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PRE 2010 DOCSCity of Fridley, Minn. BUIIDING PERMIT Date: .. ....... .... ...`.... ....... Address ...................................... N° 3399 Builder ............. Address ...................................... /� LOCATION OF BUILDING No..IP/- 6;. Street . .. .................... Part of Lot...f.s.,./�....... .........../� /� Lot ... !........ BYock ... ............. Additlon or Sub -Division . �rP..C4'� . . f/. "/ ... Inside Lot ... ........ Setback,3,A—..*... ... Sideyard ............ ..�� :. 0 . Corner Lot ......... . . DESCRIPTION OF BUILDING To be Used f `` �.,� .. .... Front /.'. Depth .. Height ./?7:' /, !G ' �Sq. Ft. /Ad -,7 Cu. Ft. 970. 6�t 10a? / v� .................... Front ........ Depth ... .. Hei ht . � . Sq. Ft......... Cu. Ft........ . Typeof Construction .......... ..... . ... � .�g .. .�........ 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 complian with all provisions of ordinances of the city of Fridley. . ... ... .................... 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, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ... ...... Building Inspector eut NOTICE: This permit does not cover the constru�tlon, Instailation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. Data: r City of Fridley, Minn. BUILDING PERMIT JUNE 25, 1965 THOMAS POLENZ Builder SAME Address 6863 Madison St. N. E. Address Fridley 21, Minnesota LOCATION OF BUILDING Z?f®-7 N° 8033 No. 6863 Street Madison St. N. E. Part of Lot Lot 7 Block 4 Addition or Sub -Division Rice Creek Terrace, Plat 7 Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: D. Garage Front 20 Depth 22 Height —^ _ Sq. Ft. Cu. Ft Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. cost $475..00 To be Completed Rebuild garage on original foundation In consideration of the issuance to me e a permit to construct the building described above agree to do the proposed work to accordance with the description above set f/�h and in co��" //aa����,,with, provisions of ordinanees of the city of Fridley. _� ► ► In consideration of the payment of a fee of $ 4.00 _.._, permit is hereby granted to Thomas Polenz 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 put thereof, shall conform in all respects to the ordinances of Fridleyof b within thecity limitsNUnnesota rega at> location, permit may be revoked�at any time upano maintenance, of any of and mthepro�visiona oseid ordinances. ALLEN G. JENSEN Builder In4pector NOTICE 'fids PWO dos FM CWW t6 ftndMCdW, kdaNdIoa for wkhgb phmblow an h -fl , swur or orator. Be wra to no 16 89l6iin8 bawed" fer npm is psrmhu for thus hums. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ADDRESS ��� �P15®N _FO- 41,4 ADDRESS LOCATION OF BUILDING =.���6 ___ ��/S��/ /✓�� . Street Part of Lot�� LOT �iLOCiC ADDITION OR SUBDIVI§tON�•e Corner' otInside LO Se �_k Side -Yard NEWER 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 To be used as: 6A P1,46 F Front Depth Height Sq. Ft. Cu. Ft. Front 'Depth Height Sq. Ft. Cu. Ft. Type of Construction�'���� Estimated Cost `/13, a ' To be completed The undersigned hereby makes application for s 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. DATA --- cif /�/� G SI2 GNATURE (Schedule of Fee Costs can be found on the Reverse Side), n Def Of (6i ,41 r-9 cV-1VP,471dW. SUBJECT NO. City of Fridley 27355 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. j ; v -____ COMMUNITY DEVELOPMENT DIV. � f1 � PROTECTIVE INSPECTION SEC. 01-41 �''L[ � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV $$432 612-571-3450 910-F15 8/24/98 JOB ADDRESS 6863 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 Rice Creek Ifterrace Plat 7 SHEET 2 PROPERTY OWN Eherdral MAIL ADDRESS ZIP PHONE Richard R*mxdxxxR 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Halek Roofing 6258 Eagle Lake Dr Maple Grove MN 55369 535-8835 5010 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 2a REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 26 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 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 $2168.40 $1.08 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROV O OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- PERFORMANCE OF CONSTRUCTION. STR -TIOWTUR $74.75 Fire SC 2.17 ZSIGNONTRACTORORAUTHORIZEDAGENT PLAN CHECK FEE TO L FEE License 5.0 .00 (DATE) EN OP VALIDATE HIS IS YOUR W SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BL -W INSP GATE NEW [ ] Effective 1/1/98 ADM [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMI� APPLICATION ConstructionAddress: ( �3 M W. b t So v► $f {u 6 - Legal Legal Description: Owner Name & Address: PCC L4' a�� Tel. # Contractor: A vi L L k Q64, F MN LICENSE # f-0 to Address: ('92.58- gt-� Cs -4 kp, Tel. # S -55- $8'3S 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: ( �6 Estimated Cost: $UL (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ' APPLICANT: Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: 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 [ ] Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: �iq 763-572-3604 CITY OF FRIDLEY �®te�'I L 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE —/©_�/�_O YOUR F--MAILADDRESS � 9 SITE ADDRESS C(�co_3 (�Q /� �<7-1--,n f /V THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: /�TdAJ // ! r/'I ADDRESS: STATTn/IIlfS OWNER/ TENANT / PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: t SUBMIT A COPY OF STATE LICENSE D % D V YOUR STATE # EXP DA TE LICENSE WITH ADDRESS i STA�� APPLICATION 22 PHONE��`J ' ��— L �� FAX-- PERNIIT TYPE GLE FAMILY [3TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEWLACEMENT ❑ ALTERATION/REMODEL DIPTED�ESCRIPTION OF WORK c FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FDITURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU _�4/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15_ LACE (WOOD) $35.00 NEW GAS GRILL $lo.00 BOII.ER $35.00 JRNACE $35.00 _GAA UNIT HTR $lo.0o _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $lo.00 _GAS PIPING $10.00 __VENTILATOR $15.00 Number of fixtures @$10.00_x$10.00= $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 ✓ x $25.00 = $ Number offlxtures @ $35.00_1_'x $35.00 = $ State surcharge = $ 60 C/ FEE$35.50 Total = $ c is > •%� 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 applicatio or a permit d work is not to start without a permit; that the work will be in accordance with the approved plan in the case f all w r w 'ch review and approval of plans SIGNATURE OF APPLIC P. DATE DPI /0 APPROVAL INSPECTORS SIGNA -- DATE PLEASE NOTE: SEP TE ARE RE UIRED FOR BUII.DING ELECWCAL AND MECHANICAL WORK �' \j City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977