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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N®s o 5 s No. Street Lot _ Block' Corner Lot _ Inme Lot Sewer Elevation ____ Foundation Elevation It DESCRIPTION OF BUILDING T Used s Front Depth Depth Type of Constrdction Es Sq. Ft. Cu. $q. Ft. Cu. Ft.. oo, be CoirnPleted In consideration of the issuance to me of a permit to construct the building described above I agree to do tho proposed work in accordance with the description above set forth and in compliance with a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $JI$ °,�` —'�'�- , permit is hereby granted to to construct the building,pr addit%n as described above. This permit is granted upon express condition that the pennon to whom itis granted asci his agents, employees and workmen, in all work in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of 7:]7d:ley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings hin the citylimitsnance=s. NOTICE: "k psradt does not eowr ft eonstruetlon, tndaMon for wkk& phnabing, on hading, ower or maMr. Be sun to as the BuOdiq lespsetor for separate psrmHs for these Hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA Owner's Name i �C Cl Q("uildar Y� ` �i�` Address Z LOCATION OF BUILDING No. Z� �('� Street �O �Q h� Part of Lot LotBlock 7/ Addition�or Subdivision Corner Lot Inside Lot Setback �� 1 0 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; Depth Front r ca Sq. Ft. �/ lj�� Cu. Ft. Front 10 Depth Yt4 Height 0 69. Ft. Cu. Ft. Type of Construction To be Completed _Estimated Cost 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 correcy. DATE /&,//SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). t City of Fridley AT THE TOP OF THE TWINS SUBJECT le BUILDING PERMIT PERM - 1244'7 f • COMMUNITY DEVELOPMENT DIV. r i � PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEY 55432 612-660-3450 R /� �J NUMBER 910-F15 REV. DATE 3/5/74 PAGE OF APPROVED BY JOB ADDRESS 7320 Memory Lane N.E. 1 LEGAL DESCR. LOT NO. 6 BLOCK 2 TRACT OR A DITION SEE ATTACHED Melody Manor 2nd Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE C. D. Novotny 7320 Memory Lane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dalberg Builders 1121-80th Avenue N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Y9 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBEWORK Construct Sundeck 131 x 121 and Remodel kitchen dining room 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. wood OCCUPANCY GROUP OCCUPANCY LOAD THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ZONING R-1 SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION JM $2s 5OO SURTAX 1.25 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 15.00 PLAN CHECK FEE TOTAL FEE $16.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGE IDATEI tl HEN PROPERLY VALIDATrjAIS YOUR PERA9IT LDG. )NSP DA SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATIi}N, OR ADDITION BUILDING PERMIT CI'T'Y OF 1-1:1 DLLY, MINNESOTA OWNER'S NAME BUILDER: ADDRESS ,DDESS:%4 P S TREET :'s^•�n-c�-� LOT:— BLOCK: 'Z� ADDITION: CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD: 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: e to1, Front: Depth' /� Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Constru :�!� E imated Cost: ®`p To Be Completed: Z The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kicL accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that -ill the facts and representations stated in this application are true and c• orr.--c t . DATE: 3 S IGNATURE : (See Reverse Side For Additional Information.) /Q F'♦� S�Re. J CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE ; FriBley. MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 Effective On March 1, 1996 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** I Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 10-00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $2_0 -50 Gas 1 Elec H KEti'=�TR Oli JFINE JOB ADDRESS 7113210 t•1EC1i;iP'•," '�HtiE t•ii iFIHTEH'3T FRIDLEY 1 cel H -f=' - 12 17 li? -dig The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 1 Z -t q -Q fo , 1996 Owner "77C— 1 2 / - Building Used As Estimated Cost ` �VU J t PERMIT NO. PLUMBING m SIGNED BY �% 101 TEL N0. Approved By Rough—In Date Final Date "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. 0) X J= t< MQ C3 yMID Z—MID Fouim C6 r__OD-iJ ..W �ar�o. COO 02_ Z> h� N J SUBJECT PER City of Fridley Fr? ` 57 THE TWINS I ; COMMUNITY DEVELOPME V -----_NT DIV. f F PROTECTIVE INSPECTION SEC. 1 � � IL -_-- ��"';'� CITY HALL FRIDLEY 55432 L A 612-571-3450 BUILDING PERMIT 28617 RECEIPT NO. NUMBER 910415 REV GATE 11/20/98 PAGE OF AF'PROvEO BY JOB ADDRESS 7320 Memory Lane 1 LEGAL DESCR. LOT N0. 6 BLOCK 2 TRACTOR ADDITION Melodv Manor 2nd SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Jane Hokenstrom 786-1217 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ea leview Const. Inc. 293791-5469 20076043 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION IRX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 22 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 80 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 STALLS GARAGES 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 VALUATION $1885 SURTAX $.94 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $59.50 FiA SC $1.88 PLAN CHECK FEE TO AL FEE C �*SIR Lice C $5.0 .32 "'AfGWATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI HE PR_OF i VALI TE HIS IS R PERMIT� !'41J I S,GNATURE OF OWNER..F OWNER BUILDERI IDATEI BL9rG INSP - DA1E N J NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 641V Legal Description: Owner Name & Address: ; Tel. # Contractor: i �; � ��uv �. MN LICENSE # ADD ? & D 4/' 3 Address: 295 % / �� 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: Construction Type: ,,& cx a .. 2 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ r—� DATE: �� APPLICANT: �iy Tel. # 75-;'5``6 Permit Fee $ Fire Surcharge $ , State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ I STIPULATIONS: CITY USE ONLY 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 $ BUILDING Permit No.: 0;0 1�0'' Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: Ork 763-572-3604 Surcharge CITY OF FRIDLEY EMMMAY 1 F2010 763-502-4977 FAX $ $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-2010 Curb Cut Escrow DATE -15A Q YOUR E-MAIL ADDRESS Erosion Control SITE ADDRESS —13ZC�' 'GY\l-YVI prld L f_1 PC!: fir- I Y,\ Q \ n �Z Park Fee THIS APPLICANT IS: ❑ OWNER AONTRACTOR Sewer Main Charge PROPERTY OWNER/ NAME:�;__oJ.e •r0. L kp Ny,; `py1 a.L-. 1�[�►j SScx'_ Total Due TENANT Make checks savable to: Citv of Fridlev Attach Stiaulations ADDRESS: C STATE ZIP PHONE: CONTRACTOR NAME:�1�7. SUBMIT A COPY YOUR STATE LICENSE STATE LICENSE # 2 L' b'Zga 39 EXP DATE AND CERTIFICATE OF ADDRESS: 1-108 p55 "aim to CITY STATE MV�ZIPj� INSURANCE PHONE Lp1 Z ab3 GI FAX PROPERTY TYPE �R SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS 13 BASEMENT FINISH .ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:Y;� S'' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES �' 11HOUSE & 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other 13 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 'a .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ I Make checks savable to: Citv of Fridlev Attach Stiaulations 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 alllark r .q it d approval of plans. SIGNATURE OF APPLICANT PRINT NAMf__ �V ATE