PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT Na 4283
Date: - - /"` ...__......__^_..._. °� .._.._.._..-...._._..._..
a
Owner: .......................... .............. _.............. -...... ..... ___._..... ................ ... ............ Builder ...... ,......................._. .----.:....._._._...----_-_._ _.._. _....._......
Address--- .............. ....... -......................... _............ _..__...._... .__..._.__.... Address ........ ...................
......... _..... _..... _._..........
L CATIO OF BUILDING
No. /.._.._.... Street ..... - - •- ----• --- �'� "... .... ............... Part of Lot ............ -..........
_
Lot ....._ .......... Block ---.---•--.` ................................. Addition or Sub-Division7Pi�leCs,�"....?1��...
Corner Lot X ....................... Inside Lot ....................................... Setback .3:47_. _P.._........ Sideyard'.d.... ' ..()....--
Sewer Elevation .........:.......... ........ ......_....................................... ........................ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
i �1...�� Depth e�.. .. _�' 'Height _1��.:... Sq. Ft./�s� Cu. Ft. -20,3/-Y'/
_............ _................... Front . _�s , .._
/6!T t —e� �...: c ®•� Ft.... Cu. Ft ..cl.
_......._.......... Front ......._......._...... Depth..'......._.. eight / .. Sq.
Type of Construction ..............._............._......--- .......... Est. CostT...../�dl'!RTo be Completed ..... .............. _.............................
In consideration of the issuance to me of a permit to construct
the proposed work in accordance with the description above set for
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.'+. ........... .......... permit is hereby granted
above, I agree to do
with all iRrovisions of
......................... 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
nrdinanepa_
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
a4180.4
_.__..__._._........._
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder
Address
LOCATION OF BUILDING
No. Street Part Part of Lot
Lot _ Block Addition or Sub.Divc ;? o-�.�7
Corner Lot�side Lot Set Back 5 Side -Yard -
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certf� ca.te of Survey of Lot and proposed building
location.
! DESCRIPTION'OF BUILDING
To be used �W.:
T:'ront
Sq. Ft.,/� ��o Cu. Ft.
—Front—' /5? Depth, 04Q Height
Sq. Ft. Cu. Ft:
Type"of'Construction ° / Estimated Cost
To Po -completed
The undersigned hereby makes application for a permit for the work herein specifiedp
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
tion&:'stated in thi appli tion are true and co t.�a
DATE?5::.r ® SIGNATURE'
(A Schedule of Fee costs can be found on the Reverse.Side.)
City, of Fridley, Won. 1076
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Zate: - j„ 1 W R7 1971
Qom: Elmer Jahn Builder S li g G e 1 C o
Address 891 Pandora nriva Address 1850 Como Ave..nue
LOCATION OF BUILDING
Na - gw Street Pandora Drive . _ Part of Lot
Lot if) Block 4 Addition or Sub -Division Riverview Terrace 3rd
Corner Lot Inside Lot Setback Sideyard —
Sewer Elevation
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
Garage Front - 24 Depth __22Height __ 1 n Sq. Ft. _528L_ Cu. Ft:. 5280
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction - Frame Est. Cost _ 2100 - To be Completed 90Days
Hard Surface Driveway
Garage slab elevation to be at least 181' above centerline of Able Street to drain
toward Able Street.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
$die proposed work in accordance with the description above set Xorth and in compliance with all provisions of
ordinances of the city of Fridley.
– eG 1 1ti
In consideration of the payment of a fee of $_ , permit is hereby granted to S11 s R e 1 Cn
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
n� city limits and this permit may be revoked at any time upon violation of any of the provisions ofordinsaid
2 zKell
wilding Inspector.
- HANK M MT('H
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
`7
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM:
&,#- _k_ k h-
BUILDER:
�v..S j &
ADDRESS: 8 9/
�2ct oho Da i v �a�
ADDRESS:
/e,SSB A✓ e C5�t to
LOT: BLOCK: ADDITION•
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
-4
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: CZ G�-- Depth: / Height:
Square Feet: i Cubic Feet: 2�®
Front: Depth: Height;
Square -Feet; Cubic Feet:
Type of Construction: /oda Q_ Estimated Cost: $ 2
To Be Completed: %O cy�,1
1✓f-��-c:=� �/ � /L' '�- -� 1����
5 S-- -SeF ��` -� �i3� = a -3/2,6V
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to-do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations.stated in this application
are true and correct.
DATE : ' U ' l %'� SIGNATURE:
(See Reverse Side For Additional Information.)
�8 C/ aA/a v C/
cf,�y _
Process Service Associates
891 Pandora Drive, Minneapolis, Minnesota 55432
560-1540
JULY 15, 1971
Building Inspector
City of Fridley
Dear Sir:
We are building a 22$24 garage on the rear of our lot.
Our now attached 1 car garage will be converted into a family
room in the near future.
Yo T;uly, �-
liner E. J
Joanne E. Jahn
LM
SUBJECT
PER
City of Fridley
- 7501
AT THE TOP OF THE TWINS
BUILDING PERMIT
�r!
r
R
�
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
i � ,,� CITY HALL FRIDLEY 55432
L ____ 612-571-3450
910-F15
5/22/84
JOB ADDRESS 891 Pandora Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
30
4
BrookvieW Terrace 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Elmer Jahn 891 Pandora Drive N.E. 571-4706
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
Convert existing attached garage to living area
9 CHANGE OF USE FROM TO
STIPULATIONS
Use moisture resistant wood in floor system unless it is vented.
PERMITS REQUIRED FOR WIRING
,EPERATE
AND 51QN&
HEATING, PLUMBING
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
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,000
$2.50
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.
$50.50
P AN CHECKFEE
TOTALFEE
$53.00
SIG"17 OF CONTRA R ur IZEDAGENT IDATEI
r
- WHEN PROPERLY V' IDATED TH S IS YOUR PERMIT
SIGNATURE OF OWNER 0FOWAR BUILDER) IDATEI
DG INSP DATE
LM
NEW [ ]
ADDN. [ ]
ALTER. [ ]
Construction Addre
Legal Description: _
Property Owner/Address: ,�Lfl�� e%��� �, �eV Tel. #
Contractor: �l��Ele Tel. #
City of Fridley Effective 4/1/84
�R-1 AND R-2
Building Permit Application
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.
C Q e
e
fa/ a
OTHER:
- -- — a
-W
400
Corner Lot [x]
Inside
Lot [ ] Ft. Yd.
Setback Side
Yard
Setback
o�
Va*4mfl*oA
40
.�
Type of Construction:
Approx. Completion Date:
SF
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: a� APPLICANT: Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
_ r
` 1
"'•; '- �~ J= to .! -
- b 7'M
,z
r�n, } vv 1
! J1 M1s a "'€�'" 4 5 tom. L ij AS %✓ .°'
f
-
Y !
.� �E �� r It 4� � - Rx�. 1{�+ r.`F" _ d °o.. ��. � A� 1 �' `•.,' 1 - �• �A � `.:j 1 ,. ; _
'L.
t ..
J
..Y
AZT,
'FINDr �.. ¢ $ r. \►
-
v s a
�+
�, Ilk
419
40
p�,q}�rttC ��� � � �' �� _r � �;; +�'' f� .: •y _�'�' .ter.. Y\ al 1'�#k"t� ` -
i� 'r r a i ♦ r
�r r�
SUBJECT
PER
City of Fridley
18142
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
REC
COMMUNITY DEVELOPMENT DIV.
1 fr
w
(I�
r , PROTECTIVE INSPECTION SEC.
��
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/1/85
JOB ADDRESS 891 Pandora Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
30
4
Brookview Terrace 3rd. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Elmer E. Jahn 891 Pandora Drive N.E. 571-4706
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 ❑X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 161 x 24. Sun Porch Addition [$creens Only)
9 CHANGE OF USE FROM TO
STIPULATIONS
Any wall of existing garage closer than 6 feet must be fire rated
(sh&trock) and door must be fire rated.
SEPARATE PERMITS REQUIRED FOR
WARNING WIRING, HEATING, PLUMBING AND SIGNS.
ire digging C89,10cal: utilities
tWpN0 . r&&kjC.' d'AS
Etc.
REQ fD 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 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
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
$4,800
$2.40
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-
$50.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$12.63
$65.50
ARIZEDAGENT (DATE)
WHEN PROPE VALIDATED THIS IS YOUR PERMIOF
WGIRE
BLDG hATE
OWNE F OWNER BUILDER) IDATEI •" --
NEW [ _I City of Fridley Effective 4/1/84
ADDN. [ �r�J000' tR-1 AND R-2 ,
ALTER. [ ] Building Permit Application
Construction Address: i�2a2 e2 eiy E
Legal Description: 1074 .?O , �i Lo eK �{ zj/eoo)�-/f erc) �'e"Z"oe P
Owner Name & Address: ���r2 J,�lf�/ Tel. # %/�`te -
Contractor: 5941-- Tel. #
Address: --
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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 Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot 00 Inside Lot[ ] // Ft. Yd. Setback Side Yard Setback
Type of Construction: Co'?" � r� V voo C Estimated Cost: $ o°
Approx. Completion Date: C4 MO. 00
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: 04M $ $
See Back Page for Explanation
DATE:�� � APPLICANT: Tel. # 15-71-
-CITY
5-%CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sever Main Charge
F ifr f .1 �!
Fee Schedule on Reverse Side
25$ of Building Permit Fee
$•50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
'4-A L ' 0�� 3W___S
t �.
SUBJECT
City of Fridley
2 500
AT THE TOP OF THE TWINS
BUILDING P E R M I T
Ir
NO.
i v -------COMMUNITY DEVELOPMENT DIV.��
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
L J"
NUMBER
REV
DATE
9/15/97
PAGE OF
APPROVED BY
612-571-3450
910-F15
JOB ADDRESS 891 Pandora Drive NE
I LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
30
4
Brookview Terrace 3rd
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Elmer Jahn 891 Pandora Drive NE
571-4706
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Dave Wiger Construction 901 Rice Creek Ter NE, Fridley, MN
55432 8293
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
572-8403
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
Reroof House & Garage (26 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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
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
$2,168
$1.08
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
PROVIS16N*r, OF ANY OTHER STATE %OR LOCAL LAW REGULATING CON-
$74.75
Fire SC $2.17
STRU ION OR THE PER RIA NCE OF CONSTRUCTION.
PLAN CHECK FE
TO L FEE
Lic C $5.
$83.00
SIGNATURE OF CO TRACTOR OR AU TNO IZED AGENT IDATEI
EN ROP VALID T
BCUCINSP
THIS IS W PERMIT
BATE
SIGNATURE OF OWNERoF OWNER BUILDERI IDATEI
NEW [ ]
Effective 1 / 1 /97
ADDN [ ]
CITY OF FRIDLEY
ALTER [ j
SINGLE
FAMILY AND DUPLEXES R-1 AND R-2 656d
BUILDING PERMIT APPLICATION
qp 9
ConstructionAddress:
Legal Description:
Owner Name & Address: �i,��
�%9`15��
Tel. # t?`
Contractor:
DA00 k) fGL
MN LICENSE# 5o9,93
Address: To( etcL
C'%z��i�' %T�,(�,c'
Tel. # 5-,76,7—cyW-C 3
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:
1
Construction Type:
Estimated C::n
���
(Fee Schedule on
Back)
Driveway Curb Cut.Width
Needed:
Ft. + 6 Ft = Ft x $ _
$
�5
`
DATE:
APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
41 Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ % , Oco)
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge-
$ S7.00
$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
$ ('�:. 00
s*nPULATIONS:
00
'
SUBJECT-
City of Fridley
' , �jTjm�T,L� THE TWINS
t
BUILDING
PERMIT
2 s 2 2 oo
O.
L5
1 `y ______ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
/ (�
r
l/ Qf1/
NUMBER
REV
DATE
PAGE OF
APVNOVED Br
i "'�•� CITY HALL FRIDLEY 55432
._-•�;
l 612-571-3450
910415
10/13/98
JOB ADDRESS
891 Pandora Drive NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
30
4
lBrookview Terrace 3rd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Elmer E. Jahn
571-4706
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 2U REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for kbuilding 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 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
1 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
1800
$. go
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
$56.75
Fire SC $1.80
PLAN CHECK FEE
TOTALFEE
59.45
S-G T E OF CO I' JOA DR A OmLED AGENT IDATEi
WHEN PROPER/3F VALIDATED THIS IS YOUR PERMIT
X4.NAT..E
OF OWN LDEp, iDATE,
BL G NSP
DA iE
I%
i
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
; AIDu,2,4
,G/ E -
Effective 1/1/98
Legal Description:
Owner Name & Address: J'ZW62 L�- o�,� #T/ Tel. #
Contractor: S-5'cF MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: efSeQ1 4A6 ,41,5f- Estimated Cost: $ dU `=-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: & - /3 — 9,P APPLICANT: Tel. # —5-71- zF76,
CITY USE ONLY
Permit Fee
$ 7 �o- %r
Fee Schedule on Reverse Side
Fire Surcharge
$ 1,80
.001 of Permit Valuation (1/10th%)
State Surcharge
$ qO
$.50/$1,000 Valuation
SAC Charge
$
$1000 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:
Building
PLUMBING
Permit No.: 6lVOU
Inspections
RESIDENTIAL APPLICATION
Received By_
763-572-3604CITY
OF FRIDLEY
n 'd 1
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE
YOUR E-MAIL ADDRESS
SITE ADD
�� G' /► �} r
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY
NAME: r✓
ADDRESS: � CITY STATE ZIP
OWNER/
A�
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # C. j -f -Ind EXP DATE �i e'
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
ADDRESS: 3 73 `'✓ CITY /yam STATEA&I Zl
INSURANCE
PHONE %!:�3 - of I'ci - - of C f- FAX AIJ - 4-Y ' Lc4, 6
PERMIT TYPE
DdSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
1 ❑ NEW P&PLACEMENT
DETAILED DESCRIPTION OF WORK Gro; �f` ► , lily
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINKILAV
DRAINS SHOWER _ WATER PIPING
_
_FLOOR _
GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35)
—BATHTUB
CLOTHES WASHER
_
KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREY. ($15)
_
_ DISHWASHER
_
_ LAUNDRY TRAY ,WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
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THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan
in theme' ase of all work which requires review and approval of plans_.
SIGNATURE OF APPLICANT /B i ��°' Z�'!� r v� PRINT NAME fG' ^�C ��" r' DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-5024977
Building
MECHANICAL
Permit No.: pL6� 4�
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
c
763-502-4977 FAX.
EFFECTIVE 1-1-08
DATE & -2-9 1 Q YOUR E-MAIL ADDRESS •e,19 e_c 1, l ri �a o I . c O rrl
-
SITE ADDRESS � gq G+ W -Q R
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: J ah n m &
ADDRESS: 9 Q CITY cl STATE ZIP55�f�y
L
OWNER/
TENANT
— u
PHONE:
CONTRACTOR
COMPANY NAME: Qyt BemelTQ�/I L
NOTE:
SEPARATE CITY
CONTACT PERSON:'e-
STATE LICENSE # EXP DATE
LICENSES ARE
REQUIRED
/ L
ADDRESS: PPL Dss��,,77(i( ky6n �� CITY STATEI,IW_1Pj5I
ANDHVORGAS
AND HVAC.
SUBMIT COPY OF BOND
(1/�(�
L ,.
PHONE I Vg- L4L2A- 7® FAX-(RO-4/3 1/265
AND INSURANCE
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW XREPLACE1,1ENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
OR
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: Cali r�m r MODEL(�p 'l K f 0 O-1 r 6 f 1 2-c simBTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_BOILER $35.00X( FURNACE $35.00 UNIT HTR $10.00
_GAS
CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00
_POOL
_DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00
PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 $3.00 = $
Stge = $ .50
Vurc
MINIMUM $15.50 MINIMUMtal = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a mechanical permit and I aelmowledge 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 esota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to
that the be ir&cordance
start without a permit; work will withlie approved plan in the case of all work which requires review and approval of plans.
l�
SIGNATURE OF APPLICANT PRINT NAME4_)0—+t r � f Ao W YIa l cbATE
APPROVED BY DATE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department j
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977