PRE 2010 DOCSDate: MAY 24, 1966
City of Fridley, Minn.
BUILDING PERMIT
Builder
HOMEDALE BUILDERS
N° 8857
Address Address 3017 LYNDALE AVENUE SOUTH
MINNEAPOLIS, MINNESOTA
LOCATION OF BUILDING
No. 7456 Street MELODY DRIVE N.E. Part of Lot
Lot 27 Block 4 Addition or Sub -Division MELODY MANOR, 4TH ADDITION
Corner Lot — Inside Lot _-__ X Setback 35 _ Sideyard 10
Sewer Elevation 881- 0 2QUWAKWElevation a84-0
TOP OF FOOTING
DESCRIPTION OF BUILDING
To be Used as: 27
DWELLING Front 40 Depth 24/30 Height 20 Sq. Ft, 1,080 Cu, Ft, 21,600
Front Depth Leight Sq. Ft. Cu. Ft.
Type of Construction FRAME Est, Cost _, X16,500,00 To be Completed
SEWER LOCATION 24' West of Manhole
WATER LOCATION 14' West of Manhole
In consideration of the issuance to me of a permit to the buidel bed above I agree to do
the proposed work in accordance with the description ab ase rte sad "CoCOs/ ce with 21 provisions of
ordinanc es, of the city of Fridley. �. _
In consideration of the payment of a fee of 8 22.00 , permit is hereby granted to HOMEDALE
EWEN a INC . 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 sad his agents, employees aad workmen, in all work
done in, around and upon said building, or any part thereof; shall oanform in all respects to the ordinaaces gosP
Fridley, Minnesota regarding pati t,�alat a 'time uponl�a�t4 n of aay of visions o said
wiord a nc�e. dty limits and tt�
WILLIAM H. SAND7N Building Inspector
NOTICE
Ob pmt den net cow the conshwWon, huftWon for rrie, plimbine, an hauls, ager or rrmr. Be am to an
the BuRdW Wwp for aperete pmft ler f6sa Neem.
,. - 6
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER 4y
ADDRESS ADDRESS ,_3�fl�.�
LOCATION OF BUILDING
N0. �% STREET PART OF LOT
DDT, • BLOCK ADDI ON OR SUBDIVISION
CORNER LOT INSIDE LOt ��SETBACR 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
To be used as: v�
FrontDepth4Height
Sq. Ft.� - Cu.
Front Depth Height
Sq. Ft.
Cu. Ft.
Type of Construction—, Estimated Cost
To be completed
The undersigned hereby makes applicationfor a 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,
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side). Orpq
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 50.3480
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ..........................
8.00 $
Replacement of Furnace .............................
5.00 $
Repairs & Alterations—up to $500.00 ..................
5.00 $
Repairs & Alterations each add. $500.00 ...............
2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ��
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) .......................
5.00
$
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
Additional Fixtures . ...............
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
ROUGH
FINAL
City of Fridley:
The undersigned hereby makes 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 this application pXe true and correct.
191
Owner 'IT
Kind of Building
Used as
To be completed about
Estimated Cost, $--.124
OldNew. uilding P
HEATING orPOWER
�
Trade Name-
PLANTS—Stearn, Hot
Capacity 'Sgq.. Ft. E.D.RIJV BTU H.P.
Total Connected Load %��� G 3 Kind of Fuel . G
if
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
RAY N.WELTER HEATING CO.
Signed 46632 01=1112.A.00 AV c
'R MINNEAPOLIS 7. MINNESOTA
�,4z Business Phone No -
City of Fridley
Application for Plumbing and G, n Fitting Permit
Dept. of Bldgs. Phone SII 4-7470 879.01
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location_ 756 Melody Dr
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
C
RATE
TOTAL
Yl
12
$1.50
y Fb'
Future Fixture Opening ................
8C Z
<� Z
O
< 3
�U'
W
(7'J aS
0
Z
�U' O
F
N
WATER HTR.
GAS
ELEC.
Base
x
2.00
$
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE
TOTAL
1st 3 Fixtures ..........................
x
$1.50
$
Additional Fixtures ....................
x
1st
$
Gas Range to 200,000 BTU ..............
x
2.00
$ 2.00
conn
1
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings IEl
Connected with
Sewer Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures ......................
x
$1.50
$
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ...... .....................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE
TOTAL
1st 3 Fixtures ..........................
x
$1.50
$
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$ 2.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $Z?$E
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, Minn 12 Sep 66 19_
Owner Home d al e B ldr s
Kind of Building
Used as
To be completed about 16
Estimated Cost,
10MC-New. Building Permit No
ROUGH
FINAL
4z aM
• 00
Business Phone No
Date: — Oct. 4.
•,
Duane Bangen
City of Fridley, Minn.
BUILDING PERMIT
Builder Western Garages
N° 948?
Address 7456 Meldoy Drive — Address 3017 Lyndale Ave.
No. 745 6 — Street
Lot 27 —__ Block
Corner Lot _ Inside Lot
Sewer Elevation
LOCATION OF BUILDING
MMMIPX Melody _.._._ Part of Lot
4 -- Addition or Sub -Division — Melody Manor 4th
Setback --- Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 22 t Depth 24' Height 10 Sq. Ft. 528 Ca. Ft
Front Depth __ _ Height _ Sq. Ft. _ _ Cu. Ft.
Type of Construction Frame Est. Cost __$1600 _ To be Completed
5280
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.
Inconsideration of the payment of a fee of $ 8;00 , permit is hereby granted to Western Coast.
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, aroundoa d upon said building, or any part thereof, shall conform in all respects to the ordinances of
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.
,
NOTICE:
Thts permit don not cover the construction, Installation for wiring, plumbing, gas heating, soarer or water. Be stn to see
the Building Inspector for separate permits for these hems.
CJ.iY O I'k.+.i):1'�1', i'1f�i:j.:SITA
OWNER Is IdMIs���/ 7—/ -- --
ADDRESS
LOCA .'10NIT OF BU LDINiG,
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:7
-
Front Depth /FIeight11
Sq. Ft. �Cu. Ft.? � V�
Front �e Depth - - height _
Sq. Ft. Cu. Ft. - -
Type of Construction. � �-- - Estimated. Cost I= 6 01d, 06
To Be Completed /G
The undersigned hereby makes application for a 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.
/
DATE('! ' � `� SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
S'x't;EL"TM ��!
�� 11 %�✓
PART OF LOT .�.
%_ $LOCI:
ADDITION OR SUiiMVTSION
J���° �o� lZZ
CORNER LOT INSIDE
LOrT,A_..._
__.SE'►`BACY.._. b —_.,.a..,.._SIDE-�'AP.A
SEWIEI'.
FOUNDATION ELEV.—MON
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:7
-
Front Depth /FIeight11
Sq. Ft. �Cu. Ft.? � V�
Front �e Depth - - height _
Sq. Ft. Cu. Ft. - -
Type of Construction. � �-- - Estimated. Cost I= 6 01d, 06
To Be Completed /G
The undersigned hereby makes application for a 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.
/
DATE('! ' � `� SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
53-84-S-915.51
City ®f Fridley
Applicesmig fw r -k end Gm R10=9
Dept, of Bldgs. Phone 960-3430
DESCRIPTION OF WORK Locate Melody Drive
7456 N. E.
Number. Kind and Location of Fixtures
A
p
�
Z
;
F
Z
Q
8s
�yy(
�2
o '?
v
'•�
u�
N
7
v
I
N
WATER MTII.
GAS
FLEC.
Base
1st
In
3taill
Gas
Gr ll
2nd
3rd
4th
• Future Connection Openings
* New Fixture. Old Openings
Coanecled wi4b sewer
Ct"p001 El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................. x $100 $
Future Fixture Opening ............. x $1.50 $--
New_
New Fixture Old Opening .....:.... . x $1.50 $ __
Catch Basin ...........:........ x $3.25 $
Water Heater ;Up to 99,000 BTU) - ... x $3.00 $
New Ground Run Old Bldg. ..... x $3.25 $
Electric Water Beater, .......... z $2.00 $
3AS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ..... • • • .... • • • x $2.00 $
Additional Fixtures .................. x $ .75 $
Gas Range to 199.000 BTU.. . x $5.00 $
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, iliCinn 7-9-74
Owner Duane D. Bangen
Kind of Building Frame
Used as Res.
To be completed about 7-16-74
Estimated Cost, $ 10.00
Old-- Building Permit No. Permit No. e
Signed
By - -
Business Phone No ldINNEGASCQ
ROUGH
REPAIRS S ALTERATIONS—Refer to Code .50 State Surcharge
Description ....... ,Install',Gas Grill $ 5.00
TOTAL FEE= 5.50
Class'A' Surcharge .50;
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE �� �
RESIDENTIAL ` RATE TOTAL Job Address
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
�'e s Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
$ 20.00
$
$ 10.00
$
$ 10.00
$
$ 10.00
$
$ 10.00
State Surcharge
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00,
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
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.
e Fridley, Minn. ( — 2S2_, 19_
OWNER
KIND OF
USED AS
$" TO BE COMPLETED ABOUT
$ .50
ESTIMATED COST
NEW BUILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Ai - o.
Trade Name �� Size No. �—
Capacity Se. Ft. EDR BTU /�/ HP
Total Connected Load Kind of Fuel C�
BURNER - Trade Name ��%/1�' Size No.
Capacity Sq. Ft. EDR BTU HEP
�o _ company ®U1���>UVuC3 r6rU•
Signed By pi 9 CENTER 1)F11"�
���� n p ;;^°I
Tel. No. �J6����G a�
Fill out back side for stack verification on replac t furnaces
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No ( )
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Com pa ny
Signed By
Da to
SUBJECT
PERMIT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV
tV
//--
a 6tP
r PROTECTIVE INSPECTION SEC
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/9/94
JOB ADDRESS 7456 Melody Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
27
4
Melody Manor 4th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Duane Bangen 7456 Melody Drive NE
784-1614
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
George B. Johnson Contr. 5410 XXX Girard Ave N, Brooklyn Center
566-2351 1061
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
RIOVINNY Residential
7 CLASS OF WORK a
O NEW ❑ ADDITION O ALTERATION X REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage
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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,750
$.88
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-
Fire SC $1.75
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$41.00
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$48.63
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPE RL VALIDATED THIS IS YOUR PERMIT
S.GNATURE OF OWNER IIF OWNER BUILDERI IDATEI
BLO I�NSP
GATE
NEW [ l
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 7/45—� �, —
Legal Description:
Owner Name & Address:
Contractor:
Address:
Effective 1/1/94
MN LICENSE #
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
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft Yd Setback Side Yard Setbacks
Type of Construction: if 1jaU SA Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Dri;7a�Curb Cut .Width Needed: Ft. + d Ft = Ft x $ — $
DA�� APPLICANT: Tel. # r --
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
$800 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 [ ]
$ , b3
Im
SUBJECT
IT NO.
City of Fridley
23902
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
Ir?
• COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
11/30/95
JOB ADDRESS 7456 Melody Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
27
4
1 MElndy Manor 4th
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Builders & Remodelers Inc 3517 Hennepin Ave S Mi3ls., MN 55408 827-5481
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 ❑ ALTERATION NI REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
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 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
@@
7'4'3
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$8s
$4.37
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-
$149.75
Fire SC $8.74
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$167.86
SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI
AOPERL ALIDATED THIS IS YOUR PERMIT
WHEN///P''/
A' V
81.0INSP
I DATE
_
SSG NATURE OF OWNER IIF OWNER BUILDE RIIDATEI
Im
NEW [ ] Effective 311/92
ADDNLTS [ ] SINGLE IYAM1LYITY ANDFFRIDLEY
DUPL DUPLEXES R-1 AND R-2
ALTER [ ] `a
Building Permit Application
Construction Address:X 8/5t ��/dcic .i�� C gerdLFc� /L/n!- 63_%/d02
Legal Description:
Owner Name & Address: X j-q� /%god, jp P" _Airr(ZT,19 A I ,'ry .Tel. #,s 776 Z�iU
Contractor: MN LICENSE #X
Address:rc ,�?YI7 ;/kAIA) Aii� A SIE Mh 09/ Tel. # x 9,77-S��/
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 Lot [ ] Ft. Yd
Setback
Side Yard Setbacks
Type of Construction: X
Estimated Cost:
$ x '9 % d, o d
Approx. Completion bate: /a - F - 9
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $,
DATE: //-.2 F7 9.- APPLICANT: Tet. # Pa 2-,rYaP/
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
$ mod
Park Fee - $
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ 1676p
. $"
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.50/$19000 Valuation
$700 per SAC Unit
$5.W (State Licehsed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ j Not Necessary [
MR- 1t)5-7
Building
$
BUILDING
Permit Zig
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:, --<7U
763-572-3604
Surcharge
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
EFFECTIVE 1-1-09
$5.00 (State Licensed Residential Contractors)
DATE �0 — 19`0')
YOUR E-MAIL ADDRESS
SITE ADDRESS 7 N 9(om
� L o,, ��, v S 2� a � l � SS 4 3 Z�-
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
Nom; U P O 4 A�J O K P1 N G° E iv
TENANT
_
ADDRESS: % 4 S (o rn E- �..ya `- � L� e i u� N rrY �; d�L�r STATE MK)ZIP S S 3 a
$
PHONE: 7103 - Qa9 4
CONTRACTOR
NAME: ST012M
STATE LICENSE # a b 39-9 /o cDS,- EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS: 1 FS -7 (p 14 tici Son P,&, 'SL., f f- a CITY w DOA (, 49ti STATE M)u ZIP 5 S 12 S
INSURANCE
PHONE (o S I - - (g % FAX % S I — 73 01>1- 1 Z 33
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH❑ ROOF 11 DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION cL(�
❑ MAINTENANCE/REPAIR ❑ REMODELING
n (�
DESCRIBE WORK BEING DONE: 1 iP r—
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING�g 3 ❑ HOUSE ONLY
NUMBER OF SQUARES HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS. & PORCHES SUBMIT:
❑ Vinyl
[]Soffit
I. Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project
❑ Other
❑ Fascia
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:
THE 1997�U.JB C FEE SCHEDULE)
TOTAL JOB VALUATION $ I D� I`e �' OCCUPANCY TYPE
Permit Fee
$
4q 7, 4�— See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$$450
Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Dae
$
n �7 Make checks payable to: City of Fridley Attach Sti mations
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 on site; that the work will be in accordance with the
approved plan in the case of 11 work which requires review and approval of plans.
SIGNATURE OF APPLICANTPRINTNAME 'r Lo TTL DATE
,-�r
Ian
Building
t 000
BUILDING
Permit No.:
Inspections
See Back Page for Fee Schedule
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Fire Surcharge
CITY OF FRIDLEY
e���a =V70
763-502-4977-, FAX
EFFECTIVE 1-1-09
.0005 x Permit Valuation Minimum $.50
DATE � -"1 a/ - d S YOUR E-MAIL ADDRESS
SITE ADDRESS 7 9 E(o
m Uod ti bei ul t� P7 e- i r�.( £ter , �Yl t0 + sS Li 3 Z
SAC Charge
1
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME: P L d' A N tU fae w I; t2
ADDRESS:: ` N 5 (p ry) L I . v & V1� VOCITX F dZt`ck� STATE MO ZIP S a Z
TENANT
Conservation Plan Review
PHONE:
CONTRACTOR
NAME: eTO 12 Vn -�uhc-AA- i �1
STATE LICENSE # V 3 Fse loDS- EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS: Iii 7 (o I + Son R&, -LL,, Vu CITY W DOd STATE mto ZIP S S 1 2 S
INSURANCE
PHONE in S I - $ - 1(-9E_ FAX Z 33
PROPERTY TYPE
FAMILY/NEW CONSTRUCTION SIZE 1 S
'�R*INGOLE
orFAMILY/NEW CONSTRUCTION STORIES_/
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION {� cC—
❑ M�AfNTENANCE//REnPAIR REMODELING �1
p❑
DESCRIBE WORK BEING DONE: 1 g ISR- O Y!-
a
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT l
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS. & PORCHES SUBMIT:
s✓inyl
❑Soffit
I . Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project.
❑ Other
❑ Fascia
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:
nPRING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
t 000
OCCUPANCY TYPE
Permit Fee
$ _2�5"
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 7 —.00
1 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ f; O U
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
R + 6 ft = ft x $21= $
Erosion Control
$$450
Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
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 on site; that the work will be in accordance with the
approved plan in the case o 111 work which requires review and approval of plans. C
SIGNATURE OF APPLICANT �4a4 _ PRINTNAME I -i ��cr1 L LATr cVn DATE V