PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N® 7153
Date:
r
Owner: Builder
Address Address
LOCA0 F BUILDING
No. jlrrrryry ��Street Fart of Lot
Lot _ _ __ Block Addition or Sub -Division
Corner Lot ._ Inside LotSetback _ _ r Sideyard
Sewer Elevation ..�i�f�s �` s� ..._ Elevation -124,
DESCRIPTION OF BUILDING
TreUser
Front _ Depth Height Sq. Ft Cu. FL3
Front Depth — Height_ Sq. Ft. Cu. Ft.
Type of Construction dMA_._ Est. �� __ To be Completed
In consideration of the issuance to me of a permit to construct a building described above, I agree to do
the proposed work in accordance with the description above set is mp ce with all provisions of
ordinances of the city of Fridley.
b
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 n 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 violation of any of the provisions of said
ordinances. AA le -1
NOTICE:
'ibis permit does not eover the construction, hutalldlon for wiring, Plumbing, gn heating, sewer or wrier. Be aro to see
6e nefldfoe lespector for wparaM psrailh for dies ffenn.
APPLICATION FOR BUILDING PEPSO:T
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER
ADDRESS ADDRESS Z, ?1- O jP0IP6 Y !f
LOCATION OF BUILDING
No. Streetd&1V#4,D M-JAoOK Part of Lot.
3'ec Vis"
Lot, a 0 Block Addition or Subdivision
Corner Lot Inside. Lot &-- Setback 3s- Side Yard L ?5`
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
_5•/���� Dkol=a1v Front A/J/ Dapth Height ?
Sq. Ft. Cu'. Ft. , 2
Front Depth Height .
Sq. Ft. Cu. Ft.
Type of Construction It/001> Estimated Coat 1,t a-,O"O _ ------ Q,
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 _AkLkS Z:4/ / Z, SIGNATURE �" "Z�'
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plumbing and Cas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures Locati-n- .�� �'- �� .l LCT -01--y :14 C2 -
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ '®
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00$�• 0
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ f
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS --Refer to Code
Description ................................................$
TOTAL FEE $7Z0�
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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 fact
and representations stated in this application are true and correct.
Fridley, Minn- ® 196tl
Owner dz
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New. uilding Permit No. Permit No _-
ROUGH
FINAL
42
Signe
By
Business Phone No
3
w
r
Z�
a
g Z
i� -
aa Z
V 3<
O x
3
J
�U'
z
Sc
Ute'
z
p
•
R
•
N
WATER HTR.
GAS
ELEC.
Base
1st
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings I
Connected with Sewer
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ '®
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00$�• 0
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ f
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS --Refer to Code
Description ................................................$
TOTAL FEE $7Z0�
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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 fact
and representations stated in this application are true and correct.
Fridley, Minn- ® 196tl
Owner dz
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New. uilding Permit No. Permit No _-
ROUGH
FINAL
42
Signe
By
Business Phone No
Application for Power Plants and Heating, Coding, Ventilation, .Refrigeration and �
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. -Phone SU 4-7470
GRAVITY WARM AIR: RATE TOTAL, Location
Furnace Shell & Duct Work .......................... 8.00 $—tom
Replacement of Furnace ............................. 5.00 $ City of Fridley:
The undersigned hereby makes application for a permit for the work herein
Repairs & Alterations—up to $500.00 .................. 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances
Repairs &Alterations each add. $500.00 ............... 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
KECK' WARM AIR Fridley, Minn 19 6&
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $'
each add. 60,000 BTU Owner
....................... 2.00 $ -
Replacement of Furnace 5.00 $ Kind of Buildin
Repairs & Alterations—up to $500.00 ................. 5.00 $
$ Used as _Z4�2�_
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. EDR 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 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU........... , x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH
FINAL
To be completed about U �� r
Estimated Cost, $- � T`�
/�� Permit No. �" / v
Ord__' ew. ding Permit No. ,
DESCRIPTION OF WORK
HEATING or POWER PLANTS—.Steam, Hot Water armAir No- 0(
Trade Name l /)e_� a[ Size No e_�O 6d" 'o -d 8 `Z
Capacity. 10---d M Sq. Ft. E.D.R BTU H.P.
Total Connected Load 42 , o CQ Rind of Fuel
BURNER — Trade Name =�/�Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
.. a z 2M 7-59
Signeee0__4r_ W.4
4PEEC1110N,".FXTINd COMPANY, INC.
By
BusinessIPhone�a ! MINNESGTA
Application for Power Plants and Heating. Cooling. 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 .............................
5.00
$
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. EDR 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
$ .2 e -V
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$ �• �y
s Additional Fixtures ...............
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
'AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
��
ALTERATIONS & REPAIRS TOTAL
FEE
$
ROUGH
FINAL
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, AD=–
Owner
Owner
Kind of Building
e
Used as
To be completed about
Estimated Cost, $`
dNew. uilding Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS' —Steam, Hot WaterWarm Noy
Trade Name ZZp4
Capacity 10'0--d Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
401,
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signe
By
., <2 2M Business Phone No_,,L " 2- / 9 g ,l
m
h HEAT LOSS CALCULATIONSDEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E,7 Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
Yes—No Yes—No 19—.
Room Length 2.2 0 Width 19 AHeight R" /' Fl.�
Windows a oors—Crackage and Area
Width Height No, of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
m���
M����®
Glass ° b
Exp. wall
Net exp. wall ® ,�2
Int. wall
Ceiling
Floor
Total Btu.
Required qq. ft. .D.R. or sq. ins. W.A. Leader area
doom ( Length ,` 27�Vidth Height
Windows and Doors—Crackage and Area
Btu
Width Height No. of Lineal ft. Area
No. of pane of p/ane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
/V O
J
Exp. wall
Coef. Btu
Coef.
Btu
Infiltration
Glass
5�®
C)
Glass
Exp. wall
16
��
Net exp. wall
Net exp, wall
y® _'2 ®® Co
Int. wall
'fes
Int. wall
Ceiling
0
/.5 v2
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
P _ 13___ I1 ___.L B fA XYILUL s U..:..L•
Windows and Doors—Crackage and Area
Btu
Width Height No. of Lineal ft. Area
No. of pane of p/ane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
/V O
J
Exp. wall
Coef. Btu
Coef.
Btu
Infiltration
Glass
5�®
/_x An
Glass
16
��
Net exp. wall
Exp. wall
y® _'2 ®® Co
Int. wall
Net exp. wall
Ceiling
0
/.5 v2
Int. wall
Ceiling
Floor
Total Btu.
ired sq. ft. E.D.R. or sq. ins. W.A. Leader area
M WVAPOLIS. MINN.
Insulation
Kind How Applied
nm I l Anat6 .-=V-Width f� HeistW
Windows and Doors--Crackage and Area
Btu
Width Height No. of Lineal ft. Area
No. of pane of p/ane lights of crack sq. ft.
-2-
/V O
J
Exp. wall
Coef. Btu
Infiltration
Btu
Infiltration
Glass
5�®
/_x An
Exp. wall
16
��
Net exp. wall
00
y® _'2 ®® Co
Int. wall
Net exp. wall
Ceiling
®
/.5 v2
Floor
Total Btu. 5/
Required sq. ft.E.D.R. or sq. ins. W.A. Leader area
zi-FLI _ e_/ oom I Lenath Width '7� Height P
Windows and Doors—Crackage and Area
Btu
Infiltration ®
Width Height No. of Lineal ft. Area
sq. ft.
No. of pane of pane lights of crack sq.
/V O
J
Exp. wall
Net exp. wall /,o
Coef.
Btu
Infiltration
Ceiling
5�®
/_x An
Glass
Total Btu. 18
��
,g'®
Exp. wall
2
Net exp. wall
r ®
.rz 00.:5-40
Int. wall
Ceiling
Floor
Total Btu. 115710 V5_
Required sq. E.D.R. or sq. his. W.A. Leader area
.� Room I Length /a, ii.Widthr� Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane ilghte of crack eq. ft.
v 194 116 1 —7 `-7 //
Coef.
Btu
Infiltration ®
cpa
Glass
5—®
Exp. wall
Net exp. wall /,o
Int. wall
Ceiling
e 2�
Floor
Total Btu. 18
vos—
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
City of Fridley, Minn.
BUILDING PERMIT
Date: XX4 May 22, 1970
Owner: games Tiller Builder
Same
LOCATION OF BUILDING
No. 5925 ., Street Oakwood Manor N.E. — Part of Lot
Lot _._.9- 0 (Pt;__ Block Addition or Sub.Division _ Aud . Sub. No. #92
Corner Lot — Inside Lot X Setback — Sideyard
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
N? 1066
To be Used as:
Garage Front 24' Depth 24' Height 0 Sq. Ft. 576' CU. Ft 5760'
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost __. _100,00 To be Completed Fall of 1970
Provide Hardsurfaced Driveway
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 ajl provisions of
ordinances of the city of Fridley. n
In consideration of the payment of a fee of 11.OQ _ __ermit is hereby granted to James Tiller
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
iaround and n,
regi �d�� g, or any part thereof, shall conform in all respects to the ordinances of
within 'the d limits and location, construction, alteration, maintenance, repair and moving of buildings
ordinances city permit may be revoked at any time upon violation of any of the provisions of said
Building Inspector
D. BAGS
NOTICE:
This permit does not corer the construction, installation for wiring, plumbing, gas beating, tower or watar. Be aro to we
tie Building Inspector for separate permits for these item
r
r
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S . NAME : Jl-fw��S 7-/666--/2-BUILDER:
ADDRESS :.30-75- 09e&)6 &V .IW,61De 4'ZIDDRESS :
ii
NO:. 5-1?d-,15- STREET • D,qe,&)Z:101��7 /�'g/��•P "0/4F.
LOT; 2 G BLOCK: ADDITION: ?7-
CORNER
Z
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:
4 Front: Depth: a I Height:
Square Feet: SZ6-' Cubic Feet:
Front:
Depth: Height:
Square Feet; Cubic Feet:
Type of Construction:n.k, Estimated Cost:
To Be Completed: 0 I,W %OLI
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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: ' 2 , 70�5i SIGNATURE:
(See Reverse Side For Additional Informat o .)
Is
.OF
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEvIGES
RATE SCHEDULE
RESIDENTIAL
RATE
Furnace Shell and Duct Work.
Burner U►lso replaoament furnace)
$
20.00
Gas Piping
$
10.00
Wiping needed with o« furnace)
Gas Range
$
10.00
Gas Dryer
S
10.00
Air Conditioning (all sizesl $ 10.00
All others/Repairs and Alterations
11 of Value of Appliance or Mork
COMriERCIA L/INDUSTR IAL
11 of value of Appliance or Work
State Surcharge
TOM I=
Reinspection Pee ($15.00)
Rough Insp.
Date (�(J
Final Znap.
Date
Approval for Permit
KINI107M PEE FOR ANY HEATING PERKIT IS SI5_00-
PLUS $.50 STATE SURCNARGB
-Air Conditioners can not be placed in aide yard without
written permission from adjoining neighbor.
$
$
$ 50
sIT,�D
Job Address
- r
M
Department of Buildings„ 6411 university Ave. N -E., Fridley, lel 55432
City of Fridley
Tel. 4571-3450
The undersigned hereby makes application for a pamlt for the work herein
Specified agreeing to do all .cork in strict accordanos with the CitY mdse
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application at* true asd correct.
rri
Fridley, Minn. ` J JC7i / 19
ONNER li L& �-
RIND OF B LDING
to
USED AS 5
DtI� 0� ►->
TO BE OPLETFII ABOUT`�
ESTIMATED COST � 00
2 OIC - NEW BUILDING PZRMIT NO. P9Rl1IT NO.
DESCRIPTION OF FUANACE/BUFliER
NEATING or POWER PIA M, Stem, got Yater, Yana Air- No.
Trade Name
Size No.
Capacity s1• n• EM Bw KP ----
Total connected Load kind of Fuel
BUMMER - Trade Name Size No.
CGpacity Sq. Ft. EDA BTU KP
company v�
signed sy
Tel. No.
Fill out back side for stack verification on replacement furnaces
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (. )
2. Is free from rust or deterioration Yes ( )
3. Has no foreign objects lodged within Yes ( i
4. Is securely supported Yes ( )
5. Meets all current Code requirements for size and Yes ( )
total BTU connected
6. Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed B
Date
.A•
No ( )
No ( }
No ( )
No ( )
No ( )
SUBJECT
PER
City of Fridley
7 2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC®(o&
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEPAGE
OF
APPROVED BY
612-571-3450
910-F15
9/3/96
JOB ADDRESS 5925 Oakwood Manor NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 20
1 Auditor's Subdivision x,492
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ren Baker 5925 Oakwood Manor
572-1119
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 p
❑ NEW ❑ ADDITION ❑ ALTERATION X R PAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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
I HEREBY CERTIFY THAT 1 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
@
$1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,000
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-
$62.25
Fire SC $2.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
$65.25
SIGN URE OF NIRA TOR OR AUTHORIZED AGENT (DATE)
WHEN PPRRO�PERLY ALIDATED THIS IS YOUR PERMIT
✓V �
a
IGNATURE OF OW NERIIF OWNER BUILDER) IDATEI
BLCZ/1 h
)ATE
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application t�
*qov.,
ConstructionAddress: %a J�f� t'(t All
Legal Description:
Owner Name & Address: Tel. # Z^i
Contractor: MN LICENSE #
Address: 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: LeWth Width Hgt/Ground Sq. Ft.
OTHER: xl-e Ji` /� Y < c; � &e- _ e
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction:�� , �(,�� Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + Ft = Ft x $ _ $
DATE: APPLICANT:
z Tel. #S27,(//
CITY USE ONLY
//
6 Permit Fee $ ��- ��7
Fee Schedule on Reverse Side
Fire Surcharge $ 0-06)
.001 of Permit Valuation (1/10th%)
State Surcharge $ /, o e)
$.50/$1,000 Valuation
SAC Charge $
$900 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:
suejECT
IT NO.
City of Fridley
32946
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
E
1 � �
NUMBER
REV
DATEPAGE
OF
APPROVEO BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
7/30/02
JOB ADDRESS 5925 Oakwood Manor NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 20
Auditor's Subdivision #92
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Kenneth Baker 5925 Oakwood Manor NE
763-572-1119
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
O NEW 0 ADDITION 0 ALTERATION JJ REPAIR
O MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Sq) 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
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
$3,001
$1.50
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
11-1
$101.75
iDATE,
EN OPER tOATED T SIS YOUR PERMIT
�/�NE �ONRACITOR4UT�iORiZEDAGENT
EILDPF INSP
MATE
S-GNATURE OF OWNER,IF OWNER SUILDERi iDATE.
NEW (j CITY OF FRIDLEY Effective 1/1/2002
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: N t�t'TH SO, t--E� Sig M E Tel.
Contractor. SAO^ E MN LICENSE #
Address: 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: Lengih rWidthh Hgt/Gmund Sq. Ft
OTHER: i % on i" S )C.C.S F e�H2� ,r- , --16
Construction Type: F - 9r"Lc- �N� Estimated Cost: $
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$
DATE: Tel.#N-3) si?--111q
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
$ 3.0® _
$ /A S o
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'Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ /0/1 `�� STIPULATIONS: