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AF - 46358r`" ; � City of Fridley, Minn. BUILDING PERMIT N° 3 8 5 3 �te: . . :� : . . /�. °. �.- � . . . . . . . . . . . ............ Builder ..... � Owaer ........................... ��.�.... . ..��2?4�E�L0 LAiG� Atldre�s ...................................... Address .............,............................... LO�C�►TION OF BUILDING ,p— . ,• No. °�1. �� . Street . . . . . . . . . . . . �. .r�. . � . . . . . . Part f Lvt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e /�j�/ /yJ�"�°� Lot . . �.�. . . . . . . Biock . . � . . . . . . . . . . . . . . Additilon or Sub-Dfvision . . . . . . . ��; .'; ;`.�?'t?°c�?. . �L Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION O� BUILD[NG To Us as: _ f � ,,, � � ` .. Front ��...�`�. K Depth ��`�� Height � � q• 7 � f.. .. �%�% . . . . . . . : . . . . . . . . . . «. . . . s �. . . . . . . . . c�. � t. . . � . . . . . . . . . . . . . . Frozrt . . . . . . . . Depth . . . . . . . . Height � . . . . Sq. F't. . . . . . . . . G�. I�'t. . . . . . . . . ...... , 7�►pe of Construcl3on . . . . . . . . . . . . . . . . . . . Evt. Cost. .1 � � � . . . . . . . . . To be Completed . . . . . . . . . . . . . . . . . . . � In consideration of t�e issuance to me of a permit to construct the building desrlbed above. I agree to do the proposed work in accordance with the descrIptton above set forth and i� campliance with all provis�tons of ordinances of the dty oP Fridley. �2 c�- °�t� ��4�,-e ��.��,.��.�.��.�..�.� � �. � �/'� Ea cansideration of the payment of a fee of $. .�Y. .�� ., permit is hereby granied to . . . . . . . . . . . .. . . . . . . ......................... to construct the buflding or addition as described above. This perrmit is granted upon the express condil3on that the person to whom it is gcanted and his agents. employees and worlanen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinanees of FridleY. Minnesota regarding location, construction, alteration, maintenance, repa3r and moviug of buildings with- in the city limits and this permit may be revoked at a�y time upon violation of any of th�pmvisions of said ordinances. , �/ �� ;.- �� . NOTICE: Thla permlt does not cover fhe aonst�uafiJon, Instaliatlon o� alteratlon for wl�ing, plumbing, gae heating, sewer o� water. Be aure to see the Bullding Inspecyto� fo� saparate pe�mits fo� these items. �M �� -- ��. a.. �.<.......�....�_..�,� _ ,�'r.7�:I� �_.�..�.� l,J.�D �d��.;.,.��L�..,�.:�'�'TA� J .r 1�'If' S�ate� � .� ��. + �1.�� C _ ; _:. � . _ . j.. �:,� � i �]'ALUl��']�;.:'�� _.._..__.. . '�.�:�`�i f�w_ � ..._r.� � _. � i'�� City of Fridley, Miun.. BUILDING PERMIT J�e 2s 1965 Date: �; .Bober� Hardov% B��, �erson Gonst. Addr� 5�1 Horizon Drive IJ. �. Ad� _ 604� B�,aisdell � �J ��/ No '7650 LOCATION OP BUILDING iv�. �'�- stceet �Ori�n Drive N. E. Part of Lot Lot �- Block 6 Addition or sub-Divi�to�•S. I�18AOP� Nor"Gh Corner Lot Ins3de Lot Setbaek Sideyard Sewer IIevatiaa Fo�mdat4on IIevation DESCRIPTION OF BUILDING To be Used as: FY+nnt Depth Hefght Sq. Ft Gt. Ft Front Depth fTeight Sq. Ft Cu. F� Type of Conatruct[on F�t. Cost �1�..��_ To be Completed Storm damage repa3r, rebuilcl gar. on old al.ab, Dett. Gar. In consideratlon of the iasuance to me of a permit to construct the building descnbed above I agree to do the proposed work 9n acxxrordance with the dr�scrlption above set forth and ffi compliance with a�l provisions of vrdinances oP the dty► oP Fiidley. � X_��` � � Ia cromstderat3oa of the �yment of a fee of $ 14.00 ,�t �ts l�ereby granted to A�lersca Gonst • to canatruct the buflding' or addition aa described above. Thiap�� t is granted upon the express condition that the person to whom ft fa graated and his agente, employees anc� worl�en, in all work done in, around and upon said building, or anyp� thereo� shall o�nPorm in all respects to the ordfnancee oP Fridley, Minnesota g locatton, cronsLruct%n, alteration, maintenance, regair and mov3ng of builc]ings within the dty ]imits��e�ind�this permit may be revoked at any time upon violation of a�► of the P�vi�tona oP satd or8inanc�s. A11eA det'16eII ��g � NOTICEa 71d� p�r�t doa eo� eovar t6s seralroaN�, �en �er �I�tey► P«�e. 6a k�tieg, wara� er wa�ee. e� sure to as� ths Botldia8 In�pseto� tor stparat� p�m6s tor tl� (t�s. APPLICA7."l,ON FOR� BLTiLDING PERI�T CTTY OF ERIDLEY, MYNNESO�A � " . � OWi�R' S :annx�ss .5'`{a ( ��► ,��-� , Ann�ss I:OCATIOYd OF BUII.DING �� f %��r�/ � �' v �i ��,��c�� No. ,SL{ r� � Street �� • Part o� Lot� LOT BLOCR � ADDIT'tON OIt 3UBDYV�SION �� f'1'l�-� �+�� Corner Lot�Inside L0 �Setback ' Side-Bard SE6dER ELLVATION � FOUNDATIOR ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and propoeed buildin� location drawn oa these C�rtificates. �- DESCRIPTION OF $UII.DItJG . T be used as :�,/��-�-� � �._,..� �--� ��._� : ! f a Front �9 sQ• �"t.�-i�� l!tf _�t. � /� ,� [��` . I�T�m- �- �^ ' Fron� Depth � Height ,. - Sq. Ft. Cu. Ft. • . • • r Type of Cbit�truction_��,t�rs� � _ EsCimated..Cost � ,�j, . � - � -... _ � To �e compYeted__ ... �� :�:�� r� �� • ��'�� , The undereigned herebq make� appiication f�r,.a,permit for the work herein specified, agreeing to do all work in strict acebrc�ance iaith. the City of Fridley� Ordinances and rulings of the Department•of BuiYdings,. aad.hereby declaree that all Che�facta and represeiiCatiot�s stated' i:a �this app�ication are true and correct. � DATE � ° � �' �.%� ' SIGNATURE �� . (Schedule of Fee Co�ts can be Eound on the Reverse Side). �, � .a �� Building Inspections 763-572-3604 763-502-4977 F DATE �'�� SITE ADDRESS _ 17�IS APPLICANT 1S: PROPERTY o�� TENANT CONTRACTOR SUBMIT A COPY OF YOUR STA'iE LICENSE. BOND AND CER'fIFICATE OF INSUR.ANCE PERMTT TYPE PI,TJNiBII�TG �SIDEl�TIAI.� AP�PLICl�.'TI�l�TT CITY OF FRIDLE�' EFFEGTIVE 1-1-OS E-MAIL ADDRESS %7br�Zun OCONTR.ACTOR PHONE: �C S I`�`� l� -I 5�� STATE LICENSE STATE BOND # _ ADDRESS: C1TY_ PHONE F� TYPE OF WORK: � � �w FANIILY DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY O TOWNHOUSE �..-Ll REPLACEMENT � Permit Received By:� D��'�°�:E C EXP DATE EXP DA'fE ATE ZIP -'i�, a PER MS 16B.665 the permit fee is a minimum of $15.U0 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, exciuding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. La.bor cost between $300 to $500 = cdst of labor x.OS = plus .50 surcharge OR FOR PROJECTS WI-IERE LABOR EXCEEDS $SQO, FEES ARE BASED ON $] 0.00 PER FIXTURE, EJ{CEPT WHERE NOTED. FIXTURES: (INDICA'tE TOTAL NiJMBER OF EACH BELOV�. MINIMUM FEL $15.50. BATH S1NK/LAV FLOOR DRAINS SHOWER _ WATER PIPING -gq�g GAS PIPTNG (NEED CITY LIC) SWIMMING PQOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHEN S1NK WATER CLOSET _ BACKFLOW PREV. ($ I S) DISHWASHER LAUNDRY'['RAY WATER HEATER ($35) FOR TRRIGATION - - WATER ME'fER _ OTHER , , -. w. . .� . .� .�. .__ _ __ _ _ _ Permit Fee $ � Number of fixtures @$10.00 x$10.00 = Surchar e .50 Number of'fixtures @$15.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$55.00 x$35.00 =$ � ' Sta.te Sutcharge = $ .50 INIMiJM $15.50 , �� (MINIMUM $15.50 Tota1= $ THIS IS AN APPLICATION FOR A PERMT7-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accuraxe; 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 d work is not to start without a permit on site; that the work will e m accor ce with the approved plan in th case of all wo k whi requires review and approval of plans. dZ7a%7 ��I�f�'fri`��- ��7� SIGNATURE OF APPLiC �� PRINTNAME �C�r. ` ��/ DATE � Z -S _� � � �f _ _ 1r1_ APPROVED BY City of I+,ridley �uilding Inspections Department 6431 University Avenue NE, Fridley, N1N 55432 763-572-3604 FAX: 763-502-4977 DA Building BUILDING Permit No.: ��`� � Inspections RESIDENTIAL APPLICATION xeceived By: . �63-s�2-3604 CITY OF FRIDLEY ° � � ��r� 763-502-4977 FAX EFFECTIVE 7-1-2010 �� DATE � O YOUR E-MAIL ADDRESS S��,v< ��v1 T\� � Ni, j(,� SITEADDRESS 5'1�1 l�fnn��,•� '�ir � . ��:c��.w .Vhh SS`'t1t THIS APPL[CANT IS: �OWNER OCONTRACTOR PROPERTY OWNER/ N� _�vy, �.��a TENANT ApDRESS: 54a+� {'{(I+MZyr� ��` �E CTfY ��`� y� STATE��ZIP 55M� j PHONE: � � OS I I � �o CONTRACTOR N�: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE �O gQ S,T �i � ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE � �DTfION ❑ GARAGF/SHED C�WLNDOWS O BASENtENiT FINISH ❑ ROOF 0 DRAIT➢ TII.R ❑ DECK ❑ SIDING L�OTE�R ❑ SWIMIvIING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDTfI0A1 ❑ MAINTENANCE/REPAIR ta REMODELING DESCRIBE WORK BEING DOAIE:� � R�OW3 Y`��(�_QW� � O►� SIZE OF IMPROYEMENT LENGTH WID IiEIGHT S Ff R ' C ❑ HOUSE ONLY �ASEMENT REMODELING SUBMTI': NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Fl�r Plan GARAGES 0 ATTACHED GARAGE 2. Pro�sed fl�r plan PROPOSED SIZE: ❑ DETACI�D GARAGE 3. List of struct�ral members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PQRCI�S SUBMIT: �lVinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Alwninum p Trim and ProPosed P�J�- O Other ❑ Fascia 2. Two sets of consWclion plans WIND�IH'S 3. Energ}+ Calculations IN EX[STIlVG OPENINGS L�'es ❑No LOCATION OF WINDOWS FOR WINDOWS — PROYIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACfURE STICKER ON WINDOW. OPENING CNANGES & TYPE OF WINDOW TO BE INSTALLED � 1� IVUMBER OF WINDOWS ALL PL� L�.� Ai[L� ISAJL+U Vlr VALUAl1V1V� ll�l(;LULIIVG ltiL (;Vl�l� Vr' LAIiUK A1Vll MA'1�l+'.KIAL�: „�(USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB dALUATION Permit Fee Plan Review Fire Surcharge Surchazge License Surcharge SAC Charge Curb Cut Escrow � Erosion Control ' Park Fee Sewer Main Charge Total Due $ �15.0� $ .S $ Ci. $ $ $ $ $ $ $ l50 . ? b OCCUPANCY TYPE See Back Page for Fee Schedule b5% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Dete�mined by Engineering � Agreement necessary ( ) Non Necessary ) Make checks payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and witl� the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all r ch requires review and approval of pl SIGNATURE OF APPLICANT �� PRINT NAME ��tV�n Z�Or}'U►v�m DATE 9/$ f! a APPROVAL INSPECTOR SIGNATURE PLEASE ATOTE: SEPARATE PERIVIITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK