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PRE 2010 DOCS1 City ®f Fridley, Mann. N° BURDING PERMIT Date: OCTOBER 202 1965 Owner: DONALD F. SEXIER Builder SEXIER REALTY Address 3600 France Avenue North Address Same Minneapolis 22, Minnesota LOCATION OF BUILDING No. 5740 Street Polk Street N. E. _ Part of Lot Lot 1 _ Block 2 Addition or Sub -Division Sexter Addition Corner Lot __X______ Inside Lot _ . Setback 32' Sideyard 10' Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING 8551 To be Used as: DWELLING Front 34' Depth 25' Height 20' Sq. Ft, 850 ctL Ft, -!Z..,000 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. CostTo be Completed In consideration of the issuance to me of a permit to c the building described above I agree to do the proposed work in accordance with the description above forth and in with a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 17 . 0 0 , permit is hereby granted to SE=R REALTY 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 limi d t regarding location, construction, alteration, maintenance, repair and moving of buildings withi nthe t3' permit may be revoked at any time upon violation of any of the provisions of said ordin ALLEN G. JENSEN . Building Inspector NOTICE 'llda pont doss not serer the eendmefion, Inatdlation for whing, phnnbing, gas heating, ewer or wafer. Be acre to as the Bundles hmpeftr for apwab pwinita for these hems. x � _ r OWNER'S NAME APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA DONALD F. SEXIER S EXT E R REALTY 36UU France Avenue NOrtn VWww 1 IMII1 . TlV\ l C IN. ADDRESS MINNEAPOLIS 22, MINNESOTA ADDRESS MINNEAPOLIS 22, MINNESOTA LOCATION OF BUILDING NO, 54Z4() PnI1C PART OF LOT LOT_ l _ BLOC'K ADDITION OR SUBDIVISION qpy -pD Aricl i j;1 nn CORNER LOT -Y INSIDE LOT_ SETBACK t SIDE YARD ],C SEWER ELEVATION FOUNDATION ELEVATION 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; One family dwe'lliag Front X4.1 Depth__2,5 f Height1 l s .0rV Sq. Ft. 850' Ist floor Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction wood. frame Estimated Cost i -�— To be completed` May 1, 1966 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. r1 _ DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley SUBJECT ! 15175 AT THE TOP OF THE TWINS UI BUILDING f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ®� 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5779 JOB ADDRESS 5740 Polk Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. ] 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Louis Adams 5740 Polk Street N.E. 3 CONTRACTOR MAILADDRESS 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 x 8 DESCRIBE WORK construct a 22' x 24' Garage 9 CHANGE QF USE FROM T � IRA skjolma STIPULATIONS g cigg IW8f Provide a hard surface driveway. dh%lft rad � uju • ELECT41C � 0/4 r QUIRED BY LAW. SEPERATE PERMITS REQUIRED FOR WIRI , HEAVING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Frame 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 $4'419 $2021 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- $21.12 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $23.33 SIGNATURE OF CONTRACTOR ORAUTHORIZED A NT (DATE) WHEN PROPERLY VA DATED THIS IS YOUR PERMIT 11 I , d C SIGNATURE OF OWNS OVUNFR Sl ERI I IDATEI +BLDG )NSP DATE PI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS ANEW, ALTERATIONS, /ADDITIONS,' OR REPAIRS) OWNER:�� BUILDER: Sc�' J Address: 5' 0 PAddress: VV (T, Tel. No. No. Street: IAT: I BLACK:_ ADDITION: c � CORNER LOT: INSIDE IAT: SETBACK: SIDEXARDS: (b 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: & r7.,, Front: Depth: �� Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: VW Estimated Cost: $ To Be Completed: nL a Pi 1::4 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired �° $ $ (SEE RE -VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the wort: 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 ad itional informatio . DATE: Sei® �%� SIGNATURE: Stipulations: X3,3 � �, 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE (.612)571-3450 Mr. Louis Adams 5740 Polk Street N.E. Fridley, MN 55432 Re: Final Inspection on Electrical Work - 5740.Polk.Street N.E. Dear Mr. Adams: The final inspection was made on April 4, 1980 on the electrical work done at your address. It was noted that the following violation existed; All receptacles in a residential garage must be either of the ground fault type or protected by a ground fault circuit breaker. Your garage has neither. This must be corrected within 30 days and a reinspection called for. If you have any questions on this matter, please contact me at 571-3450, between 9:00 am and 10:00 am any weekday. Thank you, LEONARD EICHMILLER Electrical Inspector LE/mh SUBJECTNO. City of Fridley 2 9 0 3 6 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. "-- f � PROTECTIVE INSPECTION SEC. 1 � i 1"'1 CITY HALL FRIDLEY 55432 "L.— 1.� �'' NUMBER REv DATE PAGE OF APPROVED BY 612-571-3450 910415 3/22/99 JOB ADDRESS 5740 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Louis/Loretta Adams 5740 Polk Street NE 571-6328 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 O ADDITION O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof Dormer - storm damage (1/2 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underla.yment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $.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 SACC RGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. 21.00 Fi SC . 50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT L FEE 22.00 SFCON'AACTOpORA_i;IGNATU T IDATEI NEN R VA IDA NISI OUR PERMIT SIGNATURE OF OWNER I WNE SUILOERI IDATEI INgP BATE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION J �U ConstructionAddress: ;rte Z% �% ' �� % ! 17` Legal Description: Owner Name & Address: /ee4i 5 al�a� /-e�- Tel. #5— Contractor: 0 e4-117 _MN LICENSE # 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 GARAGE AREA: Length . Width Height DECK AREA: Length WWth Hgt/Ground OTHER: �- Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = le CX/" 7qt6W" Estimated Cost: $ Tel. # Sq. Ft. Sq. Ft. Sq. Ft. ��0 ejv (Fee Schedule on Back) Ft x $ = $ ArtLICANT DATE: . -'--' Tel. # TOTAL $ 2,2 QC) STIPULATIONS: CITY USE ONLY Permit Fee $ 6 Fee Schedule on Reverse Side Fire Surcharge $�; b .001 of Permit Valuation (1/10th%) State Surcharge $ .$.50/$1,000 Valuation SAC Charge $ $1050 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 [ J TOTAL $ 2,2 QC) STIPULATIONS: v MI sue.,ECT PERUFridley1023 City of � AT THE TOP OF THE TWINS BUILDING PERMIT i ►v COMMUNITY DEVELOPMENT DIV. ______ f PROTECTIVE INSPECTION SEC. 30 i Ij CITY HALL FRIDLEY 55432BER pEv DATE PAGE OF APPROVED BY ---. ....... L 612-571-3450 r'910-F15 6/6/00 JOB ADDRESS 5740 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Louis Adams 5740 Polk Street NE 763-571-6328 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 p ALTERATION IR REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (25 Sq) Tear -off; Reside dormers 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building 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 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 $ 2,715 $1.36 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- Fire$2.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 "SC PLAN CHECK FE TOTAL F E /if/ $8/.33 5O uATU E OF CON'RACTOR OR UTNORiZED AGENT IDATEI a EN AL1 AT IS IS Y R P IT BLDG NSP 9RZ �� BATE SGNA q A U' OWNER BUILDERI DATE- v MI 7,1-47Z� ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �� 7 el J Legal Description: Owner Name & Address: Effective 1/1/2000 (763) 572-3604 BI" Insp� ofle Tel. # 7X -T Contractor. 19 LA ) /m � C 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: Ae r Construction Type: �'rS�ri� IQ®r �r Estimated Cost: $ -�5^ao - O e, Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ /I DATE: 6 — — 6 O APPLICANT: I-01-, P"-�r Z At S Tel. # SX 4c, -o 1"e / / - 1,PL -5 CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ 7 .001 of Permit Valuation (1/10th%) State Surcharge $ /s $.50/$1,000 Valuation SAC Charge $ $1100 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: $ A-7-33 �l 17 SUBJECT _ - PE City of Fridley AT THE TOP OF THE TWINS BUILDING PERM 32520 r � VV COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO. NUMBERREV 910-F15 DATE 4/22/02 PAGE OF APPROVED BY r joB ADDRESS 5740 Polk Street NE I LEGAL OESCR. LOT NO. 1 BLOCK 2 TRACT OR ADDITION Sexter Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Louis/Loretta Adams 5740 Polk Street NE 763-571-6328 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 O REMOVE 8 DESCRIBE WORK Install egress window in basement- enlarging opening 9 CHANGE OF USE FROM TO STIPULATIONS Window to comply with State Egress requirements. 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ZONING f SO. FT CU FT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISION,$ OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $600 SURTAX $.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PERMIT FEE $26.55 SAC CHARGE Fire SC $.60 PLAN CHECK fE OTAL FEE $;Z.65 SIGNATU EOFCON'RACTORORA TNOA�ZEDAGENT p+5� tDATEP NP OPERL IDATED HIS IS YO PERMIT IDI FIATS J S,GNATURE OF OVONER,IF OWNERSURDERI iDATE, �l 17 NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 57— a Legal Description: Owner Name & Address: Tel. # 763 S -71 _w' &;V Contractor. MN LICENSE # Address: Tel. # 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 Length ,r Width Hgt/Ground SS Sq. Ft Sq. t i A/J/�� Construction Type:®��r�a-i�/ Estimated Cost: $ �� moi' b Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: ��`" a' a� , ® APPLICANT: /��L / Ado all (763) 572-3604 for Permit Fees if mailing in application or Fax to 7631571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1200 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 $ ®t �� STIPULATIONS: Tfi _ a„ SUBJECT ."". City of Fridley 33489 AT THE TOP OF THE TWINS BUILDING PERMIT r F • ' _____ COMMUNITY DEVELOPMENT DIV. is � PROTECTIVE INSPECTION SEC. r � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 5/2/03 JOB ADDRESS 5740 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DIE 1 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Louis Adams 5740 Polk Street NE 571-6328 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 O ALTERATION D REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 15' Deck; 16' x 15' 3 Season Porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNMG SEPARATE PERMITS Before digging can for EQUIREU all aity location WIRING TIG oo� PLUMiNd AND giftS REQUIRED BY LAW 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 $11,749 $5.87 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE $226.87 SIGNATUR OF CONTRACTOR OR AUTHOREO AGENT IDATEI EN PROPERLY VALIDATED THIS IS,>ep R P FjM IT 1 fE SIGNATURE OF OWNER,IF OWN R UILDERI IDATEI I,& NEW [ ] ADDN [ ] ALTER [ ] Construction Addre Legal Description: CITY OF FRIDLEY Effective 1/1/2003 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Owner Name & Address: /Lo co, 15 1 ® cam ." r Tel. # 2Z ,6.3 2 Contractor. 1) W til _ r MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: .3 S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length I Width Height I Sq. Ft. Length Width Height Sq. Ft. Length 16 , Width Hgt/Ground Sq. Ft. Construction Type: `% e -J &)60A Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - n r d APPLICANT: Ali v,- 41LAA Tel. # 2k3' L 7 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $�9 Jam' $ 6,R7 $ TOTAL $ OQ 6 1 R CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] L LondPlanniny / 075-llr9hnoy sGs v.E. LOd St.r•vpying l • Mrnrxuftilis 3 Z. so,ls Tesmy ENGINEERING, INC. ,t'nncs�f° Gvrl & Manicipal SUn)ef 4406n 67j,menn9 Engineers E Sur vectors certificate Of surve For SEXTER REALTY e � H,4Coy V,4NN 4 YE: �s b SCAT - E x..40, o • DENOTE'S IRON 1_�. S Loo 11A, 4� 1 � . O` i 0� 3Z &AZ -2"Z W Lot 1, Block 21 Sexter Addition. /herby cerii ry #wl Ibis a a bw and tormcf -epremala ion o/'o survey 40fhe bwndor;es �'& ahm- daac ed /and, end f /aAw 0 '01! bra/dr q5, &mon , a -d oll risible eixrnvchmenb , r!•arx� , �iZvn or ave roil /and. As surveyed by aw 1/us- oby 9� Fcbr�l ary AD 15 65' SUBURBAN ENGINEERING, INC. • Cngineers E Sgr-reyons .cru., vV �j;Vv xc�AO Y- 'tBf0.xa�O WO •. 00'()U- 0:; do �wOM ;0 �s00 paT :ttsg �i�o�.;o.:T383 Building MECHANICAL Permit No.: �: ti Inspections RESIDENTIAL APPLICATION Received By: ' 763-572-3604 CITY OF FRIDLEY DatR"dMARMAO 9r( 763-502-4977 FAX EFFECTIVE 2-19-09 //�` DATE 3 L0 V YOUR E-MAIL ADDRESS t C e a. n rl a v(a)c, u e S+—v -P-Fi e- SITE ADDRESS 5% Ll Q d ( je-THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: Ln (l S /� C� �t ms P--2IP SS ADDRESS: CO- -[ y 0 ">t) l le— S;- CITY I OWNER/ TENANT . �STATM PHONE: & CONTRACTOR COMPANY NAME: CONTACT PERSON: r SUBMIT A COPY OF 2-P YOUR STATE STATE LICENSE # A9 3 % 0 v EXP DAT-E,, LICENSE WITH L J �L� �/ ADDRESS: OtJ S -7 7�1.'/ 1 o i% PKW (a ftCI ll CGS UUet� STATE,j/�IP S� APPLICATION PHONE (0 3- -1 S14 - Lj 000 FAX -1 Lo 3- `-1 S14 - v 13 a PERMIT TYPE 01 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCPRTION OF WORK p la e� .D x 1 •r�.� r�-.. a.�� t,.� 1nee r• �n FEES ARE BASED ON $10.00 PER FIXTURE, F. WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) TT Equipment Installed MFG: K Y1If -e MODE SIZF/BTU -7S-4 D 00 MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU _A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _ _BOILER $35.00 X_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 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ r Number of fixtures @ $35.00 / x $35.00 = $�� State Surcharge = $ .50 MINIMUM FEE $35.50 Total = $ ,3e�— 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 t of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for e t work is not to start without a permit; that the work will be in accordance with the approved plan in the case of al work Ic es review and approval of plans. /� / SIGNATURE OF APPLICANT T NAME (i�P�/'/ it U /Oy bAfAeAL- DATE i�~! (O -6 PLEASE NOTE: SE TS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK / U City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Permit Fee BUILDING Plan Review Permit No.• ,Q Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY Date Rec'd: _7tz-3 763-502-4977 FAX $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review EFFECTIVE 1-1-2010 $ Fee Determined by Engineering DATE / / A YOUR E-MAIL ADDRESS Agreement necessary ( ) Non Necessary ( ) SITE ADDRESS 5% ® O ry e r $ THIS APPLICANT IS. ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: d /1 1 -� TENANT ADDRESS: 3? 'Yo C9 ( / sS' .• CITY "�Y STA_qE IP � S / PHONE: :7 It — CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # / EXP DATE AND CERTIFICATE OF *� ADDRESS: J �j �e �g "� CITY�7f _4QW S 1`iTATE/04?ZIP -"!r� INSURANCE PHONE Cl e2— ® V l FAX PROPERTY TYPE OXINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ ❑ DgRAIN TILE ° DECK ❑ SIDING 0110 R " ❑ SWIMMING POOL +�� TYPE OF WORK: HOME CONSTRUCTION ❑ ADDITION MAINTENANCEIREPAIR ❑ REMODELIN DESCRIBE WORK BEING DONE: YAW– I_1 -Q �Q 0 # —, 2 •R �10"Q SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES O HOUSE ONLY ❑ HOUSE & GARAGE EASEMENT REMODELING SUBMIT: l . Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: IDING 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. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS es ❑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 MATERIALS: (USING THE, 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE 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 $ $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 $ '% `7 , Make checks mavable to: Citv of Fridlev Attach Stimulations 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 codesWthif Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a p rmit not to start without a permit on site; that the work will be in accordanc with the approved plan in the case of work ich rew and approval of 71s. 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