AF - 47600City of Fridley, Min.n.
BUILDING PERMIT N° o� s
Datet ....__����-`-`-._.A!�•..��''_"�_.!+�! � _.._.______.�.�
+� ,�►
Owner: _....��_...������ �' uilder
Address .....,��....,�~�.�.___...��...�..�.[.�_._. % ddress
I
.
LOCATION B I,pING
NO. ......�-,� --•--. Street ..___ ,__`�.�.:��9.,�..:�� !
... .. ... :..''�� _..... P . . ._:
� �, --------_.. r..__---•- ___..
Lot � `�Biock _.._ ' �.!� `�� �
. :.... ....._... -- ••- -----:... Addition or Sub-Divis�o� ......... .�:_'�-�!`k.�L....___.�� ---_..-_••---_._- ----
- -- -
Corner Lot ---.._ .............--•----- Inside Lot .....---�........_. Setback .....�!! .�...._...._.... Sideyard .��_..---....-------_..___._...__.._...._
Sewer Elevation ...._....__._.._.--•_.._...._..._.._......__.._.....___.._.....--•---_...... Foundation Elevation
DESCRIPTION OF BUILDING
To� vsea �
.����`-" _._....... _. Front _.� Depth !'52...__ Height .�...__ Sq. Ft /!.��� Cu. F'tf��.__�
_._..__._W._....__.....__._.._..�... Fron .__.---•-•._. Depth _._._._._�,r Hei ht .....__.._.�._�. Sq. F't. _:.._.._......_._ Cu. Ft _.._.:_._..:._
- ��r,r /? E� ti
Type of Construction .. ._::__ .. �.:. ; .�.1:,� .. Est. Cos� ..�! , --..,�`�-""".-'�o be Completed _.__._....___.._.___
In consideration of the issuance to me of a permit to construct the btulding described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
_� ._._..
In ca�sideration of the payment of a fee of $...c�`�.�..�......_....._.., permit 3s hereby granted to.____..__._
._.._..._.......___.___�_..._..___._.____. to construct the building or addition as described above. This permit is'Sranted upon
the express condition that the person to whom it is granted and his agents, employees and worlcmen, in all work
cione in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
�ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violatiar� of any of the P��ons af said
OTdinazlCes. _ w 1
Building Inspecta�
NOTICE:
T6is p�rmh doa noT covsr fh� conshuetion, installallon for wiring, plumbing, gas hsatin�, »w�r or wahr. B� wn to sN
fh� BufWing InspKtor for separota pumks for th�se fibms.
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APPLICATION FOR BIIILDING PERMI'P
CITY OF FRIDI.EY, MINNESOTl
Owner's Name ��l � o( r������ �� Builder
Aaclresa r�'"3'6� � l�`•
IACATION OF BUILDING
No. l�� 3ireet � Part of Lot
Lot � �� �,l�� � � B�.ock Addition or Subdivision 1/' � � � _ _
Corner Lot Inside Lot Setback ��— Side-Yard r 4
SE'WIIi ELEVATION FOUNDATION ELEVATION
�pplica.nt attach to this form Certificate of Survey of Lot and proposed build3ng
location.
DESCRIPTION OF' BIIILDING
To be used as:
(�,�� ! Front /=� Depth �� Height
sq. �t. l D� 6` cu. Ft.
�ont Depth Height
Sq. Ft. Cu. Ft.
Type of Construction � il�GV"� Estim�ted Cost
To be Completed
The undersigned herebq makes application for a permit for the work herein specified,
agreeing to do al.l work in strict accordance with the City ardinances and ruling of
the Department of Buildings, and hereby declaxes that all the facts and representationa
stated in this appl3ca.tion are true and correct.
DAT.E „� l/U °�/ , ��,�d SIGNATURE • •
Gv' , �.
(A Schedu].e of Fee Costs can be found on the Revarse Side.)
1 � �-'�
! � �.�_
City of Fridley, Minn. N° 9 3 4 9
.
G� ��3��� �
BUILDING PERMIT
• Date: _._....:�:7L7�$7___...__.._._._.._._._____._._._,_._
David 0. Williams Sa
Owner: ._..__.__._ _.._.. �.�._......._......_.._ Bu�lder :.._... S�.l�.-_.�_.___. * _..._............_.....__..._
Address ..634 Saffi�sv_i11e ;Stree�: N.,_E_;._�.� �,g�s
634 LOCATION OP BUILDING
No. _._.._.M__�._.�_. Street ._•?�%sy_ille _._..._.._..__.�_.._---._..._.......__----._. Part of Lot .._.......__Ba.c.t.._..
�+4-45-46 Q .. Riveruiew Hei hts
Lot ._.__.�..w..._ B1ock .______._.______._.-------,. Addit�on or Sub-Divisian .._._..__�_ .�.._
Corner,Y.ot .._�._..._..._..�_ Inside Lot _._.__........_.-----.._. Setback _._.__.__.._._._..�.._ Sideyard ___._._._..:....
'Sewer Elevatian .�._..�..._._..___......:._::_..�._...�.._..___---_�._ Foundation IIevation --..�.._._..._._-._..
�
DESCRIPTION OF BUILDING
To be Used as:
____Gara�e _.____ Front _ 24 `__ Depth ...__24 � Height ..__..�.Q.�_. Sq. F� Cu. Ft
___.__M._._... ._._........_ Front __._.._____ Depth ...___.-.� Height _-__......_.. Sq. F't. _w Cu. P't.
Type of Construction _.._..._...�'.�aDl� _..�._.:.._.__. Es� Cost __..---.�l,-�Q...DQ_......:: To be Co�npleted _•,�.,,--�--
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� propoaed work in accordance with the description above set rth and 'ance wlth pro�visiona ot
ordinances of the dty of Fridley. �
In caa�sfderation of the PaYment of a fee of �•— 9.00 _._., permit is hereby granted to David�.
__�_.._._� Williams to construct the buflding or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees az►d worl�nen, in all wo2k
done in, around and upon said building, or any part thereof, shall conform fn all respects to the ordinanc� o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repsir and moving of buil�
within the city limita and this permit may be revoked a t ar�y time upon violation ot any of the provisiana of saia
ordinancea
N ; :�1 Y ���
NOTICE:
Thts p�nnil dws not eowr �lu eonstruclioe, f�allNion for wiriny, plumbino, oas h�aNn�, aw�r er wN�r. M wn fo tN
� 1h� Buildiog In�p�cror for s�panh p�neils for fh�a tf«as.
� � � �i�
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AP£",�7C:�_�.(5:� +���i 3si�'i.D�PIG °� s`�.T
Ci .'i'i 0� i� �:�_..� :i, ri � I��i�S ^vTA
. : _ . . .
,
OWNER' S NAME�/4 �� � f,� �, C� � C_ L. �- i`�► S AT.:��:1•�ER �� f�,�� �
ADDRESS F� ,.3 ��T/� nl�' S V��.� S�_ N. E. A??'�3P.ESS �_'� M��/ �_
' iOCA�'30N Q�' BUILDIPiG _ = -' - � _
/ . - _. . '.-. _
N0. Y 3� _ STREET .�� �� v,'� � E � PART 0� LOT I�.g c �C'
F
. .. ...... .- . . . . . . .. . -� . �' � � _
LOT��� y',; -�/� BLOCK � A��IITTON OR SU$D�VISION �
CdRNER LOT INSiBE LOx__________SE%3ACK SIDE-YARD
SEWER LL�VATIQN FOUNDATiON ELEVATION • .
Applicant attach to this form Twa Certificates of Survey of Lot snd groposed
building Zocation drawn on these Certificates.
DESCRiPTIO;J 0� BUILDING _ , ,
. , _ : ., . .
. _
To Be Us ed As c . .-: > �. :: . -_ . " ; ;_ -:
• �
L% ' %���'% �' � Front � V � Depth � y � . iieight %� /
Sq. FC. �u� gt, ____..�_ �
Front � ' Degth Height
. Sq. Ft. _ . Cu. Ft,
Type of Construction �i✓ C� c� � -��g,�. � �Estimated Cost 1.�"i o o -°— .
_ ,.h /�'�7 . �_.,. _ : , .
To Be Completed /� l� ,�� 3 o Y .
The undersigned hQreby makes appiication for a germit for the work herein specified,
agreeing to do alI work in strict accordance wiCh the City of Frid?ey Ordinances
and rulings af the Depart�ent of Bui�diags, and hereby declaras that all the facts
snd repsesentations st�ted in this app�.ication are true and correct. ^
�_
DATE �/� � � SIGI�?ATURE - . �(.��GC�
_�_
�
(3chedule of Fee Costs can be found on the Reverse Side).
� � �
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BUILDING PERi�IIT FEE SCHEDULE
v
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of structure, or for any addition to any existing
building:or structure, or for any alteration or repairs to any existing building
or structure, upon application therefore, require the payment by the applicant
for such permit of fees to the amount herein below set forth and in the manner
herein provided to-wit: '
Ur.iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each
one thousand cubic feet. -
_. : � .. .
� �
/- �
For the purpase of computing fees-�for building permits, the cubical contents oz �
any building or addition to a uniform height throLghout by multipluing the ground
area covered from a point sir (6) inches belo�•� the �Ioor line of the basement or
cellar to the average height of the upper surface or to the average height of the
roof surface of the main gable of a pitched roof. ,
For repairs or alterations to an existing structure, the fee sha11 be at the
, rate of $3.00 per each Five Hundred Dollars ($500.00) oz fractien thereof �
' in the cost of all proposed work.
� In no case shall the fee charged for any�permit as set forth in Section 2 be
Iess than $5.00. � .
. I3SSSD Connection Charges based on location- Area 1 or 2.,.. �
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City of Fridley _- � � 2 2
AT THE TOP OF THE TWINS g U I � D I N G P E R M I T �
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� ' COMMUNITY DEVELOPMENT DIV.
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� � /���1 � CITY HALL FRIDLE� SS43Z NUMBER REV. DATE � PAGE OF APPROVED BV
�--�: `.J
`' 612-571-3450 910-F15 ��� f83 / /
JOB ADDRESS
634 J'ane�.ville Street N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 44�,46 Q 1;1V@L'YlEW Iiel. Il'tS SHEET
2 PROPERTY OWNER MAIL AOOFESS 21P PHONE
David Williams 634 J'anesville Street N.E. 784-5183
3 CONTRACTOR MAIL ADDfiESS ZIP PHONE LICENSE NO.
Ron Williams 6Q0 ,Tanesville Street N.E. 784-6497
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO.
6 USE OF BUILDING
EZi2 S 1CIQI1'�211.
7 CIASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Constxuct d 6` x 12` P,ddition
9 CHANGEQFUSEFROM TO
STIPULF(TIONS
��,���� ���`'`�E c� ATE PERMfTS REQtJIRFD �0� �IR�IG.
\\�o�,a�,G�S�„< SEPER
� ���c�G`�\G �p,`i"� HEATING, PLUM6ING ANU SIGI�tS.
a�� �t *�
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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 S0. FT. CU. FT.
AUTHORIZED iS NOT COMMEMCED 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
� HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 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 WORK WI�L BE COMPLIED c�
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT Y3�SOO �1. %S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISiONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. ��i�i. SO
PLAN CHECK FEE TOTAL FEE
$11.13 $57.38
Si TUFlEOFC�N� Cro o n THO iz GENT �i�rE�� T WHEN PROPERLV LI�/�HIS IS VpUR PERMIT
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IGN UREOFOWNERIIF NERBUILDERI IDATEI BLDG WSP 0 E
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CITY OF FRIDLCY
NPPLICATIO'� FO(t RCSIOL"i�JTIP,� I3UILQ1i�G P�f�iITS
(l�eu, Alterations, /ldditions, or Rc�airsj
Ot�f I�E R: � i� U�\� L(.1 i l( i i� M, S
no�r:ESS: � 3 � ��.rv; � i-� �� �/�'
TE� Ko: �d�y- .�/ �'3
STTiI�T NO: STItEF.T:
Lo��: � �.� � � sLOCx: _
Effective Aug, l, 1981
. j�'
t3UILDER: �� W � 11 %�tS
11DDRCSS: ��� �I-�-�sv,��-� 57'i✓�
TEL 110: ���'% �'`�9%
Construction Locatio
�
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ADAITIO;� : 6� w.�,,,. ��► r� i� aQ
Corner Lot: Inside Lot: L� SetbacY.: Sideyards:
Ap�licant attach to tl�is form two Certificates of SUz�tey of lot and
pzoposed building location drawn on certificates to scale.
DESCR I PT 10�� OF COi�; STF:�J CT IOtJ
��U� Front: '� Depth: J� Height:
Squarc Feet: ,/ ��Clibic Feet:
r'ront: Depth: Height:
Square Fe�t: Clibic I'eet: ��Q
�?�� x c�� 3� z ��,� . o
�pe of Cor,struction : Estimated Cost: $
Zb Be Cbr.,pleted:
Alt. A Alt. B
Proposed Drive�iay �tiidth If New Opening Is Desired: $ S
SE� PEVF:ILL' SIDE OF S}IE�T
ZSie undersioned hereb:� ma1;c� applic�lticn for a perr�it fcr the �:vrk herein spccified,
agreeing to �o .all �:ork ii► strict accordancc ��ith the City of Pridley Ordi»ances aiid
rulings of the De��artme��t of Dui2dings, and eby decl�res that all the facts and
represc�tatiens stated :n this applic�tion e true d o-rect.
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D.�TE: � 6� SIGNATUI:.:
Stil�ulations :
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sue�ecr PERM
City of Fridley � g 2$ �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� i y___�� COMMUNITY DEVELOPMENT DIV.
r � �� PROTECTIVE INSPECTION SEC. � 0�3
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� � /"'1 � CITY HALL FfiIOLEV 55432 NUMBER REV. DATE PAGE OF �� APPROVED BV
�----� • •`� 612-571-3450 910-F15
11/25/87 � �
JOB ADDRESS 634 Janesville Street N. E.
1 LEGA� �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 44-46 Q Riverview Heights SHEET
2 PROPEfiTYOWNER MAtLADDRESS 2!P PHONE
David William5 634 Janesville Stxeet N.E. 784-5183
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW C� ADDITION ❑ ALTERATION ❑ REPAIR p MOVE ❑ REMOVE
8 DESCRIBE WORK
Constx�uct a 14' x 18' Deck and a Say Windaw CDeck. Huilt for Future I�om on Topj
9 CHANGE OF USE FROM TO
STIPULATIONS
See pla,ns fox notations
SEPARATE �E}�MITS REQUIRED F�R
INIRiNG, H��ITING, PLUMBJNG AN� S1�N�
�����������
�efore d�gging call i�ca! ui�{i�:rT:>
TELEPHONE - ELECTRIC - GAS Ei�.
#��QUIRED B�' LAW
SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMt7 BECOMES NULL AfJD VOID IF WOAK OR CONSTRt1CT10N ZONING S�. F7. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOfi 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 1 STALLS 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 COMPUED
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT $4�QQ.O S2.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $44. SO
LAN CHECK FEE TOTAL FEE
�,.13 $57 . 63
. S�GNAiUREOF�tRACTOROAAUTHORIZE`AGENT IDATEi WHEN PROPERLY IDATEO THS IS YOUR PERMIT
R �- a
SiGNATURE Of OWNERiIF OWNER BU�LDERI IDATEI BLOG �NSP � pp7E
N� [] City of Fridley Effective 4/1/86
ADDN. � R-1 AND R-2 �
AI,TER. [jJ• Building Permit Application
Construction Address: � J � � �/ tir� ��� //� � /
Legal Deseription: � U%-S -�5-�/ 6 / �� i /2v I e r.J /� e h TS
owner Name & Address : �� �� n � � � �/ � �'` S Tel . � ��y—S/ �' 3
Contraetor • Tej� . �
Address•
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTHER:
Corner Lot [ ]
Attach to this applieation, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length �._ Width � S Hgt/Ground �-y�� Sq. Ft. 2'� �
�� �i �/ ° �✓ O� O � --
`e U � � i �Ur ��v� Raow. O� ��-�.--
Inside Lot [�] Ft. Yd. Setback Side Yard Setback
Type of Construction: ��'o �
Approx. Completion Date: �/� � L 0�
2s2�t �.�i3 � � �, ��. 3� �- a�53,�� _ � o
Estimated Cost: $ \��'Q — -
�iDo d
Alt. A Alt B
Proposed Driveway Width If Hew Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. #
Permit Fee
Flan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CiTY USE ONLY
� '�4 5�
$ ��.,�J —
$ a.no
$
$
�
$ 7 3
Fee Schedule on Reverse Side
�
25� of Building Permit Fee
�•50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )
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1
HARVEY /1: CARTWRIGHT C�gTWRtG�iT & OLSON
ANOKA COUNTY 6URVEYS 7�1
MENNEPIN GOUN7Y SURVEYS L A�'` D S UR L� E YORS
MINNEAPOl15 SURVEYS �
64f0 PALM STREET N W.� REG15T[Ri0 UNDER LAWS Of iTATE OF MINNESOTA
SUNlET 4•7655 LICEN�60 BY ORDIHANC� OF CITY OF MINNEAPOLI•
owNCrt FEDERAL 8-8721
326 PLYMOUTH BUILDING
INDUSTRIAL - JUDICIAL HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA
BUSINE55 - TOPOORAPHICAL �E�rbepor'g �er�l�l[ait �
UTt LOTS - PLATTING � �
Al 'rlilli�ns � �� ' �' �
.
_ �� ��-�- �d� -
;���� ,�g � ` �.
�' � � � a�
-��.o � �5
z� ��
25 ``�
a� �. .
,
-t ,, .
COMBINING THE RECOROS Oi
J. E. HILL, CIVIL ENGINE[R
E6TABL18HtD 18Y{
C. F. SANDHOFF
CIVIL ENG�NEER
ESTAULISNED 1900
JAMES NELSON
SURVEYOR
ESTABL16HED 192t
METROPOLITAN LANO
SVRVEYORS, [STAeLISNEO 1PD�
Invoics,21290
7�7/Z7
� . � �,� J
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. D�nc►�� I���;�
I hereby certify that this is a true and correct represent4tion of a survey of
the boundsries ofs
Lots lai.t, lt5 ar�d �6, Block Q� � Riverview Hei�,hts
ks surveyed by me this 25th 3�y �f ��+pril� 195�.
, . , - i._� �'� `;`'f `��..��. -�r. ��
�� c..+� _.-� `;�'
s�cNt C RIGHT wno OL90N
� __ ...�
- _a_ --- �'"1 , a�,.�. "_ �.. _ �. . �. _ . r ._ . . ,.... x.,-., _.. . . ....
. . . ..- ,
_-�. � � ,.._.-,� ._
� .� ...
����� .. .
sue�etr P .
City of Fridley W"` �
AT THE TOP OF TNE TWINS g � I L D i N G P E R M I T 3'� 8�
r
� .
� � •
COMMUNITY DEVELOPMENT DIV.
f � � � PROTECTIVE INSPECTION SEC.
� 1 /"'1 � CITY MA�� FRIOIE� SS�$Z NUMBEi1 REV OATE PAGE O� APPROVEO 9Y
�'""'�" ,'' 612-571-3450 910-Ft5 9/12/00 / /
J08 ADDRESS 634 Janesville SCreet NE
t LEGAL �OT NO. BLOCK TqACT Ofi AOOITION SEE ATTACHED
oescp. 44,45,46 Q Riverview Heights s►+eer
2 PROPERTY OWNEF MAIL AOORES$ 21O PMONE
David Williams 634 Janesville Street NE 763-784-5183
9 CONTRACTOR MAII ADDRESS 21P PMONE LICENSE NO
Same
l ARCHITECT OR OESIGNER MAI� AOOfiESS ZIP PHONE IICENSE NO.
5 ENGINEER MAIL ADDiiESS Z1P PHONE UCENSE NO
6 USE OF BUIIDING
Residential
7 CIASS Of WORK
❑ NEW ❑ ADDITtON ❑ ALTERATION � REPAIR O MOVE O REMOVE
8 OESCFiIBE WORK
Reroof House (18 Sq) Tear-off
9 CHANGEOFUSEfROM TO
STIPU�ATIONS
Underlayment must comply with the State Building Code.
TYPE OFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARA7E PERMITS AqE PEOUIiiEO FOR EIECTRICAL, PLUM8ING. MEATING.
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AN� VOIO IF WORK OR CONSTRUCTION 20NING SO. fT CU FT.
AUTHOR12ED IS NOT COMMENCED Vy1THIN 60 DAYS. OR IF CONSTRUCTION
OA WORK IS SUSPENOED OR ABANOONED fOR A PERI00 OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UNI7S OfFSTFEEI PARKING
1 MEREBY CERTIfV THAT I MAVE REAO ANO ExAMINEO TMIS APP�ICATION 1 STALIS GARAGES
AND KNOW TME SAME TO 9E TRUE ANO CORRECT. A�� PFOVlS10NS Of �AWS VA�UATION SURTAX
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMP�IED � 1� H41 �. 92
WITH WMETHEq SPECIFIED MEiiEIN Oii NOT. TNE GRANTING OF A PERMIT
OOES NOT PRESUME TO GIVE AUTNOiiITY TO VIOIATE Oii CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OA LOCA� LAW FEGULATING coN- �66. ZO lie SC �1 . H�F
STqUCTION OR TNE PERfORMANCE OF CONSTRUCTION
PLAN GMECK FEE O�A� PEE
� $68.96
5� •ru`E CO ' QO •uTHO ��GENi � iD�iE� H P O V VA 10 ED TNIS I UR/ PERMIT
.�/� ���
L
S�GNa1uAE O� OWNE ��� OWNEABU4DEA� �O�TE� �`,50 . � r�crE
NEW [ )
ADDN []
ALTER [ ]
Effective 1/1/2000
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: _t�� .� �-% ��`N�S � l LC L'� �%` /I/�
Legal Description:
Owner Name & Address: ]�U! D W I LC � j9�-t S Te�. # 7�� .S'�� � 3
Contractor: MN LICENSE #
Address:_� Tel. #
LIVING AREA:
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
DECK AREA: Length
OTHER:
_ Width Hgt/Ground Sq. Ft.
� � )LCS � _ ,. � / � �9 `J
Construction Type:rPE2oo,e Estimated Cost: !��(
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
1
� [� /
DATE: �/ �� APPLICANT: ,/ Tei. #,� g, "S I�3
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee ,$ ��, -�O Fee Schedule on Reverse Side
Fire Surcharge $ %� c� 5� .001 of Permit Valuation (1/10th%)
State Surcharge $ �� $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1100 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$
$
$
� �
' I .
$450.00 Conservation Plan Review
.Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
. �► . -
sue�ecT N .
City of Fridley 33851
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
r
RECEIPT N
i .
� �
� ; y�_���� COMMUNITV DEVELOPMENT DIV. �� %,/f"''\
r � � PROTECTIVE INSPECTION SEC. ��� U
� �
�•___ �;����;'� CITY NA�� FRIOLE� SSIjj NUMBER REV OATE PAGE OF AVPROVEO BY-
„ 763-571-3450 9t0-F15 9/3/03 / /
�oe AooaESS 634 3anesville Street NE
t LEGAL �OT NO. BLOCK TRACT Oii AODITION SEE ATTACMEO
oesca. 44,45,46 Q Riverview Hei ht SFIEET
2 PROPERTY OWNER MAIL ADORESS 21P PMONE
David & Rita Williams 634 Janesville St 763-784-5183
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Ron Williams Construction 600 Janesville St NE Fridle MN 55432 763-784-6497
1 ARCMI7ECT OR OESIGNER MAIL AODRESS IIP PMONE LICENSE NO.
5 ENGINEER MAII A�DRESS 21P PHONE LICENSE NO
6 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION �1 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace 8 windows within existing openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dweZling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
7YPEOFCONST. OCCUPANCVGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING.
VENTILATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTMORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTfiUCTION
OR WORK IS SUSPENOED OR ABANDONED fOii A PERIOD Of /20 �AVS AT
ANY TIME AFTER WORK IS COMMENCED NO DWIG. UNITS OFFSTREET PARKING
I HEfiEBY CEATIfV THAT I MAVE REAO ANO E%AMINEO TMI$ APP�ICATION ], STAILS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. A�L PROVISIONS Of LAWS VALUATION SURTA%
AND OfiOINANCES GOVERNING TMIS TVPE OF WORK WILI BE COMP�IED
WITH WHETMER SPECIFIED HEREIN OA NOT. TME GRANTING OF A PERMIT �C)�OOO �3.00
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE Ofi CANCEL THE pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON-
STR CTION OA TME PERFOfiMANC Of CONSTRUCTION �125.25 Fire .SC. �6.0�
n PIAN CMECKFEE TOTA�fEE
dG�Ll nse SC $5.00 $139.25
S�GN�TUQE O� CON"AA(;iOp ON �UtHOA�2ED �GENT iO�iE� N PROPER�Y VA�IOATEO THIS IS V R P fiMIT
'� �' �
S�GNatUAE O� OWNEQ��c pwHEQBU��DEAi iOATE� G�NSP ��<<f
NEW
ADDN
ALTER
�� CITY OF FRIDLEY Effective 1/1/2003
�� 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
( 1 SINGLE FAMILY AND DUPLEXES R-1 AND R-Z (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: �
�-C �
Legal Descriptian:
� /��r�9 .�/i � /� i� s Tel. # %��3`� 7�S/' s/P3
Owner Name Address: �AY� _
Contractor. �N �,v� l�ii9� S G� o NS T� MN LICENSE #�' -2d/„3�1 OS"-
Address: �o o.�A,v �s�'il�.e S T,�',�� o�/Qy �'9.vS'��.�� Tel. #�103`� 7�''�f'lo `f97
Attach to this application, a Certi�cate of Survey of the
lot, with the proposed construction drawn on it to scale:
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height _ Sq. Ft.
GARAGE AREA: Length Width _ Height! Sq. Ft.
DECK AREA: Length � Width Hgt/G�ound Sq. Ft.
OTHER:
Constn.iction Type•>%p �� � 8W �d0u� S � oQD �L
� � Estimated Cost: $
/�('i ��I 57`�•c�y a/-��v � N�S
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � o� APPUCANT��I�� �.�.�'��^'`''� Tel. #%1v.3" �6'�`� y�'�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �S �?�..
$ . �6
$ `3. p0
$
$ r�
$
$
$
$
$ �,� -°��
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]
_ •►
:: ,.
Building C��pa'
Inspections
763-572-3604
_.-
MECHA.NICAL
RESIDENTIAL APPLICATIQN
CITY �F FRIDLEY
DATE LP I�o � I��' YOUR E-MAIL ADDRESS
sr� �DxESS l�3 � Sc. v� es� = 1� P S� ��-
TMS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY NpME: 0.v`� �� � G `
OWNER/ a,DD�ss: 1o3�-f ��r, �� ��e 5�
TENANT PHO1dE: '�l l03 - ^ ��' 3
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERNII"f TYPE
TYPE OF WORK:
Permit No.: �.,� L �,! �
Received By:�
Date Rec'd: (r�-� �`' �'�
ATEY� NLIP,
COMPANY NAME: a.ci. i,:,u ..._�. �..�.•.•_•...
C4NTACT PERSON: JOANN ZINRF•l�i
STATE LICENSE � EXP DATE
ADDRESS: 13562 CENTBAI. AVE NE ` CITY ANORA STATE MNZIP 55304
PHONE 763-757-6202 Fp,�; 763-757-6701
�INGLE FAMILY ❑ TWO fiAMILY
❑ �W '�REPLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
O-n C
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost 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 laiwr )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS 5500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED• FIXTURES: (Il`IDiC�'TE T4TAi'
NUMBER OF EACH BELOV� 6 6
Equipment Installed , MFG: C-U,r r' e� MODEL: S� rn �$ U b0 SIZE/BTU D O
MFG: , v r� S MODEL: ��PR�'��S��TU 'l o n-S
MODEL: SIZEBTU
�C'' GAS RANGE/OVEN 510.00
✓A/C 525.00 ,FIREPLACE (GAS) 515.00 �vy Gpg GRILL S10.00
A1R TO AITt EXCHANGEER S15 —�I�ACE $3�� D) S35.00 G� �T HTR 510.00
_BOILER $35.00 — _pppL HEATER 535.00
CHIMNEY LINER $10.00 �GAS DRYER S10.00
DUCT WORK SIO.� GAS PIPING SI0.00 VENTtI.ATOR 515.00
— ��
+i1. '; .:.�"c�':. �?�?' . : .: .:.' .,�. v,.�a�nr:.i. , .+�..,.�?�, . �.rc�. _ ��, r,-.R., .� _.�.. . .,.... �.- .__ ._..
Permit Fee $ Number of fixtures @$10.00 x$10.00 =$
Surcharge $ .50 Number of fixtures Qa $15.00 x$15.00 =$
TOTAL DLJE $ Number of fixtures @$25.00 I x$25.00 =$ as,G�
Number of fixtures @$35.00 t x$35.00 = S 3 S. oG
State Surcharge = $ .50
Tota1= $ �00�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota �Constcuction 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.
SIGNANRE OF APPLIC�,�� �° � PRINT NAME ROGER flOFFHEIN DATE �P 1 a o I0�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
��z_s��_z�n4
�...
REQU{RED INFORMATION NEEDED TO PROCESS PERMIT �
RESIDENTIAL PERMIT APPL1CATfON HVAC
❑ NEW HOMES/ADDtTIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below) .
�. �iZ or solid fuel IMC Chauter 7 with NIl�T Amendments
b. Nafural Gas or PropanellFGC Chapter 3 with MN Amend.ments �
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments ,
3. Venti.n.g
a. Gas appliances ]FGC Cha.pter 5 with MN Amendments
b. Fuel other than gas 1MC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat lass & cooling load per room -
a, Required on new construction IMC 1346.0312
5. Ventilation .
a, per MN Energy C�de 7570 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines sofiwaxe may be used for
comb�stion and make up air calculations .
Building
Inspections
763-572-3604
DATE �
SITE ADD S
TfiIS APPLICANT IS:
PROPERTY
owrrExxi
TENANT
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
PERMIT TYPE
TYPE OF WORK:
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
Permit No.:
Received By: j�
D��°�1 PR 2
_ �.s C�..�r.e�✓
� o�� DavidlRita Williams
� 634 Janesville Street Northeas
N�� Fridley, MN 55432
�wnxsss: 7637845183 STA1E zrn
PHONE:
_ i I / 1 .
STATE LICENSE #_�
ADURESS•
PHONE
�SiNGLE FAMILY
❑ x�w . .
DETATLED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of
impro.vement, instailation or replacement of a resic
Labor cost under $300 =$15.00. Labor cost
=.RC1R:�.'ROJEGTS WHERE LP:BOR EXCEEDS3iW;-FEES
NUMBER OF EACH BELOV�
BATH SWK/LAV FLOOR pRAD
BATHTUB GAS PIPING i
CLOTFIES WASHER KITCHEN SIT
DISHWASHER ;-LAUNDRY Tl
Permit Fee $
� Surcharge � .50
� TOTAL DUE $
THtS IS AN APPL
I hereby apply for a building permit and I aclmo
conformance with the ordinances and codes of th�
not a permit but only an application for a permit �
approved plan in the case o�wprk which�qu'v
SIGNATURE OF APPLICANT
EXP DATE
.f __ CITY , ��
FAX((elZl �L/—
TWO FAMILY � TOWNHOUSE
�REPLACEMENT
'ATE�ZIP S�O�
I or 5% of the tot�l cost up to $500.00; whichever is greater, for the
fixtare, excluding the fixtures. (This_shovldreflect only.the cost of labor )
$300 to $500 � cost of labor x.OS =
BASED ON $10.00 PER FIXTURF,�EXCEIxi':W3-IExE Pt}:I�:.:F-[IC'F.i�A£3:�-•(A�FDfCA.TE TaT,AI.
SHOWER WATER PIPIIdG -
:muc�vsE) SWIMMING POOL WATER SOFTNER (S35)
WATER CLOSET BACKFLOW PREV. (Sl�
�WATER I�ATER (S35) FOR IRRIGATION
WATER MECER OTHER `
Number of fixtures Q S 10.00 x$10,00 =$
Number of fixtures �a. $15.00 x S 1 S:DO =$
Number of fixhues Q$35.00 _,[_ x$35.00 =$ 3S.�o
State Surcharge = $ .50
Total ° $ 3� S�
;ATION FOR A PERMIT-NOT VALiD UNTIL PROCESSED
ledge that the information above is complete and accurate; that the work will be in
City of Fridley and with the Minnesota Construction Codes; that I understand this is
id work is not to start without a permit; t6at the work will be in accordance with the
s review and approval of plans.
PRINT NAME Jt NOI'�IDI'1�I AATE� 1 Z ��
� City of Fridley
Buil ing Inspections Department
6431 Univ rsity Avenue NE, Fridley, MN 55432
763-572-3604
�AX: 763-502-49'i7
I �