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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: OCTOBER 26, 1966 Owner: Builder Address Address N0.._..75 89 Street Lot _ 3 __ Block 36s6Y--" N9 9068 HOMEDALE BUILDERS 7000 HUMBOLDT AVENUE NORTH MINNEAPOLIS, MINNESOTA LOCATION OF BUILDING LYRIC LANE N. E. _ _ _ Part of Lot _ 3 Addition or Sub -Division _ MELODY MANOR, 4TH ADDITION Corner Lot Inside Lot _.. X Setback 35 —�_ Sideyard —_ 10 and 5 Sewer Elevation Elevation _ TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: DWELLING Front 46 Depth 24/28 Height 20 Sq. Ft. 1152 Cu. Ft 23, 040 GARAGE _ Front 19 Depth 24 Height ...._..10 Sq Ft. _ _ 456 Cu. Ft. 4,5 6 0 Type of Construction _ FRAME Est. Cost _ $18, 000.00 To be Completed SEWER LOCATION-� 87' West of Manhole WATER LOCATION - 77' West of Manhole In consideration of the issuance to me of a permit the proposed work in accordance with the description E ordinances of the city of Fridley. e building described above, I agree to do and in co4i fiance with all provisions of In consideration of the payment of a fee of $_18. 00 , permit is hereby granted to HOMEDALE BUILDERS 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: 'This permit does not cover the construction, InstaWoe for whing, plumbing, gas heating, sorer or water. Be cors to no the Building Inspector for separate permhs for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM BUILDER. ADDRESS ADDRES LOCATION OF BUILDING NO. /`� STREET PART OF LOT LOT BLOCK -:5 *'ADDITION OR SUBDIVISION,������`/,�J CORNER LOT / INSIDE LOT-4—SETBACR SIDE -YARD le SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot",pnd proposed building location drawn on these Certificates+ DESCRIPTION OF BUILDING To be used as: Front 44Dept Height �7- . Sq. Ft. 1%.S "-. Cu. Ft. ' 0 '-/ Front /f Depth1-54 Height Sq. Ft._�(D Cu. Ft. 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 14P SIGNATURE (Schedule of ee Costs can be found on the Reverse Side)�tjr�� City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phon5 -3 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Lowiio pp I <3 �` �N U Z �Q F f N WATER HTR. GAS ELEC. Base f 1st 2nd 3rd _ 4th • Future Connection Openings * New Fixture, Old Openings Connected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 196-0Number Fixtures .....................b 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 BTL) ...... x 2.00 $ :2 New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$� TOTAL FEE It 5 City of Fridley: P� 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 applicatio et and correct. 'n „ Fridley, Minn- 4 A , 19�L Owner Kind of Buil ' g Used as To be completed about Estimated Cost, $�E 0-0 Old—New. Building Permit No Permit o Signe i By Nmez— Business Phone No,,�%T L� ROUGH FINAL Application for Power Plants and Healing, 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 $ 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 $ STEAM or HOT WATER SYSTEM 5.00 $ "-, 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 ROUGH FINAL Dept. of Bldgs. Phone SM -3450 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 hereby declares that all the facts and representations stated in this application are true and/ correct. Fridley,/ 19 (' 6 Owner e�- Kind of Building Used as To be co Estimated Cost, $ �' c/ Old New Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or PLANTS—Ste Hot Wa ,Warm —I Trade Nam Z. Size No 2' Capacity %Sq. Ft. E.D.R —d "-o BTU H.P. Total Connected Load `7 �� C% Kind of Fu BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) RAY N. WELTER HEATING CO. Signed 4637 CHICAGO AVE By IOINNEAPOLIS 7. MINNESOTA 40 Business Phone No �— C' 4 )q --'LL dc' 53 -8h -s-215.51 Number Fixtures x $2.00 $ Future Fixtures x $1.50 New Fixture -Old Open. x $1.50 Catch Basin x $3.25 Water Heater -99,000 BTU x $3.00 Ground Run Old Bldg. x $3.25 Elec. Water Heater x $2.00 Gas Fitting Fees; 1st 3 Fixtures x $2.00 Additional Fixtures x $ .75 Gas Range -199,000 BTU x $5.00 Repairs & Alterations Description; Install Grill See 5.00Code State Surcharge Cl iss ,r,A' ISurcha go..5N, .50 TOTAL FEE $ 5.50 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 Tulin of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and correct. a -Ce It Signa ut re Ri—LEP- "ice. Date -:� % rte/ City of Fridley, Minn. No 9260 BUILDING PERMIT Date: — May 19, 1967 Owner: Romedale Builders Builder A—$_C _ Blacktop—Mo- Address lack nnMoAddress 7677 Jackson St. N. E. Address 1308 MainSt. N. E, No. 7589_ Street Lot _ 3._.___ Block LOCATION OF BUILDING Lyric Lane part of Lot 3 — Addition or Sub -Division -Me 1 ody Mange 4th Addn - Corner Lot - .._...- Inside Lot Sewer Elevation To be Used as: Setback — __ _ Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front — Depth Height Sq. Ft. Cu. Ft Front Depth — Height — Sq. Ft. Cu. Ft. Type of ConstructionAsphalt Driyewayt C ..146.00 .__ To be Completed ,dune 1. 1967 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 compliance with all provisions of ordinances of the city of Fridley. ;/ fj In consideration of the payment of a fee of $ 5. , permit is hereby granted to A • B. C. Blacktop Co. 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 buil within the city limits and this permit may be revoked at any time upon violation oY any of the provisions of d ordinances CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, hutallaHon for whbg, plumbing, gas heating, rawer, or water. Be son to see the Building Inspector for separate permits for these home. I APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME Ll 6 JIV 9- /3L(/ Zj g�r 9 -5 BUILDER r - /B . C • �j Z1 ADDRESS �- Tq ,%.S'6 J STI Al t 4� - ADDRESS�� /iI/ 37, /L/1 � LOCATION OF BUILDING NO. ! S 9 STREET G PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. DESCIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height_ Sq. Ft. Cu. Ft. // Type of Constructionn 4T Y oc-&/ Estimated Cos %t G � • � To Be Completed 4JY, 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 ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 0 �� SIGNATURE (Schedule o Fee Costs can be found on the verse Side). G" orifi PERMIT for Power fonts and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of eating Plants C " to be ins lied ltered—repaired Make ,Size A/ 10 a---' ; Oil fired—, Coal fired—,- Gas fired ; Gas Authorization Remarks Approved Final Inspection Date , 19_ Inspector Permit N° 4698 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn.- Owner inn. Owner 0-4—' ��• Location /?z- Kind ?z-Kind of BuildivjAAMA 1J How Occupied Work to be Commenced ,19_ To be Completed D ,19Q Estimated Cost, $ C� Old -New, Building Permit No. Permission is hereby grantedto-Q4LL-LA=&2 to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set f rth in the approved application for this permit on file in the office of the Inspector of Buildings. ' , Inspector of Buildings 42 2M11 -"V 53-8b.-879.01 City of FAidley ;w MmM, md C"s RHbj Pwu* Dsvt. of Eldon. !la®m W -3M or '"® 7589 N. E. Lyric Lane L: ] PARTIAL RATE SCHEDULE _kcs: 90. KATE 70T 4U. Mumkmf k4 -r ft"'t(z ...... MAO S_ New Fir usa Ok., Opening ...... x $1.50 $_ CWN ................ x water He@ter up to 99,009 BTU). $3.00 S New Ground Run Old Bldg. ........ z $3.25 S— clectric Watw IL *4w .............. x Mo $_ GAS PITTING FEES; NO. RATE TOTAL Ist 3 lUtures ................ x $100 $_ A"bonal Inxtur" x $ .75 *_ Ow Ban* to MOM BTU ....... x S500 $_ 3,00 State Surcharge .501 F"AZRB & ALTERATIOMB-4dw to CA& 3.50 nrl ...... 0. 3.50 TMAL 7= $ MM, of phndicv, 7 a- 3 -26-73 Cqmr M. Sluienke Kind of Building Frame Res. Used as To be completed ahom_o? Estbmated CoM � 10.00 A-MZ7 --- � Old --2k= Duildmg Ppmnit Nd SCO By Busimn Phone No SUBJECT RMIT NO. City of Fridley 2 2 2 6 2 AT THE TOP OF THE TWINS BUILDING P E R M I T i RECEIP �`i COMMUNITY DEVELOPMENT DIV. ' ........PROTECTIVE INSPECTION SEC. �7 G r NUMBER REV DATE PAGE OF APPROVED BY I CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 10/22/93 JOB ADDRESS 7589 Lyric Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Benson 7589 Lyric Lane NE 784-3801 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [I REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroaf House & Garage (24 Squares) 2nd Layer 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 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 $l $.96 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1920 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- $45.00 KnX Fire SC $1.92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC N/ $47.88 SI ATURE OF CONT CTOR OR AUTHORIZED AGENT WATEI WHEN ERLYPOPICTED THIS IS YOUR PERMIT BLDG INSP GATE SIGNATURE OF OWNER OF OWNER BUILDER) ID EI NEW [ ] ADDN j ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -7S g Legal Description: �- I-r�cf 1-e Effective 5/26/93 437�5-j Owner Name & Address: k C�'1Ct--V'G{ b ct4yv -2) Tel. # %6` V- M61 Contractor:'yyy-- 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: Length Width HRt/Ground Sq. Ft. OTHER: Corner Lot j ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ / a2 ' Approx. Completion Date: Driveway Curb Cut Width Needed: (Cost on Back) Ft. + 6 Ft = Ft x $ _ $ DATE: 13 APPLICANT: z —� Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,0100 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] TOTAL $ / STIPULATIONS: 1. / SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2 EI 912 � RECEIPT NO. `� _ - COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � PROTECTIVE E . � ` CITY HALL FRIDLEY 55432 NUMBER REv DATE PAGE OF APPROVED BY -_--��"'t;'� L 612-571-3450 910-F15 9/21/98 JOB ADDRESS 7589 Lyric Ln NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Melody Manor, 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steve Aaen 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Brook Harms Construction 6541 134th Ave W Apple Valley 55124 384-5548 20131334 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 Cj REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house & garage (24SQ) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2,056.00 $1.03 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• $J4 JS Fre SC $2.06 TRU N OR THE PERFOR ANCE F CONSTRUCTION PLAN CHECK FEE TOTA EE zi /$77.84 SIGNATURE 11 CON'4.ACTO AUTHORiLEO AGENT �pATE� N P OPE ALIO THIS IP MI S,GNATURE OF OWNERoF OWNER BUILDER, ,DATE" BLO& iNSp MATE 1. / NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � �7 - ConstructionAddress: �� ��C t L L Legal Description: Owner Name & Address: 5te ve A 0 kk Tel. # Contractor: b Q2COk l�, 04S CZ JU 5�r pp UC (-ICA( MN LICENSE # 2-61 Address: C.p 5 y 1 '3�f � C\qz, �rtn (C( fj_i Attach- �S��F1 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: 2 DESCRIPTION OF EWPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. n -/) ic'r- Construction Type: '-ezetL c>V� -�r Ccevecpb Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: % Z " APPLICANT: 4\Tel. # 3Y Permit Fee $ Fire Surcharge $, C3 State Surcharge $ SAC Charge License Surcharge $ $ � Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $. ! 1 4-; `- L/jo �cetAJUL STIPULATIONS: U SUBJECT PER NO.. City of Fridley 397 `, AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ►v ______ r PROTECTIVE INSPECTION SEC. 1 NUMBER REV GATE PAGE OF APPROVED BY CITY MALL FRIDLEY 5532 763-571-3450 910415 110/17/03 f' JOB ADDRESS 7589 Lyric Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 1 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steven Aaen 7589 Lyric Lane NE 763-780-1855 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 ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install egress window 9 CHANGE OF USE FROM TO STIPULATIONS Window to meet State Egress Code. 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. 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 1 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 $1,000 $.50 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 $38.75 Fire SC $1.00 PLAN CHECK FEE TOTAL FEE $40.25 NATURE OF CON'RACT R OR AUTHORIZED AGENT IDATEI HEN PROPERLY VALIDATED THIS IS YOU PER IT 2''�-✓ �C l ✓'" v 1-I - G . )a" LNOG INSP �1 MATE NATU IE OF OWNER,6 OWNER BUILDER, IDATEI U 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 R-1 AND R-2 (763) 5714287 Fax BUILDING PERMIT APPLICATION Construction Address: �t�dS L./ A (4 P Legal Description: Owner Name & Address: Tel. #X Contract Address :NSE # Tel. # '7 _1tft1— 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:j�Fo /-- 2 Xj Cj Iv Wlje,, Estimated Cost: $, lT_/?, n Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ p-ffly 3 : ®a -el G,4 DATE:/ � 0_� APPLICANT: .��—'l Tel. ##�—%JF® 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. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation 1/10th%) n $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) `y Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ' 16:1 oa Q1