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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. Date .... K4 ........... Owner:.. .,.. ....... Address ... I,/ t ... m..77J.19%.6 A/►.d`"`% N1 Builder ..................... Address .................. 2086 LOCATION OF BUILDING No... -6-vg- . ... Street .""i ',, .... }1 ........ Part .1 1. . ........... . Lot ....... .a...... Block .. ........... Addition or Sub -Division Corner Lot ............ Inside Lot .. +w...... Setback '. .. Si and ... ............. DESCRIPTION OF BUILDING � To be Used as: ... Front 0 Depth .,'.a"8.Height Sq. Ft..... ... Cu. Ft. . . i ..... Front ....... Depth .. Height ......... Sq. Ft.... .. Cu. Ft. ........ Type of Construction ... Est Cost ; . To be Complet /....... . In consideration of the issuance to we of a permit to construct the building describeabove, 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. .......... .. ...........;}..................... In consideration of the payment of a fee of �. �,�permit is hereby granted to II. ... to construct the building or addition as described above. This ' it is upon the express `condition that the person to whom it is granted and his agents, employees an 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 m 'vmg of buildings with- in the village limits and this permit may be revoked at any .time upon violation of any o the provisions of said ordinances. . .,..... ilding Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, pl mbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these lt�ms. 0 City of Fridley, Minn. BUILDING PERMIT N®(6E35 >2 Bunde Address Address =N N O DING Z. No.Street Part Lot Lot _ Slook Addition or Sum • Corner Lot Inside Lot +'"'' S*back deyard Sewer Elevation ____ Fo tion Elevation DESCRIPTION OF BUILDING T U as: Front Depth "He1ght -, Sq. Ft. � Cu. FtFro __....__._ Depth H4eight Sq. Ft. go Cu. Ft. 4Wr nAW Type of Constructs (Est. �o be Completed Nor 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 aft provisions of ordinances of the city of Fridley. 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 violatio of any of the provisions of said ordinances.' Inspector NOTICE: Ibb ponnh doss not Cover the Coad-d1on, Installation for whiny, plumbing, gas booing, g, w or water. se . Be wn to e the Building Igor for sop-oo permHs for thea items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA - + = 1' - 400 Address 14,,� �� __ �. �. Address LOCATION OF BUILDING No. Street a Part of Lot ro Lot Block Addition or Subdivision- k; -- Corner Lot Inside Lot Setback ,Side -Yard , SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used As: Type of To be Compl DESCRIPTION OF BUILDING Front_Depth Height sq. Ft. 'V!Z 0 CU. Ft. FrontDepth Leight Sq. Ft. Cu. Ft. stimated Cost 1�,® 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 ruling of the Department of Build- ings, 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). � t � City of Fridley SUBJECT P ®14894 AT THE TOP OF THE TWINS BUILDING PERMIT • tea. ------ COMMUNITY DEVELOPMENT DIV. -, r � � PROTECTIVE INSPECTION SEC. 1 i � 1 /---1 CITY HALL FRIDLEY 55432 �.--- • •�� 612-560-3450 NUMBER 910-F15 REV. DATE 9/5/78 PAGE OF APPROVED BY JOB ADDRESS 1658 Osborne Road 1 LEGAL DESCR. LOT NO.BLOCK 3 1 TRACT OR ADDITION SEE ATTACHED Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Rudni.tski 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Gene Egan 8924 Van Buren NE 784-3953 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Alum soffit & facia 9 CHANGE OF USE FROM TO STIPULATIONS License $35.00 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 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 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 $630 0.50 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- STRUCT RR THE PERFORMANCE OFC STRUCTION. 7.50 PLAN CHECK FEE TOTAL FEE 8.00 Sid-N—ATVAEOFCO ACTORORAUTHORIZE GENT IDATEI W N 0 RLY VALIDATED THIS IS YOUR PERMIT BLDG. INSP DATE SIGNATURE OF OWNERIIF OWNER BUILDER) (DATE) 7 01 SUBJECT City of Fridley 14894 AT THE TOP OF THE TWINS BUILDING PERMIT�7?r `L ------ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � /--h CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---- • •�� 612-560-3450 910-F15 9/5/78 JOB ADDRESS 1658 Osborne Road 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Jim Rudni.tski 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Gene Egan 8924 Van Buren NE 784-3953 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ® REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Alum soffit & facia 9 CHANGE OF USE FROM TO STIPULATIONS License $35.00 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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. $630 0.50 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- 7.50. STRUCT RR THE PERFORMANCE OFC STRUCTION. PLAN CHECK FEE TOTAL FEE Sr��i 8.00 SIGINATtMEOFCO ACTOR OR AUTHORIZE GENT (DATE) • W N 0 RLY VALIDATED THIS IS YOUR PERMIT BLDG. INSP DA SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 01 • CITY OF FRIDLEY . APPLICATION FOR RESIDENTIAL BUILDING PE11141 TS (NEE. ALTERATIms, ADDITIONS, OR REPAIRS) a OWHER:' / 1 i% -S�l BUILDER: 6,FAIA Address: �(�� �S;�n D Address: t2 V" Lj xi-clu -Al 17'7 Ch TeCLtjl' . No.: (05 t Street: Cpis0otwj E Q4t LOT: _3 BLOCK: l ADDITION: ,,S�Z4Je- CORNER LOT: INSIDE LOT: SETBACK: SIDLYARDS: Applicant attach 'to this form lWo Certificates of Survey of Lot and proposed building location drawn on these Certificates. . y DESCRIPTION OF BUILDING , To Be Used As: Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet:. Type of ConstructionL�� T-,+- FJe%� Estimated Cost: $ To Be Completed: -5ep7 /VIC 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 true and correct. See reverse side for additional info ation. DATE: ��/�� 15PId SIGNATURE: . Stipulations: _ !� ,y 3 • dw 560-3450 C.it e� o� 7NidCey p ANOKA COUNTY 6431 UNIVERSITY AVENUE NE September 18, 1978 - FRIDLEY, MINNESOTA 55421 Mr. J. B. Rudni tski 1658 - 77th Avenue N.E. Fridley, MN 55432 Re: Change of House Numbers Dear Mr. Rudnitski: It has been necessary for this office to change the address of your house FROM 1658 - 77th Avenue N.E. TO 1658 Osborne Road N.E. LEGAL DESCRIPTION Lot 3, Block 1, Spring Lake Park Lak^.side Addn. We have notified the Post Office Department, Minneapolis Gas Company, Northern States Power Company, Northwestern Bell Telephone Company and various departments in City hall of this change. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh 560-3450 Cit Cy Of 7r i ANOKA COUNTY 6431 UNIVERSITY AVENUE NE September 18, 1978 FRIDLEY, MINNESOTA 55432 Minneapolis Post Office Department Superintendent of Delivery 1st & Marquette Avenue Minneapolis, Minnesota 55402 Re: Change of Address City of Fridley Gentlemen: We are listing the following change of address in the City of Fridley; NAME: Mr. & Mrs. J. B. Rudnitski FROM: 1658 - 77th Avenue N.E., Fridley, MN 55432 TO: 1658 - Osborne Road N.E., Fridley, MN 55432 LEGAL DESCRIPTION: Lot 3, Block 1, Spring Lake Park Lakeside We have notified the occupant of this change and we would appreciate it very much if you would change your records accordingly. Sincerely, Qj—(Ij I/ DARREL G. CLARK Community Development Adm. DGC/mh CC: City Water Billing Dept. City Assessing Department Minneapolis Gas Company - Brooklyn Park Office Northern States Power Company Northwestern Bell Telephone City Voters Registration Homeowner SUBJECT PER City of Fridley 18 3 8 8 AT THE TOP OF THE TWINS BUILDING PERMIT R IPTN i L'_ _ COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC. ®�® � ( i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/21/86 JOB ADDRESS 1658 Osborne Road N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James B. Rudnitski 1658 Osborne Road N.E. 786-4091 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 & shed 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be the 2nd layer but not the 3rd. Install ridged X galvanized valleys. 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 ANO 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 TOTALFEE $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE( e WHEN PROPERLY (DATED THIS IS YOUR PERMIT � BLDG (NSP G r)A E fGNATURE OF OWNER (IF OWNER BUILDER( (DATE) NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: Legal Description: - ✓i d� �� Owner Name & Address: �' ��- 10 �'� Tel. # Contractor: 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: Lengt h Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Approx. Completion Date: Estimated Cost: $ (S Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 2 Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: A _�OL APPLICANT: Tel.. 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 [ ] SUBJECT PE71"g City of Fridley ®_112 AT THE TOP OF THE TWINS BUILDING PERMIT REC L'______ COMMUNITY DEVELOPMENT DIV. _ r -- PROTECTIVE INSPECTION SEC. ---i CITY HALL FRIDLEY 55432 A / '.j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/13/87 JOB ADDRESS 1658 Osborne Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 Spring Lake Dark Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Rudnitski 1658 Osborne Road N. E. 786-4091 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 3700 Annapolis. Lane, Plymouth, MN 55441 553-0020 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 R REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM 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 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 Z 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 $1,400 $•70 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 LA REGULATING CON- $23.50 STRUCTIO THEERF ANCE OF CO TR ION. N CHECK FEE TOTAL FEE a $24.20 SI ATURE OFCONTRACTORO UTHORIZED AGENT IDATEI �HENOPERLY V I T D THIS IS YOUR PERMIfT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG iNSP DAT NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 11 sipy -S464eyA Legal Description: Owner Name & Address: Contractor Address: 70 O LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 'q.c/ s Uo�irii�iF� . Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length DESCRIPTION OF IMPROVEMENT Width Length Width Length Width Height Height Hgt/Ground Tel. #6 Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside pie's t [ ] Ft. Yd. Setback Side Yard Setback Type of Construction • Estimated Cost: $ Approx. Completion Date: 39-- /-7- Alt. Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation 011 DATE: r�-/ APPLICANT: v Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25$ of Building Permit Fee $•50/$1,000 Valuation $525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT RMIT. City of Fridley 25048 AT THE TOP OF THE TWINS BUILDING PERMIT Ir -113TT10. � COMMUNITY DEVELOPMENT DIV. r I v PROTECTIVE INSPECTION SEC 651 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/12/97 JOB ADDRESS 1658 Osborne Rd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Rudnitzke 1658 Osborne Road NE 786-4091 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D & D Home Improvement Inc 11773 Magnolia St NW, Coon Rapids MN 55448 4840 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 757-7780 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 Garage (7 Sq) Tear-Off 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING 1 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 $577 $•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 PROVISI OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $23.75 Fire SC $.58 STRU ION R THE PERFO ANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Z" License SC $5.00 $29.83 SIGNATURE OF CO ACT ROR AU7HOR12ED AGENT IDATEi WHEN PROPERLY V DATED THIS IS YOUR PERMIT BLDG [NSP QATE S,GNATU RE OF OWN ERIIF OWNER BUILDERi tDATEi NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Effective 1/1/97 A:��(2_10 Tel. Contractor: MN LICENSE # 4 6 o Address: Tel. # 7 5 7_ 7 7 8 11 773 MaCfnnl i a �i-rpat A1W � ('nnn 17a� i ria ��d_$R 0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: =i ]&:::�75;tiinatec Co , -� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $ DATE: APPLICANT: Tel. #_����� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ TOTAL $�12� /,( 0 STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 [ ] r CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 783-572-3904 FAX 763-5711287 Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer Effective 4/1/2001 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 65'B C) 5 � Fee IotJ!±! Owner ) n rte. c- ' ` cv S 1e-- l $35.00 $ Building Used AsC— o c> $10.00 $ ESTIMATED COST `"f a $ L'i PERMIT NO t $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 *Air Conditioning - All Sizes $25.00 A -C_ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever Is greater. on work less than $500.00 Commercia I/I ndustrie I/instltutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/industrial/Institutional State Surcharge TOTAL FEE V L J)A REINSPECTION FEE $50.00/HOUR $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. $..� BTU HP EDR Fuel Total Connected Load $ Burner Trade Name Size No. BTU HP EDR 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 Building Division, and hereby declares that all the facts j and representations stated in this application are true and correct. $ .50 HEATING 5� 9 ° $ 75 Signed 816 DO 41 St Street; SUit9 A, Tel # MInNAM, UN 5M7440 FAX # 1612) 4-# e *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAX: (763) 571-1287 ADDRESS : 1658 OSBORNE RD NE PIN : 123024110038 LEGAL DESC : SPRING LAKE PARK LAKESIDE : LOT 3 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01257��� DATE ISSUED: 08/04/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. PANEL UPGRADE. 200;200 # 0-100 AMP CIRCUITS APPLICANT HARD ELECTRIC SOLUTIONS 415 DECATUR AVE N GOLDEN VALLEY, MN 55427 OWNER RUDNITSKI JAMES B & JANET M 1658 OSBORNE RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC AMP SERVICE FEE ELEC CIRCUIT FEE (0-100 AMPS) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 1438 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 30.00 6.00 0.50 36.50