PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 4122
Date:.....__............._............._...,1........ /._..._..._............................
Owner: .. ._-•............................. _.................... Builder ...............:.........._._........._......._. _._........._......_. _....
Address
Address
LOCATION F BUILDING
No ........... ..... _........ Street .. a.. ---..��'.................----------------. Part of Lot ....._........... --..... ...
Lot .yy........... -......................_._............ Addition or Sub -Division 41.1w-'11 r..... . ...... .. .
Corner Lot...l..�.......................... Inside Lot ....................................... Setback �.---�.......... Sideyard ...f......._..fl..................
Sewer Elevation
6wnf+� To be Used as:
/�� ....................
�L .... ...........
Type of C�ruction
Foundation Elevation
DESCRIPTION OF BUILDING
Front, (?7 0 Depth 07. :... Height /i.:..0 Sq. Ft. .1p._ / Cu. Ft. /..-.g�.�}.J...._
Front /.,.:37.� epth 4W. Heightg��`_�%? Sq. Ft. �`_...Gf..J.o Cu. Ft.
Est: Cl rq� .�,L? ...�. 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 c pliance with all provisions of
ordinances of the city of Fridley.
o
In consideration of the payment of a fee of $45?07 . 7777;permit is hereby granted to. .... .............. -......... .
.... _.............. ................. ............. I—.............. 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 an f the provisions of said
ordinances. - - J
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.
4
City of Fridley, Mian..
BUILDING PERMIT
//-i-(�5 C.)
Date:
Owner: .....':: t .....`,f,l ,/...._._....�...
Address .___.....�-.______.....
Builder ........ ........
._._.r
Address
N® i998
treet - LOCATIONt,9F BUILDING
No. _._�...._P�,r.!...3.O-"..W��•.s=-c'�if---._....._.._.._.._---_ Part of Lot
Lot--- _ ----------------------- --- ..... Block _..._....._ .................. Addition or Sub -Division �.-•--•--..--•- _ .. _
Corner Lot _.... `."".�........ Inside Lot ------ ............. _............... Setback ....._.., _ ........... Sideyard ... - t --•----------------•-----•------ _...
Sewer Elevation ---------- - --------- Foundation Elevation
DESCRIPTION OF BUILDING
Ym be -Vied as: i.+' '
....... Front Depth -�Z?.....� Height �..-- Sq. Ft. _t�s� Cu. Ft.--
...._......_.... .......... .---------.............. Front ..................... Depth ..............rte Height ._.................... Sq. Ft..................... Cu. Ft. .....................
To be
Type of Construction .....����C�... Est. Co t..._�...�!'..,....._...._.. 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.
In consideration of the payment of a fee of $�C: ._.._........_.. 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 provisions of said
ordinances. -01 " . f 7/1
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.
Ovmer I s
Address
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
LOCATION OF BUILDING
No. 6 Street_ Part of Lot
9
Lot° _ Bloc Addition or Subdivision
A _
Corner Lot '� Inside Lot Setback Side -Yard
SEWER. ELEVATION FOUNDATION FJZVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To beu_s_ ed as:
+ P
DESCRIPTION OF BUILDING
Sq. Ft. ZZZ12 Cu. Ft. 023 � Or
Front Depth Height
Sq. Ft.
Type of Constructio _ -�,&,d�
To be Completed
Cu. Ft.
ted Cos t/0 (to
r
The undersigned hereby m*bs 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 thi application are true and correct.
DATE_ _ - - �1 — 9' SIGNATURZ
(A Schedule of Fee Costs can be found on the Reverse Side.)
k
M. 0. WATSOj;, City Manager RW. ELi A C.LA E. WSON f Poli reasurer YEAV of ��h� tt to
Chief
FRANCIS W. BASSETT, Fire Chief COLUMBIA HEIGHTS, c_ 'G
MINNN
FLOYD C. LAWSON, City Assessor 590 - 40th Avenue N. E.
SUnset 8-1613
To Whom it May Concerns
A.
WARRENSTRONG, Mayor
EDWARD CRIES, Councilman
ROBERT KING, Councilman
C. L. MCCLINE, Councilman
JOE J. ORENDORFF, Councilman
October 19, 1960
The City Council of the City of Columbia Heights on Sept. 28,
1959 granted permission to install a private water main and a private
sewer main to serve the property known as 4030 Main Street N.E.
City of Columbia Heights
By 2,�•J
Permit r
L
3, 1983
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Duane Tollefson
548 - 105th Lane N.W.
Minneapolis, MN 55433
TELEPHONE ( 612)571-3450
Re: Repair & Maintenance of the Residential Rental Property Located at
4030 Main Street N.E., Fridley, MN
Dear Mr. Tollefson:
In order to insure the quality of the residential rental housing within
the City of Fridley and to prevent its deterioration, the City Council
adopted a housing maintenance code in March, 1978. As part of the
City's comprehensive housing program, an on-site inspection was conducted
of the above listed property on May 2, 1983.
The inspection on that date found the following list of deficiencies
which are in need of corrective action. Any repairs or improvements must
be completed in a workmanship like manner. It is the City's hope that
similar or other deficiencies that were not noted will be corrected as
needed.
EXTERIOR:
1. Provide and maintain a hard surface parking area sufficient in size
to handle on-site all tenant parking.
2. Provide and maintain striping for the parking lot to designate
individual parking stalls (10' x 201).
The City is confident in your cooperation and if any questions or problems
result from this letter, please feel free to call on me at 571-3450. To
determine compliance with these items, a reinspection will be conducted on
or about June 1, 1983.
Failure to abate these violations may result in this matter being turned
over to the City Prosecutor for his legal consideration.
Sincerely,
S EN J. , R. S.
Environmental Officer
SJO/mh
Receipt #
License #
CITY OP PAIOLBY, SUBJECT LICENSE APPLICATION FOR
6431 IJNIVEROMY AVE. NE. RESIDENTIAL RENTAL PROPERTY
FRIDLEY, MN. 5543E 9610.571-3460
TO THE CITY COUNCIL OF FRIDLEY, MINNESOTA:
The undersigned hereby makes application to license a residential rental dwelling in
accordance with Chapter 220 of the City Code of Fridley.
OWNER'S NAME: Duane Paul Tollefson
ADDRESS: 8690 Van Buren Street Blaine, MN 55434
Building Manager or Agent:
ADDRESS: 15-�t Y / a 19- �r. I ^ e AZ W-, -. c A.4 `� r� S` r L/3 3
TELEPHONE NUMER: 22-)- 7-:3 6
LOCATIO14 OF BUILDING: 4030 Main Street Northeast No. of Units: 3
CERTIFICATION
I hereby certify that no order of the City to repair, correct, or improve any part of
this building or any dwelling unit therein or pertaining to the operation thereof has
been issued, or is presently outstanding which has not been fully complied with, to
the complete satisfaction of any and all inspection officers of the City, to the best
of my knowledge, except as follows: _/ �//� / `/A
LJ i, / / / � K Y a PC% r, f- h r .T /� , /`Kizer /� P 2 c, All
Mr. 4 1 s� h
P i r -✓ H A✓ / rr w A 6 �J� ) mGa
/
License Expires: August 31, 1982
LICENSE FEE
(a) 1 rental ur.it ` -
(b) 2 rental isnits -
(c) 3 to 7 un li'-s per bldg. -
(d) 8 to 12 ,„nits per bldg. -
-- I Ov•ar 12 jnits. per Ildg. -
plus $2.00 per unit f;.)r
every unit over 12.
C o��
$12.00
$24.00 -0-
$36.00 $36.00
$49.00 -0-
$49.00 -0-
TOTAL FEE $ 36.00
PLEASE NOTE: Section 11.11: The penalty for late payment of all license fees as
shown in Section 11.10 of the City Code shall be 25% of the amount of the fee if
received from 1 to 7 days late. If the payment is received more than 7 days after
it is due, the penalty shall be 50% of the fee.
SIGNE TITLE:
DATE: I .
FOR CITY USE ONLY
Council Approved: Denied: Dept. Approved By: t•
For External Uspi
Al
0-
(.v(Sah
'e r0 el r r► r e Q( 7`" �j {' .; 5 �f.! C` G` O � �d' / Yyf �' n /s'! �j /4
S // .6-- re / aC B •C e- !` C' v A , It" /i 1 c
p
d � I
I
j
w
0431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
TELEPHONE ( 012)571-3450
December 18, 1980
Mr. Duane Tollefson
548 - 105th Lane N.W.
Minneapolis, Mil 55433
Re: City Council Approval of the 1980-1981 License for the Residential
Rental Property Located at 4030 Main Street N.E., Fridley, MH
Dear Mr. Tollefson:
At its regularly scheduled meeting of December 15, 1980 the Fridley City
Council considered the approval of the licensefor the above listed
property. Council approval was tabled pending correction of the following
deficiencies;
1. Provide and maintain a hard surface parking area sufficient
to handle on-site all tenant parking.
2. Provide and maintain striping for the parking lot to designate
individual parking stalls (?0'x 201).
Due to inclimate weather, the City is aware that the above deficiencies
can not be corrected until the summer of 1981. Therefore, if a written
request is received no later than January 12, 1981, an extension until
June 1, 1981 will be granted and the license will be submitted to the
City Council for approval. If no written request is received, and the
deficiencies have not been corrected, the City will seek compliance
through legal action.
If I can be of any assistance in this matter, please call me at 571-3450.
Sincerely,
6y,
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
22, 1980
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
)cane Paul Tollefson
Van Buren Street
ie, MN 55434
TELEPHONE ( 612)571.3450
ct 27-yq-
6110. (-
Renewal of the Multiple Dwelling License for September 1, 1980 to
August 31, 1981 for 4030 Main Street N.E.
Dear Mr. Tollefson:
Enclosed please find the City's renewal form for a multiple dwelling
license to operate rental dwelling units at the above listed address.
This form must be (1) completed (2) dated and signed, and (3) returned
with the appropriate license fe-e to:
City' of Fridley
Attn: Mrs. Evelyn Loomis
6431 University Avenue N.E.
Fridley, MN 55432
THIS MUST BE ACCOMPLISHED NO LATER THAN SEPTEMBER 1, 1980. Applications
and fees received after that date will be assessed a late fee in
accordance with the following schedule; 1 to 7 days late - 25% of the
total due; 7 to 14 days late - 500 of the total due.
It has also been determined through an on-site inspection on July 16, 1980
that the following items continue to be in violation of Chapter 220,
Residential Maintenance Code of the Fridley City Code.
1. Provide and maintain a hard surfaced parking lot, e.g, blacktop.9-f-lt�7
2. Provide and maintain striping for the parking lot to designate
individual parking stalls (10' x 201). a _�� /V,,, /-/.
At this time the City staff can not recommend approval of your license.
A reinspection will be conducted on or about September 8, 1980 to
determine compliance with the above listed items. if it is found that
items continue to be in violation, then your license application will be
reviewed by the City Council at its public hearing meeting on September 15,
1980 at 7:30 P.M. Your attendance is recommended. If any questions or
problems arise from this letter, please feel free to contact me at 571-3450.
S' ,
S J. OLSO , R.S.
Environmental Officer
SJO/mh
ENC: 1
FRIDL%A'eJ TIP���ENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 - (612) 571-3450 - FAX (612) 571-1287
Gary Charles
8179 North Shore Trail
Forest Lake, MN 55025
RE: First Notice of Noncompliance at 4030 Main Street N.E., Fridley, MN.
Dear Mr. Charles:
The City of Fridley has established a City Code for the purpose of promoting a pleasant
and attractive suburban environment. A recent inspection of the property at 4030 Main
Street N.E. revealed that not all Code requirements are presently being met. Listed below
are items which do not comply with the City Code:
1. Discontinue outside storage of appliances and miscellaneous materials located by
the dumpster enclosure area.
Your prompt attention in correcting this situation would greatly assist us in helping make
Fridley a better place to live. An inspection will be conducted on or shortly after June 27,
1996, to determine compliance.
If you have questions or would like to discuss this violation, please contact me at 572-
3595. Thank you for your cooperation!
Sincerely,
Kurt Jensen -Schneider
Code Enforcement Officer
KJSAs
CE -96-163
FRIDLU yULNI�[ * CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
Gary Charley
12013 Ibis Circle N.W.
Coon Rapids, MN 55433
RE: First Notice of Noncompliance of Fridley City Code at 4030 Main Street,
Fridley, Minnesota
Dear Mr. Charley:
The City of Fridley has established a City Code for the purpose of promoting a pleasant
and attractive suburban environment. A recent inspection of your property revealed
that not all Code requirements are presently being met. The following items do not
comply with the City Code:
• Fridley City Code requires that all refuse must be stored in adequately sized
containers with secure tight -fitting lids. Please monitor the refuse storage conditions
at this address and provide additional containers or a dumpster for regular refuse
service. It has been reported that refuse continually blows through the
neighborhood and that the existing containers are not of an adequate size.
• Fridley City Code requires that all vehicles shall be licensed, street operable, and
parked on a hard surface parking area. I observed a large truck parked improperly
on the grass at this address. Please remove the vehicle and place it on the
available hard surface parking lot.
We understand that you may have been unaware of this requirement. Correcting this
situation will greatly assist us in helping make Fridley a better place to live. An
inspection will be conducted on or shortly after May 21, 1997. Please have your
property in compliance at that time.
If you have questions or would like to discuss your particular situation, please contact
me at 572-3595. Thank you for your cooperation!
Sincerely,
CITY OF FRIDLEY
Kurt Jensen -Schneider
Code Enforcement Officer
KJS:Is
CE -97-142
SUBJECT
4rERMIT NO.
City of Fridley
32686
AT THE TOP OF THE TWINS
P,•
BUILDING
PERMIT
:
RECEIPT NO.
�v COMMUNITY DEVELOPMENT DIV.
r , PROTECTIVE INSPECTION SEC.
I ,
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
1 612-571-3450
910415
6/12/02
108 ADDRESS 4030 Main Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
1
Wilson Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Chris Kruger
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Eagleview Construction Inc 16323 Edison St NE, Ham Lake, MN 55304 413-5115
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20076043
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential Tri-plex
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Tri-plex Building(13 Sq) Tear-off
9 CHANGE OF USE FROM 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
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
$.70
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,393
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-
$50.9.5
Fire SC $1.39
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
E
TOT FEE
ClPLANCHECK
oc,--Li
se C
$5. 0
58.04
�GNATURE OF CON•RACTOR OR AUTMORRED AGENT OATE3
_
HE PRO
B DGNsgr,
Y VALI T D THIS IS UR PP RM17�
/_;
GATE
S-G N A TU RE 0F Ow N E R �.F OWNER 8U40E R. (DATE,
NEW [ J CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: - 0:?o A;'1JA '.
Legal Description:
Owner Name &"d�reess: `X21,5 �L Tel. # Q_7
Contractors r/1 qui (e,�t MN LICENSE # --'� a o -76 o `('3
Address: L (A 3a 3 &6-5v,, <A• /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
Width Hgt/Ground
Sq. Ft
OTHER:
e--
Construction Type: I'Cew � Estimated Cost: $ �f 2393
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$
DATE: —APPLICANT: Tel. #
Call (763) 572-3604 for Permit Fees if ma' 'ng in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY-
Permit
NLY-
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 $ �U. O L/ STIPULATIONS:
NEW [
ADDN
ALTER
Construction Address:
Legal Description:
Owner Name & Address:
CITY OF FRIDLEY Effective 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 5714287 Fax
BUILDING PERMIT APPLICATION
0
Contractor. SEARS HOME IMPROVEMENTS
Address: 5512 LAKELAND AVE. NORTH
CRYSTAL, MN. 55429
STEVE KAUFHANN 612-261-1603
HN -LIC* BC20090017
Tel.# mel- q
MN LICENSE #
Tel. #
utificate of Survey of the
,tion drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: E' CAQ" stimated Cost: $ (0 100 • (2 r�
Driveway Curb Cut.Wdth Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:APPUCANT:
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee $ ���%a�� Fee Schedule on Reverse Side
Fire Surcharge of Permit Valuation (1/10th%)
State Surcharge $ ��.. �(y $.50/$1,000 Valuation
SAC Charge $ _ $1275 per SAC Unit
License Surcharge $ . $5.00 (State Licensed Residential Contractors)
Curb Cut 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 $ 1 rl. l
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57L -36U4 YAX:
ADDRESS
: 4030 MAIN ST NE
PIN
: 343024410024
LEGAL DESC
: WILSON ADD
: LOT 1 BLOCK 1
PERMIT TYPE
: BUILDING
PROPERTY TYPE
: MULTI DWELL
CONSTRUCTION TYPE
: WINDOW/DOOR REPL
VALUATION
: $ 8,600.00
NOTE: SEE NOTATIONS ON PLAN.
REPLACE 10 WINDOWS WITHIN EXISTING OPENINGS
PYAo r4:vA
SEARS HOME IMPROVEMENTS, 5512 LAKELAND AVE N, CRYSTAL, MN 55429
IS APPLICANT A CONTRACTOR? 1
APPLICANT
SEARS HOME IMPROVEMENT PRODUCTS
1824 FLORIDA CENTRAL PKWY
LONGWOOD, FL 32760 -
OWNER
CHARLEY GARY J
12013 IBIS CIR NW
COON RAPIDS, MN 55433
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
reeullatine construction or -lite performance of construction.
Bldg Insp
PERM NO.�2004-0027
)��'�
DATE ISSUED: 02/26/2004
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 2815
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
167.25
8.60
4.30
5.00
185.15
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-361)4 YAX: (763) 571-1287
ADDRESS
4030 MAIN ST NE
PIN
343024410024
LEGAL DESC
WILSON ADD
LOT 1 BLOCK 1
PERMIT TYPE
BUILDING
PROPERTY TYPE
: MULTI DWELL
CONSTRUCTION TYPE
: WINDOW/DOOR REPL
PERMIT NO.: 2004-01325
DATE ISSUED: 08/13/2004
VALUATION : $ 9,378.00
NOTE: SEE NOTATIONS ON PLAN. REPLACE 8 WINDOWS WITHIN EXISTING OPENINGS. SMOKE DETECTORS TO
MEET THE INTERNATIONAL RESIDENTIAL CODE.
SEARS HOME IMPROVEMENT, 5512 LAKELAND AVE N, CRYSTAL, MN 55429
STATE LICENSED CONTRACTOR 1
APPLICANT
SEARS HOME IMPROVEMENT PRODUCTS
1824 FLORIDA CENTRAL PKWY
LONGWOOD, FL 32760-
"R
CHARLEY GARY J
12013 IBIS CIR NW
COON RAPIDS, MN 55433
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulatin on do rformanf construction.
App ' Date $ / d�
Bldg Insp Date l 3
BUILDING PERMIT FEE 181.25
FIRE SURCHARGE 9.38
STATE SURCHARGE, VALUE 4.69
LICENSE SURCHARGE 5.00
TOTAL 200.32
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW []
CITY OF FRIDLEY p OF Effective 4/1/2004
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: t1030 `1'YAAX�:n�
Legal Description: _
Owner Name & Address: Tel. # '63 '
Contractor. LICENSE# RC A -n020017
AAAnmoe• A° -I - Y— / /1.►� 5.�i1�9 Tel. # 763 --�3 `7 - % 7
Attach to this application, a Certificate of Survey of the
bt, 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:--r`'�� - Estimated Cost: $ �3
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
SATE:5-13-01APPLICANT. Tel. # 63-53-2--) -2 L
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee $ /c9 Z� Fee Schedule on Reverse Side
Plan Review
$
65% of Permit Fee
Fire Surcharge
$ °
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1350 per SAC Unit
License Surcharge
$yQ
$5.00 (State Licensed Residential Contractors)
Curb Cut 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
$ �00' 3;'� STIPULATIONS:
From: 651772 2226 Page: 7/7 Date: 6/8/20071:35:02 PM `..
Building
M EC' H /-/ L—
Permit -
Inspections
RESIDENTIAL APPLICATION
Receivedd B By:
J U s
763-572-3604
CITY OF FRIDLEY
Date lffl —
DATE UP YOUR P -MAIL ADDRESS
SITE ADDRESS t Uhl �.Y� Sv N e–
TIES APPLICANT IS: O OWNER _*ONTRACTOR
PROPERTY
NAME: 4 �-A _
J
OWNER/
��- CITY STATF�IZIP
ADDRESS:"
TENANT
�7LI �z �•
PHONE: tiYlo�' JfS' J3�D
CONTRACTOR
NAME: j Y1
r1
SUBMIT A COPY OF
STATE LICENSE EXP DATE
29Au 122-�7A N CITY (F-iCo I rho STA
YOUR STATE
ADDRESS:
LICENSE WITH
PHONE FAX_�11J��"I
APPLICATION
PERMIT TYPE
O SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
0 NEW 0 REPLACEMENTS
('
DETAILED DESCRIPTION OF WORK { `� gut 5V\W_�
'�OLe 5
PER MS 1613.665 the permit fee is a minimum of 513.00 or 501, 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 = $h5.00. Labor cost between $300 to $500 = cost of labor X.05 =
it 5-O 0
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) ,g :5HUk.0S
!
BATH SINKA AV FLOOR DRAINS., SHOWER WATER PIPING
—
WATER SOFTNER ($35)
BATHTUB � GAS PIPING W. myma on) SWIMMING POOL
`
`CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREY. ($15)
— DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
—
— _ WATER METER —OTHER
PERMIT FEE PROJECTS FOR UNDER $500
PERMIT FEE FOR PROJECTS OVER $500
$
Number of fixtures @ $10.00 x $10.00 —
Permit Fee
Surchar a .50
Number of fixtures @ $15.00 ^ x $ 15A0 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge =
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 1 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 all wo which requires revipw/find approval of p}}lans.
PRINT NAME J',�,�-
SIGNATURE OF APPLICANT
PLEASE NOTE: SEP PERMITS RE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-5024977
2007
Building
See Back Page for Fee Schedule
BUILDING
Permit No.:
Inspe980ns
.001 times the total job valuation
COMMERCIAL/INDUSTRIAL
Received By:
763-572-3604
$1675 per SAC Unit (Plans to MWCC for determination)
CITY OF F.RIDLEY
Dat WD&I IN 1 '200
DATE '"'
YOUR E-MAIL ADDRESS
SITE ADDRESS(T
0
TENANT
Suite No.
PROPERTY OWNER
NAME:
ADDRESS:Ma,� CITYSTATEIP./
PHONE: /) ' 3AS'- a!5'3
ARCHITECT
NAME:
ADDRESS: CITY STATE ZIP
CONTRACTOR
g
NAME: 6; C QA5E,y\
ADDRESS: CITY`" (dc- f STATFMW
PHONE: 7t; 3 S -7/t/4 - %3Q U FAX
`NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS
PROPERTY TYPE
❑ TOWNHOUSE ❑ COMMERCIALIINDUSTRIAL ❑ INSTITUTIONAL
j2f MULTI -FAMILY
PERMIT TYPE
❑ ADDITION ❑ NEW CONSTRUCTION ZOTHER
❑ REMODEL ❑ ROOF ❑ SWIMMING POOL
PLEASE SUBMIT:
1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION
2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE
3. LANDSCAPE PLANS 7. PERFORMANCE BOND
4. ENERGY CALCS AMOUNT $
BUILDING TO BE USED AS: OFFICE sF WHS sF OTHER sF
TOTAL SIZE:
STORIES FIRE PROTECTION�Y�(Y/N
DETAILED DESCRIPTION OF WORK
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 all work w ch requires review and approval of plans.
SIGNATURE OF APPLICANT
),
PRINT NAME 1< or 1 %Sett/ e 1 a DATE
ALL FEES ARE BASED ON VALUATION
Sq. ft. X$ Cost/sq. ft. = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
TOTAL JOB VALUATION: USE tJPANCY TYPE'
Permit Fee
Plan Review
Fire Surcharge
Surcharge
SAC Charge
Erosion Control
Park Fee
Special Assessments
Curb Cut Escrow
Total Due
$ '/, ,.1-75!)
See Back Page for Fee Schedule
$
65% of Building Permit Fee
ALS
.001 times the total job valuation
$
.0005 x Permit Valuation Minimum $.50
$
$1675 per SAC Unit (Plans to MWCC for determination)
$
$450 Conservation Plan Review
$
Fee Determined by Engineering
$
Agreement necessary ( ) Non Necessary ( )
$
ft+6ft= ftx$21=$
t
Make checks payable to: City of Fridley Attach