PRE 2010 DOCSi
BUILDING PERMIT
Village of Fridley, Minn. N.2519
DateG...... ..........................
Owner.:"".: .'' "�"" Builder ....... ...... ....
tJ
S ...: /: . ........�� Address
Address ,� � v�...................,......................
l LOCATION�� �rO- F BUILDING
No. .461 J .... Street Rvf!4 '. r
................................ Part of Lot ......................
Lot ....:,........... Block ................ Addition or Sub -Division ................ ......................
Corner Lot Inside Lot ....:°!...... Setback ... Sideyard ... dam.""
DES=CRIPTION OF BUILDING
To be Used as:
,okef'10,r.9"
...... r ...........
Front ........ Depth P^. I-- Height A A V ....
Sq. Ft.:..
.... Cu. Ft, ........
....................
Front ........ Depth ........ Height .........
Sq. Ft....
.... Cu. Ft........ .
Type of construction
�"'��.' .
Fit. Cost f�s:l++�� .�R.°1°�...............
To be Compl
-0//ol`?� �
In consideration of the issuance to me of a permit to construct the building describe 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 village of Fridley.
_ r
In consideration of the payment of a fee of $, . , permit is hereby granted to
'to construct the buil • .
ding. addition as described above. This tis granted upon
- the rens condition that the person to whom it is granter} 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 moving of buildings with-
in the village limits and this permit may be revoked at any time updnviolation o any of the provisions of said
ordinances.
.. .Cd+ . ..... ding Inspector
NOTICE:
This permit does not cover the construction#. installation or alteration for wiring, pli imbing, gas heating,
sewer or water. Be sure to see the Building, inspotor for separate permits for, these ite me.
Y. a,
City of Fridley 52-84-915.51
Application for Pigg and Gat Fitting P mk
Dept. of Ridge. Phone 9®04440
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures 6435 NE. Pierce S t.
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... _ x $1.50 $
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater :Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg. ....... .
Electric Water Heat ..............
GAS FITTING FEES:
1st 3 Fixtures ............... .
Additional Fixtures ................. .
Gas Range to 199,000 BTU.. . — .......
install (1) gas grill & (1) lite
REPAIRS B ALTERATIONS—Refer to Code
x $3.25 $
s $2.00 $
NO. RATE TOTAL
2 x $2.00 ; 2.00
x $ .75 $
x $5.00 $
6.00
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that al& the fact
and representations stated in this application are true and correct
Fridley, Minn Julv14, 1971 , 18,
Owner Leonard Bergman
Kind of Building frame
Used as residence
To be completed about July 19 r 1971
Estimated Cost, $ 20.00
Old New. Building Permit No. Permit No.
By • -
Business Ph a No
ROUGH
Description ...............................— ............. $®AeA
(�l$�5 Surcharge .50('
TOTAL FEE $ 8.00
MINNEAPOLIS GAS Gp,
ol V
1
g"
FFF
$c
X73
` 3
V
�AS
Is
is i
v
•
e
WATEN MTA.
ELEC.
Base
1st
2nd
3rd
4th
• ]PUN r• Coan•elloa Openiage
e Now Fixture. Old Openings
_
Connected with
Sewer
campool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... _ x $1.50 $
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater :Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg. ....... .
Electric Water Heat ..............
GAS FITTING FEES:
1st 3 Fixtures ............... .
Additional Fixtures ................. .
Gas Range to 199,000 BTU.. . — .......
install (1) gas grill & (1) lite
REPAIRS B ALTERATIONS—Refer to Code
x $3.25 $
s $2.00 $
NO. RATE TOTAL
2 x $2.00 ; 2.00
x $ .75 $
x $5.00 $
6.00
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that al& the fact
and representations stated in this application are true and correct
Fridley, Minn Julv14, 1971 , 18,
Owner Leonard Bergman
Kind of Building frame
Used as residence
To be completed about July 19 r 1971
Estimated Cost, $ 20.00
Old New. Building Permit No. Permit No.
By • -
Business Ph a No
ROUGH
Description ...............................— ............. $®AeA
(�l$�5 Surcharge .50('
TOTAL FEE $ 8.00
MINNEAPOLIS GAS Gp,
O
SUBJECT
P
City of Fridley
27280
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RIMIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
`
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
18/19/98
108 ADDRESS
6435 Pierce Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt. 15 P134
lAud. Sub. #88
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
L. Bergman
55432 574-9266
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
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ak REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house (10 S 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
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
$834
.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.
$32,00
Fire SC .83
PLAN CHECK FEE
TOTAL FEE
3 3
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE,
E PRO
VALIDATED S IS YOUR PERMIT
k!!
SiGNATUR OWNER qF OWNER BUILDERI IDATEI
DG INS
PATE
O
Ij 51:1
ADDN [ CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 3 S—
-��e•�—
Legal Description:
Owner Name & Address:
Contractor:
Address:
Effective 1/ 1/98
53()6
Tel. # -:1'7'Y- i 2, G' q
MN LICENSE #
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
GARAGE AREA: Length Width Height
DECK AREA: Lenwh Width G
OTHER: . �� Imoi R'�� //I it
,
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: J I � 7
Tel.# -57 `t`- 72- 44
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost: $ '023 Y, 04,
(Fee Schedule on Back)
Ft x $ = $
APPLICANT: Tel. #
. STIPULATIONS:
CITY USE ONLY
Permit Fee
$ 2, 6Z)
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , JPO
$.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 [ ]
37,33
TOTAL
$
. STIPULATIONS:
suelEcr
ERMIT NO.
City of Fridley
27448
AT THE TOP OF THE TWINS
BUILDING
PERMIT
' ,
PT NO.
i
______ COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
j 612-571-3450
910415f'
8 28
98
JOB ADDRESS
6435 Pierce Street NE
1 LEGAL
LOT NO. Par.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt.1f 134
Aud. Sub. #88
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Mrs. Leonard Bergman
574-9266
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
North Central Builders Inc. 7401 42nd Ave N New Hope MN
55427
533-6168
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 jj�c REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Repair siding on house and Rarape
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building 11wrap inspection before covering.
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 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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2000
$1.00
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.
$62.25
Fire SC $2.00
PLAN CHECK FEEL
FEE
License
5.0
0.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
E PRO
B G INSP
VALI
D THIS IS UR PERMI
DATE
SIGNATURE OF OWNEROF OWNER BUILDER) IDATEI
I }
NEW [- ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Effective 1 / 1 /98
Owner Name & ddress: J Tel. #
Contractor: MN LICENSE # ,j'Jlo 3
Address: /''�L� /. ! /� vel. /�i /�/Leld s" DB,. �IIV SS�a �f Tel. # 5733 –6146f
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPRO MENT
LIVING AREA:
Length �C id"th / /L Height S . Ft.
g g q
GARAGE AREA: Length Width Height Sq. Ft. _
DECK AREA: Length Width Hgt/Ground Sq. Ft.
/ —
OTHER: -44Z
s
CovP.�r marl. fit'S/ls,�..c q..
11µ fast;
Constructio Type: Estimated C
(Fee Schedule on Bank)
Driveway Curb Cut.Width Needed: Ft. + 6 Ft = Ft x._ $ _ $
DATE: APPLICANT: Tel. #,!5'53 - b/6f
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ J Not Necessary [ ]
Building
PLUMBING
Permit No --U D (o
Inspections
RESIDENTIAL APPLICATION
R •
O�A
763-572-3604
009
CITY OF FRIDLEY
D ate
763-502-497��7AA FAX
EFFECTIVE 2-19-09
min
DATE YOUR E- AIL ADDRESS
SITE ADDRESS „l J e1,�.V� L� n .
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME:
OWNER/
TENANT
ADDRESS: CITY STATE ZIP
PHONE:
CONTRACTOR
NAME: IAP4 allfflNfifnG,
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
".= �� CITY d— STATE Ill ZIP- -2-
ADDRES'Sn A-110 .
INSURANCE
- i ,,
PHONE - UV')0
l.�« UNCI FAX
PERMIT TYPE 1,05INGLE
FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
_ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
_ _
BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL SOFTNER($
—WATER
CLOTHES WASHER —KITCHEN SINK WATER CLOSET PREV.$1 )
—BACKFLOW
DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_ WATER METER —OTHER
0 1
v � �
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
l• tio
not a permit but only ann for a permit and work is not to start without a permit on site; that the work will be in accordance
he work will be in accordance
lans.
the approved plan ie c e off all work w h requires review and approMI'AQ/
SIGNATURE OF APPLIC "&^Oa - PRINT NAME DATE IO
�
L' t t Mt w t - r
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
3-� P
Building
TOTAL JOB VALUATION $
BUILDING
OCCUPANCY TYP
Permit No. 66 7
Inspections
See Back Page for Fee Schedule
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
CITY OF FRIDLEY
Date Rec'd:
763-502-3604 FAX
SAC Charge
It
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
EFFECTIVE 1-1-2010
Erosion Control
$
DATE /
2
®` YOUR E-MAIL ADDRESS T
/��� n "
0l/a@ J /^r VVF , Cy rt^
SITE ADDRESS x/ r
dir/�- t 6T %�otwi mo
$
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
$ . ®
PROPERTY OWNER/
NAME:_ raiW'Q t il' .'WL iCo£/✓r6-
TENANT
ADDRESS: (e tL 3 r p/ wa _ CITY
b60 -i4 / STATE i"NZIP 6-1'/3 i.
PHONE: '763 -5 ->f37 -
CONTRACTOR
NAME:lZwo i1*T.
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSER ?06 3 do 3 6
EXP DATE4(3//X/-A
AND CERTIFICATE OF
ADDRESS:
CITY AWOO-V_ STATB'HAJ ZIP C'
INSURANCE
-53
PHONE FAX 7G 3 576 --09J3—
PROPERTY TYPE
PKSINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCE/REPAIR %REMODELING
DESCRIBE WORK BEING DONE: £
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
'I`
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES q
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
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
I . Site Plan/Survey showing the existing structures
❑ Other
❑Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
-
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATE LS: o�
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
OCCUPANCY TYP
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
It
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ . ®
Make checks payable to: City of Fridley Attach Stipulations
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 on site; that the work will be in accordance with the
approved plan in the case of all vyo whichre�� d approval of plans.
��� 6
SIGNATURE OF APPLICANT //� PRINT NAME 1 L • DATE If WAY 'X16