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AF - 47242% � i 0 . _...�Y . ...___ � _ : � , _�«.�.�._. - � . . RCCI:IP1' T'QP. C1iR'CTFT(;,1T)i OC TITLE • . • . . ._._ �� "` .s2 � , 19� " . • Received of 1'he City of Fridley of rinok�i.County, rli�incsota, 0►tiner'S Duplicute Certificate of Title tVo. y� 7��v �� : �v � (J-L(C'�^ A�'"YYl � iVitnesses � 51'A1'E O F—�//�/L� /1/� S O% fi� ) s s. • Co:.�nty of ��r� , � . ..' ' • . On tliis p�� day of ��G�/!�$�' ,,�.(�. 19�,>-�, Uefore me, a _� Not�r� PuUlic ��,•itiiitz a;id ior said �otmty, personally appearcu ,�, U -�' C..Z i� ��C'O�'-_._l. _.. to me kiioi�n to Ue the person�describe�t i�i anu ��ho executed ihe iore�oing instrt:r:ient and ackaottle;lged that�he executacl thc same as . �p�' free act a�id c!ced. � , _ f__�__`-�/�� P�►+�u�L�.s..,.r�.L�.. _ „� � _ _ . . . - 0 _ _ _ . . = � .��: c�Y��: v. n,�o�avE-rz . � !� "°` N�TART' PutsL[� — t�(idNESOTA � �- � �!– . � �� ANaKk CCii.iNTY � � C - �P .� . S ,>f _ , ; ��: r• p ( JS i7 L% � My C�mmission Exp;res Ge�. 2�, ty8p ; ' � `� . � a . �v �.Z � �cflo � Y �e.� T_ ' Village ol la ridley, Minn. BUILDING PERMIT N° 1283 '� �;, �. i ', .� �� ,, �,�_ v„ce: 1.'..".... _ .:... -.:..� ................... L`wner `!. .- . : � �� : � ��Z-��f. yt -. �- ....... . :....................... f3uildcr .............................................. Aric:ress ...................................... .\ddress ............................................. LOCATION OF BUILDING / ., � r/ ' /�� ' �. \a .�C^.��.,�.... Street .,C�(.�C-i:�L:`.'.°.." � �. � Part of Lot ............................. .� ....:............... Lot ....y....... Alock ........�'...... .'�ldition or Sub-DivisionC.a'`.L�f.^I.!iYf!'A......Cl.-�'T..�' ✓ Corner Lot ........... In�ide Lot ........... SetUacl. ........... gidcyard ............................. DESCRIPTION OF BUILDING 'I'o be tised as: �yG'rl��e,:,'_.�.t Front ..�7..!. Depth �1t. 4... licieh[ ........ Sq. Ft. ........ Cu. Ft. ........ �. �. . . . . . . J . Front . .. .. . .. Dcpth ..... ... Hcight ... .... . Sq. Ft. ..... .. . Cu. Ft. ........ �� T�•pe of Construction ,.-�c.Plirs+:t?..•... EsL Cost ..................... To be Completed .................. In consideration of the issuance to me of a permit to construct the building described abo�'e, I agree to do the pe•opo;ed �vork in accordance u�ith the description aboce set forth ancl in compliance with all provisions of m•dinances of the villagc of Fridley. ..................................................... __ `IG i.L..�.rti_i�,c.:,n—s•-c —...__ Yn cm�sidcration of the payment of a fee of $y%.4, ..:.. ., permit is hereby granted �..�.... �.......... .. ......................... to construct the huilding or addition as described above. This permit is granted upon the express condition that the person to W]lOdl it is granted and his agents, employees and worlanen, in all work done in, aroimd and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridlcy, Minnczota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may 6c revoked at any timc upon violation of any of the provisions of said urdinances. �__ .-- �� --. �� ; ......��,...,s:?• .. ............. Building Inspector �r..- . NOTICE: 7his permit does not Cover the construction, installation or alteration for wiring, piumbing, gas heating, sesver or water. Be sure to see �uilding Inspector for separate perm�ts for�e items. SUBJECT PERMIT NO. c�ty of Fridley . i5� � AT THE TOP OF THE TWINS B U I L D I N G P E R M I T f ; � ' ECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � j 4 �"� ' � �� r � � PROTECTIVE INSPECTION SEC. � . � � � /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE � OF � APPROVED BV �`°•� � ,'� 612-560-3450 910-F15 5�2��g / / JOB ADDRESS 6821 Hickory Street N.E. t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 OS'I�Rdri� S FlY'S't AC�ltlOri SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wilfred Bolkrom 6821 Hickor Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING R 'de t' 7 CLASSOf WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK 9 CHANGE OP USE FROM TO STIPULATIONS �of can be second but not third roof. Install ridged galvanized valleys. 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. F7. AUTHORI2ED 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1� O4O y�. SZ DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINCa CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � �`9.00 � PLAN CHECK FEE TOTAL FEE $9.52 SIGNATUREOF N� nCro ORAU ORIZEDAGENT �onTE� -. � WHEN PROPERIY A�IDATED THIS IS YOUR PERMIT . �C� � `�� ,� c ATUREOFOWNE RE�RBUILDERI IDATEI BLDG.INSP � DATE � _ � _ , • , � � CITY 0f= F(ZIU�EY . ' - APPLI CI�"f I Oi� FOR RES I 1�(�f��T I�,L LU I I_D I NG f'Eftf�1I TS , ' � (I�CIJ, �LTL"-R/1TIONS, /�DDISIOWS,' OR REPAIftS) '� � • �. `� ` � � OWtiER: �:' � IIUILDER: ' ° � • 1 . . Addressc�w�2-�. .� Rddress: � Tel. No.: ' � � • No. :��_ Street: �� 1/ ) I,OT: � BIACY.: � ADDITZON: ��C77Xa� °�,�L�S� ��+ CO1tNER LOT: - iNSID� IAT: a'� SLTBACY.: SiDEYT1ItDS: Applicar-.t attach "to this form Ztao Certi�icates of Survey of Lot and proposed building location drawn on these Certificates. . ., � DESCRI PTTOPJ OF BUI LDI NG ,, To Be Used As: � . . Front: Depth: ' � Height: " Square Feet: Cubic Feet: Front: � Depth: � Height: � � Square Feet: � G1�bic Feet: ' Type of Construction�.� -- Estimated Cost: $�� "�►�� -. �� ' ?b Be Campleted: �� - Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ ` . � (SE� R�VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work Ilerein specified, agreeing to do all ��ork in strict accard�ice with the City of Fridley Ordinances and rulings of the Departme�it of Buildings, and hereby declares that.all the facts and representations stated iii this application are true ancl correct. See reverse side far additional infonnation. DAZ`L: � �� `� SIGNIITUREa `_,` \ � \ Stipulations: �� -� .�.d . r''J , �= �"____..._ � � �s�' � . �. . _ - . . 0 SuBJECT 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. r � v � PROTECTIVE INSPECTION SEC. � , � � �"'t � CITY HALL FRIDLE� 55432 NuMBER RE� �'""� � ,'' 612--571-3450 910-F15 JOB ADDRESS 6821 Hickory �treet NE t LEGAL LOT NO. BLOCK TRACT OR ADOITION DESCR. 2 2 Ostrnan `s lst Addri 2 PROPERTY OWNER MAIL ADDRESS Harry/Ann Bolkcom 6821 Hickory Street NE 3 CONTRACTOR MAILADORESS Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADORESS 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION O ALTERATION 8 DESCRIBE WOHK Construct a 16F x 10" Deck Addition to F�ant o� Dw 9 CHANGE QF USE FROM TO STIPULATIONS See notations on pl�,n, DATE 7/29/91 ZIP ZIP PAGE OF � � � i 1-. PHONE PHONE PHONE 20966 // 3 APPROVED 8Y SEE ATTACHED SHEET IICENSE NO. LICENSE NO. IICENSE NO. ❑ REPAIR O MOVE O REMOVE WAR�� Before di�ging r.2!) for ail utility ior..atior�s 45�l-0002 . REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBtNG, iiEATING, VENTILATING OR AIR CONDITIONING. THtS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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. UNITI I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL 8E COMPUED $1 2QO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT t DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- c� STRUCTION OR THE PERfORMANCE OF CONSTRUCTION. Y29.QO NATURE OF CON�ACTI�OA D AGENT IDATEI �___.. -�- Z�� , R SO STALLS NCY CU. FT. )FFSTREET PARKING GARAGES iURTAX $,6Q iAC CHARGE k'ire. �C $1.2Q fOTAI FEE $30..80 ) H►S IS YOUR PERMI � �r DATE � � ) � � � �� [ � «�tr�.�im aaa�: 7�ga1 Des�'iPtian: _ ow,�r xam�e � Address : CarYtYac.'to�: � � �l � �Z Buil 't �1pQlicatian \ ��2 l � , �, v,� J .) I d h aaa�ss: �(/ ��► e... � . , , .,�,. �• -r r,- •�;.. . ;� -,�.. .1r:��; �� ti � EffeCtiv+e 1,/1/91 L=.. , � �+e1. # S 7/- 2oZ-� 'i�el. � Pittadi to this applic�tian, a Qertificate of �v�ey of the lat, with ti�e p�cposed oanst�uc.tian drawn an it to acale. �BBCRIPRZiON C� �tT �x,�tn w�atn xei�t sq. r�. Length w3rath Iiei�t sq. Ft. �th .�� wiatn /D ' �t/�� t' .G " sq. �. /G � � C�o,� '� . $L '�- 1Z.O�j', � ` o�rner Iot (] Insiae Int j Ft. Ya side Yara setbacacs _ Zype of Qo�c�structian: Ti^�ea . �o►s�s �� ►n Esti.mated Oost: $ �o �. �� : - �t 1 Pt�q�osed Driveway Width If New Op�nirig Is Desired: Ft. $ S Width + 6' See Back Page nATE: APPLICANT: �el . � P�etmit Fee $ Z�/. O 0 �ire sur�i�arge $ I . '252� State Suxrharge $ • �i C1 �� S D�iveway Esc.��w $ Pe�rjC FEe s sew�er Main Ct�arge S �I'AL $� . b '�TIRJIATI�IS: : I�ee Sd�e�ile an Aeve=se Side .001 x P�etmit Valu�ttirn (1,/lOth $) S.SO/Sl,000 valuatian - $650 per' SAC Unit �llt. "A" C�' Alt. «B" Above Fee Dete�_*+� by �*?•,��r;*� � N�Y I ] � N�Y I ] r �� 'b �► — 7�1 0 i� � � 2'� �i�a� �' > �� , � �n o,.fs� �r� A�.�,c.�— s�a�` ~ � . ti � h � �:��r p�� . �� Oou�bt�!'i. 2x$ R, r✓► g!� D� �. _ __,___.__.__� ___ S.'3Z --- ,----- _ ._a ,. _. — - -._.,_. _ ___ _ - _._ _ _ _ _ . _ -, - -- _ !: ; S. S'� ;- : ;: , _ T _ _ � - _ - __ _---- -- � - - - -_ _ �- � _ _ _ ,, _. ; , M , ---- ------ _ __._ .___- -_.___.__�___ � �`fl �.__ ___-.- -- -_.-- ,_ �A'1�i �`S - _.,_... � _ _ � . ----- --___.___ _ .� ___ << R � : _ ____ ._ __ � ,_ _.� , � , -- _ _ _ �. _+. .__ ____ - - - g m� . : _ - : _ --. _ � �.�i�-- , . � ._ ___ . _ _ ._ � � � -- --:_ _ - . _ _- ; . ��. ; _ .. � � , ; � ; . t_ ; , _ . _ ._ . , � ? � ; _; � _ �� . . �� ; � � � ; � � _. �_ .. . _ _ _ _ : _ . _ . __, ._ � __ ,__� __ i � ___�..�._ � � ' a � � __ -- _�. _ � _ . , , i.._._ � _ ---- ,;` : , _ ._�- _ • . .. _ . . _ ._..._ - i r, r J I�- __.. , . ..._ .._ .,__ , _ --- --; -- -t .t . i �� , _ _ r ; �� ; ____� _i � , ; 1 � __ , � ___ � , , . . : r .i . � ._ , � � -- . . -- - - _ __ , ; �s-_ �- _ __ _ , i - ` • p � .,, . � _ ___---___v___,._-____ _ _ �� ; � � . � ��_;, , , � . - v: � . � _ _._ _ . ; . . : �. . -- -- ,_.__ , . . , _.,. - - -_ -_, ; � _ __ : _ ; �``i i _ ; ��. __ � � -- --- _ __ _ _� - , � r _ _ _ u _ �_ _._�--- -_ --_._. � � _ ,�� ,�_ 1� , -: _ . � :.. _. �- - -- - - ---____ J � _ � � .. __...�-,--� ;� � � � � � � �� . . � � \ 3 _ ��l� . /}� 11 � t� . I ••�v � o�� .�__ �.__ ____.._ - __ � ___�_ _. __��. ____� - . _, _ . - _. • ' ,, �l _ _. _ _ _ _ _ . �, , __,, ..�`:� ___: _ _ _ - - _ _ _ :-� - . _ : _. _. _ , _ �, -; . _ _, . _ ., �. ,..� CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 643i University Ave NE � Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTIMG PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wate� Bath Wash Drink. Floor Catch Auto. Cas Gas Misc. Water Heater Stories Closet Urinal Tub Shower Sink T�ay Fount. Drain Basi� Washer Appl. Ran Fixt. Gas Elec Basemen Fioor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDR New Fixtures + Old Opening, New Fixture Beer Dispenser Blow Otf Basin Catch Basin Rain Water Leader SumpJReceiving Tank Water Treating Appliance � Wate� Heater -Electric Water Heater - Gas , Gas Range Gas Dryer Back Flow Preventer Required ()Yes () No Type a �.00 S 4.OQ a 5.00 a �.00 a �.00 a �.00 � 7.00 a�o.00 a �.00 a10.00 a� o.00 a�o.00 a5.00 Reinspectbn Fee 530.00 ALL OTHERS AND/OR REPAIRS AND ALT�RATIONS 19�6 of Value of Fixture or AppUance State Surcharge � .50 The undersigned hereby makes application for a permit for the wo�k herein i specified agreeing to do all work in strict accordance with ihe clty codes and rulings of the Building Division� and he�eby declares that all the facts and representations stated in this application are true and correct. ,.//}'/� . 2� , 19� Owne� Building Used As,�,Sf`a�n � Estimated Cost ��- PERMIT NO. �C� ��r� � PLUMBING SIGNED Bti Approved 8y J�� Rough-' n Date i ! � �� ` v Final Dete MINIMUM FEE FOR ANY PLUl�81NG/GAS PERMIT IS 515.00 TOTA! FEE S��d PLUS THE 5.50 STAT� SURCFiARGE SUBJECT . P • City of Fridley 2 2 7 6 0 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � RECEIPT NO. � � � • COMMUNITY DEVELOPMENT DIV. '`� r �� PROTEC7tVE INSPECTION SEC. d�� i � � � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""� � ,'' 612-571-3450 9t0-F15 � � 7/28/94 JOB ADDRESS 6821 Hickor St t LEGAL �OT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 O � SHEET 2 PROPERTY OWNER MAIL AODRESS ZIP PHONE Diane Bolkom 571-2026 3 CONTRACTOR MAIL AD�RESS ZIP PHONE LICENSE NO. Interior Motives 7841 Wayzata Blvd �1f211, Mpls., MN 55420 593-9860 5118 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAtL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW � ADDITION ❑ ALTERATION � REPAIR X MOVE ❑ REMOVE 8 DESCRIBE WOFiK Construct a 16' x 16' Sun Porch; an 8' x 14' and a 10' x 8' Addition Remove existi�rg deck and reposition free standing away from house. 9 CHANGE OF USE FROM TO STIPULATIONS ' See notations on plan. w��G Before digging cali for all utility locations 454-0002 RE�UIRED BY LAW TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRtCAL, PLUMBING, HEATING, VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONING S0. 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 ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIEO WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �31 � 23$ LS . 6Z DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERMIT FEE SAC CHAFGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE ORM, CE OF CONSTRUCTION. �297.5� Fire .5�', 3. J� -- PLAN CHECK FEE TOTAL FEE , , `% Zg % icense SC $5.00 $349.36 NATUREOFCON"RACTORORAUTMOR12EDAGENT ID TEi P VA ATED THIS IS YOUR PEFMIT � , _ �� .. 4 GZ SiGNATURE OF OWNER Uf OWNER BU�IDEAI IDATEI BLDG �NSP qATE N F,VJ ADDN ALTER [J 1.� [l CITY 4F FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND �-2 Buitding Permit Apptication ConstructionAddress: �P �� L.egal Descripti�n: !�t � r'�Th 2..�x,3� 1 r �" C,�m � Effective 1 / 3 /94 �� Owner Name cX� Address: �'j j�, �� p lke ,y� Tel. # S'%i" 2-O 2.G '�Contractor:. �i ��a i,es��'c�l`�-�+ �.T� bg�} �',�+ut� wl.�`�i�� esMN LICENSE # S/� �$ Address: 7 % (.t� a.� �'ci. �d �#'2!� �.%f'%.nile,a.ye-�i`S � �'ti"�el. # � y' 3 — 9�(i D I:IVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this appiicatiorr, a Certif''icate of Survey of the lot, with the proposed construction drawn on it to scale. � � � DES��PTION OF� IMPR�IVEMENT / Length / (r Width / Height �_ Length Width Length Width Height Hgt/Grounci _ Sq. Ft. -�' �� Sq. Ft. Sq. Ft. L Corner Lot [] Tnside Lot [� Ft. Y� Setbackr Side Yard Setbacks Type of Construc6on: �_., Estimated Cost: �__T Approx. Completion Date: �/ ,S 3�, 23�1 La (Cost on �ack) Driveway Curb Cut Width Needed: Ft + Ft Ft $ _$ DATE: � 9� APPLICANT: ,. Tel. # �3 "�� 3- �' �'s� Permit Fee Fire Surcharge State Surcharge SAC Charge $ 1 � . �d $-� / �� _�� $ License Surcharge $ �. C% l=� Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ i�TAL STIPULATIONS: $ � �� CITY jLSE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1i lOth%) $.50/$1,000 Valuation $800 per SAC Unit $5.00 (State �,icensed Residendal Cantractors) Alt. "A" or Ait. "B" Above $450.00 Conservation Pian Review Fee Determinec� by Engineering Agreement Necessary [� Not Necessary [ l .s s � - , . � j�' l l . '{?. . . - `'.� , 5- � ;:i'. .`7. �:�y .�'S'r�� – - 'j'Y`''`: `j�%I�lS�i%� 1� .^ , � i 1 � 7� � _i 3 • '� f � i � s �-'d � '� 1 ,� �;� �.. a � � \\.. v c�. ,1 _ - _ __ �-- -- _ __ _._.- —; � ,, �'' �� d � � � l� � �(?;�U:G�� % . ' __ � : _-- � _ __ _..._------ �,e _ t.; �_..... _. ._ _ _. , --- -�-- i , 4 I I � � � . , � � ----, _ i � 1 � -, � � ��,';�J}� l�i�C� � ; � � ! � . �. � �'� �� Q �+ ; "; ! .� : �'� r^, .' � � P � � , h� � . - - �` , , 3 7 � � \ � I � --- �_ l � \ 1 � 1 t � { } � t \ . . _ .... ......_ . ... -_r-. �_ �_ � � –.. — � �c ��/,'��% �7 � � � �� ' � .J � � '�1`'`_ , -...� \ �— �.i i r t�r rniu�cY uv�rt� i i�iv uiv. 6431 University Ave NE Fridley, MN 55432 572— 3604 tneet�ve un ,�anuary i , � yy3 APPUCATION FOR PLUMBING AND GAS FITTING PERM}T MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIX7URE RATES N0. RATE TOTAL New Fixtures � Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water 7reating Appliance Water Heater —Electric Water Heater — Gas Gas Range Gas Dryer Back Flow Preventer Required ()Yes () No Type $ 7.00 �2� $ 4.00 $ 5.00 $ 7.00 $ 7.00 � �.00 $ 7.00 $10,00 $ 7.00 $10,00 $10.00 $10.00 $5.00 ReinspectionFee $30.00 ALI.OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance � E' -- State Surcharge $ .50 JOB ADDRESS C9 �� /V ��r� A-"�� C� �0 � The undersigned hereby makes appiication for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Buiiding Division, and hereby declares that all the facts and representations stated in this application are true and correct, 2� ,199�./ Owner � v ` �� Building Used As �� d'"� --� r / �Estimated Cost ! c� �G o PERMIT NO. 1` (� � ,.-_ � ('\ F r PLUMBING � SIGNED BY Approved By Rough—In Date � Final Date 6� MINIMUM FEE FOR ANY PLUMBINGiGAS PERMIT IS $15.00 TOTAL FEE $��8 PLUS THE �.50 STATE SURCHARGE � � >� _ _ �� OF FRtDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 September 29, 1994 Ann Bolkcom 6821 Hickory Street Fridley, MN 55432 Subject: Property Located at 6821 Hickory Street, Fridley, Minnesota TO WHOM IT MAY CONCERN: The above-referenced property is zoned R-1, Single Family Dwelling. The property is located in Zone C of the flood plain, which is considered to be "areas of minimal flooding" as defined by the Federal Emergency Management Agency's National Flood Insurance Program. The Community Map Panel Number is 270013 0003 B, dated March 2, 1981. If you have any further questions regarding the above-referenced property, please contact me at 572-3593. Sin erely, LC�I� `� �-�..�/ � �ic ele McPherson, BLA Planning Assistant MM:ch C-94-262 CITY OF FRIOLEY fNSPECTiON DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 �.7:��i�L��IT1�� APPLICATIUN FOR POWER PLANTS AND HEATING. COOUNG, VENTftATION� REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVtCES Residential Fumace Shell and Duct Work, Bumer - Also Repiacement Furnace (Side Vent - Fiii Out Back) Gas Piping (Needed with new tumace) Gas Range Gas Dryer *Air Cond�ioning - All Sizes All (ithers/Repairs & Alterations (LIST ON BACtn 1% of Value of Appliance or Work Commercial/industrial 1% ot Value of Appliance or Work Rate TO7AL $ 20.00 $ $10.00 $ $10.00 $ $ 10.00 $ $10.00 $ State Surcharge TOTAL FEE Efiective On January 1,199'� JOB ADDRESS_ _ �go2/ �7'� �,L'o�- �/ ,�-- �%� 7_"_._ : The undersigned hereby makes application fo� a permit for the work herein speci�ied agreeing to do all work in �rict accordance with the City Codes arid rulings af the Building Division, and hereby declares that ail the facts and representatfons sta�d In thls application are true and correat. , � ,_, -/o�a v ,,�� BUILDlNG USED AS in��o_ �tuM.'( y�s i o%— ESTIMATED COST �D� a� PERMlT NO. �l j I � ; 1�. • :,_ :,� •�; �:►_: $ No. of Heating Units Circie One (Steamj (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Totai Connected Load �� /�S SD MINIMUM FEE FOR ANY HEATINGLOOLINCNENTtLATIfJN REFRIGERATION/AIR CONDITIO(dING PERMIT IS $15 00 PLUg THE 5.50 STATE SURCHARGE REINSPECTION FEE �30.� *Air Condit�ners can not be piaced in a side yard without written pertr�ission from adjcining property owner. Bume� 7rade Name Size Mo, BTU HP EDR HEATING COMPANY ,a l,� p g � ci�,°�a /� �!� � _ , Signed Approvi �e.+� Tel No. yai�a �f / % Ro - � �. � ugh In Date ,�,_ Fina{ Date FiLL OU'f BACK SIDE FOR STACK VERl�ICATION O(d REPLACEMENT FURNACE % NOTE: #1 through #8 required when using a side vent furnace. .. _��_►1_ , ►. ► `y ; , / _:_l� . � � The undersigned hereby verifies that the eacisting chimney or stack: L Has been carefully examined Yes {) No {) 2. Is free from n�st or deterioration 3. 4. � Has no foreign objects lodged within Is securely supported Me�s all cunent Code requirements for size and total BTU's conaected 6, Has total heating BTU's of 7. 8. All �her BTLi's TOTAL BTU's Has a liner been provided for water heater Has combustio�n air been pmvicbd for wa�r heater . . i�� .�. j.�. AI .T�R ATI�� /,/l�( � '� �vv� �, �n � del. ��r� I'% ,� / ,6.�� Yes()No() Yes()No() Yes{)No() Yes { ) Na ( } YesONoO Yes()No() HEATING CO: Signed By: Date: / v /_,., �%1' �._ sue�ECT P��MiT NO. City of Fridley �'' ; � �� 3 � AT THE TOP OF THE TWINS g U I L D i N G P E R M I T �� ` _. � _ __ __ . � � COMMUNITY DEVELOPMENT DIV. RECEIPT NO. . �� ------. .�0 9�' r � � PROTECTIVE INSPECTION SEC. � � i � ' � �'��1 ' CITY HALL FRIDLE� 55432 NUMBEA AEV DATE PAGE OF APPROVED B� �'""�"� �'' 612-571-3450 9�0-Fi5 7/12/96 / / JOB ADDRESS 6821 Hickory Street NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Ostman's LSt SHEET 2 PROPERTV OWNEF MAII ADDRESS 21P PHONE HarryjAnn Bolkcom 6821 Hickory Street PiE 571-2026 3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO Same 4 ARCHITECT OR DEStGNER MAIL ADORESS 21P PHONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PNONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WOHK Construct a 220 sf Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. � wa .� �r�s Befor.e , digging ��-c�� for �� Utillty iOCStjORS REQUIRED BY �aw TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY LOAO SEPARATE PERMITS ARE REOUIRED fOR EIECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITtONtNG. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 6� OAYS, OR lF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ @ WITH WHETHER SPECIFIED HEREIN OA NOT. THE GRANTING OF A PERMIT W1,951 y�.98 DOES NOT PFiESUME TO G�VE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- $62.25 Fire SC �1.95 STRUCTION OR THE PERFORMANCE OF CONSTFUCTION. PLAN CHECK FEE TOTAI FEE $65.18 I NATUAEOFCON�A ,TOA nuT ZEDnGeNr ionrE� WHEN PiiOPER VALIDATED THIS IS VOUR PERMIT f � �-i�,� �S� TURE O N auFOWNEaBUiLDEAI ID EI BL �NSP ��°TE NEW ADDN ALTER �j �� [� ConstructionRddress: Legal Description: l�� Owner Name & Address: Contractor: �" �t � Address: CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-Z Building Permit Application Effective 3/ 1 /96 � �_� `` ) �c " _.._e,._ .., .... l `i �� ..�1 � LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. �f ,� / � �� Z So MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed constcuction drawn on it to scale. DESCRII'TION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height �Ft. Length ^ �� Width � Hgt/Ground � Sq. Ft. �� o Y�' �% — = � ��/ ya Comer Lot [] Inside Lot [� Ft. Yd Setback Side Yazd Setbacks Typ,� of Construction: _ i�.� �p� �U-'�.. rh, �., Estimated Cost: $ 4�� l f, Y� Approx. Completion Date: Driveway Curb Cut Width Needed: DATE: APPLiCANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: (Cost on Back) Ft. + 6 Ft = Ft x$ CITY USE ONLY =$ Tel. # $ � 2 Z� Fee Schedule on Reverse Side $ , � .001 of Permit Valuation (1 / l Oth %) $ $.SO/$1,000 Valuation $ $�0 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Abave $ $450.00 Conservation Pian Review $ Fee Determined by Engineering $ Agreement Necessary [ j Not Necessary [] d , G � . . i ; ;� i g � f � � \� ,. , _. _ ,p ; ,_.__� �1 � �_ 1`. i ol _ . —T� `' r -'- ` `J. 0 (n �`_ �.? � �� \�'` �" �.s,/ V,.�.,_ r: � �� ' �''� `r `� �� y � �� U � ; .. � , I �.., 1 � v � � `.! � r� ' J � �, , �, I .�..�` � 1 �i i � _ . _. .. .._ .._ ._..._... __ ... . .. . .�`,.,._ ... � .. _..-_V......_.._. . 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' '�, . 1n . ��1 �.` . i � '� .� � _ � � 4 � - '7' _ -, : ; , { c'� � � . ; - � c,t � _ /r�; : _ _. - �J `� �� . . ; - l_ . � `) : �i ? . ,-� � � � � - � � ? � �°, _ ��l � � , _ �_ _ .9 �. �- � .... a , �: � � � � � �� - y � S._� _ % W t ! +. � � t.� �3 `-" � � ' � ',, i . , � , , __ - ��--• ._ _ _ .___... _ _ °� � '�.ht�: .. _ . . . � .� � � � � ^ � � � � � . . . � d� -_ � ,.- . � ,. . , . , , . : � - . , ,� , ..,_. , ; � � v. � •. _. • � � �, .... ...._ , , . _. . .,_ � . `� ��" �.�.{' -- -- ---_ _ . _ . . , • � �r ;�_� ;.� -....., i � � � ✓ � ," � i C� . . �� `� � .`,' - , . . _ . ! � _ � . / . . � . r. � � ` � . �� .. � . .. . . . .. .. '. . . _ - . � � / • , � �. '� � ' � .....�_... .�..� ' �� . _._. ._. . _,.. . .. _.. _ _ /n , ` S _ ��:�. - ---_�-._.. 'i � ,� ` `� � � , �, _ ` -- ;� � I '1 `1 . l� � � � ' . ' . . . i. f ,, � ^ f li � J , � � j. .. _ 1 . . � . � �. •4.P�` ! " � ... r l� i � . .. �/_�.. . � . � �. � � . . � . . V . � � �._ .. . .. . ..... _.. 1'' i ' . � yy �� , �A\ — . �� I " `.� / �� _ � .. ,.+.. � J ; . -. C-. . . � . . � . . tt� ; � .J `� '" . r,\ 1 ` '} �. ...___.: .. __ ., _:.. . . r� :� r . . �y _ ,{., j 'i . 1-� . � i � � • . . � . . . ♦ �' - .�s . CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Fioor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES APPLICATION FOR PLUMBING AND.GAS FI1?ING PERMIT ,„ MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR :, Batti ;; :: Wash pCihk ..: Floor CatG}i .; Auto. Urinal 7ub:: : Shower S.i.nk ; Tray Fa.Unt Drain BasEn:: ' Washer NO, RATE TOTAL New Fixtures � Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range** � Gas Dryer** Back Flow Preventer Required ()Yes () No Type— — . �15.00 _ $7.00 0��.� $ 4.00 $ 5.00 • $ 7.00 $ 7,00 $ 7.00 $ 7.00 �10.00 $ 7.00 $10.00 $10.00 ��}. � $10.00 Effedive On January 1, 1997 Gas [ Misc. :, Water Heater Range jF�xt ,,,..; ; Gas Elec JQB ADDRESS � .� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accord�nce with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 'l.S' 199� Owner � % � O? 6 Building Used As � ' � J ��/ � �� J � Estimated Cost'� PERMIT NO. 1��`1�, PLUMBING COMPANY L�/% �j�..�.�u� �_ Reinspection Fee $42.00/Hr . StGNED B��:.l�_ TEL NO.� �� / ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance � Approved By Rough—In Date __ Final Date ✓" �'a State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20 00 � TOTAL FEE $ 3l•SlJ PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MiNIMUM SIZE 9 SD INCHES. sua�ecr P � City of Fridley 2 5 9 2 8 ' , AT THE TOP OF TME TWINS g U I L D I N G P E R M I T EIPT NO. r � �` COMMUNITY DEVELOPMENT DIV. r � L � PqOTECTIVE INSPECTION SEC. � 7� 7 � � � � �"�1 � CITY HALL FRIDLE� SS132 NUMBER REV OATE PAGE Oi AVViiOVED 8Y �'""� � �'' 612-571-3450 9t0-Ft5 4/13/98 / / JOB ADDRESS 6821 Hickory Street .NE 1 LEGAL �OT NO. BIOCK TqACT OR ADDITION SEE ATTACNED OESCR. 2, 2 Ostman's lst Addition SHEEt 2 PROPERTV OWNER MAIL ADDRESS ZtP PHONE Harry/Ann Bolkcom 6821 Hickory Street NE 571-2026 3 CONTqACTOF MAIL AODRESS ZIP PNONE UCENSE NO. Remodeling Dimensions 58T2 Excelsior Blvd, St Louis Park, MN 55416 920-5555 ' A AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 20084895 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OP WORK ❑ NEW ❑ ADDITtON � ALTERATION O REPAIR � MOVE O fiEMOVE 8 DESCRIBE WORK Remodel kitchen; open wall to dining room; new header 9 CHANGE OF USE FROM TO STIPULATIONS See natations on p1an. SFPARATE PERMITS R�QUtRED FUR �VIRING,. HEAT1yG, PLUMBtNG At�D SEGN� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD SEPARATE PERMITS ARE REOUIFiED FOR EIECTRICAL, PLUMBING, HEATING, VENTILATING-0R AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. f7. CU. FT. AUTHORI2E0 IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOFK IS SUSPENOEO OR ABANDONED fOii A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIfV TMAT I HAVE READ AND EXAMINED TMIS APPLICATION ]. STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SUFTAX ANO ORDINANCES GOVEFNING THIS TYPE OF WORK WILL 8E COMPLIEO WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 18 � SOO �9. LS OOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONS?RUCTION. �274.%S Fire SC �IH.SO <� , ., P�AN CHECKFEE TOTALFEE License SC $5.00 $307.50 S�GNATUAE OF CON'RACiOA Op AUTMOA�2ED AGENT IDATE� WHEN PROPE VALIDATED THIS IS VOUR PERMIT � � � 'V SiGNATUFlEOfOWNEAUFOWNEABUILDEAi �OATEi B G �NS� � qpiE 0 NEW ADDN ALTER �) [l �) ConstructionAddress: Legal Description: Effective 1J1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ,.L�� BUILDING PERMIT APPLICATION �? `-� 1�� Owner Name & Address: ��,Z.tz,v �: AN� �1 A��c�r"� Tel. #�S'71 -202GcJ Contractor: }��yvwo�� Jt��l � M�S lb�.�.S MN LICENSE # 7C�'.'8�8�� Address: t`� t yL. Ex ��1._� ��k. �L►�'O� ��L��S Q�Ck �� ,��-Tel. # 9?�-�S� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of th� lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. I,ength Width Height Sq. Ft. I.,ength Width Hgt/Ground Sq. Ft. Construcdon Type: � Estimated Cost: $ I�0�� 4 W Au--•- � ��N�- �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �--�1 APPLICANT: �A2�/ � �-k'� �R� Q 2� �'��^�eas�Tel. #'�j'L�J� 555�_ Permit Fee Fire Surchazge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �y 7.� $�_� $ �, 2 J� $ $ �� $ $ $ $ $ 30�• � CITY USE ONLY Fee Schedule on Reverse Side .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 [ ] � _ v�nr [ ) �DDN [ ] �LTER [ ] Construction Address: � g z I ��d� - o�� CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg tnsp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION � Legal Description: Owner Name & Address: �i��' +F- �•�/ �oL,��,o Tel. # 7�3--.�7'/~ �Z�° Contractor: ��r �i��t�,v✓/-._ MN LICENSE #�U S33o Z Z. Address� �,loz �-' Z,E.v�.7� �-1/� J� /2o�3i,�Sbi9'L.Z�i Tel. # <o�Z—?7D —8'j�b'r� LMNG AREA: GARAGE AREA: �� L Attach to this application, a Cert�cate of Survey of the bt, with the proposed construction drawn on it to'scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft DECK AREA: Length � Width HgUGround Sq. Ft OTHER: �z%i''1D7�1� /�i1�'lT�'�D'O/`'I � �� /PDI�� " t �061.� Construction Type: Estimated Cost: $��U• O�' . Driveway Curb Cut Width Needed: F� + 6 Ft = DATE: �"Z-� d�APPLICANT: Call (763) 572-3604 for Permit Fees if you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Esccow Erosion Control Park Fee Sewer Main Charge � 1�5; ��' $ � ll - �� $ S. S� $ $ � -dU $ $ $ $ � Ftx $ _$ Tel.#�Z�%%D "�l�S/ in application. Fax to 763-571-1287 ff using credit card and we wiN catl CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or A{t. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary j] Not Necessary [] TOTAL $ ��G. r%� STIPULATIONS: �bDS�� D I �3 PLUMBING RESIDENTIAL APPLICATION City of Fridley ��S-c��3 Permit Number Received By Date Received NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE �� — C`�S— YOUR E-MAIL SITE ADDRESS ti4� 2,1 GF. ��, .� � � THE APPLICANT IS: (CIRCLE ONE) OWNER NAME / PROPERTY OWNER/ qpDRESS � c.�� TENANT � CITY �f'��a/�Gf/ STATE PHONE # � CONTRACTOR PERMIT TYPE NAME l�la�g [7 ✓�, ADDRESS �S�P A CITY/.X, �� PHONE # %/'T — eZ�,� SINGLE FAMILY TYPE OF WORK I ❑ NEW ZIP iTATE !�`l.�l/ ZIP�T� T7`-� Fax# �G..�.��- �'�S"33 TWO FAAAILY � REPLACEMENT TOWNHOUSE l DETAILED DESCRIPTION OF WORK ..�+�lSn-�� tc.�.-z� s^ '�G�6 OZ' t7C�vPU. .�,�af� ��;r�t.✓S _ _ a � ,(,� J �„�,- FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED �� FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING �BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. (S75) DISHW/�SHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION WATER METER OTHER Permit Fee Plan Review Surcharge TOTAL DUE � a� pD S $ .50 � �S =S� MINIMUM: �15.00 or 5% of cost of the improvement-whichever is greater on work less than $300 Make checks payable to: City of Fridley FOR A PERMIT — NOT VALID UNTIL I hereby apply for a piumbing permit and 1 acknowledge that the information above is complete and accurate; that the work wiil be in conformance with the ordinances and c�des 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 requires review and approval of plans. NAME OF APPLICANT (rp�+oO'i Gi � �Gt"/�crl/!- DATE a'��ds Ple�se type or print SIGNATURE OF APPLICANT 6431 UNIVESITY AVENUE NE, FRIDLEY, MN 55432 (763)572-3604 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# ��OS -0�,3�� Residential Application Date City of Fridley See Back Side For Repuired Information Site Address: The applicant is: (cirlce one) Owner' Contractor Property Owner: � � Address: �8"Z � City: State: Zip: S 4�3 Z Phone: G 3 �Sy7/�ZG?-1iCell: Fax: Contractor Information Company Name: Contact Person: City: Phone: Cell: Email: of Work (circle one): New Detailed Description of work: State: Zip: Fax: MN Bond# & Exp Date AlteratioNRemodel Equipment Installed: MFG:,�f1��Sv�✓+[— ModeL �!/68'trQ Z Size/BTU: 7 O C�i"1 MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 _A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Fumace $35.00 Pool Heater $35.00 _Boiler $35.00 Gas Dryer $10.00 �Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee Surcharge Total Due $ v � � (Total from above-Minimum fee $35.00) � _ 0.50 $ �'SS. SUMake check payable to City of Fndley This is an application for a permit- not valid until processed I hereby apply for a mechanical permit and I acknowledge that the informa6on 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 accordanca wid� the approved plan in case of all work which requires review and approval of plans. Signature of Applica � Date: ??�'��d� Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 Building (,1'T• Inspections 763-572-3604 SITE ADDRESS (IJOc�( 1 THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STA"FE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE BUILDING RESIDEIVTIAL APPLICATION CITY OF FRIDLEY E-MAIL ADDRESS ❑ OWN R �SNTRACTOR �U °t f1 PHONE: - �,l.0 �:J NAME: �'' srATE Lic� ADDRESS PH E S SINGLE FAMILY/NF O TWO FAMILY/NEW D ADDITION ❑ BASEMENT FINISH � DECK TYPE OF WORK: � _� DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQiJARES GARAGES PROPOSED SIZE: PROPQSED HEiGHT: SIDING p V inyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ONo OR FOR NEW OPENINGS-DESCRIBE S[ZE OF OPENING CHANGES & CiT'Y EXP DATE FAX ❑ ROOF ❑ SIDiNG O SWIMMING POOL ❑ ADDITION � REMO�ELING LENGTH O HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE � DETACHED GARAGE �Soffit ❑ Trim � Fascia LOCATION OF WINDOWS Permit No.:, Received< �et�J \7�I�R�i, � �� /,�' �.�1�� ■ ►� �� .�, •• � ATE_ZIP -�`'� � I � F� BASEMENT REMODELING SUBMIT: 1. Existing Floor Plas► 2. Proposed floor plan 3. Gist of structural members to be used FOR NEW C4NSTRUCTION INCLUD[NG DECKS, ADDITIONS. & PORCHES SL38MiT: I. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of conswction plans • 3. Encrgy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $,�(� • O(� OCCUPANCY TYPE -- -- Pertnit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Controi Park Fee Sewer Main Chazge Totat Due $�7j, �(j See Back Page for Fec Schedule $ � 65% of Building Permit Fee $ � .001 rimes the total job valuation $ ��"� .0005 x Permit Valuation Minimum $.50 $ <<j'�(� $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservarion Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $.��%,.7`% Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby appty for a building permit and I acknowledge that e information above is complete and accurate; that the work wiil be in conformance with the ordinances and codes o th Ci f Fr' ley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli t or a p ►t wor is�� to start without p rmit; that the ork ill be in accordance with the approved plan in the case of al! w rk i Fj r�q�i,r�� ; �� vy�f� �]��s.q., �� f� �� ,�,,� �. ., � _ �_ f ,._, SIG1�fATURE OF r��:ia. di�.. � jF �... � i t t�l9��F��-� i i ;�t!,b> <� t�� y f . F�� ;�- � r• �e r��.�,� ,i�i�,� s: f Y 3�� t 7! IJ s. i:�.ldi . #'. i;��i��{- Building MECI�ANICAL Permit No.: L��'l> �3� Inspections RESIDENTIAL APPLICATION Re�ei��ed By,��;� 763-572-3604 CITY OF FRIDLEY Dat � 763-502-4977 FAX EFFECTIVE 1-1-08 �� DATE ��"' J Z. —� YOUR E-MAIL ADDRESS //I�`� !/�c � L C� l�G( SITE ADDRESS �� i G 1�C'�'! �T h� TH[S APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY N,�rtE: n � P i' L 1��0 yVl OWNER/ pDDRESS: C� ?/C%Gr11� S� N� CITY�/L � t STATE��LIP��j TENANT PHONE: CONTRACTOR COMPANY NAME: � � i�/�L NOTE: CONTACT PERSON: �/R�M fE S/1%'� SEPARATE CITY � LICENSES ARE STATE LICENSE # -� EXP DATE REQUIRED FOR GAS �DRESS: � 7� C) '" � it i/ l�1N /il�� N CITY 1 L OS�-° U� � STATE aI%/L�IP ��I AND HVAC. SUBMIT COPY OF BOND pHONE ��51� �� 3-_/O�/ L FAX ANDINSURANCE ' PERMIT TYPE '6'L�II3GLE FAMILY ❑ TWO FAMiLY Cl TOWI3HOUSE TYPE OF WORK: � NEW O REPLACEMENT � ALTERATIONlREMODEL DETAILED DESCRIPTION OF WORK �'►�'I � � Y) 4C� r� L+w� PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total co§t 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 ) OR Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of iabor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUPviBER OF EACH BELOV+� Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 �AS DRYER $] 0.00 _POOL HEATER $35.00 DUCT WORK $10.00 �C'AS PIPMG $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @$10.00 x$] 0.00 =$ Surcharge $ .50 Number of fixtures @$ I 5.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @$35.00 x$35.00 = S State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 Min ta Construc 'on 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 cord ce with e oved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME_ �Tl'rYK !� S%�r?'� DATE � 2� APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Builaing In.spections 763-5�72-3604 763-502-4977 FAX DATE r a " � � ` d � BUILDING RE�IDENTIAL APPLICATION CITY OF FRIDLEY EFFECTNE 1-1-u8 YOUR E-MAIL ADDRESS SITE ADDRESS �v A� Z I �� G,L�D'I'�7 � T J� TH1S APPLICANT iS: –t–.1 UWNEk �ONTRACTOR PROPERTY OWNER/ NAME: TENANT qpDRESS: PHONE: Permit No.: Received By! Y "'� � � D��°�CT 1 � 2008 CITY STATE ZIP CONTRACTOR ADDRESS: Liv Z� Zl�.✓ i7`/� i4✓F�– /t-J , CITY �/e.l L STATE '�/�LIP SUBMIT A COPY OF � pHONE fel Z°%�� ` g�g� F� YOUR STATE LICENSE ZOS33a Z'Z— EXP DATE 3"--'3'U -- d q STATE LICENSE # PROPERTY TYPE I�SINGLE FAMILYRJEW CONSTRUCTION S[ZE ❑ TWO FAIvIILY/NEW CONSTRUCTION STORIES PERMIT TYPE' ❑ �DrrtoN ❑ GARAG ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING TYPE OF WORK: DESCRIBE WORK BEING C17F C1F TMPRnVF.MF.NT ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING O Vinyl ❑ Aluminum ❑ Other � NEW HOME CONSTRUCTION ❑ MAINTENANCE/REPAIR :� ��a1. �,��u�-� WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPF nF WINDOW TO BE TNSTALLED NG POOL ❑ ADDITION � ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑ DRAiN TILE L_ ,�-�1� , BASEMENT REMODELING SUBMIT: l. Existing FloorPlan 2. Proposed floor plan 3. List of stnictural members to be used FOR NEW CONSTRUCTION 1NCLUDING DECKS, ❑Soffit ADDITTONS & PORCHES SUBMIT: O Trim 1. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project. 2. Two seu of consuuction plans 3. Energy Calculations LOCATION OF WINDOWS NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 LfBC FEE SCHEDULE) TOTAL JOB VALUATION S.�OC�. (S C� OCCUPANC�' TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ � .001 times the total job valuation $ _ 5'Q .0005 x Permit Valuation Minimum $.50 $ -rj. (� $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) � � Make checks navable to: City of Fridley Attach THIS IS AN I hereby apply fot a building permit and I acknowledge of the City of Fridley and with the Minnesota Const i permit on site; that the work witl be in accordance w� SIGNATURE OF APPROVED BY FOR A PERMIT-NOT VALID UNTIL PROCESSED info ion above is complete and accurate; that the work will be in confortnance with the ordinances and codes � at 1 understand this is not a permit but only an application for a permit and work is not to start without a ve plan in the case of all work which requires review and approval of plans. PRINT NAME � �� DATE /0 lls �� ' . DA'IT�D�b� License lookup �.. . ;,..; � °, �, � � Construction Codes � Building Codes � Electricity � Plumbing � Boilers/HPP � Residential Contractors License/Certificate Detail Here are the details for the license/certificate you are currently looking for: License name: FARNESS JAMIE GLENN License doing business as: JGF REMODELING License address: 4025 ZENITH AVE N City state zip: ROBBINSDALE, MN 55422 License number: 20533022 License type: RESIDENTIAL BUILDING CONTR Company structure: INDIVIDUAL PROPRIETORSHIP License status: ISSUED License original issue date: 7/18/2005 License expiration date: 3/31/2009 License print date: 5/19/2008 Qualifying person: JAMIE G. FARNESS Continuing education hours required to renew license: 7 Contractor's phone number: 612-7708484 Enforcement action: No searchfor Page 1 of 1 https://secure.doli.state.mn.us/licensing/licensing.aspx 10/16/2008 a� � c� � ,