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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT No 4 5 5 Date: Owner: ... ...� _ _. Builder _..._._._......._..._...._. ._._.._.._...____...._.__ Address _.(?r,,C`A s Address ...._.._......y�'..... .__- .._......._.-._._..._.._._.... � I,OCATI BUILDING NO. .... ... ............ Street _ , _ ._.:......_ ......,,e..._....._._ Part of Lot _.... Lot ..-- ---------------------- --------- Block ._.._.._......... .............. - .............. ... Addition or Sub -Division _............ ............. ---- Corner Lot ..... . ................... _........ Inside Lot ..... ....................... -........ Setback .... ........................ ............. Sideyard Sewer Elevation ........... ............ .......... ..._.......... ............. —...... ........ _._ Foundation Elevation DESCRIPTION OF BUILDING To yUed�: _�....:.. Front .,A._.. Depth -.---. Height ...._.. Sq. Ft. Cu. Ft.. .... _............ -............. ........ -.............. Front ... -............ _.. Depth ............. _. Height_..._ .- Sq. Ft ....................... Cu. Ft. _.................... Type of Construction .----..... Est. co;t-z ................... To be Completed .................................................. -o TE I LAND COVjENANT$.,AVR RESTRICTIONS, In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. X In consideration of the payment of a fee of$�._�" '`'�`., 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, re. and moving of buildings within the city limits and this permit may be revoked at any time onviolation 6. of the 7il vons of said ordinances. pp00// 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. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY., MINNESOTA Owners Name ,,._. Builderla, v Address .���Q �� ► �- Address -LOCATION OF BUILDING No.: ' Street* _ Part of Let Lot Block Addition or Sub.'Div. Corner Lot Inside Lot Set Back ;Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING fia be.used as 1,4 rl Front � C° Depth Height `® Sq. Ft. -/g 0 Cu. Ft. Z/ fo C Front —Depth Height Sq. F`t. Cu. Ft....� Type of Construction ��-�;" Estimated Cost ­f// 00—" . 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 ef.Buildings, and hereby declare$ that all*the facts and representations stated in this.applieation are true and correct. Date �_T / 9 G ® signature (A Schedule of Fee Costs can be found on the Reverse Side) Date: City of Fridley, Minn. N° 8397 BUILDING PERMIT Address OCATION NG No. Street Part of �--- % Lot _ Block Addition or Sub -Di on Corner Lot _ Inside Lot Setback ideyard Sewer Elevation -- Foundation Elevation DESCRIPTION OF BUILDING '�.� %�:��, 'mss..- • I rr�cr,� Depth Hel: I // Sq. i Cu. o, DepthSq.CIL Ft. � _ fie. Type J� y I Con C A A I I�y.%Y• 1: /.. 1 1 -Completed �ff i In consideration of the issuance to me of a permit to construct the building des cri hove I agree to do ==Was! he proposed work in accordance with the description above set fo in complian a�l provisions of ordinances of the city of Fridley. n _ cancidera on of the payment of a fee of $--, permit is hereby granted to construct the building or addition as described above. This permit is granted upon oaa L titan that the person to whom it is granted and his agents, employees and workmen, in all work. in, around and upon said building, or any pari thereof, shall conform in all respects to the ordinances of dleF. Minnceota location, constructCon, alteration, maintenance, repair and moving of buildings within the dty limita� permit may be revoked at any time upon violation of any of the Provisions of said ordinanoes. NOTICE: 7W pwmb den not cover die constraadon, huff a w for wbtne, piambine, on he d m sewer w wafer. Be wro to see the Balldiee hu" ter for sepmte pwmds for dbess items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA NAME / - l DD' I .� - ADDRESS� LOCATION OF BUILDING NO, ?` D STREET &G °Yj PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE YARD SEWER ELEVATION FOUNDAtiON ELEVATION Applicant attach to this ford Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; Front�y Depth,2?�Height Sq. Ft. �Z '�70 Cu. Ft. � �® Front Depth Height Sq. Ft. Cu. Ft. Type of Construction C a Jt. CES Q� Estimated Cost � ��o 00 To be completed Al6 J -P127 h -e (r 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 (Schedule df Fee Costs can be found.on the Reverse Side),. l�s� R•a�..�c��.iu nom:! ri �'� t�:.a�' u�_....-..:� ��o-.�.� ��Pv�.0 ®...:'�� 4� "`A .. �6".'y� ���+a ,F°?,..{`. o,�,�+� °tT� A..,�Ep ^r"�"`s t.'.9+., ry�m+' L-'�',i \*,�i,'r�uiurw.ur:7 L'a,yr�i.i•� Q,J��,iU.uriJ�J t�.s J'� li✓vbrry. PARTIAL RATE SCHEDULE GRAVM WAW-, Ara: 1M' -' `1°t:➢D'"2AL Fur=ce Shell & Duct Work . $10.00 `�— Replacement of Furnam 6.00 P.epairs & Alterations -up to 5500.00 600 'Repairs & Alterations each add. 3500.00 3*W $ b=C13. WMMI PM Furnace Shell & Duct Work to 1241,000 BTU ..$1000 e=h add.. 60,00 BIV . ......... 3.OJ $ Replacement of Furnace 6.00 $ ,Repaira & Alterations -up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 STF_1kM or HOT 4'J M P. S'aJ.'F'�'...4 Furnace Shell & Lines -to 400 sq. ft. FDR Steam $10.00 g Furnace Shell & Line- -to 640 sq. ft. EDR Hot Water 20.00 S. Each add 200 sq. ft. EDR Steam -4.00 $ Each add. 320 sq. ft. EDR Hot Neater 3.00 $ OIL BURN= -to 3 gal. per hour 6.00 S. over 3 gal. per hour See ree Schedule GAS BU'M1o" EER (up to I!..-,0;::1 BTU) 6.00 $ ow;:: 199.M BTU See Fes schodule GAS FI=HG iF.a: 110 RATE TOTAL Ist 3 F%xtures x3 103 S Additlonai Fixtures _ x .78 Gas Range to 1M,M x'S 6.M $ State Surcharge 50 _ AlitCC:D:'S�trBsEe:a FAX A. LQF�.,ai��S�lIi.�S � 1�0�LcJ ��i1.g.,c• l�.".o p Dapt. of Bldg. is &n* -34M City Of ridley: The undersigned hereby makes application for a permit for the woraa here;.: specified. agreeing to do all work in strict accordance with ttie City Ordinarce= and ruling of the Department of Buildings, and hereby declare. that all the fa�� and representations stated in this application are trye and correct. Fridle�, Minn 19 C:wner Kind of Building U Used as To be completed about,` oa Estimated Cast:, $ XQ 6 �ew. Building Permit No. --- Pormit No.- HE.4,7ING or POWER. N75--St=m, Hot Water, Warm Air -No Trade Name Sym No •Capacity—_-• — Sq. FL E.D.R BTU B.P, Total Connected r=d bind of stmt EUR -MR - Trs& Name Size No Capacity Sq. n F-DIL BTU - 6 -6 -v - TU . te��aaeas�-®e�a1 6fJv-Or CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Effective On January 1, 1995 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace . (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial I% of Value of Appliance or Work Rate TOTAL $ 20.00 $10.00 $10.00 $10.00 $ 10.00 State Surcharge TOTAL FEE $ .50 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $,50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS 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 at rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER_ _T)<:;/`® i�� Q��i1s BSc BUILDING USED AS ESTIMATED COST���� PERMIT N0. / DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Signe B ---z Tel No.f k:� Approve Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. CHIMNEY AND STACK VERISCATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( } 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes( ) - No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water beater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: HEATING CO: Signed By: Date: SUBJECT City of Fridley " :3115:5 2AT THE TOP OF THE TWINS BUILDING PERMIT O. • ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 . � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 11/9/00 JOB ADDRESS 6340 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 5 Christie SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dorothy Jacobsen 6340 Madison Street NE 571-2269 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Imp. 8400 89 Ave N, Brooklyn Park, MN 55445 425-2227 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION GR REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Replace three windows 9 CHANGE OF USE FROM TO STIPULATIONS 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. Permit inspection Cards Will Be mailed To Homeowner 'ou p- P®st 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 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 @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,200 $1.10 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- Fir STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 SC $2.10 PLAN CHECK F TOT FEE Lice S $5 1.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE, ENRWE ALID G INSP D HIS IS :) A PE 1T _ PATE SIGNATURE OF OWNEROF OWNER BUILDER, (DATE, 3Q�p 5-9 NEW q[ Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: %.3 +0 nlad ','- S 6rl S+ Legal Description: Owner Name & Address: Contractor: 1 I) 'A r r1A, -, U rrrgm�ffiikm LIVING AREA: GARAGE AREA: DECK AREA: IVB- lav L A)0 Tel. #,5'11- as & 9 MN LICENSE # 7,003.925-9 8e_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 Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Estimated Cost: $ 0?6Q&), 0 a (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 11 12j c,0 APPLICANT: Tel. # Permit Fee $ ql. Fire Surcharge $ 1 State Surcharge $ Lf. 00 SAC Charge $ License Surcharge $ 5,00 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 $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 [ ] TOTAL $ TsA STIPULATIONS: D� ��Y ae Wj "r, —We- v�lo.