PRE 2010 DOCSCity of Fridley, YHnn.
BUILDING PERMIT N° 5915 '`
Date:
Owner: sunder
Address Address �_ _
LOCAT N OVU�MeDIING
No. Street -I�„ P rt of Lot
Lot _ Block Addition or Sub -Division%'"
Corner Lot __ Inside Lot SetbackSideyard
Sewer Elevation _ __ _ Foundation Elevation
DESCRIPTION OF BUILDING
.; � "
To Used ,�►�{
Front � Depth ���� Height Sq. Ft_..... Cu.Ft
Fr Depth _..._Height —, Sq. Ft. Ca Ft.
Type of Construction .. Est. Cost �VoA t To be Completed
In consideration of the issuance to me of a permit to construct the building 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 consideration of the payment of a fee of U 4 ""r! , permit is hereby -granted to
to construct the ,building 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 and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
w� � city limits and this permit may be revoked at an violate of any of the provisions of said
or
NOTICE
This permit does not cover the construction, installation for whing, plumbing, gas heating, newer or water. Be euro to we
the Building Inspector for separate permits for these home.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name aA 1 L�n e���ww� Builder
Address Address
LOCATION OF BUILDING
No. StreetAj- rt of Lot
Lot Block_,,�Addition or Subdivision ��---�
Corner Lot Inside Lot A-- Setback Z5 % ' Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To a used as- /
Front Depth.1 Z -J_,,' Height J0
Sq, Ft. Z Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction " Estimated Cost 'J'6 ; ®�
To be Completed
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and represent :ions state in this application
are true and correct.
a
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SU 4-7
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE �TOTAL
Number Fixtures ...................... — x $1.50 $�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ......----/x 2.00 $ ° J
New Ground Run Old Bldg. ............ x 3.25 $
r'
GAS FINING FEES: RATE TOTAL
1st 3 Fixtures .......................... x $1.50
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE SZD
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are true and correct.
Fridley,
Owner
Kind of Building ZA c
Used as
To be completed about
Of
Q,
Estimated Cost, $
Old ew. ding Permit No. Permit No.
Signed
By
Business Phone No d'& ®
ROUGH
FINAL
as NA
1968
3 fC3J
m
Z
;Sy
G p
Q� ✓�
�+�
�'c
= in
FZ
c�
O
a33
�°'
c�°d
ZZw
�<
c9rc
?
a
t�0
•
F
`
N
WATER HTR.
GAS
ELEC.
Base
1st
2—
Future Connection Openings
Future
New Fixture, Old Openings I
Conaected with
Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE �TOTAL
Number Fixtures ...................... — x $1.50 $�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ......----/x 2.00 $ ° J
New Ground Run Old Bldg. ............ x 3.25 $
r'
GAS FINING FEES: RATE TOTAL
1st 3 Fixtures .......................... x $1.50
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE SZD
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are true and correct.
Fridley,
Owner
Kind of Building ZA c
Used as
To be completed about
Of
Q,
Estimated Cost, $
Old ew. ding Permit No. Permit No.
Signed
By
Business Phone No d'& ®
ROUGH
FINAL
as NA
1968
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERMIT
PERM) O.
.13263
r
--_____ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 ; r
1-'-1 CITY HALL FRIDLEY 55432
�•--- • •�� 612-560-3450
R
C�
NUMBER
910-F15
REV.
DATE
10-15-7
PAGE OF
APPROVED BY
JOB ADDRESS 5203 Lincoln Street N.E.
1 LEGAL
DESCR.
LOT NO.
C
BLOCK
3
TRACT OR ADDITION SEE ATTACHED
Marion Hills SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
John Steichen 5203 Lincoln Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Company 2513 Central Avenue 9IX N.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
sae residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ek REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
partial roof
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
20jKx shincr
e
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
ANY 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OFcfgRMITno
30 0
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CA'T(.�I�L L THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
5.00
/
l /a-
PLAN CHECK FEE
TOTAL FEE
5.50
SIGNATURE OF FACTOR OR AUTHORIZED AGENT (DnrE)
VLIDAT D THIS IS YOUR PERMIT
6HENROP
BLDG INSP DATE (;
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
I r11
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME : \/ o 0 -T a " C H e,,� BUILDER : - All L?e .,1 /"/ iu
ADDRESS: - Ca �' 'V o ,� IU ADDRESS:
�?. cc "J
NO:. S'd n STREET:
LOT: BLOCK: ADDITION: '
CORNER LOT: INSIDE LOT: SETBACK:- SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposeA
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front:
Depth • Height:
Square Feet; Cubic Feet:
Front: Depth: Height:
-
Square
Feet; Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: 10, 1 SIGNATURE:
(See Reverse Side For Additional Information.)
SUBJECT
PERMIT NO.
City of Fridley
22009AT
THE TOP OF THE TWINS
BUILDING PERMIT
r?
_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
/2 �-3 7
�[
r
(/
NUMBER
REVGATE
PAGE OF
APPROVED By
CITY HALL FRIDLEV 55432
�.__.11.' �•J 612-571-3450
910-F15
8/2/93
JOB ADDRESS 5203 Lincoln Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
6
3
Marion Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Litchy 5203 Lincoln Street NE
3 CONTRACTOR MAIL ADDRESS IPPHONE LICENSE NO.
4816 W 710 St, Bloomington 55437
Loon Builders Inc xE 571-7513
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION SCJ REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Reroo:ff House C18 Squares) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Roo:Ung underlayment must comply with.the State Building Code. Provide
adequate attic ventilation, provide smoke detectors as per UBC 1210 adjacent to
all sleeping areas and in basement,
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
SO. 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
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$972
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISI S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
Fire SC $.97
STRUCT) N OR THE PERtf.QWANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
� _ � w ^
j[ ��(�J�rj/
License SC $5.00
$31.47
SINATURE OF O R A NORIZED AGENT IDATEI
WH E VALIDATED THIS IS YOUR PERMIT
r
BLDG )NSP DATE
SIGNATURE OF OWNER I IF OWNER BUILDER) IDATEI
NEW [ ] Effective 5126/93
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 'S; 2 D 3 cl-,l W f, c , -5 T -
Legal Description:
Owner Name & Address: d r-) -6—e (C - H `� Tel. #
Contractor: rJ (.p MN LICENSE #
Address: Z o r l L o i r -i Tel. #5-71 -
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on 'it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER: I
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Pt.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Seft4W.,
Type of Construction: (2-g-EstimatedCost: $ ::
fy
i
Approx. Completion Date:
Driveway Curb Cut Width Needed:
)I DATE: 3 ` (jr-g-
(Cost
on Back)
Ft. + 6 Ft = Ft x $
CITY USE OMly
Permit Fee $ 2-
5-av Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ '50 $.501$1,000 Valuation
SAC Charge $ $750 per SAC Unit
License Surcharge $ 6-,00 $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ Conservation Plan Review $450.00
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ / STIPULATIONS:
Tel. # SSS l CPC> 3 0
SUBJECT
IT NO.
City of Fridley
�
q 3 5 a7
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
'7
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/5/95
JOB ADDRESS 5203 Lincoln Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
3
Marion Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Betty/John Litchy 5203 Lincoln Street NE
571-7513
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014
786-0550 ZXEMFT
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION I. ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install interior drain the
9 CHANGE OF USE FROM TO
STIPULATIONS
Electrical extension cords can not be used as part
of the power source
to the pump. Drain tile car not. by connected to the City Sanitary Sewer; it also
can not drain onto a neighbor's property.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1'671
$.84
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRU I OR TH PER MA Ec F CONS UCTION
$39.00
Fire SC $1.67
N
PLAN CHECK FEE
TOTAL FEE
License SC $N/A
$41.51
SIGNATURE OF CANTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY
BLDG NSP
UIDATE THIS I OUR PERMIT
L
r)ATit
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [
ADDN (]_
ALTER
Construction Address:
Legal Description: _
Owner Name Adds
Contractor:
Address: q�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ur'r-o)yv �-f-
Effective 1/1
�U
;ss: YlY\ C�I I � - 0 � Te�. # 57J,7513
MN LICENSE #
Tel. #�
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.
Length Width Hgt/Ground Sq. Ft.
Comer Lot [ I Inside Lot [ ]
Type of Construction:
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + t = Ft $ _ $
DATE: -30' -'F$7-- APPLICANT: Tel. # ;:Y,/-
Ft. Yd Setback Side Yard Setbacks
Estimated Cost:
ITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ %
.001 of Permit Valuation (1/10th%)
State Surcharge
$ c�:'
$.50/$1,000 Valuation
SAC Charge
$
$850 per SAC Unit
License Surcharge
$ /. OCA
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$ �:: _— .
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
ee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [) Not Necessary
�U
TOTAL
STIPULATIONS:
•
SUBJECT
- I
P NO.
City of Fridley
3 1893
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO
DIV.
v ---� COMMUNITY DEVELOPMENINSPECTION
PROTECTIVE INSPECTION SEC.
572.36504
r � �
1 . ,
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
6/12/01
JOB ADDRESS 5203 Lincoln Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
6
3
Marion Hills
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Litchy 5203 Lincoln Street NE
763-571-7513
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Stinson Exteriors 901 22 Ave NE, Mpls.,
MN 55418 612-414-7331 20069652
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION IR REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Repair siding
9 CHANGEOFUSEFROM
TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING.
TYPE OFCONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
ANY TIME AFTER WORK IS COMMENCED. '
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 ISTALLS
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
$500
$•50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY O HER STATE OR LOCAL LAW REGULATING CON-
Fire SC $.50
STRUCTION R 7HE PE FORMANCE OF CONSTRUCTION
$23.50
PLAN CHECK FEE
TOTAL E
12- IC;' (
Lice $5.00
$ .50
,,,0§4NATUREAYFMAJTAkeTOR 0 AGENT IOATE,
EN ROPER (DATED HIS IS VfjUR P�WAIT��
BlD (NSP c% //QATE
SIGNATURE OF OWNER i1F OWNER BUIL DERi IDAiE-
NEW [ ] Effective 1/1/2001
ADDIS! [ j CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 2'-9-,!27 di E
Legal Description:
Owner Name & Address:
Contractor. '5�t kn -.5 v
Address: 10 t 2 9 �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel.# 7(. 3 S7( -7.r/ 3
MN LICENSE # 2 CQ C cl 6 S 2
l8 Tel.# G(2 4114-7331
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length 3 'x- Width t Height Sq. Ft.
Length Width . Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: �� a .� Estimated Cost: $ �'O D
Driveway Curb Cut Width Needed: Ft. + 6 Ft = t x $ =$
DATE: 2 — U ( APPLICANT: Tel. # U2 - 3 3
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
Fee Schedule on Reverse Side
$ . gG .001 of Permit Valuation (1/10th%)
$ ..SU $.50/$1,000 Valuation
$ / $1150 per SAC Unit
$ CS $5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ '.;t A-6
SUBJECT
City of Fridley
33635
AT THE TOP OF THE TWINS
BUILDING
PERMIT
WtfffTNO.
COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
r �
qq?
LIMBER
REV
DATE
PAGE OF
ER!011EO BrNU
CITY HALL FRIDLEY 55432
l 763-571-3450
910415
6/23/03
JOB ADDRESS 5203 Lincoln Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
3
1 Marion Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Litchy 5203 Lincoln Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Five Pillars Contracting. 1202 Hathaway Lane NE, Fridley,
MN 55432 612-759-1554
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20098641
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW G. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 15' x 19' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
WARMING"
SPA.91ATE PERIN T
',
��°���9RED FOR:
Before digging call for
"I�y HFa'nilG
A utility locations
'r��uly WNG' ANDSIGNS
4540002
REQUIRED BY LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,539
$1.77
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$07.25
Fire SC $3.54
TRU TION OR THE PERFORMANCE OF CONSTRUCTION
PLAN C CK FEE
TOTAL FEE
ce a SC $5.00
$107.56
SIG T ON'AACTOR OR AUTHORIZED AGENT iDATE,
EN PROPERLY VALIDATED THIS IS YO PE MIT
g .NSP
TjATE
SIGNATURE O� OW NER ��� OWNER BUILDER, OE R� iDATE�
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 157 o-� l-1 M co t h S
Legal Description:
Owner Name & Address: X6,4,4 L i d
Contractor: F it, 9 N L 1 Wi 14
i9
Effective 1/1/2003
(763) 572-3604 Bldg Insp
(763) 5714287 Fax
Tel. #
MN LICENSE # Z Cap 91 5?6
Tel.#
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
4
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length > Width ' Hgt/Ground 1 �// Sq. Ft. Z 19
OTHER:
Construction Type: Poa� _ r� 7� Estimated Cost: $ 5-11-70
D
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 11,61 D 1 APPLICANT: ✓ITel. #J6 1 Z -1 S ..»L+
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 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 $ 1011 .542
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 [ ]
g��1-1a-D:>
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
XConstruction Address:
Legal Description:
Owner Name & Address: JMO [? �tTG(fi i AI¢} A07(zt:55 Af3cvt-r, Tel. #
Contractor:
Address: Tel. #
MN LICENSE #
Attach to this application, a Certificate 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/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed:
DATE:
Call (763) 572-3604 for Permit Fees
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
R
TOTAL $
00
+ 6 F =,4Ft x $ =$
�0s
Tel. #1 o S 71 ^ (S` 3
in application. Fax to 763-571-1287 if using credit card and we will
CITY USE ONLY -
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 Necesso^�
Building
Oe'7.0— OCCUPANUY I*YrJL
BUILDING
Permit No.:
Inspections
Plan Review
RESIDENTIAL "PLICATION
IA
Received By:
763-572-3604
$
CITY OF FRIDLEY
D �' E P�0%
(
DATE 1 J 20.- YOUR E-MAIL ADDRESS �Fn t�. [alb. �1 4/ t
c S T'�t w►�Y� . n cst°
SITE ADDRESS 5ao
3 L LI.,c�w%, 31
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per SAC Unit (Plans to MWCC for determination)
THIS APPLICANT IS:
Cl OWNER CONTRACTOR
ft + 6 ft = ft x $21= $
PROPERTY OWNER/
NAME:
$450 Conservation Plan Review
ADDRESS: SAO 3 4N. qslti 4!�JCITY Cr.� STATE Y�JILIP SSyd i
TENANT
Fee Determined by Engineering
PHONE: -763- 57(- -7-515
$
CONTRACTOR
NAME: '1A4.n j. -- tP.-f-t (_oei
$
STATE LICENSE # aQA9 O ?jR S EXP DATE iJ% 3l� 2t90
—�
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 2.) Y) Ova,, 1 ooK Leone-_ /ll • Crry t4. -cart
LWt" STATE4WIP - SbBa.
WITH APPLICATION
PHONE G - A O - Q9 SL FAX (? 9- 432 - ?2621 $
PROPERTY TYPE
M.SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION 0 GARAGE)SHED ❑ aTNDOVI'S
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
• DECK SIDING ❑ OTHER
❑ SVTvAJING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
LaINTENANCE'REP?dRt O REMODELING
DESCRIBE WORK BEING DONE: �LS: c�� �n 'F ons
pit
- 4 1 ear
u't
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT ' Sq. Ft.
ROOFING
❑ HOUSE ONLY
NL1JBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBXIIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List
of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
O Vinyl
[]Soffit�n
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
E3 Trim Y `,S
1. Site Plan/Survey showing the existing structures
0 Other L,/ V&V —�C C dq.�, O Fascia
and proposed project.
2. Two
sets of construction plans
WINDOR'S
3. Energy Calculations
IN EXISTING OPENINGS ❑Yea ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALa:
(USINP THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ "'
Oe'7.0— OCCUPANUY I*YrJL
Permit Fee
$ A 5
See Back Page for Fee Schedule
Plan Review
'N
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$ a./ S
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ 56T
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
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 qf Etidley and with the Minnesota Construction Codes. that I understand this is not a
permit but only an application f a t and N - t to start without a permit, that the work will be in accordance with the approved
plan in the case of all work wh' r qu- s vi d roval of plans. 1/
SIGNATURE OF APPLICANT PRINT N.AMEAaae, SK a DATE rIC7