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