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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 4083 Date: ......... ...._...._............._............._.............�.... .................... ... Owner: - .............................................. ......................- .................... Builder ....-....----------- ........... ...... .............. - ............. Address.... -...... -................ ................. ... _............. Address._......_............._............._..._.................... OCATIONING No... ./. Street ....._ .....�.....- ...• -a Part of - _.....,_.............._...._._...._.._.._... _ Lot ..... ._..._........... Block ...........-;? .............................. Addition or Sub -Division ... - ---..[�._.. ..- Corner Lot ................................... Insid Lo .................................. Setback . -' ............. Si yard Z-0.7! .. --------------------•------..... ... Sewer Elevation 11/1 ........, . .... .......... Foundation Elevation .................... _............. To be Used as: .. �.... - ..'_............. Type of Construction DESCRIPTION OF BUILDING Front ...I_...!.�1....� Depth 0C._..©-..../� Height .. �� !. Sq. Ft. ®._ ® Cu. Ft. 1l...l.._..4V Front ............................. Depth _......... Height Sq. Ft. ..... - ............ :.... Cu. Ft. ..................................... .. Est. Co ...../.��,�fg............. 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 forthoand in compliance withr provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of /� f� P Ym $-07(/•.-, 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 within the city limits and this permit may be revoked at any time upon violation of any of the rovisions of said ordinances. / Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 - - r2/ds? ,P Old" .Pf %q ' '� �V APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name er_ Address LOCATION OF BUILDING No. Street A S`7 ACPart of Lot _ Lot Block — Addition or Sub.Div. 7e- /-P. /2e�- ,r f io Corner Lot Inside Lot i-- Bet'Backe � Side -Yard /d ,6 � � � —e SEWER ELEVATION_2z _ _ ELEVATION 2az J Applicant:;at�c o t s';C'orm' Certificate of Survey _of Lot and proposed building, location. DESCRIPTION OF BUILDING To be used as: Front < Depths Height Sq. Ft. ­'16 Cu. Ft.I Front Depth Height Sq. Ft. 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'Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated `in',this'"application are true and correct r. ::4, DATE SIGNATURE (A Schedule Fee costs can be found on the Reverse Side.) z 1 • �4 • Al j.0 • N G I N. E RS AND'- . r3 �i'E7►I,' !f . - 4►ND- sVRVgYINO +' 601LA 9""TINiQ CIVIL Qt., MUNICIP" ENSINEEMNS Lkmo MAW= 6418-56' : AVENUE . N. MINNEAPQL19 Wr. MINN. KE 'i- 5437 cit rl*H6;4to-4 of yAY- LOVa lV1' Scalar' i y. n ` LQ y 1 7 fi a r�eNI, - Iron► ran f-� �Idck 2, tnp116 rra A dltzo ' a .ot _T" INE' HEREBY CERTIFY TNRT TII15 t$ A TRUE D CORRECT REP�k5EN3"i'I�rtttfl�L �� St> fEY tib_ 1N� Jri A4 5' OF tOf. AN IAND''AMF DEXR[f*D AND OP*Mt' �i,11CATlOM OF Ii4.1. �IJILOINGS,;IP Ai31l,.THP.t E4N, At�1© Al.t. V15r181,fic ENtROiwCNME!`IT$� IF ANY, FROM OR ON SMD CAND.Mc e t bei.:: ho: alCffp-TMtO.�.�...OAYOF .--..*--ip,..�-r-------r' o Eli O%%, filly b1/iCl� t►!#il.�/it Q -S • 1 323-�► � - „�• � � �� _� ,� ,` � 1 City of Fridley Application for Piumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4.7470 DESCRIPTION OF WORK 3 Al4 Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures...................... x $1.50 z z o g 1.20 w z • g W WATER HTR. GAS ELEG r x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. Base 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd �9D 4th — • Future Connection Openings Connected with � New Fixture, Old Openings I (� Sewer E] Cesspool E] 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) ...... Z x 2.00 $ 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 ................................................$ S'S' &a TOTAL FEE $—/� i;� 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. S� iLd /) Fridley,,, EP 2 in/n� 19_ Owner 4 19— Kind of Building 19 Usedas To be completed about / 4, Estimated Cost, $ Old—New. Building Permit No - sign ND®N PLUM"NG Co. By —72 Business Phone No SEP 2 9 1959 Rough .011W11 POST IM -12-58 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixturee Future Fixtures Old Opening, New Fixture Beer Dispensar Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve sump or Receiving Tank Water Treating Appliance Not Water Heater Gas Range Gas Dryer $ 5.00 $ 3.50 $ 1.50 $ m $ 5.00 $ o $ 5.00 a 5.00 water 5.00 $ 7.00 $ 5.00 $ J44. o+ e A e u� Heater m J m u U0 a a� ai a� vii 3 aw° w v[i o s lec 1st 2nd 3rd 4th (R) . Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixturee Future Fixtures Old Opening, New Fixture Beer Dispensar Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve sump or Receiving Tank Water Treating Appliance Not Water Heater Gas Range Gas Dryer $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 S Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $L157-115 t9 Effective Date May 1, 1988 Job Address / ./�`�U `(��� ✓/ _� Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and he eby declares that all the facts and representations stated in this appl ati are true and correct Fridley. Mn. l9 OWNER KIND OF BUILDINGS A,, -y7 USED AS TO BE COMPLETED ABOUT 71 ESTIMATED COST OLD - NEW BUILDING PERMIT NO. Company - Signed By Tei. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE ERMIT NO. SUBJECT - P City of Fridley 29697 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. _ tV ----- , r � � PROTECTIVE INSPECTION SEC. 1 <r CITY HALL FRIDLEY 55432 NUMBEN F1Ev DATE PAGE OF APPROVED er j 612-571-3450 910-F15 6/16/99 JOB ADDRESS 5361 Madison NE 1 LEGAL LOT NO. -Street BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 ITemRle T SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marion Billington - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Trend Roofing21 Zachary - 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 ❑ ADDITION ❑ ALTERATION )CX REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 1 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 $1748 $-87 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF AN ER STATE OR LOCAL LAW REGULATING CON- $63.15 Fir C $1.75 STRUCT STRUCTION THE PERF ANCE OF CONSTRUCTION PLAN CHECK FEE TOT L EE Lic s C $5 $7 . 7 GNA TUAE ON'RACTOA ORA RIZEO AGENT IDATEI MEN A 8L INSP LIO �IS Is 6 Yf�Ufi P�1� (/f)AT( S,GNATURE OF 0WNER,1F OWNER BUILDERI (DATE, ERMIT NO. NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRMLEY ALTER [ ] SINGLE FANJULY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ✓ Construction Address: —SID C Legal Description: Owner Name &—�A°ddress: Ns t ; Tel. # Contractor: MN LICENSE Address: t® V ®\ 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 _Hgt/Ground Sq. Ft. OTHER: L� -5x - 7t, 6 - 1 -0 ic — Construction Type o'� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Tel. #j STIPULATIONS: CITY USE ONLY Permit Fee $ /S Fee Schedule on Reverse Side Fire Surcharge $ r S .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ _ 60 $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 STIPULATIONS: