PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT o :49:0j)
Af
Date: ""w .. ice'
.
Owner: ._ _......e...._..... _..�.. .... .. _ . _....... .. _ " Builder _.._..._._._._... _....
Address .._ ,_ _. Address ___ ._..._ ___.. .._. ... .._.w_..._...__._.___....._.....__._._
LOCATION OF BUILDING
No........ Street _......_..... Pari Lot ..---
Lot .._... ..... Block .--------.-....---------.. Addition or Sub -Di i - -•---....... � . .., __. ....- ....._ ..........._±_._....._.....
'
Corner Lot .......................... _........ Inside Lot... ... Mtback . ..... -..... Sideyard ....._..... .._.__.---.
Sewer Elevation ................. F ation Elevation .................................... _._.....
DESCRIPTION OF BUILDING
To U as- ,
�+ Front ..,._.. Depth ._ —Height .�%.._.. Sq. Ft. Cu. Ft. _
_............ .._..............................ont... _............. ... Depth ............. Height Sq. Ft......_............._.. Cu. Ft.......................
Type of Construction... .. r�... Est. t... ... , .----------------- To be Completed ............. ....... _.........................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $....7--=.., permit is hereby granted to.. ........... ..... .............................
..._._..
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon yiolation o)any of the provisions of said
ordinances. .r° --V7 //
Building 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.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIZY, KDWSOTA
Owner's Names • Builder
Address Address
LOCATION OF BUILDING
No. Street /�9/���'d9% Part of Lot.
Lot .�� $lock _��� Addition or Subdivision
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.
DESCRIPTION OF BUILDING
To be d ass
��/
s �
Sq. Ft. ,1 , Cu. Ft.����
Front Depth Height
Sq. Ft. Cu. Ft ev 04
Type of Construction Estimated Cost
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representations
stated in this application are true and correct.
DATE SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
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SUBJECT -
PE
City of Fridley
4093
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
L _.____ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 `�
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
/'•'1 CITY HALL FRIDLEY 55432
�'� ,'�
"'• 612-660-3450
910-F15
5/19/77
JOB ADDRESS 212 Panorama Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
12
3
Carlson's Summit Manor South SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
William Merry 212 Panorama Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Homeowner's Service Co. 5942 Kentucky Avenue North 535-4581
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 l REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling, Reside Dwelling and Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
$4,000
$2.00
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-
$24.00
STRUCTION OR THE PERFORMANCE OF NSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$26.00
SIGNATURE OF CONTRACTORORAUTHORIZEDAGENT 1 AT
WHEOPERLY VALIDATED THIS IS YOUR PERMIT
s
)NSP
SIGNATURE OF OWNER I IF OWNER BUILDER) (DATE)DATEBLDG
CITY OF FRIDLEY,
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OW14ER: O
Address:/?✓ CvYi.O'`LCL4tc� C
No.: 2,12,--" Street • lJ G
BUILDER: &U k 6el/%
Address:
Tel. No.
LOT: � � BLOCK: _? ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
a- rFront: Depth: Height:
. Square Feet: Cubic Feet:
Front: Depth: Height:
Square eet: Cubic Feet:
Type of Construction:
To Be Completed:
ll//
Estimated Cost: $ TODp
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 information.
DATE: i �IF %-7 SIGNATURE:
Stipulations:
0
L.
3rd
3200 FRANCE AVE. S0.
STREET
N.E.
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ROMAN
I hereby certify that the above is s survey of Late One (1) through Twenty (20). Block
Three (9)..CAWQN'.4.S11MT MANOR SIOUTH ADDITION. Anoka County. Minnesota. shoving the
100etion of the houses on said lots.
As surveyed by me this 18th day of April 1955 A. D.
Minnesota Reglatration No. 2KBb
ROAD
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SUBJECT
P. IT NO
City of Fridley
4 -_ 17 4 8 0
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R EIPT NO.
may_______ COMMUNITY DEVELOPMENT DIV.
r -I PROTECTIVE INSPECTION SEC.
ly
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L J\ 612-571-3450
910-F15
5/4/84
JOB ADDRESS 212 Panorama Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
12
3
Carlson's Summit Manor south SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
William Merry 212 Panorama Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Western ConstrucCion Co. 5353 Wayzata Blvd., Mpls. 546-3385
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
=1 Construct a 24'.x 28' Detached Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
r'Yi I
�- , ( l
d t Lppr SEPERATE PERMITS
REQUIRED FOR WIRIN
{ HEATINC, PLUMBING AND SIGNS.,
.;
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
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
$� 533
$3. %%
WITH W SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES OT PRE E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
CAL LAW REGULATING CON-
PROV MONS OFA OTHER STATE?,CC
$68.50
STRUC R THE FO NSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
(�\J (®(
$72.27
SIGNATUREOFCO RACTORORAUT EDAGENT (DATE)
WHEN PROPERLY LIDATED THIS IS YOUR P RMI
CE
19
BLDG PIP OVE
SIGNATURE OF OWNER IIF OW BUI LDERI IDATEI
NEW [�
ADDN. [ ]
ALTER. L ]
Construction Address
Legal Description:
Property Owner/Address
Contractor:
Address: 9,3E
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
City of Fridley Effective 4/1/84
�R-1 AND R-2
Building Permit Application
C
M
Attach to this Widication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Height
Hgt/Ground
Tel. #
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback
{�]
Type of Construction: 1 '% Estimated Cost: $ _�z
000
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
Tel. # ��- 33�
g
DATE: T 7 APPLICANT:
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY
$ 68 . S -Z'
$ 17P.a i
STIPULATIONS•
A- OP19,6 Z;, 2GA2E
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary L ] Not Necessary [ ]
d?, L)(tw
Building
NIECHANICAL
Permit No.:W [0-H I W
Inspections
RESIDENTIAL APPLICATI®N
Received By:
763-572-3604
CITY OF FRIDLEY
c'
763-502-4977 FAX
EFFECTIVE 7-1-2010
DATE '-I- It-- YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER SCONTRACTOR
PROPERTY
NAME: al n ti
OWNER/
ADDRESS: 011 A 1L ✓1 @ P -t to w- CITY F P -t A (� � STATE"O ZIP 554 -1
TENANT
TE
C
PHONE: 9 Sol-- Y 6.1 -. 8 0 YC -
CONTRACTOR
CONTRACTOR
C
COMPANYNAME: S�
CONTACT PERSON: C In r aipj o
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: Fa -T0 tj(s(:, Ne CITY EAi!l STATEH"ZIP 0,14-,
APPLICATION
PHONE 1-k 3 1514 021 FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW EPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK --rn��va l ( i2�� t��4�� Fc, �+�+Q�. �sv►P��E�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALCIS PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: 12..E v MODEL: V& Jeri D 6 L rV A atS SIZE/BTU (& 0 0 V v
MFG: a, u +G MODEL: t/A P'rl d ak(J A "L ifru Q TO n
MFG: MODEL: SIZEBTU
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 $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
_DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
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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 permit 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 requires review and approval of plans.
SIGNATURE OF APPLICANT Q PRINT NAME G. t e .1 DATE_j - 1 S 1
APPROVAL INSPECTORS SIGNATURE DATE �7
;q : xl'i^",,.M, -AIE, ..,µ 4 ,,<Di..iZ;-L/LDI:L?\`i.,g ,�A✓+u:.£ r �..
�. City ®f Fridley
tlaliding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977