PRE 2010 DOCSVillage of Fridley, Minn. 30 6
BUILDING PERMIT N?
Date: ... //• • • ... ....... .... .
r a
"" Builder .. ..?. '..........
. .
Owner ..
Address...................................... Address ........ �"....... ........ !� 0
LOC TION OF BUILDING
No.../7 .. Street . ........ .. . .. 2................ Part of Lot
Lot ..... ........ Block ................ ddition or Sub -Division
Corner Lot ........... Inside Lot ........... Setback .A; ..... Sideyard !. ® .......
DESCRIPTION OF BUILDING
To Used as*
. .......... Front . Depth .. Height q. Ft. � ... Cu. Ft. ........
..................... ont ........ Depth ........ Height......... Sq. Ft. ........
�j e/
Type of Constructio ...... Est. Cost ... ,1./..�l . To ®Conipld
57
4 -a 1 0 �.
L 71
c t C
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 village of Fridley.
Cu. Ft. ........
6 ............
Ar I * I I I I I I * I * * * * *
09 ---
In consideration of the payment of a fee of $.le....., 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 village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
rt .. g�►spe for
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 No 26
Date:
Owner: ...... Builder ...to, .,:...__:_.._.__._.._..._..._.. __.._.__._._..__..._____._
Address °� Address
LO TION OF BUILDING
C�._.
No....._. ___._ _ Street_. _ , .:... ��,�_._.._..._..... Part of Lot ...__.._...---..__...._....__...._. ....... _........ ........
_..__
Lot....._ .....................:_........ Block .... _...... ......---...._........... _........ ddition or Sub -Division .... _.......... ......................... ..
Corner Lot .................................... Inside Lot .....__ ............. Setback ....._............._....... ............ Sideyard .... ....._...: .
Sewer Elevation ...._..---_-----------_--__.._..__ ----- -.............___.._..._...._....._ Foundation Elevation
DESCRIPTION OF BUILDING
To �be Used as:
°�... rz+� ....n Depth ..= .•:=•. Height ...:.� . Sq. Ft. .a,
t=�:....:: _ S.x...... Front ..
Cu. Ft. �-- --- --'�
_..... -- - - ._... - ....._..... Front ..................... Depth ............Heigh � ............ Sq. Ft. ...................... Cu. Ft. ..... _.................
Type of Construction . ._ l& , r
• & ..:.--.. Eat. Cost .. F .....:. _..--- 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.
In consideration of the payment of a fee of $. ..__`�"''_.._..y 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 violation of any of the provisions of said
ordinances. r'"; 1 P r —) I
Building Inspector
NOTICE:
This permit does not cover the construction, installation for will , plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name
Builderr
LOCATION OF BUILDING
No. ®`1 % 3
StreetCj-
4U
a Part of Lot
Lot
Block
Addition
or Sub.Div.
Corner Lot
Inside Lot
A--' Set Back
Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
Front A Depth®® Height A®
Sq. Ft. e Cu. Ft. y,' ga 9'
Front Depth Height
Sq. Ft. Cu. Ft. gr
Type of Construction 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 Ordinances and ruling of
the Department of Buildings., and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE__Y '
S� • �® - G SIGNATURE ��,�. � ..,,�..
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley, Minn. N° 7690
BUILDING PERMIT
Date: dune 3, 1965
Owner: BOnedict Shutray —Builder Same Bbnedict Shutrop
Address 14.73 inondago Street N. E. Address 3473 Onondago Street N. E.
LOCATION OF BUILDING
No. 1473 Street Onondago Street N. E. Part of Lot
Lot 2 Block 1 Addition or Sub -Division . Hi tZ@M
Corner Lot Inside Lot g Setback Sideyard
Sewer Mevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost a 10-00- 00 To be Completed
Dett. Garage Storm damage repair
In consideration of the issuance to me of a permit to construct the building
theproposed work in accordance with the description above set forth and in co
ordinances; of the city of Fridley. -.j A ,
Iprov=isio s off
In consideration of the payment of a fee of13-x- 0 _—, permit is hereby granted toBenediCt Shutrop
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 thereoiy shall conform in aIl respects to the ordinances of
Fridley, Minnesota regarding location, ao�ostructfon. 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.
Allen Jensen Building Inspector
NC' L%
Ibis pump den rm sown the coedmd1m, hutsl Wm for wkb& phimbiAe, Bn hedht& www w wdw. Be sore to we
60 sumins h"ador hr sep"aft pwnft for thew Moms.
r . . .
ll
OWNER'S NAME
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
No._ Street,
of Lotr
LOT eZ BLOCK / ADDITION OR,
Corner Lot�_Inside LOT SetbackZ,-ff Side -Yard' 1619
SEWER ELEVATION FOUNDATION ELEVATION
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. Depth3Height
Sq. Ft,. Cu. Ft. l'
Front Depth Height
Sq. 'Ft,. Cu. Ft.
Type of Construction_ Estimated Cost 0,2
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.
(Schedule of Fee Costs can be found on the Reverse Side).
�� 7 2-
City of Fridley, Minn. N° 8700
BUILDING PERMIT
Date: March Us 1966
Owner: Ben Shutrop Builder Taylor d RP.ms
Address _ W3 Onondago N.T. Adm 1562 - 15th St.
'' LOCATION OF BUILDING
No. x4+71_.___ Street Onandam N-Ef Part of Lot
Lot Part of _8 Block Addition or Sub.Division AUDITOR IS SUBDIVISION 129
Corner Lot _ Inside Lot -- Setback _ _ _ Sideyard
Sewer Elevation __ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Remode 1 Front Depth Height Sq. Ft Cu. Ft
RasaWnt Front Depth Height — Sq. Ft Cu. Ft.
Type of Construction Est. Cost _ 5M- _ 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 and in pliaace with afl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 15- , permit is hereby granted to Ta;l or .TIM d
$nmPS . to construct the building or addition as described above. Thisrmit is granted upon
the express condition that the person to whom it is granted and his agents, employees anaworkmen, in all work
done in, around and upon said building, or any thereof, shall conform in aII respects to the ordinancg Of des0off
Fridley, Minnesota regarding >��,� � alteration,
ttaany t'me�upon violation of any of and ththeeproovisions, of said
ordinance. city ]units and tide
NOflCS i
T16 pm* don not con► tho condrudion, hutapation for wMhg, plumbing, gn ho dng, s wor or wdw. Be wn to ao
the Building haps for for apmft pormih Por thea Nunn.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME /7 y i -o t? BUILDER A, /7 pie A�6ay�s
ADDRESS / �, ADDRESS ZS"6 ,2- 1.5-,4 .5,),L
LOCATION OF BUILDING
11 J
NO, y ,Z3 STREET PART OF LOT
LOT BLOCK ADDITIO OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
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;
&k,,f cc-s� e e , Ls 7L Front Depth Leight
Sq. Ft.
Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost ,'®a,:D
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 3 ' f/ �,�� SIGNATURE
(Schedule of Fee Costs can be found .on the R verse Side).
City of Fridley
AT THE TOP OF THE TWINS
SuBjECT
BUILDING
PERMIT
RMIT NO:
25596
�• COMMUNITY DEVELOPMENT DIV.
-
r � PROTECTIVE INSPECTION SEC.
1 � I
CITY HALL FRIDLEY 55432
L J` 612-571-3450
RECEIPT NO.
NUMBER
910415
REV
DATE
10/15/9
PAGE OF
APPROVED By
JOB ADDRESS 1473 Onondaga Street NE
1 LEGAL
DESCR.
LOT NO.
pt g
BLOCK
TRACT OR ADDITION
Auditor's Sub #129
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
Cliff Cote 1473 Onondaga Street NE
ZIP
PHONE
717-4327
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 ❑ ADDITION ❑ ALTERATION [A REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof Garage (10 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$834
SURTAX
$.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 PERFORMANCE OF CONSTRUCTION.
$32.00
Fire SC $.83
PLAN CHECK FEE
OTAL FEE
1�
/
/f
$33.33
SIGN T RE FCONTRACT OAUTHORIZED AGENT IDATEI
HE PRO
V VAL
ATED THIS IS YOUR PERMIT
•
8 OG IN
�/1
��'/��/
MATE
S)GNATU O O INEROF OWNER BUILDER) IDATEI
NEW [ J Effective 1/1/97
ADDN [ J CITY OF FRIDLEY R
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION`
ConstructionAddress:
Legal Description:
Owner Name & Address: 014 Cole, Rzi dP,_P&4A�g Tel.
Contractor: ---` ` MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE A Length Width Height Sq. Ft./000
DECK AREA: th-Width Hgt/Ground Sq. Ft.
OTHER:
V L,;- 7, �1
r��
Construction Type:, — si't f%7,i r, rr�0 Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: /D / 5 /�2 APPLICANT: 0-11-p/ O&-% Tel. # `71 _ - f ,�
iTlPULATIONS:
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
$
$950 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
rosion Control
$
-$450.00 Conservation Plan Review
?ark Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
iTlPULATIONS:
SUBJECT
-'
PER `-�
City of Fridley
9 5 8 3
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RE
`� -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
f PROTECTIVE
j
� f
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BV
612-571-3450
910415
3/1/99
10B ADDRESS 1473 Onondaga Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt 8
Auditor's Subdivision #129 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Cliff Cote 1473 Onondaga treet NE
717-4327
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Midwest Construction Services Inc PO Box
442, Litchfield, MN 55355 20101426
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
(320)693-3620
5 ENGINEER MAIL ADORES;
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reroof House & Garage (29 Sq) Tear -Off; Reside House & Garage; Replace 9 windows
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code. Install smoke
detectors to meet the State Building Code
- in each sleeping room and on each
level of the dwelling. 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 E.0 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
$7,185
$3.59
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 -
STIR CTION THE RFORMANC OF CONSTRUCTION
$137.25
SC $7.18
PLAN CHECK FEE
FEE
Lic S $5 0&153.02
SIGNATURE OF CON'RACT OR AUTHORIZED AGENT (DATE,
EN ROP SOUR PER
S,GNATURE OF OWNER,,F OWNER BUILDER, IDA TE I
! O
BI B G INSP pAtE
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress7 �i
Legal Description:
Effective 1/1/92
Owner Name & Address:/19 Tel.
Contractor: MN LICENSE#fib/ ri(0
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.
Hgt/Ground Sq. Ft.BS
_
DECK AREA:
Length
Width
OTHER:
"h `� add
x l •� `�
I _%Ob
Construction Type:
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width
Needed:
Ft. + 6 Ft = Ft x $ = $
11% 7 loo -C 1/���S
DATE: " "' APPLICANT:
4g �7� Tel.
CITY USE ONLY
Permit Fee
$
12 7 c) -S
Fee Schedule on Reverse Side
Fire Surcharge
$
% /S
.001 of Permit Valuation (1/10th%)
State Surcharge
$
3..5-%
$.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:
L
SUBJECT
PER O.
City of Fridley
i 793
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
Ir?
L
`y _____ COMMUNITY DEVELOPMENT DIV.
r - - PROTECTIVE INSPECTION SEC.
572 -3604
36,P
I = 1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/3/01
JOB ADDRESS 1473 Onondaga Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
pt $
Auditor's Subdivision 4129 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Cliff Cote 1473 Onondaga Street NE
763-717-4327
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW 0 ADDITION O ALTERATION 0 REPAIR O MOVE IR REMOVE
8 DESCRIBE WORK
Remove existing 12' x 25' Deck; Construct
a 25' x 16' Deck
9 CHANGEOFUSEFROM
TO
STIPULATIONS
See notations on plan.
r„WAKIN '
Before digging call for
SEPARATE PERMITS
all utility locations
REQUIRED FOR:
4540002
WIRING HEATING
REQUIRED BY LAW
PIAIMBINd AND SIGNS
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 BO 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
$4,400
`1'2.20
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 -
111.25
Fire SC $4.40
TION
TION
WPLAN
CHECK F E'41
TOT FEE
z4mg
17.85
AGENT [DATE,
HE PROP VALID D THIS IS YOUR PERMIT
00, �•
S,GNATURE OF OWNER,If OWNERSUILDERi aOATEI
Bl NSP - OATE
L
NEW [ ] Effective 1/1/2001
ADDN [ J CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address J -7 -P On on AA!aij S4 • i)% E
Legal Description:
Owner Name & Address: (%) i TT 0-p-�e, 1 Xgi-k .51, AiTel. # 70 --7r7-OF
�
Contractor: Ok,�h GY` MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the L L q4'
lot, with the proposed construction drawn on it to scale. f" f4_
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: L ng Width &Z i Hgt/Ground Sq. Ft.
OTHER: EMo o� - 7-"A.)6 /a k --f
Construction Type: Estimated Cost: 'Woo
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 5& 2 -LOO APPLICANT: �_7 j�t C � Tel. #
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ Fee Schedule on Reverse Side
$ U .001 of Permit Valuation (1/10th%)
$ off•,70 $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
e,APPROVED
PLO ri TO E1ELD
Building
Inspections
7.63-572-3604
DATE 1�
THIS APPLICANT i3:
PROPUTY
OWNER/
TENANT
SUBMIT A COPY OF
YOUR STATE
LICENSE WrM
APPLICATION
PERMIT TYPE
• MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIODT1EY
O OWNER
COMPANY NAIVE -
1 -CONTACT PERSON:
STATE LICENSE $_
PHONE
LE FAMJLY
YOUR S -MAIL ADD
/'-t e� 1/ 1
1!
,.^ill 3 RI . ; .
i
ITTEMN OVER
0 TWO FAMILY Q TOWNHOUSE
TYPE OF WORK: I 13NEW XREPLACEMENT
DETAILED DESCRIPTION OF WORTC jac6L
D A13 ERATION/RSMODEL
permit No.;�
Received By:
Date Recd:-- --A6
6e
A
PER MS 165.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is grearer, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (71:is should refect only the cost of labor }
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 -
ARE RASED ON 510.00 PER FIXTURE, EXCEPT WH W NOTED, FDa URE4: MiDICATE TOTAL
FOR PROJECTS WHERE LABOR EXCEEDS
SS00, FEES
NUMBER OF EACH BELOW)
EgWpm=d hz%I1ed
MFG: MODEL:
SIZE/BT"[T
MFG: MODEL:
� SIZ MTU
A/C $25.00
�.�.—
FIREPLMODEL.
MFG ACE (GAS) $15.00
- - SIZEMTU_,�.._
_GAS RANGEIOVEN 510.00
AIR TO AIR EXCHANGEER $15
FIREPLACE (WOOD) 535.40
j FUitNACE 535.00
NEW GAS GRILL 510.00
UNIT = $10.00
BOILER 535.00
CHIMNEY LINER $10.00
ftTT -r Wnr�rr vnm
GAS DRYER $10.00
GAS PIPING $10.00
,,,_GAS
POOL I1fiATER 15.00D
YENM ATOR$15.00 _..._.
Permit Fee $ _ Number of fixtures @ $10.00 -j— x $ =
Surcharge 50 Number of fixtures 0 $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 0 x $25.00 = $
Number of fixtures @ $35.00 = x $35,00 - $
State Surcharge - S .50
Total T $ o
TMS IS AN APPLICATION FOR A PERMT - NOT VALID UNTIL PROCESSED
I hereby apply for a building permit ajad I acImowledge 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-Constluctlon Codes; that i understand this is
not a permit but only an ap tas, 'on for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case f a1�1 work wh requires r/e and approval of p
SIQNAnME OF APPLIC
DATE
City of Fridley
Building Inspections 1Departmelat
643I University Avenue NE, Fridley, MN 55432
763-572-3604
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