PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3693
Date: ............
Owner....................................... Builder ........ .......................
Address ...................................... Address ................. ..........................
No. .U.'./.-./.,. Street A ...... ' .. �� Part -of Lot......................
Lot .... ��...... Block .... ........... Addition or Sub Division 61�LPI�r:
Corner Lot ............ Inside Lot-. X........ Setback V.. y. Sideyard .................
DESCRIPTION OF BUILDING
To Used �a e � � .�
.. .. .. ..... ... Front ."I.. ��. �1�lpth/7�.�,p Height l..r�—® Sq. Ft �Q� Cu. Ft.
Front J.9? � Depth l..-.� Height Sq. Ft ��� Cm
Type of Constfluction.
C/ ppi�p
.:... lit. Cost...i.9.V.8... To be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed 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.
In consideration of the payment of a fee of $.R? .� .`�., 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 with-
in the city limits and this permit may be revoked at any time upon violation of ally of the provisions of said
ordinances.
.. i 71 v .:�Y/. V14W. ...BuilAing Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspeothr for separate permits for these Items.
r
el
Date: June 7s 1965
Vernon Johnson
City of Fridley, Minn. N° 7769
BUILDING PERMIT 7
Builder
Johnsons Anderson & Bergman., Inc.
Address 6710 Madison St, N E, Address 74S w• Idaho Ave. St. Paul, Minn.
LOCATIONOF BUILDING
No. 6741 street Madison Street N. . Part of Lot
Lot 9 _ Block - ' 4 Addition or Sub -Division Rice Creek Terraces Plat 6
Corner Lot Inside Lot
Sewer Elevation
To be Used as:
Type of Construction
Setback ____ Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Fit. Cost $1, 5M.00 To be Completed
Storm damage repair
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of1$ 0!� , permit is hereby granted to Johnson Anderson &
Berg ?nCe 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 regardinglocation, construction, alteration, maintenance, repair and moving of buildings
within the city ts and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen Jensen Building Inspector
NOTICE:
'h k penah don not cswr the sonstmegm, ha ffiMon for whdng, plumbing, gas heating, sewer or water. Be sure to ae
*A BuiMlieg hapestor for apm to permits for thea Nana.
OWNER'S NAl►B;
APPLICATION FOR BUILDING PERMIT
OF FRIDLEY,. MIIMSOTA
M
ADDRESS _ l ADDRESS'Z�rs . JJA4e,
V,
LOCATION OF BUILDING
No. Street „C Part of Lots__
LOT BLOCK ADDITION OR SUBDIVISION
Corner Lot Inside_LOT Setback Side -Yard,
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot.and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
i
To be u d
-�� Fr. th Height
Sq. Ft. Cu. Ft.
Front Depth `Height
Sq..F:.. Cu. Ft
e
Type of Cdnstr'uction Estimated Co/
To be completed'
The undersigned he.ieby makes application for a permit for the work herein specified,
agreeing to do all work 'in strict`aocordance 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.
•� I/ f`�a' qF `, ) STCUATMR Ii f .,, �r�►,�/ ..s� �� / / ti�"��o...., ,
(Schedule of Fee Costs can be found on the hese d�ej:�
53-84-879.01
j I I F 16
® s
it. 1111,111 Ila lit 1!111111 111plials(la .211
Rose
tit
!rd
PARTIAL RATE SCHEDULE
G rUCTUM RJt.TM NO. MAIM Tcvr*u
twtm3 tztt M ................
tom! (l .... a .. • ...
Z f Y.E�O 9�— .
N" NZWre ON .........
C849% Balft .............kart er r
Z IM
Mater heater :Up to MAW B'PV1. w s •
a am 9
New Gra:ed Rus: Ow Bkw ........ •
s S .Z $
nM*ff*waftr............. w
a 'o A
rM 3 rMw is ......... t ...... . • -ROM
.........r .....
amMWft WOft WFU�..........s
�
State .7Y
� .50
Rtp� a 011110M' cal tw '
Connect Pool Heater
5.00
�.�.. .......
rarrALV= 9 5.5o
- if s "A® Surcharge -uoy
at, of moi:
The uadersigned heretby snakes application for a permit for the worts hemi
specified, agreeing to do afi work In stilet amwdamw tenth the ig1w v
and ruling of the Departmeft of BuddinM and hereby declares that 24 tM tad
aced representstims stated In this applicadm oee true aW correct
Fridley. Mm 9-12-73
O®axr, Vernon Johnson
KMd of Bufidia` Frame . .
Used as Res.
To be compktad about 9-19-73
Estimated Cod. f 10.00
ola-Ma'MuiWing Flow miFarm* tfe.
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P
CITY OF FRIDLEY
HEALTH AND SAFETY INSPECTION
BUSINESS NAME: �® �. PATE: 5 / f '%
IF If
OPERATOR: TEL. #
ADDRESS: ( -2 Vy 9A& -a" :A- .41, E, TYPE OF BUS .
On this date, the health authority made an investigation of the subject facility.
The deficiencies noted at this time and the necessary corrective measures are
given below. If you have any questions concerning this matter, please feel free
to call on us at our offices (City Hall, 6431 University Avenue N.E., Fridley)
Telephone No. 560-3450, Ex. 41.
Received by;
✓..�_,_ , � _ _. -.�. � _..mac .. _.
Health Authority
sueJEcr
City of Fridley
�
CR
AT THE TOP OF THE TWINS
BUILDING PERMIT
,).r
• COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
a
r
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-560-3450
910-F15
8/16/73
JOB ADDRESS 67441 Madison Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9
4
Rice Creek Terrace Plat 6 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vernon Johnson 6741 Madison Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Aquarius Pool Inc. 16900 South Cedar, Rosemount, Minnesota 432-1130
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
CN NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBEWORK Construct 0 X 0 Below Ground Pool
9 CHANGE OF USE FROM TO
STIPULATIONS See Attached Health Inspector's Memo dated August 15, 1973
FOR WIRI
PERMITS REQUIRED
gff--
EpERAND SIGNS.
HEATING, PLUMBING
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
R-1
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
$49000
$
2.00
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 ANY OTHER STATE OR LOCAL LAW REGULATING CON-
24.00
STRUCTION OR TH PERFORMANCE OF NSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
`�
.. t,
N
$26.00
SI ATUREOF CONTRACTOROR AUTH RIZEDAGENT (DATE)
WHEN PROPERLY DATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DAT EI
BLDG )NSP DATE
N:
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:_&_W ZV_ 0 1/W:S
0W BUILDER, j)A1ey/�/1 D AIC -
ADDRESS: ZMA2/57,ml- 5,7, & ADDRESS:jad so,
NO:. STREET / 1__IQ A Q�
r
LOT: 7 BLOCK: ADDITION:A'0f C eZ & 17
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As;
5 ll -1 l"l 1116 6 L.. Front /� C� Depth: Height.
Square Feet: Cubic Feet:
Front: Depth: "eight:
Square Feet; Cubic Feet:
Type of Construction: _&i C 61 �, Estimated Cost:A__ IV, Q 0 0
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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: ��---Ar—3SIGNATURE: /
(See Reverse Side For Additional Informat2o .)
Z,
at
owner of the property located
4iave no objection to the City
allowing the construction of a to be located at
67z// without the required certificate of
survey that the City ordinarily requ
Witness
for all ew onstruction.
aaaress
Date
63-811-h16051 CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
RATE
SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$ 5.0a
$
Future Fixtures
m
$
Water
$ 1.50
M-9:
Beer Dispenser
$ 4.00
►�i
H�
.[I
'0
y
q
$
"u
$ 5.00
$
Rain Water Leader
Heater
$ 5.00
$
Hydraulic valve
$ 5.00
Mme
Sump or Receiving Tank
-,4
$ 5.00
$
Water Treating Appliance
$ 7.00
$
Hot Water Heater
m
$ 5.00
$
Gas Range
49
O
d
$
Gas Dryer
$ 10.00
$
.4
ALTERATIONS
1% of Value of Fixture or Appliance
W�m
$
o
State Surcharge
W
r U
D
y
3
Q w
W
w
U
ao 3
t�
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 Fixtures
$ 5.0a
$
Future Fixtures
$ 3.50
$
Old Opening, New Fixture
$ 1.50
$
Beer Dispenser
$ 4.00
$
Blow Off Basin
$ 5.00
$
Catch Basin
$ 5.00
$
Rain Water Leader
$ 5.00
$
Hydraulic valve
$ 5.00
$
Sump or Receiving Tank
$ 5.00
$
Water Treating Appliance
$ 7.00
$
Hot Water Heater
$ 5.00
$
Gas Range
$ 10.00
$
Gas Dryer
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND
ALTERATIONS
1% of Value of Fixture or Appliance
$
State Surcharge
$ .50
Reinspection Fee $
($15.00)
TOTAL
FEE
t 5
Effective Aug. 1, 1981
Job Address 67U1 Madison Street NE
Department of Buildings
City of Fridley
Tel. #571-3450
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 hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 7-19-82 , 19
OWNER JOHNSON
RIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 7-26-82
ESTIMATED COST 50.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. Q 2- O ` a
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
SUBJECT
N0.
City of Fridley19088
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RE
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
.lJ�
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
J 612-571-3450
910-F15
7/30/87
JOB ADDRESS 6741 Madison Street N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Rice Creek Terrace Plat 6 SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Vernon Johnson 6741 Madison Street N.E.
571-5608
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Panelcraft Inc. 3118 Snelling South, Mpls., MN 55406 721-6628 .
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 jj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof & Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
The roof can be 2nd layer but not 3rd. Install ridged galvanized
valleys.
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
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
$10 200
$5.10
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
r
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR VISIONS OF ANY OTHER S E OR LOCAL LAW REGULATING CON.
$86.50
ST CTION OR THE PE O RUCTION.
XCON,,,
PLAN CHECK FEE
TOTALFEE
/�W'-z// !21
$91.60
—
F NTRACT(59 OR AUTHORIZED AGENT (D09)
I
WHEN PROPERLY
)DATED THIS IS YOUR PE MIT
ke
BLDG )NSP
V
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ]
ADDN. L ]
ALTER. L ]
Construction Addre
Legal Description:
Owner Name & Addze
Contractor:
Address:�L
City of Fridley
�R-1 AND R-2
Building Permit Application
Effective 4/1/86
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:
Corner Lot [ ] Inside L0% of� Ft. Yd. Setback Side Yard Setback
Type of Construction:
c®Sl�� v��" /"�Istimated Cost:
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICAN - Tel
CI USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
m
TOTAL
New Fixtures
m
r.-4►eiu+
5.00
$
Future Fixtures
$
3.50
m
Old Opening, New Fixture
Water
di
m
e
Beer Dispenser
$--1.
w
$
M
o
m
to w
..i
a
a
..xi
w
a
$
Heater
W
v ren
cxfi
$
•.ci
$
x
j
''
�
11
G X
a
u
m
water Treating Appliance
En
Id U
7.00
oo
Hot Water Heater
to
3
G w
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
Back Flow Preventer Required.
Yes { ) No
ari
)
Type
to
rrk
U M
4 3
U
o
as lec
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or
Appliance
$
Reinspection Fee $
State Surcharge
$ .50
($15.00) -
TOTAL
FEE
$ ♦ 7
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 Fixtures
$
5.00
$
Future Fixtures
$
3.50
$
Old Opening, New Fixture
$
1.50
$
Beer Dispenser
$--1.
00
$
Blow Off Basin
8
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic Valve
$-5.00
$
Sump or Receiving Tank
$—A.00
$
water Treating Appliance
$
7.00
$
Hot Water Heater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
Back Flow Preventer Required.
Yes { ) No
(
)
Type
$
5.00
4
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or
Appliance
$
Reinspection Fee $
State Surcharge
$ .50
($15.00) -
TOTAL
FEE
$ ♦ 7
Effective Date May 1, 1988
Job Address / sc,,,1
Department of Buildings
City of Fridley
Tel. #571-3450
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 hereby declares that all
the facts and representations stated in this applijeat are true and torr t
io
Fridley, Mn. ? , 19]W
OWNER /�- V (7/SIl Sl/
KIND OF BUILDINGy/�Qy�/
USED AS
TO BE COMPLETED ABOUT
0
ESTIMATED COSTyf�f 'do
Q/�
OLD - NEW BUILDING PERMIT NO. PERMIT NO. L D/ l(Jv
Company le
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
sue.iEtT
PERMIT
City of Fridley
28366
713 THE TWINS
'5713,04
BUILDING
PERMIT
RECEIPT N
COMMUNITY DEVELOPMENT DIV.
` INSPECTION SEC.
r PROTECTIVE
7
NUMBER
REVDATE
PAGE OF
APPROVED BY
i A CITY HALL FRIDLEY 55432
��"',•�
_-__
1 J` 612-571-3450
910415
110/22/98
JOB ADDRESS
6741 Madison Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Rice Creek Terrace Plat 6
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vernon & Carol Johnson
571-5608
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Panelcraft of MN 3118 Snelling Ave S M is MN 55406
721-6628 2179
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATIONS j REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Siding and fascia
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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
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
1899
.94
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
$59.50
Fire SC $1.90
PLAN CHECK FEE
TOTAL FEE
cense
• 0
67.34
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE.
WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT
® ����
S-GNATURE OF OWNER IIF OWNER BUILDER. (DATE.
BLO .NSP -
gAtE
lel L W
ADDN CITY OF FRIDLCY
AI;I'Elt I j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
rstructionAddress: �12 ?/i
Legal Description:
Owner Na►ne & Address:.—V L d w r 0 �: o Je 1�'jSo r--° Tel. #0"7'
contractor: (J �qA1 e(_C(t tj F-7 C' F til hj _-- MN LICENSE lI
V
Address: :"� I ( R 25 k' Cc L i /'j C S c V( Pt -S, N I-) � �� �� C� � Tel. /t
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVCMENI
LIVING ARCA: Length Width Height Sy. Ft.
GARAGE ARCA: Length Width Height Sq. Ft.-
DECK
t.DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHE, It:
Corner Lot I I Inside Lot [ I Ft. Yd Setback Side Yard Setbacks
'I'vne of Construction: , /�b,&'6 --F,-4--S,--171 Estimated Cost: $
:ox. Completion Date:
(Cost on Back)
Driveway Curt) Cut Width Needed: Ft. + G Ft = Ft x $ _ _ $
DATE: _ °//Drt 8 APPLICANT: Tel. //
CITY 1M.—ONLY
Permit Fee ��/ $ Fee Schedule on Reverse Side .
Fire Surcharge % 90 $� .001. of Permit Valuation (1/10th%)
State Surcharge $_ 9k $.50/$1,000 Valuation
SAC Charge $_-___--- $800 per SAC Unit
License Surcharlive
Driveway Escrow
Erosion Control
$� $5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary I I Not Necessary
TOTAL
STIPULATIONS:
SUBJECT
City of Fridley
3 2 8 0
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RECVPrlff.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910415
11 / 2 6 / 0 2
JOB ADDRESS 6741 Madison Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9
4
1 Rice Creek Terrace Plat 6 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vernon Johnson 6741 Madison Street NE 763-571-5608
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Standard Water Control 5337 Lakeland Ave N Crystal, MN 55429 763-537-4849
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
1522
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Install interior drain the system
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. Caulk and flash all
exterior openings.
peg It Inspection ands
Will Be Mailed
To ®eownerT® Post
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
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
$3,500
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1.75
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-
$97.25
Fire SC $3.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TAL FEE
Licen 14107.50 0 C $5
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE,
HE PWFRLY VALID ED THIS IS YOUR P RMIT
•
S,GNATURE OF OWNER,IF OWNER BUILDER, (DATE,
BAG INSPf MATE
4611- - Fax Note 7672
FAX N0. : 7635371882 Nov. 25 2002 05:01PM P1
tis Na of Req Today'e D6ts�� Tbae
e�
IAS
NEW L J CITY OF FRIDLEY Effective 111/2002
ADDN L I 6431 University Ave NE, Fridley, MN 55432 (763) 672-3604 Bldg Insp
ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
�/
e,t BUILDING PERMIT/APPLICATION
Construction Address: / / r�W /1/M if d r S111l
Legal Description:
Owner Name & Address:
Contractor. _`;ia 1 dr,
Tel.: 7A ? 57/ :9 G6
MN LICENSED
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:
Le thj,dth/� � H Ground Sq. Ft.
Construction Type:
Estimated Cost: $ Ze-l&
Driveway Curb Cut Width Needed: _,Ft. + e Ft a _Ft x $ = S
DATE: D APPLICANT: Tel. 7Io3-r3J ���/
Call (763) 572.3604 for Permit Fees If mailing in application or Fax to 763-671-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
$ ' S l=ee Schedule on Reverse Side
Fire Surcharge
$ .001 of Permit Valuation (1/10th%)
State Surcharge
$ /, %S $.50/$1,000•Vaivation
SAC Charge
$ $1200 per SAC Unit
License Surcharge
$ $5A0 (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 [ J Not Necessary [
TOTAL
S f]� • S ® STIPULATIQ_N„S;
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00 $ 3n. Q )
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement)
Gas Range $ 10.00 $
Gas Dryer $ 10.00 $
*Air Conditioning - All Sizes 3A ee d $ 25.00 $ S. 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
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
$ .5�o
Effective On January 1, 2000
JOB ADDRESS ( `i U11 Y1 S�
OWNER Z:S 0�n N S 013
BUILDING USED AS_" W e Lu vy
ESTIMATED COST Si 00 . OZj PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units 1 Circle One (Steam) (Hot Wate ( arm Ai
Trade NameGo,,Q_Q�% P -C, Size No. IR 0o
BTU n 00 HP EDR
Fuel V h �& 4 k S Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
River City Sheet Met,9i, Inc.
992.8 Bluebird St. N.W. DATE
Coon Rapids, MN 55433
HEATING CO -7cw nge%,,
r
• 10111 1 � i
Approved By 4
Rough-in Date Final Date
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
z
' and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
c, n 77 g
Building
$ 167.Tk-
BUILDING
$ ( ®�Z . j l
PemiitNo.:
Inspections
Fire Surcharge
RESIDENTIAL APPLICATION
License Surcharge
Received By:
763-572-3604
$
CITY OF FRIDLEY
$
Date Rec'd:
DATE I fD L�
YOUR E-MAIL ADDRESS 6yo `@ c-ZM
40q 9
--+
T
Total Due
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME: VE "J ®-3 y i a1i e I r'®Lw t. -J
ADDRESS: �n�!{ 1 �Ulgr�aSraoJ S' -/g E CITY P-R�
L
STATEN�GIP� 43Z
TENANT
PHONE:®S?
CONTRACTOR
NAME: I ze* J LikeS W ,,.,Jow Co.
SUBMIT A COPY OF
STATE LICENSE # ZD 0 6 M 2 4 EXP DATE ?i 's 1 /O
lilt 9-0 &1 (e.,. J CITY
M00
( V I( f STATE ZIP
YOUR STATE LICENSE
ADDRESS: 0� r) a.
WITH APPLICATION
pH0 51 — FAX 2- q I- 2 S
PROPERTY TYPE
❑ GLE F /NEW CONSTRUCTION SIZE
❑WEW CONSTRUCTION STORIES
TO
PERMIT TYPE
❑ ADDITION ❑ GARAGEJSHED ❑ WINDOWS
ASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
OIDECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ DITION
❑ MAINTENANCE/REPAIR XREMODELING
DESCRIBE WORK BEING DONE:( /Libea.J C�c�� 6^'��� n� �� �► S %^�'1 YS ��' '^
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SU MIT:
GARAGES
❑ ATTACHED GARAGE
L
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used V/PROPOSED
HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
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:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $—q—,aO ID OCCUPANCY TYPE
Permit Fee
$ 167.Tk-
Plan Review
$ ( ®�Z . j l
Surcharge
a
$ —1.60
Fire Surcharge
$ , ®'
License Surcharge
$ 5.0o
SAC Charge
$
Curb Cut Escrow &�-10
$
Erosion Control 0J
pj$
$
Park Fee
40q 9
Sewer Main Charge
$ o
Total Due
$ I I ,moo t1
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/100%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary
Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
Attach
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applicati for%:!2mmt an ork is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work vhf U!s - ey�and approval of plans.
SIGNATURE OF APPLIC 'I A,-/- A 1-- PRINT NAME �IJ \Q\Q 6°�-'
FROM :City of Fridley FAX NO. :7635711267 Dec. 08 2005 01:44PM P2
Building
MECIiANICAL Permit No.• -�
Inspections RESIDENTIAL APPLICATION Ftecei°ed By'—
763-572-3604 CITY OF FR,IDLEY Date Ree'd: -
DATE YOUR GMAII. ADDRESS
5LT13 ADLiRBSs
THIS APPWCANT IS: O OWNER
OWNER/
TENANT
SU13WT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PRRM TYPE
TYPE OF WORKI
DET.
COMPANY NAME; -
CONTACT PERSON:
991NOLE FAMILY 0 Two FAMILY 0 TOWNHOUSE -
o REPLACEMENT
OF WORK
0 ALTERATIONIREMODEL
PER MS 16B.665 the permit fee i$ a minimum of $15.00 or 5% of the total cost up to $500.00, whiebever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the f os. ('This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 - cost of labor b x 5
FOR PROJECTS WHERE VXOR EXCEEDS $500, MFES ARE BASED ON 510.00 PER
NUMBER OF EACH BELOW)
MFG: MOT
Equipment Installed
—
MFG: M
x $25.00 $
MFQ_ �^ OI
AIC $25.00
AIR TO AIR EXCHANeSER $15
FIREPLACE (GAS) $15. 1
$3�� D) $3 .
BOILER $35.00
FURNACE
GAS DRYER $10.00
CHIMNEY L24SR $10.00
DUCT WORK SI O.Oq
OAS PIPING $10.00
w
Permit Fee
$ W
Surcharge
50
TOTAL. DUE
$ . -.
gOICATE TOTAL
y�ran, , T IZEMTU —
1 SIZEISTU
SIZEIM
{� S RANGF,IOVEN $10.00
W GAS GRILL $10.00
GAS UNIT HTR $10.00
POOL DATER $35.00
VMMM ATOR 515.00
Number of fixtures @ $10.00
x $10.00 = S�
Number of fixtures @ $15.00
_ x $15.00 = $
Number of fixtures ® $25.00
x $25.00 $
Number of fixtures @ $35.00
x $35.00 = $,�________
State Surcharge = S.Q
Total = $__
THIS IS AN APPLICATION FOR A PE MIT NOT VAUD UNTIL- PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley omd with tho Minnesota Construction Codes; that I understand this is
not a permit but only an 4ROCIPoii for permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of a i few d approval of 1
SIGNATURE Qtr CANTA,1 11 11n,.1AA;;7P
PRINT NAME ATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-5723604
FAX- 761-502-4477
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
PLUMBING
Permit No.: _ -
Building
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
Cy
DAA _X U � � / YOUR E-MAIL ADDRESS
SITE ADDRESS P_YI I r /V
THIS APPLICANT IS: 0 OWNER KCONTRACTOR
PROPERTY
NAME: Z, -►
ADDRESS:, 7 i�/ /lO� ``So ST/tl�CTfY r "e�ee % STATE Vk14ZIP `
OWNER/
TENANT
PHONE: —;?4-1,3 - S' 7 / - 5-�0
CONTRACTOR
NAME: TZ C-0 do r
STATE LICENSE # d G 3r 2 V2 P "" E DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS: R? 6, /30 r V3 9 y CITY )-avtr_1k" A/f rIleSTATEP-1 &-ZIP5`5—IY 5'Y
LICENSE WITH
PHONE %k3 —,6 3 U a FAX
APPLICATION
PERNIIT TYPE
SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
)dNEW 0 REPLACEMENT
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINKILAV DRAINS _ SHOWER _ WATER PIPING
_FLOOR
_ BATHTUB —GAS PIPING ww cnTucEw4 _ SWIMMING POOL _ WATER SOFTNER ($35)
CLOTHES WASHER _ KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15)
_
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
— WATER METER _OTHER
—53
ya
y
Permit Fee $�. G J
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $._�jj
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of review and approval of plans.
�Kkwhnichnrequires
OF APPLICANT PRINT NAME edmtd p C (- �' GZ Aft DATE l� `-
SIGNATURE
= � PFJ2 AMM . Al'iC��-<Wolaila il"Al""' 3�"?w _.
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977