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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N° 4 217 Date: ........ SEPTUM 11.,.._1�5�__. Owner: ..... Builder .-.- LYNDALE_BUILDERS.:..INC._._._..__._ Address ..................... ......................... ..... ........ _. ._. _ _ _._......... Address 3019 Lyndale Avenue South - Ni.nneapolis, Minnesota LOCATION OF BUILDING No. ....... S.L+Ql............ street ....._._M�.dison.._St...-5!- -E� ' -- .......... Part of Lot _..._.. - . ..... Lot ....._ ...4 ............. _........ Block ..... ........ ....... 1.............................. Addition or Sub -Division ....._..Lyndale....Bui CZera ....A.th-Add-In Corner Lot .......................... _........ Inside Lot ....._....X...........-. 35t ...................... Sideyardi .......... Setback.-----..3�........-•----�.._..---.._...._............................__ . - Sewer Elevation ...... ............. ............... ............. ............................. _....................... Foundation Elevation .................... _............. DESCRIPTION OF BUILDING To be Used as: . Wail. ........_.............. Front ..... C.._.. Depth V'10-" Height Sq. Ft.. Z,C63. Cu. Ft. x:197 .... . .............. _............. _................ ....... Front ...---................. Depth .................... _.. Height ........................ Sq. Ft......................... Cu. Ft......................... Type of Construction ......... .............................. Est. Cost........13.t.r�..:.................... 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. ,_"'�, A I ( 1 f In consideration of the payment of a fee of $.....---_20_OW......., permit is hereby granted to....._._v...................................... ... ._....................... -................................. 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. i o - _ Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder Address Address " y L �►�"A'�°` `( LOCATION OF BUILDING No.. S L/ 0 V Street `' T ' Part of Lot Lot `( Block Addition or Sub.Div. Corner Lot Inside Lot L_,"� Set Back J" Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to•:this form:C .rtificate of Survey of Lot and'proposed'building location. _ DESCRIPTION OF BUILDING To be used jas: Front Depth Height Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft: Cu. Ft. r-,..7.7.. _. .. Type of Construction Estimated Cost To be completed The undersigned hereby makes application for a germit.for the work herein specified, agreeing to do all work in strict accotdance 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. DATE `� �/ { ' % SIGNATURE (A Schedule'"6'k Fee costs can be fouiad on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Permit W DepL of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK�(�� Number, Kind and Location of Fixtures Location .y Xµ411 F F NO. RATETOTAL N Z yN $ C Fz x w N New Fixture Old Opening .............. x w z o� ? W coo R • N WATER HTR. GAS ELEG Bas Zr G� Water Heater (Up to 200,000 BTU) ......x 2.00 $ " New Ground Run Old Bldg . ............ —$6 x 3.25 $ GAS FITTING FEES: NO. , RATE TOTAL 5 1st 3 Fixtures 1st $1.50$—/—, .......................... f Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 2nd _ 3rd _ 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATETOTAL Number Fixtures ...................... x $1.50 $ C Future Fixture Opening ................ x 1.20 $ f �t New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Zr G� Water Heater (Up to 200,000 BTU) ......x 2.00 $ " New Ground Run Old Bldg . ............ —$6 x 3.25 $ GAS FITTING FEES: NO. , RATE TOTAL 5 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�G City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do 411 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 trulfland correct. is ., V%4miw .Mnn_ 4e- ae, - `-A. 19 � !!" Kind of Building.. Used as To be completed about Estimated Cost, Old—New. Build ROUGH JAN 1 j 1969 FINAL - -Q80-42 a 2M 7-59 City of Fridley, Minn. BUILDING PERMIT N® 6528 Date: -6- - 3' --- 6 - owner: wL9Builder Address V Address r L TION ° D G No. Street Part of _ Lot _ _ _ Block _ _ _ Addition or Sub- a Corner Lot Inside Lot Setback deyard _. J- Sewer Elevation — F dation Elevation DESCRIPTION OF BUILDING Front Depth Height -,�- `= - Sq. Ft. L�k Cu. Ft. J.f_.. Depth H 'ght Sq. Ft. Cu. Ft. Type of Construction V - Fit. _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, Ido 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. AV In cansideration of the payment of a fee of 2 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 ]imus and this permit may be revoked at anypon5 olatio o any of the provisions of said ordinance& Building Inspector NOTICE: We permit doss not cover the construedon, Installation for wiring, phnmhing, gas heating, sewer or wafer. Be acre to we the Buildhn0 Inspector for separate permits for than item. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA • ' ► �' < •, l BUILDER BI' ADDRESS ADDRESS LOCATION OF BUILDING" No. t��y® % Street a part of Lot Lot Block �+ Addition or Subd ision OCA Corner Lot Inside Lot Setback. Side: Yard �.� SEWER ELEVATION F UNDATION 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 b sed s; Front Depth Height V 9— Sq. Ft. ���. Cu. Int., ��, 90 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned agreeing to do rulings of the representations hereby makes application for a permit for the work herein specified, all work in strict accordance with the City of Fridley Ordinances and Department of Buildings, and hereby deglares that all the facts and stated in this application are true and correct. b DATE_ �x SIGNATURE .0 r (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE ' Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 $ Gas Range $ 10.00 $ Gas Dryer $10.00 $ �U *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs $ Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge .50 TOTAL FEE �.SU MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. The undersigned hereby makes application for a permit for the work herein specked agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. _� <__/_1" — 1996 ESTIMATED COST PERMIT NO. /;�26,< DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_Z Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU EDR Fuel Total Connected Load Burner Trade Name BTU HEATING COMPANY Signed By .JAG Size No. HP EDR V Approved ByRough—In Date FILL OUT BACK SIDE OR STACK VERIFICATION ON REPLACEMENT FURNACE Final Date SUBJECT City of Fridley f27339 AT THE TOP OF THE TWINS BUILDING PERMIT r EIPT NO. ______ COMMUNITY DEVELOPMENT DIV. v �t j r 1 i PROTECTIVE INSPECTION SEC. %tA L{- 1 1 I 6 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/24/95 JOB ADDRESS 5401 Madison Street NE 1 LEGAL LOT NC BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 1 Lyndale Builders 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tim/Jonie Knudson 5401 Madison Street NE 574-1767 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO- Legvold Construction Co 374 E Belmont Ln, Maplewood, MN 55117 774-9422 3650 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 �7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace front window 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 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 $2,800 $1.40 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $2.80 STRUCTIO OR THE PERFORMAN E OF CONSTRUC ON $54.00 ' PLAN CHECK FEE TOTALFEE r5� License SC $5.00 $63.20 SIGNATOR OF N'RACTOR AUTHORIZEDAGENT IDATEi WHEN PROPE Y VALIDATED THIS IS YOUR PERMIT - 'B G INSP �y.� OAT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/ 1/95 ADDN [ ] CITY OF FRIDLEYl� r f ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 7` Building Permit Application Construction Address: �r- Legal Description: Owner Name & Address: ti' rn Rev Tel. # :57 Y - 1 Contractor: &; 0 MN LICENSE # .3 & 5 d Address: 3 71! 8F , &C--- Lhh� r/ i� e c n o Tel. # 7-7q'-2- 4/ z Attach to this application, a Certificate of Survey of e 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: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 6. - -zel F.ile-7p-ze,&-�cz,.AW,.Estimated Cost: $ Approx. Completion Date: S .2 6 - � Driveway Curb Cut Width Needed: _ DATE: APPLICANT: (Cost on Back) Ft. + 6 Ft = Ft x $ Tel. # TOTAL $ J • a 15 STIPULATIONS: CITY USE ONLY Permit Fee ' / $ i . �� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 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 $ J • a 15 STIPULATIONS: SUBJECTMIT City of Fridley 3 01 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. - -----_ I- r PROTECTIVE INSPECTION SEC. E i� E I"'1 '- CITY HALL FRIDLEY 55432 t'' NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910.F15 99 8/2.5/99 JOB ADDRESS 5401 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 L dale Builders SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tim 4 Joni Knudson 574-1767 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Le old Const. Co. 374 E Belmont - - 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 [XX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows in house with vinyl; Install egress windows in -basement: Update basement bath 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. 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 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 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 $9800 $4.90 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- $181.25 Fijfe SC STRUCTIO OR THE PERFORM CE OF CONSTRUCTION $9.80 PLAN CHECK FEE T Al FEE 9� cry Lice $5 200.95 SIGNA R CON'RAC AORAUTHORIZED AGENT IOATEI HE BL 1 INSP Y V I D THOUFJ �E 7SIGNATURE OA TE OF OWNEROF OWNER BUILDERi IDATEI y NEW[ ) Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMH.Y AND DUPLEXES R-1 AND R-2 �S BUILDING PERMIT APPLICATION3 Construction Address: 15yD % Legal Description: Owner Name & Address: `�y1 01- SOAJ A�;!VCI Tel. # Contractor: LF (2:A®'c— is. ;P"- cz® MN LICENSE #� Address:�- R Llko,,v $` N,e- %1��� � 9 R-- � Tel. # - 9 s z Attach to this application, a Certificate of. Survey of-wise'l;> lot, with the proposed construction drawn on it to scale.. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: /? � � G� �- — Construction Type: Driveway Curb Cut Width Needed: Estimated Cost: $ 9k8' Q Cr Ft. + 6 Ft = Ft x $ DATE: •� 7_9 � APPLICANT: Tel. 11-7,;" AY Z � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $ , vU $ y�o CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On May 10, 1999 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Urinal '��� Shower .::.,...:....... ... Wash :<:r:::::: I��::<<:<:: :: I�:E�ttl� Floor rain ... :. ffi�<>` ::�::;:: :..�:<::>:<-: Auto. -.�..•��..�.� Washer :. "::'_: ����"�: F..r Gas Range �: Water Hea :GG'°. ter O� St nes -���`���`��� �Q.t ��;.::::,.:. Gas Elec Basement t Floor r1 Floor 2 Floor l0 3 Floor PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 5 Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 02 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE JOB ADDRESS Al 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. ,1999 Owner / 1-h o v Building Used As AM Estimated Cost PERMIT NO. PLUMBING COMPANY - SIGNED BY ` Approved By Rough -In Date Final Date **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. SUBJECT PERM >,W__ City of Fridley AT THE TOP OF THE TWINS r BUILDING PERMIT 3 1 6 8 5 R COMMUNITY DEVELOPMENT DIV. —�'� �i y_ _____ r I � PROTECTIVE INSPECTION SEC. NUMQER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/19/01 10B ADDRESS 5401 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 4 2 Lyndale Builders 4th SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Tim/Joni Knudson 5401 Madison Street NE 574-1767 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Home Products 3770 W Broadway, Robbinsdale, MN 55422 521-9211 2332 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 J7 REPAIR O MOVE O REMOVE B DESCRIBE WORK Install soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet the State Building Code. 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 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 $2,000 $1 •00 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- $23.50 Fire SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE License SC $5.00 $29.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE, WHE PROPERLY VALIDATED THIS IS Y UR PE IT SIGNATURE OF OWNER OF OWNER BUILDERI IDATEi iNSP 'BATE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: -1)y0 t —�" (4 ' s ��, % Legal Description: Owner Name & Address: IT,,, d- s f Contractor: ffi,(41 K e z Address: 3? 7P "54— Tel. # .5-1,1-176 j MN LICENSE # c) 3 3� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT 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: ��`+ `%� - 4ts c : Estimated Cost: $ 2,0,00, a v Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ 'Zr DATE: '746-o APPLICANT: L Tel. #_ CITY USE ONLY Permit Fee $'2 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ j-00 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ c;. o J $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 $ 'd- 2, S-0 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE It Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES; New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () No Type N©. RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB ADDRESS 14 -11z: - 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. z? ,20 1101, Owner ,6AAAiME Building Used As J Estimated Cost t—inko PERMIT NO. 1 i PLUMBING COMPANY SIGNED BY L 4C _Zh S�Ml TEL N0. 6 Approved By Rough -In Date Final Da MINIMIJM F.?EE.EQR-ANY PLUMBINGIGAS PERMIT 1 S201 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE I-% G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 November 5, 2001 Ms. Joannie Knudsen 5401 Madison Street NE Fridley, MN 55421 Re: Final Inspection at 5401 Madison Street NE Contractor: Mr. Rooter - KCJ Enterprises Dear Ms. Knudsen: A plumbing permit was issued on December 21, 2000 to install a water heater at your address. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspection to make sure the work was completed according to the Plumbing Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection, or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh