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AF - 47133• , • . .� �. � ��G �, City of Fridley, Mi.n.n. �.1T° '7'743 BUILDING FERMIT n8te: Jvne 7, 1965 —___._._�......_...._� Owner: �u�..� �s� .._.._... Builder _.._.. �� F� �P� --_._�.._....._.__...._....._.._._..._ Aaaress 67�_:.. Helene Plaee .�...__.._.._.___._____. aaares� _._.. 370 �°a Av_e -�.._.__. st. Pau�, �. 551t�z LOCATION OF BUILDING No ._67� .._._.. s�t H618IIC P18C8__.._.._ _..._.._.._..._...__._ Part of Lot ._.__...._. Lot _.__�#.....�_.—__ Block _.�..._.....� ._.�.._.___._ Adcliti� or Sub-Division �gP.L�W Adt�.�3.oA Corner Lot ..�__.�..._.._ Inaide Lot _._.__..._...._.�.. Setback ._._..___.._..._....___ Sideyard Sewer Ele�vatian ..�....__......_._...__... �.._... Foundation IIevation ....�_�. To be Uaed as: ._...._.. �ont ._..__.__._._.__.,___ Front Type of Construction DESCRIPTION OF BUILDING Depth _.__�____ Height .__..._..___ Sq. Ft. ..—._�. Depth _._..._:._.._.. Height __.._.....:.._ Sq. Ft. ____....._ _�_ Es� Cost �._.t��!�a..�_._...__....__ To be Canpleted C�. FL Cu. F't. Storm datiaage r�pair: Re—roof 1 stcry frame house and gara,�e da�aged by �tcsm. In co�usideratioa oi the fsauance to me of a permit to construct e buil ' described aba�e, I agree to � the ProPosed work in accordance with the description above and i��liance with all ra �' ns of ordinanoea of the city of Fridley. //� � _ �� ' t� In co�sideratf� of the payment of a fee o! �.6!� .._._...._.., permit is hereb3' 8�ranted to �1C7�8 F�1 �1• to construct the building or addition as described above. This permit is granted upaa the express c�dition that the person to whom it is granted and his agents, employees and workmen, in all wark done fn, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o� Fridley, Mi�pnesota regarding location, construction, alteration, meintenance, repair and mavin8 of buildin,�s within the dty limfits and this permit may be revoked at aqy time upan violation of any of the provisioa�s o! sa�d ordinanoes. A7.1.e21 d6m88II B��B � NOTICE: 7Ms p�rn� do�s ae1 sewr f1N eoesMuallos, inalalinhn fer widno. v��Y. Yas h�d4q, s�wK er wMn. !� sun to a� fM 8uildino Intp��lnr for s�pnah pmsils for fbu� inms, APP'LICATION�FOR BUILnING PERMIT .� ;..: . ; CITY OF FItIDLEY, MiNNB$OTA, ' ' - . � , j., '. _, pt�R+g NAI� ..'Douglas L'arson �BUILDER Thomas F�inn �o�ri�i'any ADDRBSS 670 Helene Place pDDggss 370.-Daytdn.'Av�'.'- .. S:t. : Paul, Mir�n. 55102 . � LOCATION' . OF �' B�TILDING ` � ` - . - � _ .. � , . ` 670 Helene Plac� � ;: :. .. � •„:. - . .� , No. $treeC .. � part'of ��"ot� LOT BLOCK .;'' • • : . • • �ADDITION OR SUBDi'VIS�ON .C,x- t�' ' Corner Lot�_Inside L� Setback �� "-��ide•�Ca�d �� J�"-�, : , � ,. ; . SEWER' ELEVATiON ' ; ' ' FOUNDATI� LLEVA�iON � .. . ; _ F. Applicant attach to this �form Two .Certificates of Survey of Lat and prs�po$+�d building location drawn on these Certificates. �� ---�-•- To be irsed as ; DESCRYP�.''I�T Ol� �UI�DING . a�� Front Dept �� Hei$��,y4,.� � 3q. Ft. Cu..Ft. , , .�_ _.. . ' . . � � . .. . ' ... . ..� . •. . . . . .. .a � ��: . .;..n . .. . 1 .,I. . . . ' : , . . �. .. .. , . . . _ . Facant Depth fi�eight .� . . � . Sq. I�t . _ . Cu:: Ft : , � . . . . � . . . . . . . � � . �i.. , i i . ..-- . . . _ . , , , . Type of C�tatruction Estimat�d �Coat �9It�.00 , . Re-roof 1 story frame house an.d garage dama�ed by storm., �..,� � , 'To be campleted • , ., , 1 week . ' The undersigned hereby makes appiication for a permit for the wark hereta �pecified, ' agreeing �tp•�do all work in strict accordance with the Cit�y of Fridle.y Ozdiaances and ruling� of the DeparCipent of Buildin�s, and hereby d�clares that al� the facta and representations stated in this application are true anc� correct. . THOM��INnJ' COM�'ANY . . DATB `�UN - 2 1965 SIGNATdRE�B�,,, (3chedule of Fee Costs can be faund on the Reverse Side), • r ,. . w _ , o- � . � _ r . City of Fridley r AT T114 TOP 0� TNE TM�INi 1 � � �. r rti-------, GOMMVNITY pEVf1..01MENT pIV, � � � MoTCCTiv[ wt�crlph os►r. t� � � �. . ; pTV ►u►�� flupt.Rr iMit 4....1`.� �.J Ni-�{0'�MO Job Address ner Contractor Kind of Bui Completion 670 N. F. Heleme Place John F. Wold �IINNEGASCO ng 12 -20-7l� T, u� � i ; � II � � I I W I !� � — ' _— __�; W � ' ` t � � � � �� ; � I I , � a�zral � ( � � � i '� 'iddY � � sv� ( I I � � I �I •��w i •saai �•enNiva � d sNisve +� N71Y� X i�'w" ;O 0 inrv+�o YOflld ;3 Q i4+'e i ,O �) SSI3MON$ jp'� � ��q •iNno�J d HN�aoI b '� a� s�vai� q ' MsvM iNNtil �av� mvNwn .tsso7� waivM � �� i i I'�I _ I �� i ! o` , 'aa . I I r�^ � V � � � i i _ � � � � � � 3' � - 7 G 2�� CL `f � � B � � I� I. , i 53 -�1; -s-915. 51 iw�iGT pLUM� I�r, PERf1 I T aPPL I C�T I,�� , .� l 1j/.5 S 5�1 3991 S �7�3.� M1IRQUETTE AVENUE use ---- -- • ......... Res. stimate ost 10.00 Plumbing Fixture Rates: N0. RATE TOT.AI, Number Fixtures x $2.00 �__ Future Fixtures x $1.50 New Fixture-Old Open. x $1.50 �— Catch Basfn x $3.25 Water Heater-99,000 BTU x $3.00 '� Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: lst 3 Fixtures x $2.00 Additional Fixtures —� x $ .75 _� Gas Range-199,000 BTU x $5.00 � Repairs & Alterationa I See Description: Gas Dry�r Code 5.00 State Surchart�e .50 ! � TOTAZ FEE $ 5,50 �Class �'A� �t�r.cFiarge .5t?¢ !The undersigned hereby makea application for a permit for �he work herein apecified� ag�eeing to do all woxk . in strict accorda,nce with the City Ordinances and rulin of the Department vf �uildi.nga, and hereby declare that a11'the Facta and xepxeeentation8 stated in this application are true a�d correct. 'Si a ure ' Date � , f . 53-81a-S-915.51 ' . �ity of Fridiey ' � � �i��i�`�� 4�r P�r�bit� c�od �s �� Dept. of Bldqs. Phon� 5�0-3450 -- - D�SCRIPTtON OF WORK � 670 Helene Place AT. E, Numb�r, Kiad aud Locaifon oi Fix2�area ��°° w � s N WATER MTR. t y � i 3 � � S � � � � � O v : � b � � t� � � � � � O d t�! E / N GAS fLEC. Bast lat � 2nd 3rd 4th • Fuxu:� Cona�ctfoa Op�niaps * N�w Fixtur�; Old O�nis�s PARTIAL RATE SCHEDULE S�w�s ❑ �� PGIIMBING FIXTURE AATES: NO. RATE TOTAL Number Fixtures . . . . . . . . . . . . . . . . x a2.00 a �ture flxture Opening . . . . . . . . . x a1-50 s _. New Fixture Old Opening . . . . . : . . . . , x a1.50 E,__.._ Catch Basin . . . . . . . . . : . . . . . . . . x a3.25 S Water Heater ;Up to 99,000 BTU) .••• x$3.00 E New Ground Run Old Bidg. .. . x a3,25 $ El�ctric Wat�r H�at�s. . . . . . . . . . . : a2.00 = 3A8 FITTING FEES: NO. RATE TOTAL lst 3 Fixtures . . . . . • . • • • • • . . . . • x S2.00 ; . Additioaal 1+Yxtures . ... . . ..... . . . . . x : .7b : . c� x�n�� co i9s.000 sTV .. .... ... .... ? x as.00 � 5. o0 City of Fridiey: The undersigned hereby makes application tor a permit for the vrork herei specified. agreefng to do all work ia strict accordance with the Ci43 Urdinance and nilfng of the Department of Buildings, and hereby declares that all the tact and represer�tations stated in this appHcation are true and correct � 6-26-71� Fridley� Minn l9_ Owner John F, Wold - tcina ot suilaing Frame Used as Res. To be completed about 7-3 –7�l Estimated Cost, $ 10.00 P�rmit P[o. �� f i Old--� Building Permit No. �� Signed ' r' �� j� ,/ \� . $y . 'I�,J''/ .G�w`� � . �i�e�3'�'n:�„ - Business Phune No �ii�,^,�1 , - ROUC3FI r��w 3 ' ?�'ti - ? �° . REPAIRS �r 11LTEAATIONB—A.i•s !o Cod• .50 State Surcharge • Description . . . . . . . . . .. . . .. . ... . ... . . . .... . . .. . .... . ... . ; � mrwi. � � 5 5° � , ' � Class �'A� Surcharge, .�0¢ sue�ecr PE �'"'~ City of Fridley � 16 6 4 5� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� r ; � ECEIP . � • COMMUNITY DEVELOPMENT DIV. ' j V ' � r � � PROTECTIVE INSPECTION SEC. s�� 1 � � ' � �� cirr �A�� FRIDLE� rJrJ4$2. NUMBER � REV. DATE PAGE OF APPROVED BV �"'"� � ,�� 612-571-3450 910-F15 6/18/82 � � JOB ADDRESS 670 Helene Place N.E. 1 IEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. C� 9 �Ii��X Donnay's La�i2Vl@4V MaT10P SHEET 2 PROPERTY OWNEp MAIL ADDRESS ZIP PHONE Michael T. Papillon 670 Helene Place N.E. 574-9717 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 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 �l ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOFIK Reside Dwelling and Add Picture Window 9 CHANGE OF USE FROM TO STIPULATIONS 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 ZONING SQ. FT. CU. FT. AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOAK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNi7S OFFS7REET PARKING I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�- /2OO $.6O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �ZO.SO NONE � PLAN CHECKFEE TOTALFEE NONE $21.10 SIGNATUREOFCONTRACTOFl RAUTHOAIZEDAGENT i nre� WHEN PROPER VALIDATED THIS IS YOUR PERMIT � 0 1— - 8�— SIGNATUREOFOWNER�IfOWNERBU� ERi DATEI BLDG iNSP ATE � CITY OT FRIDLEY Effective Aug. 1, 1981 APPLICIITI0:�1 FO(t RCSIDL'i�TI/1L I3U1LDIi�G PCfL'�ITS (Ne��r, Alterations, Additions, or Repairs) .�� . . OI,It�ER: �1�f � c ti � c `- ( . /� Q! c.. C�o /1 [3UI LDER : -s� ►'� � � ADDRESS: ��D H��n� PL�.�� IIDDRESS: TEL N0: .� ?�I -�( � l 7 TEl f10: � Construction Location • ST1tI��T NO: 7 8 _ STItEET: �-%��.F/I F P I Ct �- e LOT: HLOQC: _� ADDITION: ��nn a-� rS ��n ��{ vl�� /YfA�p� Corner Lot: Insic3e 7�ot: SetbacY.: Sid�yards: Ap�licant attach to this form two Certificates of Swrvey of lot and pzoposed building locatio� drawn on certificates to scale. � �;��c � DESCRIPTIOi� OF COtJSTRUCTIO�J i'ront: Depth : Height: Squane Feet: Q,ibic Feet: . i`1 � i`� �..%I i� 1� }Front: Depth: Height: Squar.e� Feet: Aibic Teet: � �&� f� Q� Rj►pe of Cor,struction : Rb 8e Oc�r.�pleted: ��y, o�^ v Estimated Cost: $ /� Oo �� Alt. A Alt. B Proposed Drivecray Width If New Openinq Is Desired: $' $ , . SE� RzVERSE SIDE OF SHEET . T'iie undersiqned hereby make� application for a permit for the �•aork� herein specified, agreeing to c3o .all wozk fn strict accordance with the City of I'ridley Ordinances zaid rulii�gs of the DeZklrtment of IIuildings, nnd hereby declares that all t]ze facts and represr�tatiens stated in this application are true and correct. D.37`�: w►�- /�� (�1 �L— 5IGNATUI2E: Stipulations: `� ��'�� (� � n.�q�� _ .� � � �� . , -- '� CITY OF FRIDLEY Effective Date May 1, i9aa APPLICATION FOR PO►�ER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING $YSTEMS AND DEVICES FATE SCHEDl1LE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (pipinq needed with new furnace) Gas Range Gas Dryer RATE $ 2U.00 $ 10.00 $ 10.00 $ 10.00 * Air Conditioning (all sizes� $ 10.00 All Others/Repairs and Alterations 1� of Value of Appliance or Wor}: COMMERCIAL/INDUSTRIAL .Z8 of Value of Appliance or Work State Surcharge TarAZ r� Reinspection Fee ($15.00) Rough Insp. Date TOTAL $ 2�.�0 $ $ S $ IQ.O� $ $ $ .50 $ 30.50 $ �� Also installing one (1) Carrier 38TK024 2 ton Final Insp. air conditioner Date � Approval for Permit __rl�� MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00� PLUS $.50 STATE SURCHARGE Attach stack verification foxm with.replacenent furnace peaoits *Air Conditioners can not be placed in side yard without written pexmission fr� adjoining neiqhbor. Job Address 670 Helene Place Department of Buildings, (i431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 The undersigned hereby malces application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. �Y 1 , 19 89 �R Mike Papillion KIND OF BUILDING Frame USED AS Residential TO BE COMPLETED ABOUT ESTIMATED COST ZHOO.00 OLD - NEW BIIILDING PERMIT PJO. PERMIT NO. ( G� ,S,V DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. One Traae Neme Carrier size rto. 58SSB060 Capacity Sq. Ft. EDR BTU 6 O O O HP nat. gas Zbtal Connected Load Kind of Fuel BURNER - Trade Name Capacity . Size No. Sq. Ft. EDR BR41 HP �P�y � Dependable Heating and A/C Siqned Sy�� 1.�-I 'LX � � `l �l .��i Tel. No. 757-5040 _ __ �i�1��. �c�J+ I I i Un L,�� -�e� �I�� \ l� ` � CHIM�dEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes , No () 2. is free from rust or deterioration Yes�o O 3. Has no foreign objects lodged within Ye� O 4. Is securely supported Ye ) No () 5. ��e�s al � car:r�e;�� Cade requirements for size and total BTU connected Ye ) No O 6. Has To ta 1 hea ti ng BTU' s of All other BTU's TOTAL Rema rk s � �� Q � � Com pa ny Signed 1 Da te ► � � R sue�ecT P City of Fridley ,, � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� Y l�[ � r � � , � IPT NO. � COMMUNITY DEVELOPMENT DIV ' � V-�-��', � r � � PROTECTIVE INSPECTION SEC. ,�j f� � v 1 ' �"�L � CITY HALL FRIDLE� 55432 NUMBER FlEV DATE PAGE OF APPRO�ED B� �""�' �'' 612-571-3450 910-F15 7/15/96 � � JOB ADORESS 670 Helene Place NE t LEGAL �OT NO. BLOCK 7RACT OR ADDITION SEE ATTACMED DESCR. /{ 9 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNEF MAIL AODRESS ZIP PHONE Stephen Rozek 670 Helene Place NE 574-2249 3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK CI NEW ❑ ADDITION O ALTERATION i� FiEPAIR p MOVE O REMOVE 8 OESCRIBE WORK Reroof House & Garage (23 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUM8ING, HEATING, VENTILA77NG OR AIR CONDl710NIMG. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTqUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLC�. UNITS OFFSTREE7 PARKING I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOf1K WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1sH97 �.95 DOES NOT PRESUME 70 GIVE AU7HORITV TO VIOLATE OR CANCEL THE pEqM17 FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFORMANCE Of CONSTRUCTION. y�59.5� Fire .SC �1.90 PLAN CHECKFEE TOTALFEE $62.35 S�GNATU OF �RACTOA AUT RIZEDAGENT IDATEI WHEN PAOPER�V LIDATED THIS IS�R II./L�L�_ �-z ?-!S 1� _ � � SiGNA URE OF OWNER�iF OWN BU�LOERI �OATEI BlD iNSP pFfE NEW ADDN ALTER [� [l �� ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application U f� �€ �✓� �G- /i�� {�� , �02 �/C: 5�� f� s �� Effective 3/ 1 /96 ..�l�� Tel. # �7 �{ � Z 2. �{g MN LICENSE # Attach to this application, a Certiiicate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IlViPROVEMENT Width Height Width Height Width � H�t/Ground Tel. # Sq. Ft. Sq. Ft. Sa. Ft. �:�°U��" Corner Lot [] Inside Lot � Ft. Yd Setback Side Yard Setbacks Tyge of Construction: �� -�� - Estimated Cost: $ a Approx. Completion Date: 7- a2 l� -- y'!o l� 9�j`, � (Cost on Back) Driveway C�rb Cut Width Needed: Ft. � 6 Ft = Ft x$ _$ DATE: �-ls -q� APPLICANT: _ ST��`�✓ ,�, d Z� Tel. # s�y-- 2 z�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL � �d'—/ • J V � / 90 $ • �� $ $ $ $ $ $ � �a.� � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lUth%) $.50/$1,000 Valuation $900 per SAC Unit $5.� (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary {) Not Necessary j] STIPULATIONS: - _ _ , _ � � ' � SuBJECT - ' � P c�ty of Fridley 2 8 0 2 0' � AT THE TOP OF TNE TWINS g � I L D 1�1 G P E R M I T � . R � � � • COMMUNITY OEYELOPMENT DIV. / �/�O r � L � PROTECTIVE INSPECTION SEC. �v �� 1 � i_--- w,��"��;'j CITV HALL FRIOLEY SS��Z NUMBER NEV D4TE PAGE OF APVROYED 8Y i �� 612-571--3450 9�0-Ft5 9/29/98 � � JOB ADDRESS � 670 Helene Place NE t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE IITTACMED oescR. 4 9 Donna � S Lakeview Ma OY' SNEET 2 PNOPERTY OWNER MAIL ADDR�,$$ Z�P PHONE Steve Rozek J CON7RACTOF MAIL ADDAESS ZIP PMONE UCENSE NO Owner a ARCNITECT Oii DESIGNER MAIL AODRESS YIP PHONE LICENSE NO. 5 ENGINEER MAII AODRESS ZIP PHONE UCENSE NO 6 USE OF BUILOING Residential 7 CLASS OF WOFiK ❑ NEW O ADOITION ❑ ALTEFiATIQN � REPAIR O MOYE • O REMOVE 8 DESCRIBE WORK Reroof house and ara e 23 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS " Underlayment must comply with the State Building Code. ` TVP OF CONST. OCCUPANCV GROUP OCCUPANCV lOAO SEPARATE PERMITS ARE REOUIqEO FOF ELECTRICAI, PLUMBING, MEATING. VENTIIATING OR AIR CONDITIONING ' 7HIS PERMIT BECOMES NULL ANO YOIO !f WORK OR GONSTAUCTION 20NING SO. FT CU FT. AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTIpN OR WOFK IS SUSPENOEO OF ABANQONEO fOR A PERIQD OF 1Z0 OAYS A7 � ANY TIME AFTER WOFK IS COMMENCED. ' NO. DWLG. UNITS OFFSTREEI PARKING I MEREBV CERTIFY TMAT I MAVE AEAD ANO EXAMIN�D TM15 APP�.ICATION STA��S GARAGES ANO KNOW THE SAME TO BE TRUE AND COPREGi. ALL PROVISiONS Of LAWS VALUATION SURTAx ANO ORDINANCES GOVERNING THIS 7YPE OF WORK WILI QE CpMPLIED WITH WHETHER SPEGfIED MEREIN OR NOT. TNE GRANTING OF A PERMIT ],971 .98 OOES NOT PRESUME 70 GwE AUTHORITY TO VIDLATE OF CAMCEL T►fE pEqMf7 FEE SAC CMAAGE PROVISIONS Of ANY OTHER STATE OR LOCA� LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 62, 25 Fire SC 1. 9% PLAN CMECK fEE TOTA� FEE 65.20 S�GN�tu �CON"�7A(;TOpOAAUTMOp�2E0AGENT iD � WMEN PROPERLV LIOAT D THI$ IS VOUQ PEAMIT G, �, `�'�9�� ° _ /� � t: : i— S�GNntU E O� OwNEQ i�� OWNEA BU0.DEAi� � � � �6AfE� . ' � BLO �ti5o � � � +t � NEW [ ) ADDN [ ] ALTER [ ] ConstructionAddress Legal Description: CITY OF FRIDLEY SINGLE FA1�iILY A1�TD DUPLEXES R-1 A1�1D R-2 BUILDING PERMIT APPLICATION �i� ,��,�� ,�� Effective 1 / 1/98 �O � �� S L��v�ti+-v %�'►A,�o,� Owner Name & Address: �r"E✓� �o�.ci� / S!-�r� ��) Tel. #.S tJ.�—zz�[9 Contractor: D w�� MN LICENSE # �� Address: � � �� Tel. # �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length DESCRIPTION OF IMPROVEMENT Width W idth Width. Construction Type: �`�— "- �'� o � Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: / Z 9 % APpLICANT: �fi�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ �� s-� $ � $ , o $ $ $ $ $ $ j�S-�.�� $ ' � Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. �.3 � % �/�! 0 , � U. Estimated Cost: $ f �� (Fee Schedule on Back) Ft x $ _ $ /L � Z� lL_.. CITY USE ONLY Fee Schedule on Reverse Side Te1. # .r7''�—ZZ y� .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 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 [ J STIPULATIONS: °