PRE 2010 DOCST
SUBJECTIT
NO. -
City of Fridley
27261
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
DEVELOPMENT DIV.
tr -------COMMUNITY
f PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/18/98
JOB ADDRESS
990 Mississippi Street
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
1 Moore Lake Highlands
Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Richard Ritter
571-1705
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Right Way Roofing Inc.
-
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 7a REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 20 S Tear -off
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
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
$1668
.93
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
$54.00
Fire SC $1.66
PLAN CHECK FEE
TOT&L FEE
Lice $5.
1.59
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATEI
HEN RO VALID
BL INSP
D THIS IS Y UR MIT
F TE
SIGNATURE OF OWNER OF OWNER BUILDER( (DATEI
NEW.. Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: QQ® M15516SIP121
Legal Description:
Owner Name & Address: P= ,Lhald gl.alL Tel. # 5--+--- I p5
Contractor: W 0-u Qpogiytq MN LICENSE # Dc7f)�SQaq
Address: l2®U �{-, Tel. # '-6575i�4
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF Il%ZPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: D _0 I /�-1 j ni j l f j Ve R"r/ C 2f yy
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ 40600
(Fee Schedule on Back)
Ft x $ = $
DATE:�� Q APPLICANT: Tel. #
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
S`�
Fee Schedule on Reverse Side
Fire Surcharge
$
1.66
.001 of Permit Valuation (1/10th%)
State Surcharge
$
Qin
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
00
$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:
F
SUBJECT
�City
of Fridley
14AT
15T
THE TOP OF THE TWINS
BUILDING
PERMIT
NO.
COMMUNITY DEVELOPMENT DIV.
_
PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
1
1812 6,9.
JOB ADDRESS
1 LEGAL
LOT NO.
BLOC
TRACT OR ADDITION
SEE ATTACHED
oEscR.
Moore Lake Hi hlan A it
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard kittel571-1705
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Phalen Siding and Trim Inc. 1528 Lincoln Ave. St. Paul MN
55105 731-2092
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 xp REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Reside house with vinyl siding
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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
1 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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
3500
$1.75
DOES NOT PRESUME TO G AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O NY OT R STATE QR LOCAL LAW REGULATING CON.
STRL V OR E PE ORMANCE OF CO TRUCTION.
$87.25
Fire SC $3.50
`
�(\
PLAN CHECK FEE
TOTAL FEE
Licens
5.001$9,7/.50
SIG AT EOF ONTRACTORORAU HORIZEDAGENT IDATEI
N 4POPArELIDAT
BLD )NSP
IS ;11S &ERIT
1
r)A E -1
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
F
NEW [ Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: SG 'Jr.- xr. /ge. ' Tel. # 2°r
Contractor: 14 � ��' -�- MN LICENSE #
Address: "'L- c � ��" � � e--�� 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: (/ r`"7� Estimated Cost: $ �J
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: Gam'' Tel. #
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 [ ]
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
QESIDENTLAL `
RATE
TOTAL
j}
Job Address
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $
20.00
$ a 0.o0
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping $
10.00
Tel. •571-3450
(piping needed with new furnace)
Gas Range $
10.00
$
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
Gas Dryer $
10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
• Air Conditioning (all sizes) $
10.00
S /6 L
Fridley, Minn. 19
,
All Others/Repairs and Alterations
OWNER
10 of Value of Appliance or Work
$
KIND OF BUILDING
COMMERCIAWINDUSTRIAL
USED AS
1• of Value of Appliance or Work
S
TO BE COMPLETED ABOUT
ESTIMATED COST
State Surcharge
$ .50
/
OLD - NEW BUILDING PERMIT NO. PERMIT NO. C
TOTAL l7rE
$
Reinspection Fee ($15.00)
$-Tu--�!
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.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER RfANTS, Steam, Hot Water, �Air-No. /
Trade Name U_b° i n Size No.
Capacity Sq. Ft. EDR BTU��+ /f HP
Total Connected Load Kind of Fuel Cr'C 5
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR `BTU �HP
Company
Signed By�F-./!/e-�a�
Tel. No. /F
v
Fill out back side for stack verification on replacement furnaces
CHIM14EY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney
or stack;
I.
'Has .been_ careful ly 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
Remarks
Company
a
Signed By
Date