PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N?6264
Owner: Builder
Address Address
i�► LOCA N D G
No. Stt'eet P of Lot,
Lot __ Block ddition or Sub-Divisiane
Corner Lot _ Inside Lot T Setback Sideyard �,+�%_ •
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
T Used
Front Dept Height Sq. Ft Cu.
Fro Depth j eight Sq. Ft. Cu. Ft.
Type of Construction .� Est _If' r''''To I 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 afl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of -vt --A 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 anc� =Use= in all work
done in, around and upon said building, or any part thereof, shall coffiorm in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, re and moving of buildings
within the dty limits and this permit may be revoked at any time upon violation oyE any of the Provisions of said
ordinances.
Building Inspector
NOTICE
Me pandt don sof corer the construction, hwaffation for whieg, phno6tag, gas heath, sorer or water. Be son to we
the Building Inspector for separate per®he for thew hepar.
OWNER ° S NA14E
ADDRESS
APPLICATION FOR BUILDING. PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot>4, etback Side -Yard C�
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
Front Lj Depth Height
G �
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction ="n c Estimated Cost 0 C ® '�D
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_ 1�C1 SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
Application for Power Plants and Heating.. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work ..........................
8.00
$
Replacement of Furnace .............................
5.00
$
Repairs & Alterations—up to $500.00 ..................
5.00
$
Repairs & Alterations each add. $500.00 ...............
2.50
$
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
8.00
$ 900
each add. 60,000 BTU .......................
2.00
$
Replacement of Furnace .............................
5.00'
$
Repairs & Alterations—up to $500.00 .................
5.00
$
Repairs & Alterations each add. $500.00 ..............
2.50
$
R
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal. per hour .......................
5.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) .......................
5.00
$
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures
x $1.50
$ --
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS TOTAL FEE
$_-E-120
ROUGH
FINAL
Dept. of Bldgs. Phone SU 4-7470
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and here declares that all the facts
and representations stated in this application are and correct.
Fridley,
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $ it 10
Old—New. Building Permit No. Permit No.'��"
DESCRIPTION OF WORK
HEATING orK2i79=-
Hot-�Warm Air—No
Trade Name Size No Mniks40ft-
Capacity 'Seq. Ft. E.D.ft BTU O a Q ® H.P.
Total ConnectedLead �'f % — - Kind of Fu
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
.JhM 4E 2M
��' � MINGS
1YI NAI
HEAT LOSSr,CALCULATIONS �� �'1 �e sDEPARTMENT F
J
Weatherstrips
A.S. H. V. E.Guide
ReferenSp
19
Construction No.
Insulation
Windows
Doors _
Out. Wall
Int. Wall
Ceiling
Roof
Floor
Kind How pplied
Y No
I No
I
/e
I
I
I
°
Fl. oom I Length 11F Width
Height
Fl. Room I Le th "P Wirth /y Height
Windows and Doors—Crackage and Area
Windows
Doors—Crackage and
Area
No.
Width Height
of pane of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
No•
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coll
A AS
Coef
Btu
Coef
Btu
Infiltration
Glass -'—
Exp. wall
Net exp. wall
Int. wall
/� r/
Yom—
//,
®e
Infiltration '®
Glass
Exp. wall
Net exp. wall
Int, wall
YJL
®®
Ceiling
Floor
Ceiling
Floor
®i
Total Btu.
Total Btu.
t
Requiresq. f). E.D.R. or sq. ins. W.A. Leader area
A*W
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. fRoom Length Width Height f
Fl. Room l Length 9 Width Height
Win
ows and Doors—Crackage
and
Area
Windows
No.
and Doors—Crackage
Width Height
of pane of pane
No. of
lights
and Area
Lineal ft.
of crack
Area
sq. ft.
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coef
Btu
Coef
Btu
Infiltration
Glass
Exp. wall
4AGlass
Infiltrationy�
Exp. wall
b
Net exp. wall
Int. wall
Net exp. wall_
Int. wall
Ceiling
Floor
® a
Ceiling
Floor
b
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader areaf
Required a ft. E.D.R. ore . ins. W.A. Leader area%IG
G�
Fl. Room I Lengt Width /s' Heightf
Fl. Room Length Width G Height
Windows Ad Doors—Crackage and Area
Windo and
Doors—Crackage and Area
Width
No. of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq.ft.
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coef
Btu
Coef
Btu
Infiltrationt_
/
Infiltration
Q
Q
Glass
Exp. wall
/
OD 0
Glass
Exp. wall
Ijk"
-YA
31,06
Net exp. wall
-�
—t!v 7
Net exp. wall's---
�—
Int. wall •
Int. wall
Ceiling
Floor
Dqj_
�—
Ceiling
Floor
Total Btu.
®
Total Btu.
Required sq. ft E.D.R. or sq. ins. W.A. Leader area
��; i,,.,Lo
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
e e
HEAT LOST CSLCULATIONS
DEPARTMENT OF BUILDINGS
Weatherstrips.
Windows Doors
I
A. S. H. V. E.Guide
Reference
19_
Construction No.
Insulation
Out. Wall Int. Wall
Ceiling
Roof
Floor
Kind
How Applied
Yes --No
Yes—No
I
I
I
Fl. oom I Length
Width Height F7
Fl. Room I Length Width Height
Windows and Doors—Crackage and Area
Windows
and Doors—•Crackage
and
Area
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. f
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coef
BtuCoef
Btu
Infiltration
Q
Infiltration
Glass
_rj)
Glass
Exp. wall
Exp. wall
Net exp. wall
6y r
Net exp. wall
Int. wall
Int. wall
Ceilingy
Ceiling
Floor
Floor
Total Btu'.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. it. E.D.R. or sq. ins. W.A. Leader area
Fl. oom I Length Wid 4 Height V
Fl. Room Length Width Height
Windows and Doors—Crackage and Area
Windows
and
Doors—Crackage
and Area
No.
3_
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coef,
Btu
Coef Btu
Infiltration "t.--�
Glass
irI&#
Infiltration
Glass
Exp. wall
Exp. wall
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
L
Ceiling
Floor
��
y
Floor
Total Btu. —r
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. ore . ins. W.A. Leader area
F1. Room I Lengtl4.tl Width/0,r Height
r
Fl.I Room Length Width Height
Windows
and Doors—Crackage and Area
Width Height No. of Lineal ftArea
.No• of pane of pane lights of crack sq. ft.
Windows and
Doors--Crackage
and Area
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Coef
Btu
Coef
Btu
Infiltration ®
Glass
Exp. wall
AK
0 o
Infiltration
Glass
Exp. wall
Net exp. wall
-1
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor
���� a/
Q
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
19,`,y�,
Required sq. ft. E.D.R. or sq. ins. W.A. Leaden area
CoQ .
City of Fridley
Application for Plumbing and Cas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL.
Number Fixtures ...................... x $1.50 $ • d-®
Future Fixture Opening ................ x 1.20 60
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... % x 2.00 $ o�r
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ...... ................... x $1.50 $ /' "6—v
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
X .50 $
x 2.00 $
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 fact
and representations stated in this application are true and correct.
Fridley, Minn. ' se 19-&'t
Owner gKow
Kind of Building
Used as
To be completed about /`Z'ga.f
Estimated Cost, $
(!�
Old ew Building Permit No Permit No.),,,Q
Signed �V'L?-i7/ , j4
By 4- r� �
Business Phone No 141—� 1/7
ROUGH
FINAL
Description ................................................$
TOTAL FEE $ d2 2t►
F
88�Z
�
<�
U
O
<1>'
,
�U' g
mU'
0
N
(9
i
0O
•
R
•
N
WATER HTR.
GAS
ELEC.
Base
Q
1st
ot
2nd
3rd
4th
Future Connection Openings
New Fixture, Old Openings I
Connected with Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL.
Number Fixtures ...................... x $1.50 $ • d-®
Future Fixture Opening ................ x 1.20 60
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... % x 2.00 $ o�r
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ...... ................... x $1.50 $ /' "6—v
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
X .50 $
x 2.00 $
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 fact
and representations stated in this application are true and correct.
Fridley, Minn. ' se 19-&'t
Owner gKow
Kind of Building
Used as
To be completed about /`Z'ga.f
Estimated Cost, $
(!�
Old ew Building Permit No Permit No.),,,Q
Signed �V'L?-i7/ , j4
By 4- r� �
Business Phone No 141—� 1/7
ROUGH
FINAL
Description ................................................$
TOTAL FEE $ d2 2t►
7
r
SUBJECT
P
City of Fridley
o 19918
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
RECEIPT "NO
• ______ COMMUNITY DEVELOPMENT DIV.
v
SEC.
Iy
r PROTECTIVE INSPECTION
����
1 i �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/26/89
JOB ADDRESS 5237 Lincoln Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
2
3
Marian Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
Michael Sipsma 5237 Lincoln Street N.E.
PHONE
571-8107
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Same
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 C* ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 256 sf Deck onto Back of Dwelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan
Before .di.9girrg ollfoG.di Lil!f;lP;
`` Gq ��q P?41/7*S TELEPHONE • ELECTRiC -GAS EtL
TANG, �Irp
CUIED BY 4►
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
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 OF A PERMIT
$1,100
$.55
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$27.00
P AN CHECK FEE
TOTALFEE
$27.55
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY ALIDATEQ THIS IS YOUR PERMIT
M
BLDG INSP
DATE
SIGNATURE OF OWNER I IF OWNER BUILDER( (DATE)
7
r
NEW [ ]
ADDN [ ]
ALTS [ ]
R-1 AND R-2
Building Permit Application
Effective 5/1/88
Construction Address: 52- 3"1 L: ,,-` �, S-- QE Fv-,Ak? �e . r -t M 5v"42/
Legal Description:
Owner Name & Address: e 5 i p vna S awl ¢ --air a 6 e v e Tel. # 5- I - 8'/0 " t
Contractor: _�16 w». ��� Tel.
Address: Saw. -3s Zb ore
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIFPION OF n4PROVEMENT
LIVMG AREA: Length Width Height Sq. Ft.
GALE AREA: Length Width Height Sq. Ft.
DECK AREA: length � � O Width � / � Hgt/Ground `� Sq. Ft. ZSR•
07HER:
Corner Lot [ ] Inside Lot Ju] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $10
Approx. Ccupletion Date: �"� u rue '1K,(
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
W" th + 6' See Back Page
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ (%V Fee Schedule on Reverse Side
State Surcharge $ C $.50/$1,000 Valuation
SAC Change $ $575 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ •��
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
DI 11\Al2IAIP_ =1VT1I0= GATGC• WN BATF TnTei Ana ennRFq.q 4 .5�3 7 I-, n c 6 ( , s`e NC Fr za(a,, M N
New Fixtures 3
Water
Closet
Urinal
Bath
Tub Shower
Sink
Wash Drink. Floor Catch
Tray Fount. Drain Basin
Auto. Gas
Washer Appl.
Gas Misc.
Range Fixt.
Water Heater
Stories
Gas jElec
Basemen
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
1 Oki 11991
Sump/Receiving Tank
$ 7.00
Floor 1
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$ 7.00
Water Heater - Gas
$10.00
Floor 2
Gas Range
$10.00
Gas Dryer
$10.00
O.
Estimated Cost PERMIT NO.—
Back Flow Preventer Required ( )Yes () No
Back
Floor 3
Type
$5.00
PLUMBING COMPANY
Floor 4
DI 11\Al2IAIP_ =1VT1I0= GATGC• WN BATF TnTei Ana ennRFq.q 4 .5�3 7 I-, n c 6 ( , s`e NC Fr za(a,, M N
New Fixtures 3
$ 7.00 .2� U®
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture
$ 4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$ 7.00
and representations stated in this application are true and correct.
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
1 Oki 11991
Sump/Receiving Tank
$ 7.00
t
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$ 7.00
Water Heater - Gas
$10.00
Building Used As
Gas Range
$10.00
Gas Dryer
$10.00
O.
Estimated Cost PERMIT NO.—
Back Flow Preventer Required ( )Yes () No
Back
Type
$5.00
PLUMBING COMPANY
Reinspection Fee $30.00 SIGNED BY,��TEL N0. _?/- gf
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
I% of Value of Fixture or Appliance
Approved By Rough n Date Final Date
State Surcharge .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
TOTAL FEE $�S� PLUS THE $.50 STATE SURCHARGE
SUBJECT
PERM
City of Fridley
1131
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RECEI
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
I I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i
�'� CITY HALL FRIDLEY 55432
.-•- ��"'
L 612-571-3450
910-F15
10/23/91
JOB ADDRESS 5237 Lincoln Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
3
Marian Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mike Sipsma 5237 Lincoln Street NE 571-8107
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Netko Bros Roofing 7118 Riverdale Rd, Mpls, MN 55430 566-3731
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 O ALTERATION (j REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Dwelling (18 Squares) Tearoff
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with.State wilding Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
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.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS I 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
$936
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$255.00
Fire SC $.94
CTIO PE ORM E CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
44
%�
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PR ERLY V LI T HI S YOUR PERMIT
C) "a 3-
.
DATE
SiGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
Address:
-17 .-y
,
`",- 'S 1
Effective 1/1/91
Tel. #
Tel. #� %3 /
YyU
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 11"ROVEMENT
LIVING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
Height
Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
IS szk1 -
Corner Lot [ ] Inside Lot [)
Ft. Yd Setback
Side Yard
Setbacks
Type of Construction: zea L-
p iA e i^m d �`
Estimated Cost:T—
Approx. Completion Date:
�90� as
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
(CM
Ft x $ _ $
DATE: APPLICANT: �'( b�� Tel. #
Permit Fee $ b 0 Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1 / 10th %)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $650 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
INSPECTION REPORT
CITY OF FRIDLEY MINNESOTA
/7IMZ% X7'2_'2cnw
OWNER
BUILDER
Y' DATE • • PERMIT NO.
E3
g DESCRIPTION
INSPECTION REPORT
H no correct re listed above, appro I is hereby given to proce fou will be in
dation of th_ _rdinance If you do not II for the proper inspections -A make
ns as called for.
•
SUBJECT
r
City of Fridley
3190
3
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
RECEIPT NO.
'
`v ------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
��_360q,
J�Jy q
r
1 . �
v�
NUMBER
REVDATE
PAGE OF
APPROVED BY
1 1 CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
6/15/01
JOB ADDRESS 5237 Lincoln Street NE
I LEGAL
LOT NO.
I
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1 2
3
Marian Hills
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Dan/Erika Rasmussen 5237 Lincoln Street NE
763-572-2003
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE N0.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION) ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Rebuild roof; Soffit/fascia
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
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 80 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
25 OOO
12.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
T AL FEE
$428.75
SIGNATUR OWAACTORORAUTHORIZEO AGENT IDATEI
HE PRO
Y VAL D ED THIS IS YOUR PERMIT
LA,G A 0F Q IL IDATEIK.,ALG
INSP
- f1A1E
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 37 1l01e,91W �iF /t%�•
Legal Description:
Owner Name 8 Address: Tel. # 763 -672-2003
Contractor: MN LICENSE #
Address: 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. .
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Lefigtb- Wd H Ground S . Ft.
OTHER: Ct��t/�
Construction Type: at 4t.5,A; k t66�^ Estimated Cost: $ 2500!
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:4�'-/�/ / APPLICANT: Tel. #.;V,5 60
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ 0�9/, �S^ Fee Schedule on Reverse Side
Fire Surcharge $ a� 00 .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ .2& ! Sr
STIPULATIONS:
SUBJECT
P NO.
City of Fridley
32267
AT THE TOP OF THE TWINS
BUILDING P M IT
r
COMMUNITY DEVELOPMENT DIV.
`(;,
572®
RECEIPT NO.
r L PROTECTIVE INSPECTION SEC.
F _ �
CITY HALL FRIDLEY 55432
NUMDEp
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
10/22/01
JOB ADDRESS 5237 Lincoln Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1 2
3
1 Marian Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dan Rasmussen
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Added Value Exteriors Inc 1607 University Ave, St Paul, MN 55104 651-647-6777
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION .] REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside House; Soffit/Fascia; Replace Windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all exterior openings. Permit Inspection Cards
Will Be Mailed
Namanoun—'r- 06
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. A OAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
$15,000 $7.50
WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE T TAL FEE
LiceV,j SC $5AO $278.75
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ioArEi N P P LY VALID ED THIS IS YOUR PERMIT
`
K;QG
S,GNATURE OF OWNER of OWNER BUILDERI iDATEi SNS TATE
OCT -19-2001 11:17 FROM CITY OF FRIDLEY TO 6515479527 P.02/02
NEW [ ] Effective 1!112001
ADDN () CITY OF FRIDLEY ,(763) V24=4 Skig Ir sp
ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 5 a O I L1/060L)
Legal Description:
X Owner Name & ddress:,9 ffS i/ e -t Ter.
X Contractor: H AJC MN LICENSE #
V,Address: t 69 Tel.-#.- 6S7-
Attach
ate7-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 Wldth Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA:LI
dth Flgt/Ground Sq. Ft:
k OTHER: �SI�p �rQs
Construction Type: Estimated Cost: S to O
Driveway Curt? Cut Width Needed: -PL + 6 Ft = �Ft x 3 _ $
DATE: ) 'I d _ APPLICANT: Tel. #
CrTY_ USE ONLY - Call (763) 5724604 for Permit lees If mailing in application
Permit Fee $ 0��1 �S� Fee Schedule on Reverse Side
Fire Surcharge $ Z471,00 .001 of Permit Valuation (1110th%)
State Surcharge $ 2. SD _ $.50/$1,000 Valuation
SAC Charge $_$l 150 per SAC Unit
License Surcharge $ a $5.00 (State Licensed Residential Contractors)
Driveway Escrow. $ _ Alt. "A" or Alt. 'B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ 1
TOTAL S
STIPULATIONS: /� ���_ � ���.���.a � � ' �?l�• q• /
ll�� ��' c, �• du�.�� ,���✓i,Lr� .Q r SLI-
�cT�-i s��--- �la�•clju�- .
• . 4 TOTAL P.02
$uilding
BUILDING Permit No.: ' S
inspections
RESIDENTIAL APPLICATION Rmived By:
763-572-3604
CITY OF FRIDLEY Date Rec'd.91/1 Loe
763-502-4977 FAX
I EFFECTIVE 1-1-06
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS 15 —7
(AC LN 31 L Q ,
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: 3 I N u Lhi !97. N SC1TY 1'& L STATM&ZIP
PHONE: _11,g3 — I—ri 1,7q
NAME:
CONTRACTOR
ADD k6tVtS : e CITY _ STATE
SUBMIT A COPY OF
PHO (,42-- X-Iff4j2MS FAx 6 12 "' 0
YOUR STATE LICENSE
_
e�
7— ® ZJ I9`� LoD
STATE LICENSE # 1 EXP DATE C.S� q
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERIVIIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑. WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ I)9AIN TILE
)RVECK ❑ SIDING ).OTHER D 0 b1Z
❑ SVANIM iG POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDTI'ION
❑ MAINTENANCEMEPAIR iOEMODELING
1 q�
DESCRIBE WORK BEING DONE:13yL ® i-�il�" SE O �� 1►�1 fIlrrE JiiS�/�J� r"►1�
SIZE OF IMPROVEAEE14T
LENGTH WIDTH HEIGHT to ® SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
Dsl�
I. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE —�
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
(.}y
�
FORNEW CONSTRUCTION INCLUDING DECKS,
IDIN
• Vinyl
0soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim I
1.. Site Plau/Surveq showing the existing strucbues
D Other
❑ Fascia
and lroposed proms'
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑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 MATERIALS:
—if .....,, ••uw i1RV FRF C('ANWITi.F.l
DOTAL JOB VALL
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
5
OCCUPANCY
Seep Back Page for Fee Schedule
65% of Building Permit Fee
.0D1 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$ ) $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 payable to: City of Frldlev Attac
TIM IS AN APPLICATION FOR A PERMrr NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in confbmutace with the ordinances and codes
of the City of Fridley andwith the on es; 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 accordah the appro the case of all work which requires review and approval of plans. A
SIGNATURE OF APPLICANT PRINT NAMF�(VCL jZ. tp1 � DATE/ J ( 0 ?
APPROVED BY DATE
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