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PRE 2010 DOCSCity of Fridley, Minn. -�- /`1%7)? BUILDING PERMIT N° 6430 Date: — / 9—_ Owner: Builder _ Address Address _ r LOV NrOF BUILDING No. Street AW Part of Lot Lot ___ �___ ____ Block �- Addition or S - on _ Corner Lot _ Inside Lot . "tback Z _ Sideyard Sewer Elevation— —Foundation Elevation DESCRIPTION OF BUILDING To V as: Front . Depth Height Sq. Ft. "V' Cu. Ft. 44 Fro t DepthHei t Sq. Ft. Cu. Ft. Type of Construction - Est. '�� To be Completed 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 compliance with all provisions of ordinances of the city of Fridley. _ rs . In consideration of the payment of a fee of $ (P , permit is hereby granted to— 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, around and upon said building, or anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings w o city limits and permit may be revoked at tim �up violatie� of any of the provisions of said t NOTICE: This peradt does net serer the construction, Installation for wiring, phnnhing, gas hooting, sower or water. Bo saes to see the Building Inspector for separato permits for these Iteea. r J - r OWNS. R I S ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No.Street Street Part of Lot Lot Block Addition or Subdivision Corner Lot &'00e Inside Lot Setbadk Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING 01, Front Depth Height,_ Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft._ Cu. Ft. Type of Construction OTA a,116A Estimated Cost To be -Completed 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 °*/'�e SIG1VATiTRE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Mi WELDING PERMIT NA 6445 Date: Owner: 1. Builder Address Address �% � LOCAT U ING No. /0J _c I Street __s _ Part of Lot Lot __ Block Addition or Sub -Division . Corner Lot _ Inside Lot Setback ___ Y Sideyard Sewer Elevation ...... Foundation Elevation DESCRIPTION OF BUILDING o U4Ci B Front Depth Height Sq. Ft Cu. Ft n Depth eHeight ,,— Sq. Ft. Cu. Ft. Type of Construction -� Est. To be Completed 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 compliance with all provisions of ordinances of the city of Fridley. - _ "17. In consideration of the payment of a fee of permit is hereby granted to 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, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violationany of the provisions of said ordinances. /\ -I A NOTICE: ihb perndt don not em or the cond. c*on, Iestalliion for whing, Plumbing, on hea8ng, sewer or water. Be sure to no the Building hupeetor for nparab permits for three Items. Application for Power Plants and Heaft Cooling, Ventikdone Reld.- - W ion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIB: RATE TOTAL Furnace SheD & Duct Work ................ $10.00 i Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 6.00 $__ Repairs & Alterations each add. $500.00 3.00 $____ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ...... . ..$10.00 $L_ each add. 60,000 BTU .................... .. 3.0U = Replacement of Furnace 6.00 i1 Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .... .. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.00 Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ... over 199,000 BTU See Fee Schedule GAS FITTING FEES: 1st 3 Fixtures .. . ..... _ Additional Fixtures _ Gas Range to 199,000 _ AIR CONDITiONIING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH 6.00 $ — 8.00 $ NO RATE TOTAL - x$ 200 i - x .78 $ _ x$ 5.00 $ Sol Fes Schedule TOTAL FEE (SURCHARGE $ _.50) Dept. of Bldgs. Phone 860.3480 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 Ordinance. - and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Building Used as _ . __--" To be completed about _— T EsUlpated Cost, Ol New. Building Permit No. Permit DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No--L— Trade Name Capacity Sq. Ft. E.D.R BTU n�3 Total Connected Lead Hind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU BIP: (REMARKS -OYER) SLBURBAN AIR GONDITIOIt,(9gG �, IVIDN,NEAI'OLISa 1411NNL;O�,a �R a�� City of Fridley SUBJECT 16 8 8 AT THE TOP OF THE TWINS BUILDING PERMIT r RECE�� COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/15/81 JOB ADDRESS 1027 Mississippi Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Brookview Second Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter Leimgruber 1027 Mississippi Street N.E. 571-3859 3 CONTRACTOR MAIL ADDRESS 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 Dwelling - 2nd roof on Back - lst roof on front 9 CHANGE OF USE FROM TO STIPULATIONS Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt 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 $2,000 $1.00 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 CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $32.50 o PLAN CHECK FEE TOTALFEE J 9z& -= L= $33.50 SIGNAfURE OF CONTRA TOR OR AUTHORIZED AjP.ENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT Xq SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG INSP Ifi E 01 CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OW14ER: e rr TEL NO: f—L 7Z - BUILDER: P"nLS-s'.110"a I ADDRESS: ` TEL NO: Construction Location STREET NO: I r) STREET: s� 1 LOT: BLOCK: ADDITION: ���go edar Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIO14 OF CONSTRUCTION 1ST o e.► �r�.o�T, Front: Depth: Height: _ Square. Feet: Cubic Feet: Front: Depth: Square -Feet: Cubic Feet: _ Height: Type of Construction: -CA Estimated Cost: Rb Be Cbmpleted: ®% 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 trqe and correct. „ DATE: —/�j - �1 SIGNATUM: Stipulations: 3Q. /,Do SUBJECT City of Fridley 29529 AT THE TOP OF THE TWINS BUILDING PERMIT t iO- • COMMUNITY DEVELOPMENT DIV. "I -ti -------, SEC. r PROTECTIVE INSPECTION I . , ----f CITY HALL FRIDLEY 55432 �'' NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 5/24/99 JOB ADDRESS 1027 MississiDDi Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Brookview 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cully & Michelle Smutzler 586-0151 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO PTL Contracting 2526 N Ferry t323-7400 5294 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 X® REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (26 Sod) Tear -off 9 CHANGE OF USE FROM 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 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 $2228 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1 • 11 DOES NOT ESUME TO GIVE THORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIO S F ANY OTHER TE OR LOCAL LAW REGULATING CON• $83.,L5 TR CTI N THE P F CE OF CONSTRUCTION Fire $lII��. $2.23 PLAN CHECK FEE TOTAL FEE License SC $5.00 $91.59 S16NATUR OF CO TRACTOR AUTHORIZED AGENT �_ Ei WHEN PROPERLY LIDAT D THIS IS YOUR PERMIT 0 1--2,K-# _ S,GNATURE OF OWNEROF OWNER BU4DER1 iDATE� Bl0 �N$P DATE NEW ADDN ALTER [ ] Effective 1/1/9 [ l CITY OF FRIDLEY [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �w ConstructionAddress: Legal Description: _ Owner Name & Contractor: kr- Address: ';21S LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: MN LICENSE # -� Tel. #3 1 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%1PROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Driveway Curb Cut Width Needed: F�/'� 6 Ft = DATE: ,j Z 7� wee Scnea(ule on Back) Ft x $ = $ Tel. # �; �-3 �� TOTAL $ 9'/S79 STIPULATIONS: OS— CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ / / $.50/$1,000 Valuation SAC Charge $ $1000 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 $ 9'/S79 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2002 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS `�Z a ""7�ieip-'� /1-16)0 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00�v 2 , 20 dZ Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gas"` $10.00 Building Used As Gas Range" $10.00 Gas Dryer"` $10.00 Estimated Cost 20C' PERMIT NO. I! 3 Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBtNG COMP Y ��� i f Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance FAX # Approved By DC- --•l' Rough -In Date TEL N0. 1 ' �C %— bo? 3 Final Date 2 State Surcharge �.50 MINIMUM FEE R ANY PLUMBING/GAS PERMIT IS TOTAL FEE $ ' PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT. VENT CnNNFCTQR ANIS CQMR1 ORTIM AIR VFRIFI ATION When rp la _in_ an EYjstingf� ramp, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new enmhusfinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a now vpntinrj sySipm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 763-572.3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 2001 g 10 -- State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO,.. CM42SM Signed TEL # Approved By Rough -In Date Final Da )�,, f -1 � BACK SIDE MUSI BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION JOB ADDRESS Ids OWNER.r✓��3�`G, Rate TOTAL _ BUILDING USED AS $ 30.00 ESTIMATED COST 1T ). PERMIT N0.J - $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units _ Circle One (Steam) (Hot Water)armAir $ 10.00 $ Trade Name -4T4,107— Size No. BTUHP EDR $ 25.00 $ Fuel A.) �� Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO,.. CM42SM Signed TEL # Approved By Rough -In Date Final Da )�,, f -1 � BACK SIDE MUSI BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (() No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No 0() The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (I No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No (} When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (V) No( When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes AA No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 TypeBTU Input �nssisted n Assiste r Nat Appliance #2 Type i�� 1 e le,-- BTU Input Appliance #3 Type BTU Input Fan Assisted o at Total Appliances Total Btu Input h Common Vent Type L r ep Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter +' -y e AAppliance #2 Vent Connector Height ft Length ft Diameter> PP 9 9 �-P Q �Y�e Appliance #3 Vent Connector Height ft Length ft Diameter_i,.Type ALTERATIONS: (Describe) . ,r HEATING CO: Signed By: Date : 3 SuBjEtt PE City of Fridley 2485 AT THE TOP OF THE TWINS BUILDING PERMIT r? PT NO. i VV COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � 1 � � NUMBER AEv DATE PAGE OF APPROVED By I CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 3/29/02 JOB ADDRESS 1027 Mississippi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Brookview 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Deb McCarthy 1027 Mississippi Street NE 763-574-0687 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO MN Remodeling & Restoration Co 310 Meadow I;ahe, Golden Valley, MN 55418 4789 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-371-7858 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION ❑ ALTERATION j7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Install glass block window in basement and garage window 9 CHANGEOFUSEFROM TO STIPULATIONS 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 S0. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $400 $ •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- $23.50 Fire SC $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION .40 PLAN CHECK FEE TOTAL FEE Lice a SC $5.00 1 $29.40 SiGNAruRE OFC NTRACTOA OR AUTHQAiZED AGENT �OATE� EN PROPERLY VALIDATED THIS IS YOUR PERMIT GATE S-GNATURE OF OWNEA,'F OWNER BUILDERI tDATE1 NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg !psp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 5 BUILDING PERMIT APPLICATION Construction Address: / f) 1 Legal Description: S � a Owner Name & Address: Tel. # 7e� o 5771-/ -O(-T7 1 ` 12 -,A, MN LICENSE # y % Contractor. MAI. /G e-,,,, ��e , ,�., /Ze s t� a Address: 31d 1M c A i./ Ve,v l/,r 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 Vill LA� LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Wdth Hgt/ ound Sq. Ft OTHER: �� s'S,�as2,�,�,�� �� �r�y L•�e°a/��Ws i �7 /, fi_ Construction Type: re f-% Estimated Cost: $ �/00 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ .=$ DATE: e "� _p �' APPLICANT: re -IW Tel. # C/2 -- 0 at - 7 Y®z') Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ $ 66 CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit _ $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. 'B" Above $450.00 Conservation Plan Review Fee Determined by*Engineedng Agreement Necessary [ ] Not Necessary [ ] TOTAL $ °� STIPULATIONS: