PRE 2010 DOCS0 0
I
vil,age of Fridley, Minn.
is,umm NG PERwr
N? 752 Ofce o U48PECTOB OF BUILDINGS
Owner
Architect
LOCATION
Fridley, Minn., ti..�.. e , 18 .
OF BUIMING
No. ? � 2 Street (zL z aa A:t4- D p Part of Lot
64
Lots Block Addition or Sub -Division -
k,
DMCRIPTION OF BUIMING
ter+ "b . ,c=
FronL�"y Dgpth � Height � Storied 'Manner oP Construction -- -
To be used as`` To be completed Estimated Cost <
I
Permit is hereby granted to°tea.. m"„tsar-, `r to
the
4"X :--
upon the express condition that the persoi
the work done in, around and upon said
nances of Fridley, Minn., regarding the
within the city limits, and this permit mm
ordinances.
described in the above statement. This permit is granted
).whom it is granted, and his agents, employees and workmen, in all
Lilding, or any part thereof, shall conform in all respects to the ordi-
dstruction, alteration, maintenance, repair and moving of buildings
be revoked at any time upon violation of any of the provisions of said
Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
li
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
Subscribed and sworn to before �e at Fridley, Minnesota, this
day of A-D.I,1
City of Fridley, Ygnn- 1122 0
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: _ October 18. 1971
owner: —David L. Batcher Builder Same
Address 4627 Main Street N.E. Address _ Same
LOCATION OF BUILDING
1% IR 4627 Street Main Street N.E. ___ Part of Lot
Ut 20221 Block 12 Addition or Sub -Division _ Plymouth Addition
Corner Lot Inside Lot - Setback — Sideyard —
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Car .,ga Front 201 Depth - 22 1 Height 10' _ Sq. Ft. — 401 Cu. Ft. 4,400'
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost -- 1,949,20 To be Completed _ Nov. 15, 1971
Stipulations: Provide a hard surface drive. Elevation minimum: 18" above venterline
of street. Move forms over to North to 3' from South property line. Trench 4"
below grade at perimeter.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordanwith the description above forth and i co�gp 1 ce with, all provisions of
Ordinances of the city of Fridley.03 / //
In consideration of the payment of a fee of $9.90_, permit is hereby granted to—David j;atc er
to construct the building or addition as described above. This permit is granted upon
theress 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 buildiIIgB
e city limits and this permit may be revoked at any time upon violation of any of the provisions of said
l� 0 .✓l �°.� Jam_ L a R iil
--�ding Inspector
CLARENCEBELISLE
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sun to see
the Building Inspector for separate permits for these Hems.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME :k�� BUILDER:
ADDRESS: 6&2 % A6 /y moi% ADORES s
NO: 2- % STREET: 14/1,a Al A-111 S7
LOT:& BLOCK: / ADDITION:- VMI,)
CORNER LOT: INSIDE LOT: �SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of hot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Depth: -�' Height:
r
Square Feet: V6 Cubic Feet:
�F
Front: Depth: Height:
Square Feet; Cubic Feet: /
Type of Construction: l`�C1�� Estimated Cost: $ ! J'� d
To Be Completed: IVO �% 1�, 1? z /� y
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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: ALO V4 SIGNATURE:
(See Reverse Side For Additional Information.)
City of Fridley2
ATTR T P THE TWINS
SUBJECT
BUILDING
PERMIT
PERMIT
8 5 08
..572
_ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
�'' 612-571-3450
NO.
7�/
NUMBER
910415
REV
DATE
11
3 98
PAGE OF
APPROVED BY
J08 ADDRESS
4622 'In Strppt N'z
1 LEGAL
DESCR.
LOT NO.
20 21
BLOCK
TRACT OR ADDITION
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Donald Lynch971-0916
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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
O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 17 S Tear -off
9 CHANGEOFUSEFROM 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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT
CU FT
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
VALUATION
SURTAX
WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT
1456
.73
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$48.50
Fire/)SC $1.46
PLAN CHECK FEEal'o
L F'EE
S, NATURE CON"AA RORAU H A1ZEDAGENT [DATE,
9 0.69
N P OP.HIS
IS YO PERMIT
S,GNATURE A,,F OWNER B q0 R, [DATE,
BL [NSP
OATS
&A
NEW - F ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �\
ConstructionAddress: A�27 S% A45
Legal Description: do u5 C
Owner Name & Address: ; 'Do i, -j A W �_ k y N C,k Tel. # S 7 / — O � 1 (o
Contractor: MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRIPTION OF IMPROVEMENT
-pof
LIVING AREA: Length a �r Width ;0- Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: LengWidth Hgt/Ground Sq. Ft.
OTHER: 17 A� � C14 f� �„ l % _ (! I �.4-,P - (-j
Construction Type: �Foyy'- Li Estimated Cost: $ % 7 �Q
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: j t 3- c� APPLICANT:9-' Tel. # S-7(— 091_L
/ CITY USE ONLY
Permit Fee $ `'/—//o .L 0 Fee Schedule on Reverse Side
Fire Surcharge $ %. `y .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 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 $O06a-if b4 -IJ
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
� ? W3Lf
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
JOB ADDRESS �[l ul I n Si N E
New Fixtures
$10.00
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture
$10.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$10.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$10.00
and representations stated in this application are true and correct.
Catch Basin
Rain Water Leader
$10.00
$10.00
DATE: 20 U
Sump/Receiving Tank
$10.00
I
1
�� 1y� 4 e(A L y h cj�
Water Treating Appliance
$35.00
OWNER l.-� 1
Water Heater -Electric
$35.00
�1
Water Heater- Gas**
$35.00 j�J v"
BUILDING USED AS
Gas Range**
$10.00
��u �< � (�
Gas Dryer**
$10.00
ESTIMATED COST PERMIT NO.
Back Flow Preventer Required ( )Yes () No
f/
r
Type
$15.00
PLUMBING COMPANY
r
Reinspection Fee $50.00/Hr
SIGNED BY TEL N0.
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
Approved By Rough -In Date Final Date
State Surcharge
$
ff
">
MINIMUM FEE FO ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
TOTAL FEE
$ ��'
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SID
5 . �5 u f+ f�
FILL IN COMPLETELY FOR REPLACEMENT FUEL BUI4NING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTIONAIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
BTU Input Fan Assisted or Nat
specifications including sizing, length, number of elbows and termination.
Yes (} No( )
The undersigned also verifies that the replacement unit is a listed assembly
BTU Input Fan Assisted or Nat
and meets the current codes and manufacturer's specifications. This does
Total Btu Input
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 #2 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 :
Building
BUILDING
Permit No.:
Inspections
RESIDENTTAT, APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: ��
DATE 1O O
YOUR E-MAIL ADDRESS
SITE ADDRESS Y61 % ,* iU 5":2 -lee -1—
'eekTHIS
I HIS APPLICANT IS:
❑ OWNER
PROPERTY OWNER/
NAME: 190/V ftjD wt— L!N NSA-
TENANT
ADDRESS: A 7, % MAIN s'j1�re� N�,crrY
,e1n G STATE ZIP Z/
PHONE: -
CONTRACTOR
NAME:_ The Home Depot A.H.S. Inc.
SUBMIT A COPY OF
STATE LIC 3200 Cobb GalleriaPkwy.
YOUR. STATE LICENSE
ADDRESS: Atlanta, GA 30339
CITY STATE ZIP
WITH APPLICATION
PHONE 763-542-8826
A License #20268257
TE
PROPERTY TYPE
o Two
_ .OR1ES
PERMIT TYPE
❑ADDITION ❑ GARAGEISHED
l3 WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWRvflvE 1G POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
0 MA24TENANCEMEPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:L-R) � � W ;y— / s -
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
I. Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2. Proposed floor plan
PROPOSED HEIGHT:
3. List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vmyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT.-
UBMIT:❑
13Aluminum
❑ Trim
L Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
`d✓INDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS Ves ❑No LOCATION OF WINDOWS
3. Energy Calculations
DR FOR NEW OPM\TINGS-DESCRIBE SIZE OF 415 fest.! rs 't
DPENING CHANGES &
rWE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL k EBs ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 9, — OCCUPANCY TYPE
?ermit Fee $ ('a Ia See Back Page for Fee Schedule
?lan Review $ 65% of Building Permit Fee
Surcharge $ (.0005) times the total job valuation — Minimum $.50
?ire Surcharge $ '� .001 x Permit Valuation (1/10%)
,icense Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
'urb Cut Escrow $ ft + 6 ft = ft x $20 = $
3rosion Control $ $450 Conservation Plan Review
'ark Fee $ Fee Determined by Engineering
>ewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
e"Otal Due $ -71 Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMrr-NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
onformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
-ermit 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
lan in the case of all work whio res vie an approval of plans. / /
IGNATURE OF APPLICANT PRINT NAME _ T j�,/t JC.- ?/V1,1� DATE ( 0 to