLACE(WOOU)535.00
FURNACE 535.00
GAS URYtRS10.00
GAS PIPING $10.00
SILtiHiU
GA$ NANG6i(1VEN $10.00
N E W GA S GRILL $10.00
GAS UNIT HTR 310.00
AOOL HtATER $35.00
VtNTILATOR$I5.00
�
THIS IS AN APPLICATION P'ORA PERMIT-NOT VALID UNTIL PROC'ESSEll
I hcrcby apply for a buitding permit and I acknowtc�gc that thc information abovc is complctc and accuratc; thai thc worl: will bc in
conformancc with thc ordinancc.s and codcs of thc CiTy of Fridlcy and with thc Minncsota Consuuction Codac; that I undcrstand this is
not a pc:cmit but only an application for a permit and work i� ot to start without a permit; that thc work will bc in accordancc with thc
approvcd plan in thc casc of all work , rcqui s vi nd approval of pta�
� Jf �j� �/Ip� T,1In
SIGNA7URtiOFAPPLICAN , ' PRINTNAME���VJl���._ IVL�_ICJ1�Vl`1 UATE �O 6
City of Fridley
Building lnspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 7b3-502-4977