PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT S® 4 4 21
Date: 1••-•-._...._.._ ._.. -•--• ..... .._.l✓ _ - - ._..
Owner: ...... .�.. j ... - _ ...a.......... . Builder ------------------ .._.............
Addresss ..G /..91.._:.. ._ !1 _$ _az_ Address ..._ ........................................... ........... ....................
LOCATIO OF BUILDING
No.... ��.....e .....�---.. Street _... s .......... ... ---......_....d. ...... _.............. Part of Lot ...................... ---............. -......_...._......_.. __
Lot ............. r...�.......... Block ........... ............................... Addition or Sub -Division . .
Corner Lot ................................. Inside Lot ....._.!..'......._.......... Setback ...P........... .............. ,. Sideyard ._.._ ..........._.� ............ .... _...........
Sewer Elevation ........... L,/w�rryy
.v------ ---- -- - --.................. .............. ......... Foundation Elevation ..............1
DESCRIPTION OF BUILDING
To be Used as:
.. Front ..... V,9.. ®Depth .. .. -� Height ...1..--'7 Sq. Ft. .,�� �- � Cu. Ft.
....- _,..__........ Front ..... �... Depth Height 14.1
Sq. Ft.gam...,,��s... Cu. Ft. A.Z,34
'00
Type f Construction ._.._7� .x... Est . Cost j>.j1.g...._.-------- To be Completed .............._...._....................__.
In consideration of the issuance to me of a permit to consthe !ding d d above, ee to do
the proposed work in accordance with the description above et fort d in p ce with ovisions 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 time upo viola ' of any of the provisions of said
ordinances. ��� 1
Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
0
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY MINNESOTA
9 0�
Owners Name _ Builder
Address ':®0 �. - /. i c s Address
LOCATION .OF BUILD NG
No. Street. ® Part of Lot
Let Bleck Addition or Sub.Div w� . _
,
Corner Lot Inside Lot ►� Set Back Side -Yard /® '
SEWER ELEVATION - fez 'FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed -building
location.-..
DESCRIPTION OF BUILDING
•
To bo„,used as: . .
Front DepthZ __._Height_ -
Sq. Ft, /0 7&”' Cu. Ft. Y1f >6
Front Depth Height'..
Sq. Fit Cu. Ft.
Type.:.pf Construction_a Estimated Cost
To be completed_ /0 •
The,,ndersigned 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 corrgct.
DATE �® ice '" SIGNATU.03vr, dig
���.e�z
(A Schedule of Fee costs can be found on the Reverse Side.)
A
,,I g.sF�
City ®f Fridley, Kinn. N° 7675
BUILDING PERMIT
Date: June 2, 1965
Owner: James Sweeney Builder P. D. Q. Claim Service
Address 71 Pandora Drive N. E. Address 6305 Bryant Ave. So.
LOCATION OF BUILDING
No. 81 Street Pandora Drive N. E. Part of Lot
Lot 23 _ Block 4 Addition or Sub -Division Brookview Terrace, 3rd. Add.
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation -- 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 Est. Cost To be Completed
Storm damage repair
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 aboye_.@et forth and in compliance with ail provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 5/ ` , permit is hereby granted to P• D• Q. Claim
Service 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 anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
wiorthi nthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said
Allen Jensen Building hiqwtor
NOTICE:
ink pamb den M neva AS eondm0m, hwhWan for wGh & plumbing, gn huMn , dower or wale. Be ane to no
the Befb$ng ImWeela for apwafe paaih for than bans.
0
APPLICATION FOR B' ING PERMIT
PikCITY OF FRIDLEYy •NNESQTA
LOCATION OF BMDING
MAR
No. Sheet Fart of Lot
Lot. Block Addition' or Subdivision �\ ��•
_ L "fin%,`
Corner Lot Inside Lot _1..$et sok Side :Yard ...
SEWER ELEVATION FOUNDATION ELWATION
Applicant attach to thid form, Two Certificates of Survey of Lot and proposed build-
ing location drdwn`on these Certificates.
To be used ds:
DESCRIPTION OF BUILDING
PronC Depth Height
Sq. Ft. Cu. Ft..
Front Depth Height
Sq. Ft. CU. Ft.
Type of Construction Estimated, Cost �:ya3e XO
s
_._Zb-.he -Completed
The undersigned hereby makes application for a permit for the, work herein specified,
agreeing to iso all work iit 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).
r - % T
PARTIAL RATE SCHEDULE
Estirr.•ated Cost.. S 10.00 r, r7sry•
Old—New. Building Permit No.__ -__e----
,: LL•vt8I11C F1XTU:?E RATES: NO. RATE TOTAL
Sigr;ca`T
NumberflXturetl • • • • • • • • • • • • • • •'• �—.. x $2.0.0. S•-••��
. B MINNEGASCO
Future Fixture Opening .. • • • • • • • • • x $1.50 S , -• y
8usinms Phare No .
New Fixture Old Opining.... • • ••• • • • ---- �_
Catch Basin • • • • • • • • • • • • • • • • • • 4L• ��..r x $' q
.i5 $ • '
Pater I[eater 'UP to 99.000 BTU) • • • • x 53.00 ROUGH
• Ntw Ground Run 013 BW9. • • .:. • . • x 11.25 S '
Eiecte.c Ylater Fleatar.. • S2m S FIN 1,_/, 3 2 Z� .
S FI?TING FEES: NO. AnTY. TOTAL
Z
• lst 3 Fixtures • • • • • • • • ......... - x $2.00
Addlucual Fixtures • . • x + .75
• • ....• . • • • • S , .
to 1
:3 R.:: ae 997.000 BTU
-- x $S.CO
G
• • ......... e9'sa R '
P..EW.T.R3��hfo Code
AL:>=AA?IONS--P.efe*
.50 State Surcharge
.rk=rwlpuon .......••••••••:••....••.N•.. ...Y..... -� O
TOTAL Feet
• • 53-8Z-9915051 •
Ci%r of
rF; iala y
aprlicio7 for t'1cI>•rs r,Wid G—M Rfi:� �eri9
•
---..�........�..
Dopa. of Bldg%. Phono SM -3450
--
'
DESCi'IPTIOIT
O: V1011t:'871
.
Pandora Dr•iva NE
Lo..atloa
Humb::
ar.''''
a.•sd Lecr:foa of Fixtures
City of Fridley;
_ �
7 � �•
:
� i� "
�
7 �
7
o
►
e
a
waTr. Mrs
ws ruG
The undersigned hereby rr:3kes application for a permit for the vorY.he
Citl
�i ; is �.
a ,s •
�
f
3
= �w
3 # I �
� ° •
i°
specified, a� acing to do all work in strict acco.da::ce with the
that all Lie
hereby declares t
xn
a^.d ruling of the Dapar trnent of Buil`lnp. ni
Es:r
I
• , and tepresc-rtatioas stated !a Llys app:icaion are true MA eosre�`t'
c
nn
Ct
d r
6-3-76 1S
I
j^ridley. Mina
1:d
—"
kwon Dupr®
Owner
33.
frau
Kind of Building
s.4
• FL't'.:.•0 Ca•-azct.:a C"f'rGlr.•`9
Cca :ts::d with
fj�p7rx°'`4•
❑
Used as
s New Fi::turo. Old trrsnir:Cs
Cc::pcol (]
6-10-76
�.-.._...__-
To be completed about
PARTIAL RATE SCHEDULE
Estirr.•ated Cost.. S 10.00 r, r7sry•
Old—New. Building Permit No.__ -__e----
,: LL•vt8I11C F1XTU:?E RATES: NO. RATE TOTAL
Sigr;ca`T
NumberflXturetl • • • • • • • • • • • • • • •'• �—.. x $2.0.0. S•-••��
. B MINNEGASCO
Future Fixture Opening .. • • • • • • • • • x $1.50 S , -• y
8usinms Phare No .
New Fixture Old Opining.... • • ••• • • • ---- �_
Catch Basin • • • • • • • • • • • • • • • • • • 4L• ��..r x $' q
.i5 $ • '
Pater I[eater 'UP to 99.000 BTU) • • • • x 53.00 ROUGH
• Ntw Ground Run 013 BW9. • • .:. • . • x 11.25 S '
Eiecte.c Ylater Fleatar.. • S2m S FIN 1,_/, 3 2 Z� .
S FI?TING FEES: NO. AnTY. TOTAL
Z
• lst 3 Fixtures • • • • • • • • ......... - x $2.00
Addlucual Fixtures • . • x + .75
• • ....• . • • • • S , .
to 1
:3 R.:: ae 997.000 BTU
-- x $S.CO
G
• • ......... e9'sa R '
P..EW.T.R3��hfo Code
AL:>=AA?IONS--P.efe*
.50 State Surcharge
.rk=rwlpuon .......••••••••:••....••.N•.. ...Y..... -� O
TOTAL Feet
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
m
E
M
41
0
MU'
F
m
W
.ci 4
f�
S
I
p
8
w
m
$-+
to
U M
4A w
8.0
4 9
pA',
a
u
14
U
V
m
a
w
9
m
o
water
Heater
$
lec
$
Beer Dispenser
S
4.00
$
Blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain water Leader
$
5.00
$
Hydraulic Valve
lst
5.00
$
Sump or Receiving Tank
$
5.00
$
Water Treating Appliance
$
7.00
$
Hot water Heater
$
5.00
$
Gas Range
$
10.00
2nd
Gas Dryer
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
li of Value of Fixture or Appliance
$
Reinspection Fee $ State Surcharge
$ .50
($15.00) TOTAL FEE
$A
3rd
4th
F1
T1
I
I
(R) a Future Connection Opening
(*) a New Fixture, Old Opening
Connected with Sewer
water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
New Fixtures
$
5.00
$
Future Fixtures
$
3.50
$
Old Opening, New Fixture
$
1.50
$
Beer Dispenser
S
4.00
$
Blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain water Leader
$
5.00
$
Hydraulic Valve
$
5.00
$
Sump or Receiving Tank
$
5.00
$
Water Treating Appliance
$
7.00
$
Hot water Heater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
li of Value of Fixture or Appliance
$
Reinspection Fee $ State Surcharge
$ .50
($15.00) TOTAL FEE
$A
HtlectlVe Aug. 1, 19bi
Job Address � � / `=.? ��•La �" �' !�
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. ��� , lg kz
OWNER
KIND OF BUILDING
USED AS )C� LEi e
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. / PERMIT NO. g ��
Company e` " e
Signed By
Tel. No. _ �d
ROUGH INSP.
Date
FINAL INSP. "— _3
Date
APPROVAL FOR PERMIT /'/ G
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
City of Fridley
SUBJECT
fO1787�
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
;,
CEIPT
L'-____ COMMUNITY DEVELOPMENT DIV.
-:PROTECTIVE INSPECTION SEC.
r 1
�� -5
1 �
`
CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
10/30/86
JOB ADDRESS
1 LEGAL
LOT NO.TWA-CTOR
ADDITION SEE ATTACHED
DESCR.
28 4
Brookview Terrace 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Owen Dupre 871 Pandora, Drive N.E. 574-9269
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 ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 101. x 121 Storage Shed in Re4r Yard
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS REQUIRED FOR
WIRING, HEATING, PLUMBING AND SI GOofS. ���°�
Before digging call focal utill!W
TELEPHONE - ELECTRIC - GAS Ei .
REQUIRED BY LAW
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 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
]
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
$'50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$350
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$15.00
SIGNq-7.ktREOFCONTRACTOR OR ur RIZEDAGENT (DATE) 3IWHEN
'ED
V
PROPERLY V IDAT THIS IS YOUR PERMIT
•
-F 7BLOG INSP /® TE
SIGNATUREOF OWOW NER tlF OWNER BUILDER IDATED
N£V; [ J City of Fridley Effective 4/1/6(
ADDK. F R-1 AND R-2 i
ALTER. I J Building Permit Application
Construction Address:
R
Legal Description:
Name i Address:
w Env 0UP M -E
Tel. S Gh4--Ct zC09
Ownez
Contractor: ��� Tel i
Address:
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width _ Height Sq. Ft.
DECK AREA: Length - Width - Hgt/Ground Sq. Ft.
OTHER:
3To rc A GG q% -Ac --b 1 ®1 tC 1 Z' - o m c)
Corner Lot [ j Inside Lot [xJ Ft. Yd. Setback Side Yard Setback
Type of Construction:
Estimated Cost:
Approx. Completion Date:
Alt. A Alt P
Proposed Driveway Width If New Opening Is Desired: _
See Back Page for Explanation
,,.� e,� CS*I4 -9'L(-e9
DATE:
APPLICANT: `��`� Tel. � -
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
:9Q Fee Schedule on Reverse Side
f 25% of Building Permit Fee
6 $.50/$1,000 Valuation
$475 per SAC Unit
Fee Determined by Engineering
Agreement necessary [ J Not Necessary [ J
4Z
0
"-I r. -, �
t c -
..de —
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
� /4kctive On January 1, 1993
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 20.00 $0-0,
Gas Piping (Needed with new furnace) $10 .00 $
Gas Range $ 10.00 $
JOB ADDRESS !jL7 C 1t.f�
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 and
representations stated in this application are true and correct, ,d
L� ,1993
OWNER x -.J 1, 9— 06 b 0
BUILDING USED AS;��
Gas Dryer $1.0.00 $ /
ESTIMATED COST �`��aC�` `�� PERMIT NO. / /S-�
*Air Conditioning — An Sizes $10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $ No. of Heating Units_ Circle One (Steam) (Hot Water (Warm
Trade Name r Size No. Cr 0_ dUU 67L1
Commercial/Industrial BTU_ j Uo HP FOR
1% of Value of Appliance or Work $ Fuel ---T Total Connected Load
State Surcharge
TOTAL FEE
$ .50
MINIMUM FEE FOR ANY HEATING/COOLJNGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without I"
written permission from adjoining property owner. T� 'V �` �
Burner Trade Name Ar9-,4^J6 Size No.
BTU -Y� cP+ HP
HEATI N
Signed
EDR
Approved Byif_�__ Rough—in Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACE
oeQ�
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes V) No ( )
2. Is free from rust or deterioration Yes (y_) No ( )
3. Has no foreign objects lodged within Yes QrJ No ( )
4. Is securely supported Yes (K) No ( )
S. Meets all current Code requirements for
size and total BTU's connected Yes (}4 No ( )
6. Has total heating BTU's of 15(, ,otrZy
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
1
HEATING COMPANY �`� 2-�r4�rf-
Signed By
Date _
0
SUBJECTERMI
City of Fridley
5 5 3 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
tr ------ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
9/24/97
JOB ADDRESS 871 Pandora Drive NE
t LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
28
4
Brookview Terrace 3rd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Owen Dupre 871 Pandora Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Exterior Design Service 6391 Monroe St NE, Fridley, MN 55432 571-3720 3237
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 O ALTERATION )J REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (18 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$1,501
$.75
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-
$51.25
Fire SC $1.50
STRUC N OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$58.50
SIGNATURE OF CON RAC ORO UTHORIZED AGENT IDATEI
WHEN PROPERLY VV4DATED
:g::BLD .INSP
THIS IS YOUR PERMIT
DATE
SIGNATURE OF OWNER i iF OWNER BUILDERI IDATEI
NEW
ADDN
ALTER
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor;
Address: p I/ Y/
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
k
C
Effective 1/ 1/97
Tel. #
MN LICENSE #_ 3 7-3 7
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Len Wi th Hgt/Ground
Driveway Curb Cut Width Needed:
DATE: J'-'2-- Lll-�
J
Sq. Ft.
Sq. Ft.
Sq. Ft.
2 Q/�c
Estimated Cost: $
(Fee Sche _ on Back)
Ft. + 6 Ft = Ft x $ $
Tel. # `i '7
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
S
Fee Schedule on Reverse Side
Fire Surcharge
$
/ • S
.001 of Permit Valuation (1/10th%)
State Surcharge
$
i.
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
_
005
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
S
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:
SUBJECT
PERbo
City of Fridley
2 7 766
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
�•
COMMUNITY DEVELOPMENT DIV.
• _ __
L PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
_ �1 CITY HALL FRIDLEY 55432
ti' ,'�
--'11.0
612-571-3450
910415
9/14/98
JOB ADDRESS 871 Pandora Dr NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
28
4
1 Brookview Terrace 3rd Addn.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Dupre Same
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Exterior Design Service 6391 Monroe St NE Fridley 55432571-2380
3237
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION l REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside - storm damage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATIONa
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
���D
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$500
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-
$21.00
Fire SC $.50
STRU TION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
Lice SC $5.
toe /SIGNATURE
$27.00
OF CONTRAC R OR AUTHORIZED AGENT IDATEI
Jr
NMOPEIDATED T Y PER
r
0000901�
SIGNATURE OF OWNER IIF OWNER BUILOERI IDATEI
13'Mjf INSP
GATE
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Address: L
Effective 1/1/98
MN LICENSE #
Tel. �7/--2 --7- d`ze
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF BUROVEMENT
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: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ /l4.3
DATE: q,r4 � APPLICANT
CITY USE ONLY
Tel. #
Permit Fee
$ /.!�1)
Fee Schedule on Reverse Side
Fire Surcharge
$ ,_s"O
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ., S!%
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$Ql.J
$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:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
Urinal
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Wash 1 <I>`« Floor : Auto.
::tt:...;:
_. Shower T ><< D
ra rain Washer
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00 /"0.'00
Water Heater -Electric
$ 7.00
Water Heater - Gas*`
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $ �0 S2)
Effective On Jan 1, 2000
JOB ADDRESS P 71 VA ntinn2 In DP - t Z
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
and representations stated in this application are true and correct.
Owner oL,,'s i= k� r-> u P 2 C—
Building Used As 2 r. I'L A
A; 406
Estimated Cost Cc 00PERMIT NO.
/4, 2�3
PLUMBING COMPANY Sd IL04 ti: LO M2— do . 'ink^
SIGNED BY
Approved By
Elec
20 oa
TEL NO&,Z) Z3 -y -S2--1411
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
Appliance #2 Type
Appliance #3 Type
Total Appliances
BTU Input
_ BTU Input
_ BTU Input
Total Btu Input
Fan Assisted or Nat
Fan Assisted or Nat
Fan Assisted or Nat
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
on _ /
Building
$ ___3 3, 94Y
BUILDING
Plan Review
Permit No
Inspections
Fire Surcharge
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$ (. 4 1
CITY OF FRIDLEY
Date Rec'd.
'/ ® b
DATE '�d
f
6 YOUR ADDRESS
SAC Charge
SITE ADDRESS V1
Nn efol-a Dr • F-.
Curb Cut Escrow
THIS APPLICANT IS:
❑ OWNER ,"CONTRACTOR
Erosion Control
PROPERTY OWNER/
NAME: O 11 �n
Park Fee
TENANT
ADDRESS: 8{ / CuAd®-1-4[Jj : �, CITY
�� STAT)�l14w
$
PHONE: A-2-574-
G?-57td-CONTRACTOR
Total Dae
CONTRACTOR
NAME: Q.ic,IC;3 (Z®X,!!tri L s7 l�L
STATE LICENSE # — ,JbC EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: )SG Oe --44-4 Ave, S. 1J.
Crry)W,w y STATHi JZIPSV/A
WITH APPLICATION
PHONE -42-7- 63 FAXW-W-61471
PROPERTY TYPE
WSINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERNM TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH fiMOOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OT iER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
MAINTINANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: ` t1ir QP- " 4
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING
3
❑ HOUSE ONLY
NUMBER OF SQUARES .2
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
ENG 7 U�B�C� E SCHEDULE)
TOTAL JOB VALUATION OCCUPANCY TYPE
Permit Fee
$ ___3 3, 94Y
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$ (. 4 1
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ S.00
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Dae
$
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a pernV and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which eq , review and approval of plans. �y
SIGNATURE OF APPLICANT PRINT NAMB-�'' 'N LFP®� �E / DATE /�� f