PRE 2010 DOCS879.01
City of Fridley
Application for Pk=Mng and Gas Ruing Permit
Dept. of Bldgs. Phone 5W-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg. ............
Electric Water Heater
GAS FITTING FEES:
1st 3 Fixtures ........................
Additional Fixtures ...................
Gas Range to 199,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
— x $2.00
$
— x $1.50
$
— x $1.50
$
0°1
(�'�o�
0
Z
�O
F
N
WATER HTR.
GAS
ELEC
Base
— x $2.00
$ 2.00
—x$.75
$
— x $5.00
$
1st
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings
Connected with
Sewer El
I Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg. ............
Electric Water Heater
GAS FITTING FEES:
1st 3 Fixtures ........................
Additional Fixtures ...................
Gas Range to 199,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
— x $2.00
$
— x $1.50
$
— x $1.50
$
— x $3.25
$
— x $3.00
$
— x $3.25
$
_ z $2.00
$
NO. RATE TOTAL
— x $2.00
$ 2.00
—x$.75
$
— x $5.00
$
Location 710 Marigold Terrace
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Alin NOV 13 1968 19_
Owner 000ulant
Kind of Building Frame
Used as Residence
To be completed about No 19 1968
Estimated Cost, $
Old-ANew. Building Permit No Permit No. ,17 q%
s, ede.7MINNEAPOLISYS CO.
or
• [
Business Phone N i`
ROUGH
FINAL --j::
Description ................................................$
TOTAL FEE $ 2_00 42
CHIMNEY AND STACK VERIFICATION
VENT DAMPER INSTALLATIONS
LOCATION
CI�Z -@ V
DATE
,s
OWNER '�
��
ADDRESS
S
5. That it meets present current code
Chimney properly sized and in safe condition y .e 3
Is liner installed yes no
Heat exchanger test yes no
_ Vent connectors properly sized >< yes no
_ Vent connectors need replacing yes' no
_ Vent connectors properly supported and fastened >( yes no
Furnace/Boiler replacement necessary yes no
— Are other appliances tied into vent )< yes no
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examinedye
s
2. Is free from rust or deterioration
,s
3. No foreign objects are lodged within
4. That it is securely supported
S
5. That it meets present current code
requirements for size and total BTU connected `1i
6. Total Heating BTU .S& ,0 0C)
All other BTU �� , 60C
TOTAL � io e) 0
Diagram of existing.installation: (include proposed damper
location).
--Additional work necessary on existing installation
--Install combustion air per SBC 7722 (Note fireplace
and exhaust fan
installations that may create back draft conditions
on chimney or vent.)
--Electrical work necessary for installation (list).
(Electrical permit"
required for electrical work.)
--Installer certification when required by vent damper
manufacturer
--Contractor license when required by municipality
Vent damper installation instructions must be left at job site.
REMARKS:
Heating Permit #
SIGNED���
Licensee
By
Address _
Telephone
License #
SUBJECT
ER
City of Fridley
19733
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEI
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
® ��
1 � �
e-"1 CITY HALL FRIDLEY 55432
' %.j
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/27/88
JOB ADDRESS 710 Marigold Terrace N.E.
1 LEGAL
LOT NO.
10
BLOCK
4
TRACT OR ADDITION
Donnay vs� Lakeview Manor
SEE ATTACHED
SHEET
DESCR.
2 PROPERTY OWNER MAIL ADDRESS
ZIP O
�1+E765
Herb Ford 710 Marigold Terrace N.E_
5�/
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
R.J. Peterson & Sons Construction 4005 5th-Street
N,E.s Cal, Hgts. 7816884
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 52 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 121'.x IV Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Use treated sill Plate with-1/2" anchor bolts 6F on center.
Before digging call 1001
SEPARATE PERMITS REQUIRED FOR
TELEPHONE - ELECTRIC -CAS Et'
WIRING, HEATING` PLUMBING AND SIGNS.
REQUIRED BY LANty
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
SQ. 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 1 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
$37 101, 76
$1.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$63.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$64,55
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERE
VALIDATED THIS IS YOUR PERMIT
BLDG INSP
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
T1ATE
NEW [ ]
ADDN [ ]
AMER I ]
Construction Address: 671
Legal Description
City of Fridley
R-1 AND; R-2
Building Permit! Application
I
Effective 5/
jqq
LAKE -Via.
Owner Name & Address: RG -AE, P2�2L/� TO MAR16OLD TakR/aC', Tel. #671 -4 -765 -
Contractor: R.J. pa-r6p oC '( e Tel. 7
Address: 400, 5ftf S7. Al. c. C`,OL�-i�'113� 1461!�7 ft7s
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
�sauPrloN � IMpRova�r
LIVING AREA: Length Width Height 511. Ft.
GARAGE AREA: Length /� � Width �_ Height � � Sq. Ft. �®
DECK AREA: Length Width Hgt/Ground Sq. Ft.
Corner Lot I ] Inside Lot V Ft. Yd Setback Side Yard Setbacks
Type of Construction: <-iAR�at-:! Abpl% -Al Estimated Cost: #
Approx. Completion Date: 31- 00 `� ®r • ��
Proposed Driveway Width If New Opening Is Desired: $_
DATE: l .a2 -g8
Permit Flee
State Surcharge
SAC Charge
Driveway Escrow
Park Fee
Sewer Main Charge
T ML
LP0
v•
M Y 1 '1 •.
Alt. A Alt. B
See Back Page
Tel. # '751-66
Free Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC unit
Alt. W or Alt. "B" Above
Flee Determined by Engineering
Agreement Necessary I I Not Necessary I ]
�5
To
LA -11 - P. a 6 6 c-
" S . .
Sold To:
R. J. PETERSON & SONS CONSTRUCTION
4005 - 5th St. N.E.
Minneapolis, Minnesota 55421
(612)781-6884
h�
Totalili`.'housar��; _:andr2d _fifty ?.�t�-r "?�:ar��±:.v�.
rice
Down Payment, if any -/5 down ;.71 F
$
Manner of Payment
THIS ESTIMATE IS GOOD FOR 30 DAYS ONLY
Of the above contract price; no recovery, however, to be in excess of the entire contract price unless extra work is done. It is further
agreed that in the event of default in any payment or payments, the entire balance at the time of such default shall immediately
become due, that the owner or other contracting agent hereby agrees In event of default to pay reasonable attorney fees and costs
of collection.
You, the buyer, may cancel this purchase at any time prior to midnight of the third business day after the date of this purchase. See
attached notice of cancellation form for an explanation of this right. Date
Signature
PERSONS OR COMPANIES FURNISHING LABOR OR MATERIALS FOR THE IMPROVEMENT OF REAL PROPERTY MAY ENFORCE A LIEN
UPON THE IMPROVED LAND IF THEY ARE NOT PAID FOR THEIR CONTRIBUTIONS, EVEN IF SUCH PARTIES HAVE NO DIRECT
CONTRACTUAL RELATIONSHIP WITH THF OWNER_ IUINNFSnTA LAW PFRMITR TNF nWNFw Tn wlTuunl n cone Tule rf%UVOArTnn
Date
19
We propose to do the following work at
Specifications as follows:
'Id 'L'•
C:�
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:Steri.. Ll
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' t r. .
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W,` -y .. ,. J Li :v . r; . C..
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T .... .. .' 1 t ., i.: �:' C ri • [ . _
., _
�1 ♦ .. L :� lr.�! '_t 11
(' ., .:r:I ! t', e.1
1�� �� j L. �'�.��
/
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}��
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t.
h, 6-1 `
1. i1,..t I 'L 6,1--r) 21dir,.�. o
.. .t. n,
..x_.:ating an
--j_•is)�.
`•. i '7 = i01l.�i) ®C rdt31 L
?n�i
C) A li L�J'P 1i11
,. r'.) 1341 iw)r3tEd .�earr,.
,CJc�C
A r_.:'.
i,lurn.L3h .fir +gin s an'1 p� .: it ��:7.L.i red bj tii,
u_. t,/ of r'ri3iey.
h�
Totalili`.'housar��; _:andr2d _fifty ?.�t�-r "?�:ar��±:.v�.
rice
Down Payment, if any -/5 down ;.71 F
$
Manner of Payment
THIS ESTIMATE IS GOOD FOR 30 DAYS ONLY
Of the above contract price; no recovery, however, to be in excess of the entire contract price unless extra work is done. It is further
agreed that in the event of default in any payment or payments, the entire balance at the time of such default shall immediately
become due, that the owner or other contracting agent hereby agrees In event of default to pay reasonable attorney fees and costs
of collection.
You, the buyer, may cancel this purchase at any time prior to midnight of the third business day after the date of this purchase. See
attached notice of cancellation form for an explanation of this right. Date
Signature
PERSONS OR COMPANIES FURNISHING LABOR OR MATERIALS FOR THE IMPROVEMENT OF REAL PROPERTY MAY ENFORCE A LIEN
UPON THE IMPROVED LAND IF THEY ARE NOT PAID FOR THEIR CONTRIBUTIONS, EVEN IF SUCH PARTIES HAVE NO DIRECT
CONTRACTUAL RELATIONSHIP WITH THF OWNER_ IUINNFSnTA LAW PFRMITR TNF nWNFw Tn wlTuunl n cone Tule rf%UVOArTnn
SUBJECY
PE
City of Fridley
9222
2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECepriko
� • COMMUNITY DEVELOPMENT DIV.
,®�
_ ___
r PROTECTIVE INSPECTION SEC.
O(
NUMBER
AEv
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 53432
L 612-571-3450
910415
4/15/99
JOB ADDRESS 710 Marigold Terrace NE
1 LEGAL
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1LOTNO.
lO
4
Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Donald Winberg 710 Marigold Terrace NE
502-0803
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
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
O NEW O ADDITION O ALTERATION REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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 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
11
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,228
$1 •
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-
$74.75
Fire SC $2.23
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TO L FEE
If
78.09
Si '.44PkC N- ACTOR OR AUTHO iZED AGENT IOATE,
•
HE P O
Y VALID THIS IS Y' R gERMI
/�v
S-G4ATURE OF OWNEROF OWNER BUILDER, 10ATE1
GATE
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
-x,ConstructionAddress: 7/6) %1%�
Effective 1/1/99
Legal Description:
Tel. #qZ
Owner Name &Address: / '
ontractor: ����2�' MN LICENSE #
Address: 7%4` 1v/,�il,/� %a tis
Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA: �7
xOTHER:
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 Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $���
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
`iDATE• _ `S1 4 -
APPLICANT Te1. #
CITY USE ONLY
Permit Fee
$ 2�,a—
Fee Schedule on Reverse Side
Fire Surcharge$3
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , l /
$.50/$1,000 Valuation
SAC Charge
$
$1050 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
$
STIPULATIONS: