PRE 2010 DOCSCity of Fridley, Minn.
WELDING PERMIT
Date: .. f �s� S
Owner .......................................
N® 3535
Builder... .. 40..0!!::i . ..............
Address..........................................
LOCATION OF BUILDING
No..40.3.!. Street.... .......... Part of Lot ..
Lot ....4...... Block .....��........... Addition or Sub -Division �C.�. .... ... .. .... .
Corner Lot ... x....... Setback . c� Sideyard t .l
......... Inside Lot .. ��' . � ................ .
DESCRIPTION OF BUILDING
To be Used _
... F rontf/. >/. Depth 9Zr-..W-'. Height /)F. nq Sq. Ft. /00–Y Cu. Ft. C7
.................... Front ........ Depth ........ !. �H+eight ........ Sq. Ft. ........ Cu. Ft. ........
Wt Type of Construction ................... t. Cost./�;. k.y �=" ... To be Completed ...................
In consideration of the issuance to me of a permit to con
the proposed work in accordance with the description above
ordinances of the city of Fridley. ,
desribed above, I agree to do
mpliance with all provisions of
_.vp..........................................
//0
In consideration of the payment of a fee of $t7l........, 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 with-
in the city limits and this permit may be revoked at any time upon violation of any f the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
City of Fridley, Minn.
BUILDING PERMIT
Date: t ..... f "
r
Owner:Y-)x 6—,= Builder
Address — i%r ® __ _ Address
5230
r LOCATION O �UIIkDING �
No. �, StreetPart of Lot —
Lot_ .` _Block Addition or Sub-DivWon
/
Corner Lot __ Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
I{ -
DESCRIPTION OF BUILDING
T Front Depth Height ,�... Sq. Ft. Cu. Ft.
' e .C. ---
>'ront� _ Depth eight Sq. Ft. Cu. Ft {
Type ofAWS—tMea r Est. Cost+�i " To beCompl ted —
In consideration of the issuance to me of a permit to construct the building descri above, I agree to do
the proposed work in accordance with the description above set forth and in complian a with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $'- l ,permit is hereby gran to
to construct the building or addition as described above. permit is granted upon
the express condition that the person to whom it is granted and his agents, employees d workmen, in all work
$one in, around and upon said building, or any part thereof, shall conform in all re is to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair d moving of buildings
within the city limits and this permit may be revoked at any time upon violation of;ani of the provisions of said
ordinances.
_• ✓1e F:..- �,y Building Inspector
NOTICE
This permit does not cover the construction, installation for wiring, plumbing, gas heating,
the Building Inspector for separate permits for thew items.
G
or water. Be sure to see
i
No.
Lot Block
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION
BUILD
Co • Part of Lot
,tion or Subdivision
Corner Lot „Inside Lot X Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
�� Sq. Ft. Uu. Ft.
/ U
Sq. Ft. Cu. Ft.
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 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.
DATEd—U SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
a ♦ - "
.A • � f
SUBJECT
PER
City of Fridley15
8 3 5
AT THE TOP OF THE TWINS
BUILDING PERMIT,/(0-
rp
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
j Lu -------
;
f PROTECTIVE INSPECTION SEC.
t � �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVE Y
612-571-3450
910-F15
7/17/80
JOB ADDRESS 6731 Monroe Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
9
4
Brookview Terrace SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
R. R. Enkhaus 6731 Monroe Street N.E. 571-1652
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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 l ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' x 16' Gara a Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR MRP
HEATING. PLUMBING AND SIGNS.
a tilt locii
utilities
ELECTRIC.,
4S Eft
I mul`RIED BY
LAW
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
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 I 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
®
` I"Z- o2p/
$ygg- $1.41
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.
8':9ig 12.80
PLAN CHECK FEE
TOTAL FEE
$8.98 $14.21
SIGNATURE OF C�ROR AUTHORIZED AGENT (DATE)
WHEN PROPERL(Y�V'A®LI�DAT�ED�T)H IS IS YOUR PERMIT
12P
�
BLDG INSP DA(E
]T���� SI TU E OF OWNER IIF OWNER BUILDERI "DAYEI
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS: ----
TEL NO: ;57FE 1 `52
BUILDER: - S�
ADDRESS: — -
TEL NO:
Construction Location
STR]ET NO: STREET: ST 6
�n�
LOT: BLOCK: ADDITION: � U] w
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.
DESCRIPTION OF CONSTRUCTION
AU�� T�'�D)-7) nt: � 0®� Depth: ��Height: /
Squane.Feet: Cubic Feet:
Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: W d d b . ��� Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: R4N f $ $
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 'nd correct.
DATE:_ 0 SIGNATUF.E
Stipulations:
00
o
0
4�1
lir
M'llqDEnFNGr4ERlZlNCy®
ENGINEERS AND SURVEYORS
8OILS TESTlt4G
LAND SURVEYING
CIVIL. 8,. MUNICIPAL ENOINEERING LANA PL.AtJNINO
6418 -SGT" /AVENUE N.
a�
1,11NNEAPOLIS 2i, MINN•
KE 7- 3to3T
Dr:
byp � b E_ , ::) N
c
LAJ
.LL3
Q!SC
W -
Q)
d
MA
Lo -r 9, 4, Ecjcgvir-vv
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTNTION OF A SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL EWILDINGS, IF ANY, TNEREONi , AND ALL VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SAID LANG. MINDER ENGINEERING CO., INC.
ONTED TX15 DNYOF ',+C�' I�.O.t95
,�j ENG►NHER$ A40St7RVEYORS
CITY OF •FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
Furnace Shell & Duct Work
$12.00
* Replacement of Furnace
7.00
Repairs & Alterations -up to $500.00
7.00
Repairs & Alterations each add. $500.00
4.00
MECHANICAL WARM AIR:
7.00
Furnace Shell & Duct Work to 100,000 BTU
$12.00
each add.'50,000 BTU
4.00
*Replacement of Furnace - to 100,000 BTU
7.00
Repairs & Alterations -up to $500.00
7.00
Repairs & Alterations each add. $500.00
4.00
STEAM OR HOT WATER SYSTEM:
$10.00
TOTAL
Job Address 62 ,7 3 ( "
Derartment 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.
Fridley, Minn. "4" _ a , 19
OWNER
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
USED AS
each addn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ d 906
G e�'�
OLD - NEW BUILDING PERMIT NO./ 6 3 .J PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
o
lst 3 Fixtures x
$ 3.00
$ ,� .
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
/
Gas Range to 199,000 BTU x
$10.00
$
HEATING or PO PLANTS, Steam, Hot Water, Warm Air- No.
AIR CONDITIONING$
O m
FAN HEATING SYSTEMS
$
Ttade Name Size No.
See Fee Schedule
VENTILATING SYSTEMS
$
ALTERATIONS $ REPAIRS
$
Capacity sq. Ft. EDR BTU HP
State Surcharge
$50
Total Connected Load Kind of Fuel
TOTAL FEE
$Z�W_
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Date (.$10.00)
C
FINAL INSP. //--f7 3y I
Company
Date
Signed By
APPROVAL FOR PERMIT
Tel. No.
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
SUBJECT
N
City of Fridley
18575
ER'M-fiW*44Cr._
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
=
1 �----; CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE `�
PAGE OF
APPROVED BY
612-571-3450
910-F15
JOB ADDRESS 6731 Monroe Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9
4
Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mr. Roland Enkhaus 6731 Monroe Street N.E.
571-1652
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
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
9 CHANGE OF USE FROM TO
STIPULATIONS
Existing roofing to be removed. Install new
roofing with starter
roll. XXXXKM ymn XXX Install additional roof vents if necessary.
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
$800
$.50
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-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$15.50
SIGNATURE OT7R CTORORAUTHORIZEDAGENT IDATEI
I&HEN'AROPERL VALIDATED THIS IS YOUR PERMIT
6GNTUREO
/
r OWNER OF OWNER BUILDER) IDATEI
BLDG INSP
AT
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] �R-1 AND R-2
ALTER. L ] Building Permit Application
Construction Address: L2%1 Ma Al Ka E
Legal Description: 6r -
Owner
TOwner Name & Address:
'6 SRN 17 %�hilC H�4 US Tel. # �-
Contractor: �G Tel. #
Address:
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: K L 9JA F N (f U '56
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: AS-.P)9AL 7- SN 1 N GG `S Estimated Cost: $ $ ��
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: APPLICANT: Tel.
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY
Fee Schedule on Reverse Side
25$ of Building Permit Fee
$.50/$1,000 Valuation
$475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
�l
�odr-'('06-
o1��
��L.
FA
SuBjECT
City of Fridley
9 .AT
THE TOP OF THE TWINS
BUILDING
P E R M I Tr
(Z6
1COMMUNITY
DEVELOPMENT DIV..
r � � PROTECTIVE INSPECTION SEC.
� I
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/8/99
10B ADDRESS 6731 Monroe Street NE
T LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
1 Brookvi ew Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Rollie Enkhaus
571-1652
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Gary Nordstrom Constr. 17235 Driscoll St NW Ramsey 55303 441-3787 8832
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 IV REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (27 2/3 S) 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
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
$2447
$1.22
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$83.25
Fitb SC $2.45
j
PLAN CHECK FEE
TO A FEE
6.�I® `c�� �l
Li a SC
5 0
.92
S1604CTUVEFCON'RACTORORAUTHORIZED AGENT IDATEI
HE PRO
B G IN'.
VALID E HIS I$ VRUR PERMIT
DATE
S-GNATURE OF OWNER,IF OWNER BUILDER, IDATEI
FA
r �
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:®�� �Nk ��as �Q"t 3®�,� Tel. #
Contractor: C f,��Z_ya.S �EZa c� �(Xl CDS ��C�Lv e T, ��, �a� MN LICENSE # 4 3�
Address: Tel. # `M\ - j y
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
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: 90EQo®l�- - 21 ' Estimated Cost: $ kA
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. # UDR ^ 3i
TOTAL $619
STIPULATIONS:
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
$
$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 $619
STIPULATIONS:
1�
SUBJECT
RMIT NO.
City of Fridley
29821
AT THE TOP OF THE TWINS
BUILDING P E R
M I
r
�
REC
`v -____ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r .1 PROTECTIVE
1 r
= CITY HALL FRIDLEY 55432
NUMBER
NEV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910415
7/6/99
JOB ADDRESS 6731 Monroe Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
9
4
Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Rollie Enkhaus
571-1652
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Nutzmann Bros. Constr. 736 1st Ave N 651-629-n128
ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION U REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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 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
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
$8150
$4.07
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-
STRUC ION OR THE PEERFO AN OF CONSTRUCTION
$167.25
Fire SC $8.15
C/I 1 (( ��
PLAN CHECK FEE
TOTAL FEE
�
�v 1
se SC $5.00
1$184.47
SIGNATUREOFCON'RACT OR AUTHORIZED AGENT tDATEt
OPERLY ALIDATED THIS IS YOUR PERMIT
'11WH
BLDG INSPU
-4 -91
rjATE
S-GNATURE OF OWNEAoF OWNER BUiLOER3 (DATE.
1�
'W .
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor: AJ
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
rj
Effective 1/1/98
N..
%2� Tel. # (alZ-,S2/ -/652
MN LICENSE # 2JOZ�<-el,�
Ah 5 71 ?-- Tel. # 6,9 — (t�-2 8",60Y
Attach to this applicaftion, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
- ,
- " -� -
Construction Type: U Estimated Cost: $ F, 1 ,
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
n
DATE: I -1 APPLICANT: Tel. # %'��2C�OX
TOTAL $ l
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ A� /,c2S
Fee Schedule on Reverse Side
Fire Surcharge
$ e-97), A
.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 $ l
STIPULATIONS:
3uilding
$ 1�4 O
BUILDING
$
Permit No.:
Inspections
Fire Surcharge $
License Surcharge_--$
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$
CITY OF FRIDLEY
Date Rec'd: 4
)ATE lo ." 2 `% — ®
YOUR E-MAIL ADDRESS 1"F744
i C.QEe' pEgokrurrnii rn
1TE ADDRESS Q075 ,
h2 ,9,J 1zo f �!
$ ��
'HIS APPLICANT IS:
❑ OWNER ONTRACTOR
PROPERTY OWNER/
NAME: 99 rty g-ka K- 644os
TENANT
ADDRESS: el
CITY elZ t d L_ —1 STATE ZIP
PHONE:7k3 _ 57 I— L CPS -2.
CONTRACTOR
Nps: --M�$U I L-PoeS
STATE LICENSE # Z p 3 8'S 34S EXP DATE - 2C'-OCp
SUBMIT A COPY OF
ADDRESS: 4 L �L "Z o -2 � hI N -CCTTY�
e STA _
YOUR STATE LICENSE
WITH APPLICATION
PHONE ! 2 r' FAX
�- —
TYPE
CONSTRUCTION
SIZEPROPERTY
❑TWINOGLFEA=YYWCWONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ SWIMMING POOL
TYPE OF WORK:
❑ N' ❑ ADDITION
❑ MAWTENANCEIREPAIR ❑ REMODELING�—
:)ESCRIBE WORK BEING
DONE: fZ C'W rJ
>c.g_ O4= 4l®iB-]s+4
SIZE OF IMPROVEMENT LENGTH
WIDTH Z— HEIGHT Sq. Ft.
GOOFING ❑ HOUSE ONLY
DUMBER OF SQUARES ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
3ARAGES
❑ ATTACHED GARAGE
2, Proposed floor plan
?ROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
'ROPOSED HEIGHT:
>IDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
:1Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
D Other
❑ Fascia
and proposed project
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
N EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
DR FOR NEW OPENINGS -DESCRIBE SIZE OF
JPENING 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 $ YM 0 O OCCUPANCY TYPE
Permit Fee
$ 1�4 O
Plan Review
$
Surcharge
$
Fire Surcharge $
License Surcharge_--$
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$ ��
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation - Minimum S.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary( ) Non Necessary( )
Make checks payable to: City of Fridley Atta
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
ch
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 work is of to start without a permit; that the work will be in accordance with the approved
plan in the case of all wor is requires r ew and r laps.
SIGNATURE OF APPLIC PRINT NA]v1)`�j�P�►JC��%—
m
AVA
MRI
,,I
-ItlA