PRE 2010 DOCSVillage of Fridley, Minn.
N° 208 BUMMING PERMIT
Office of INSPECTOR OF BUILDINGS
Owner. '3a""' •_= °` `�`.t, ,�
S
Architect- Fridley, Minn
Builder `
LOCATION OF BUILDING
kkNo. Street''- + Part of
Lot Block Addition or Sub -Division
DESCRIPTION OF BUILDING
Front �Depth Height-! " °'- Stories Manner of Construction -% r A
To be used as � '�s To be completed= � Estimated Co
Permit is hereby granted to—./Yb rx c to Q!A-n'y�
the buildinv-- des bed in the above statement. This permit is granted
upon the esprea ondition thJ4 the person to whom it is granted, and his agents, employees and workmen, in all
the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding, the 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. ,.
�11J-1-11,�—o,—Inspector of Buildings.
AGREEMEN'i' AND SWORN STATEMENT
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 me at Fridley, Minneskta, eii d
da o a� ,Dm `,
y . 1! - �„
Application for Power Plants and. Hewing. Coding, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
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 0.00
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. IDR 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 $ -S 1516
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ sem'S-
Additional Fixtures ................. x "„ .50 $
S
Gas Range to 200,000 BTU ........... x 02.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM TT
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH—
OUGH
FINAL-
FINAL
91"M
r
Dept. of Bldgs. Phone SU. 4-7470
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 are true and correct.
Fridley, Minn- �/a /tet/ 19
Owner Lz&C'dZQs2—1, a E/
Kind of Building�-
Used as
To be completed about Z �. �` r'!� '7
Estimated Cost, $
OldLNew. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS --Steam, Hot Water, arm ) No `
Trade Name Size No X�U --3 9
Capaci d—N Sq. Ft. EM.R�i43_� BTU H.P,
Total Connected Loads Kind of Fue
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Signed
By .
42 TM 7.59 Business Phone No z41 - 2 ���
I'
01
SUBJECT
P ,
• City of Fridley
14603
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i
RECEI
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 S �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
A r ,'1 612-560-3450
910-F15
3/27/78
10B ADDRESS 870 Mississippi Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
28-30
3
1 Florence Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Catherine Wenzel 870 Mississippi Street N.E.
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Professional Roofing 7257 Yucca Lane
425-8233
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
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�❑
8 DESCRIBE WORK
Reroof structure
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be the second but not the third roof.
Install ridged
galvanized valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Asphalt
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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 TMS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR .NOT. THE GRANTING OF A PERMIT
673
$.50
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 PERFO `NCE OF CONSTRUC ION.
50.
PLAN CHECK FEE
TOTALFEE
6 3-,-.7 - ^7
$8.00
G ATURE OF CONTRACTOR OR AUTHORIZED AGEr/r)DATE)
WHEN PROPERLY VALIDATED TIS IS YOUR PERMIT
BLDG. )NSP
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDAYE)
01
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PE11141TS
'MEW, ALTLRATIoNs, ADDITIONS, OR REPAIRS)
1
OTAMER: _t _,a-f-�e-rivr L I ®IF,P TAUILDER: �•® �-�...
Address : ,�s ' a� -CL IIS-_ Address:
Tel. No.
No.: (S. O Street: SSS /-�,S ( Ppl
LOT: QS - 30 BLOC K: 3 ADDITION: F LLnP-E J 1F- � 0 � '
CORNIER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
Front:
Square Feet:
Depth: Height:
Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: f Estimated Cost: $Q%s
To Be Completed: _� - �� Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: -3 -Q % - 72 SIGNATURE: -12y 7
Stipulations: 4�)o 0 %l-6 M67
P -o0 61T -, 0(5 10 (QqLUA �jI z�
lie ��
C3�1 C ITS w OT `I=ds
WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH M nnesot Well and Borin
WELL AND BORING SEALING RECORD Minnesota Unique Well No. o.H 16 4699
County Name —
Minnesota Statutes. Chapter 1031 or W -series No.
Anoka (L— Nenk N W k—) J
Township NameTownship No. Range No Section No. Fraction Ism. i Ig) Date Sealed Dale Well or Boring Constructed
Fridle 30 24 14 '_� 8-1-00
Numerical Street Address or Fire Number and City of Well or Boring Location
870 Mississippi St, F r i d l e y Depth Before Sealing _ 20 --m Original Depth n
Show exact location of well or boring Sketch map of well or boring AGUIFER(S) STATIC WATER LEVEL
in section gnd with 'X". location, showing properly W Single Aquifer ❑ Multiaquifer
lines, roads, and buildings
N WELL/BORING Zi] Measured n Estimated
Wale, Supply Well I l Monil Well
---------------�__ _ ❑ _— -- Y
Env Bore Hole U Other 13
n Lb below El above land surface
W --�- -i-- -i-- --i-- E CASING TYPE(S)
x
-4-
........ i i Steel ❑ Plastic ❑ Tile ❑ Other
yandle
CASING(S)
ti 1-111-1{ Diameter Depth Set in oversize hole? Annular space initially grouted?
r mStle—fie 1
J.
in. from 5 l0 17 If. ❑Yes No [:1 Yes ❑ No ❑Unknown
PROP RTY OWN 'S NAME I in. from to n ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
ohn enzel
Property owner's mailing address if different than well location address indicated above in. from to ff. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
14045 Iodine St NW SCREENIOPEN HOLE
Ramsey, MN 55303 Screen from 17 to 20 n. Open Bole from to _ n.
OBSTRUCTIONS
WELL OWNER'S NAME ❑ RodstDrop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill X[NO Obstruction
Well owner's mailing address it different than property owner's address indicated above Type of Obstructions (Describe)
Obstructions removed? ❑ Yes ❑ No Describe
PUMP
Type
GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO
[I Removed [X Not Present [I Other —
FORMATION
It not known, Indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
'jXri Annular Space Exists
O Annular space grouted with hernia pipe
❑ Casing Perforation/Removal
in, from to _ n. ❑ Perforated ❑ Removed
in. from to N. ❑ Perforated ❑ Removed
Type Of perforator
❑ Other
GROUTING MATERIAL(S) (Olio bag of cement - 94 lbs., one bag of bentonite = 50 tbs.)
Grouting Material Nt Cmt .__.— from 5 to 2 0 n. yards 1/2 begs
from to n. yards bags
from to n. yards begs
from to __ n. yards bags
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS
Other unsealed and unused well or boring on properly? ❑ Yes Rg No How many?
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or bodnC was seated in accordance with Minnesota Rules, Chapter 4725. The information contained in this rayon is
true to the best of my knowledge.
Mrk We lWe11�Q,_�__1_nC 02658
Contractor mess Name License or Registration NO.
8-1-00
Aufhorizedepresenfafive Signature- Dale
Ron Danielson____ _
MINN. DEPT. OF HEALTH COPY H
164699 Name of Person Sealing Well or Boring
HE -01434-05 ICY 140-0423 4199 R
SuBJECT
R
City of Fridley
31461
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
_NO.
� `v ______ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
_/ _T
�
r - PROTECTIVE
I
i , CITY HALL FRIDLEY 55432
�---• A
NUMBER
REV
DATE
PAGE OF
APPROVED BY
.......
J\612-571-3450
910 -FIS
10/10/00
JOB ADDRESS 870 Mississippi Street NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
28,29,30
I 3
I Florence Park Addn to Fridley
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
John Wenzel 870 Mississippi Street NE
531-1218
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
American Building Contractors 12247 Nicollet Ave S,
Burnsville, MN 55337
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
612-328-3451 20169383
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION Q REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House (15 Sq) 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
ZONING
SQ. 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
$1,534
$.77
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
AC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THEPERFORMANCE OF CONSTRUCTION
$57.05
Fire SC $1.53
PLAMCK FEE
TOTAL FEE
�A,
Le S
5.00
$64.35
NATURE OF CON • ACTOR OR AUTHORIZED AGENT IDATEI
H N PERLY VA DATED THIS IS YOUR PERMIT
BOG I
7ir
f1Aft
S.GNATURE OF OW NER .IF OWNER BUILDER, I ATEI
NEW[ ] F
Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:<�70 1' ` �s/ S�� A0 � S
Legal Description:
Owner Name & Address: J0k1V eN2el Tel. #
Contractor: 1/UC /o?a X7 ,&o,�QZ 14 Ve J MN LICENSE # -?6���3� 3
Address: A 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.
r
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft. _
OTHER: 75 2
U
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = __Ft x $ _ $
DATE: O - 0 APPLICANT: Tel. #B 5-:9
CITY USE ONLY
Permit Fee $ ��� Fee Schedule on Reverse Side
Fire Surcharge $ 1,53 .001 of Permit Valuation (1/10th%)
State Surcharge $ .77 $.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: {� /'
Il
SuB.,Ecr
FRERMIT NO.
City of Fridley
33246
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
fr _-r---
: � PROTECTIVE INSPECTION SEC.
6d 47'-/r
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
11/12/02
JOB ADDRESS 870 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
28,29,30
3
SHEET
Florence Park Addition to Fridley
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jay Christensen 870 Mississippi Street NE 763-502-8279
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200 Atlanta GA 30339
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
763-542-8826 20268257
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Replace 9 windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all seeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
Per it Inspection Cards
Will oftellynialled
To Homeowner To Post
SEPARATE PERMITS ARE REOUIRED 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 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
$9586
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4.79
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$181.25
Fire
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
SC $9.59
PLAN CHECK FEE
TOTAL FEE
$5.00
$200.63
SIGNATURE OF CON'aACTOR OR AUTHORIZED AGENT iDATE.
PERLY VALIDATED THIS IS YOcUR PERMIT
`�
tt4l;sp
S-GNATURE OF OwNER,.v OWNER BUILDER. 'DATE,
f1ATE
Il
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUIL DING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: -.FDA cjmskylsle�- Tel. # A%3 •SOA . j ;p j!:2
Contractor:; RMA HOME SERVICES INC. MN LICENSE #
Home Depot Installed Sales
Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. #
Atlanta, GA 30339
A 763-542-8826 urvey of the
k C-20268257 ,1n4t to scale.
DESCRI 3 N OF IMPR0. EnRENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: '-?,e �� e e C1 l i nnri M. VZ U A•l..ln.w,v A x: SAN)A Cr -.11-[/Y1 f i4
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ 115&
Ft x $
e$
DATE: 5 -POW -0a APPLICANT. Tel. # ISO' 3 YS. (CM IL
Permit Fee
$ R I. S
Fire Surcharge
$
State Surcharge
$ q.3q
SAC Charge
$
License Surcharge
$j.
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
(03
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
sueJEcr
IT NO.33247
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
'16L-______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
41 7dy
F
1
NUMBER
REV
DATE
PAGE OF
APvgpvEO By
� �"'1 � CITY HALL FRIDLEY 55I32
A 763-571-3450
910-F15
11/12/02
JOB ADDRESS 870 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
28,29,30
3
I
Florence Park Addition to Fridley SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jay Christnson 870 Mississippi Street NE
763-502-8279
J CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339
/ ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
763-542-8826
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION .0 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace fascia
9 CHANGE OF USE FROM
TO
STIPULATIONS
Permit Inspection Cards
WillBe Mailed
To Homeowner To Post
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 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,896
$1.45
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.
$83.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire SC $2.90
PLAN CHECK FEE
TOTAL FEE
" cen a SC $5.00
$92.60
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN PROPERLY VALIDATED THIS IS YUR PERMIT
I ) \ \ b'
8l INSo RATE
_
S,GNATURE OF OWNER SIF OWNER BUILDER- --DATE,
Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FA d1ILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: �q r;s „�„�� Tel. # x(03.50 o7.8a�9
Contractor:; RMA HOME SERVICES INC. MN I:JCENSE #
Home Depot Installed Sales
Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. #
Atlanta, GA 30339
A 763-542-8826 urvey.-of the
k•C-20268257 ....�.... inn 4t to scale.
- r --r---- -
DES.CRI ION OF DW ROVEMENT . .
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width* Hgt/Grouud Sq. Ft.
OTHER: 'Ka e, I cao,
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft
Ft x $ _ $
DATE: 5 *-V\:)W- 02k APPLICANT: Tel. #Lj�2-3y.5•6
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
OTY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 VAX: (763) 571-1257
PERMIT NO.: 2004-01812 sq I
DATE ISSUED: 10/05/2004
ADDRESS : 870 MISSISSIPPI ST NE
PIN : 143024410067
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS
SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114 -
OWNER
WENZEL CATHERINE R
870 MISSISSIPPI ST NE
FRIDLEY, MN 55432
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 118132
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
regulating construction or the performance of construction.
Applicant Date
Bldg Insp
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.