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City of Fridley, Minn. BUR DING PERMIT N® 3326 Date: ............................. Owner ...... Builder .. .. . �:...... Address ...................................... Address ............................................. ,LOCATION OF BUILDING 0 No. .:....mac..... Street ................. Part of Lot .... ®............. ...... Lot .... . Block . �.... ddition or Sub-Pivision�.... ...... . Corner Lot .......... de Lot ...:........ Setback .. ... Sideyard .. ..... ........N....... DESCRIPTION OF BUILDING To be Used as: a .r %Iak..... Front 31. .. Depth Height ........ Sq. Ft. .. : � cu. Ft. 17. .................... Front ....... Depth ........ Height...... V 0 Sq. Ft. ........ Cu. Ft . Type of Construatio ....: , ..:5..... let. Cost.. AB ... �.....-77"Fo be Completed . L�.. .....:... . a In consideration of the issuance to me of a permit to construct the building desribed 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 $�b1..:- ...., 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, employee 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �4 .. ,... Building Inspector t� c NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items ication far Power Plan and Hearin Cooling, Ventilation Refrigeration and APPI '� 9. 9. ge Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL Location 6350 Quincy Me Furnace Shell & Duct Work ...........:.............. 8.00 Replacement of Furnace ............................. 5.00 Repairs & Alterations—up to $500.00 .................. 5.00 Repairs & Alterations each add. $500.00 ............... 2.50 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 each add. 60,000 BTU ....................... 2.00 Replacement of Furnace ............................. 5.00 Repairs & Alterations—up to $500.00 5.00 Repairs & Alterations each add. $500.00 .............. 2.50 STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 Each add. 200 sq. ft. EDR Steam ...................... 2.50 Each add. $20 sq. ft. EDR Hot Water .................. 2.50 OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ •00 GAS PIPING (Vp to 3 Fixtures) .......................... 1.50 1950 (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARKS: $ See Fee Schedule $ TOTAL FEE $ 14 • 5 0 City of Fridley: 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. Owner Fridley, P inn NO'V • 79 , 195 Joe Maciaszek 195..._ Kind of Building Frame 195— Used as T)WIM114 nj To be completed about January 1958 Estimated Cost, $ $ 500.00 Old—(Nevoouilding Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, (Warm Air—)No Trade Name 'Perfection size No- 100DXN Capacity 100M Sq. Ft. E.D.R BTU loom H.P. Total Connected Load 339195 Kind of Fuel_ Gas BURNER — Trade Name Size Capacity Sq. Ft. E.D.R BTU H.P. S By PERFECTIOM PE,�TING COMPAMY, lNIC 11 POST 1M-8-58 Busine$gAXQAyk.. SO •s TA- -1-528Z MINNEAPOLIS 4 MINNESOMW ems-' HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS►„�3 Village of t Weatherstrips Guide Guiddee Construction No. Insulation Windows I Doors Reference Out. Wall Int. Wall Ceiling Roo£ Floor Kind How Applie I Yes—No Yes—No 19_ Room I Leniath .1.r7 Widt s�a- Heiaht OrII /FII Rrnm I l m.th 4 Width t �HeiQ)ftt Windows and oors—Crackage Ad Area Width Height No. of Lineal ft. No. of pane of pane lights of crack Area sq. ft. ax f� Coef. Btu LO ,Coef. Btu Infiltrations id® a 0 Glass Glass Glass. Glass`,+ Exp. wall Exp. wall - aJq Net exp. wall Net exp. wall Net exp. wall ® tj// Int. wall (� Int. wall Ceiling Ceiling .-. Ceiling Floor / 3 � G ;j .7 i+ Total Btu. 1 - 4D -4 4 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 ,%° Room I Length 5 Width ,/,/ Height Sr Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ax f� Coef. Btu Infiltration ,� Coef.1 id® a 0 Glass g' Glass. Glass`,+ Exp. wall Exp. wall - aJq Net exp. wall Net exp. wall tj// J (� Int. wall Ceiling 5,11-1 .-. Ceiling 12t / 3 Floor Ceiling 7 ( y 0 Total Btu. I - �- Required sq. ft. E.D.R. or sq. ins. W.A. Leader area JFlA 7 Room I Lenitth 7 s- Width e. Height d Windows and Doors—Crackage and Area Width Height No. of No. of pane of pane lights Lineal ft. Area of crack sq. ft. f� Coef. Btu Infiltration ,� Coef.1 Btu Infiltration Glass' g' Glass. Glass`,+ Exp. wall le - aJq Net exp. wall to Int. wall I /. Int. wall Ceiling 5,11-1 .-. Floor 12t / 3 I otal Btu. 2- 0 f Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of _Lineal Lt. Area No. of pane of pane lightsofcracksq. ft* fir J� �r f� Coef. Btu Infiltration ,� (-ge Glass' r� Glass. Exp. wall - aJq Exp. wall Net exp. wall I /. Int. wall 5,11-1 .-. Ceiling Floor Ceiling o Total Btu. Required sq. ft. E.R.R. or sq. ins. W.A. Leader area Room I Lenath 47 Width j i.. Heiaht .v” Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. fir J� �r f� Coef. Btu Infiltration ,� (-ge Glass r� Glass. Exp. wall Exp. wall Net exp. wall Net exp. wall Int. wall 5,11-1 .-. Ceiling Floor+, Ceiling o Total Btu. 1.4% & a3 Required sq ft. E.D.R. or sq. ins.. W.A. Leader area % F1.I A.ee Room I Lenirtli —11007- Width a Heiaht A" Windows and Doors—Crackage and Area Width Hetght No. of Lineal ft. Area No. of pane of one- lights of crack sq. ft. f� Coef.1 Btu Infiltration 4z 4) r� Glass. Exp. wall Net exp. wall 5,11-1 .-. Int. wall Ceiling Floorf`�' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area V C p 1' - ._4 City of Fridley, Minn. BUILDING PERMIT N® 4344 Date: - ....... !._./_`......... 6__1.. ..... _... .�.. ..- -................ Owner:...144r; .... - - - ............... Builder 1� ._.... Address........... -................................... _........_.. Address ................... ........ LOCATION OF BUILDING No...... Street_.. -....._...._......... _----------- Part of Lot -----------••------•-;-............_.............- ... - Lot ............................. Block ....._.........- ............. ._......dition or Sub -Division .......... CornerLot ...................... ............ Inside Lot ....................................... Setback ..... _............. _....................... Sideyard .. -----........ ................. ---...•-----..........----.........._..-....... Sewer Elevation ...... ...................... _.... ......... -... _............. ....................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front l.._..�_�Depthe�:._ Height .�_® Sq. Ft.®.. -Cu. Ft_d�O . ' ............. ........._._ Front -...._./......y...6 Depth ....._ Height .�®-..'-_� Sq. Ft. _f 5.._�.. Cu. Ft..%..�._�Z� Type of Construction..........._-...................__............_.._.... Est. Cost..l. . % 7 ............�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 iyco lien with all provisions of ordinances of the city of Fridley. ......_..........._..........._..... ....«.._......«._...........-........_...._..-.......... In consideration of thea p yment 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 upon violation of any of a provisions of said ordinances. _......��............ _..... ........_.... .... -........ 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. 4 City of Fridley, Minn. BUILDING PERMIT Date: SEPTEMBER 7, 1966 Owner: ROBERT SWITZ Builder Address 6350 QMCY STREET N,E. Address FRIDLEY, MINNESOTA 55421 SAME LOCATION OF BUILDING No. _6350 Street QUINCY STREET N.B. — Part of Lot Lot — 4 __ Block 7 — Addition or Sub -Division — CHRISTIE Corner Lot — Inside Lot ____ $ Setback --- Sideyard Sewer Elevation To be Used as: Type of Construction Foundation Elevation DESCRIPTION OF BUILDING Nq 9004 ADDITION AS SHOWN ON SURVEY SHEET (FILL IN BREEZEWAY AND ADD PORCH) Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. FRAME Est. Cost —A -1a -0-0Q--- 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 $—L 00 , permit is hereby granted to ROBERT SWITZ 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, constru on, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any tune upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sura to sae the Building inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS �3 S76 ADDRESS /—I/ - LOCATION -OF BUILDING NO. STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT. Y SETBACK SIDE YARD 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; -:00 �3. l Front Depth Height Sq. Ft. Cu, Ft. Front Dept h Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cosi/ J G' C) 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 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 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). 53-84-s-915.71 J 1_ City of Fridley lu EGT AT TME TOP OF TME TWINE 1 PLUMBING PERMIT APPLICATION S tu-------- COMMUNITY MVELOMENT MY. i PROTECTIVE W*09CTION DEPT. CITY WALL FRIOLCY 0641t -600-3N0 sq NUHOER NAV. PATE PAGE OPA OV P - 0 12/15/73 1 1 800 Job Address 6350 Quincy St. NE ner James M. Schafer Same Address Pone Contractor Address Phone Minnegasco 733 Marquette Kind of Building Use Brame Res. Completion- Date Estimated Cost 6/2/74 10.00 Plumbing Fixture Rates: NO. RATE TOTAL n ci �I W — Number Fixtures x$2.00 Future Fixtures x $1.50 New Fixture -Old Open. x $1.50 i Catch Basin x $3.25 '1ddYl rYDI + Water Heater -99,000 BTU x $3.00 Ground Run Old Bldg. x $3.25 Saa, i I� m Elec. Water Heater x $2.00 a. SNISYB i % HOtY9 I I � I _Gas Fitting Fees: �O c ®NIVU ;3 0x 1st 3 Fixtures $2.00 .w= j0 Additional Fixtures x $ .75 I I I ( d „NIa4I Gas Range -199,000 BTU x $5.00 A HSYM) �J1 q I I I Repairs be Alterations I I I I See I»N"1$I Install (1) Grill Description: Code 5.00 I I I v� State Surcharge Class '�A© Surcharge .500 .50 SHISVO I I TOTAL FEE $ 5.50 sun.L Suva I I I !The undersigned hereby makes application for a permit 91YNIM(fI ( I i I for the work herein specified, .agreeing to do all work in strict accordance with the City Ordinances and Tulin N81YM of the Department of Buildings, and hereby declare that all°the facts and representations stated in this gg application are true and correct. r 'Signature Date SUBJECT City of Fridley 15 9 9 6 AT THE TOP OF THE TWINS BUILDING P E R M I rp RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 i CITY HALL FRIDLEY .55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 11/4/80 JOB ADDRESS 6350 Qui cy St. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 7 1 Christie Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Jim & Marie Schafer, 6350 Quincy St. N.E. 571-0501 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. f 'IMP 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Rpsidintial 7 CLASS OF WORK ❑ NEW IN ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Room Addition 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood 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 2'80000 1 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT X40 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 18.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 4.50 $23.90 SIGNATURE OF CONTRACT RORA THORIZED AGENT (DATE) N PROP R ID IS YOUR PERMIT 41A E�DTHIS / L/,8 //_ R OF OWNER(IFOW E I L E IDATE) BLDG INSP OATE CITY OF FRIDLEY APPLICATION FOR PESIDI"N-f IAL BUILDING PEW111TS (Went, Al aerations, Additions, or Repairs) OWNER: / � BUILDER: ADDRESS. le 3 ADDRESS: TEL NO: 2z 0 �Ev% TEL 110: . " # 9, � - 7 75 - .Construction Location P ST ET NO: (/i 3 g STREET: LOT: BLOCK: - ADDITIa1a : . Corner Lot: Insiae Lot: Setback,: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: --���� Depth: l �, Height: Square. Feet: �r �' Cubic Feet: • Front: Depth: Height: Square - Feet: Cubic Feet: _ v Type of Construction: Estimated Cost: $ To $e Completed: 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 %:pork' 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. DATE: J6 ',,�9 7' SIGNATURE: � Stipulations: a b s l 011 SUBJECT City of Fridley 30386-1 AT THE TOP OF TINE TWINS BUILDING PERMIT • COMMUNITY DEVELOPMENT DIV. v _ PROTECTIVE INSPECTION SEC. NUMBEII REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55442 ' 61211 571-3450 910415 10/12/99 JOB ADDRESS 6350 uinc Street NE 1 LEGAL LOT NO. BLACK TRACT OR ADDITION SEE ATTACHED DESCR. q 7 Christie Addition SHEET 2 PROPERTY OWNER I MAIL ADORES$ ZIP PHONE Patty Galli an $ Wes1e Johnson 572-0878 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen 350 73rd Ave NF, F502-4777 201909R3 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 XX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 4 window ins its in home within existiniz o enin s 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the house. i ?ermit Inspectionct' ®¢ Cars Will Be ailed T o Homeowner'To Post SEPARATE PERMITS ARE REQUIRED FOELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND V10 IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDO�EO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENC D. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2736 $1.37 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 $83.25 Fir SC $2.74 PLAN CHECK F TOT EE icon S 5. W1 6 SIGN A TUBE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi MEN R THIS ISYOUR PERMIT PALID S.GNATURE OF OVVNERi1F OWNER BUILDER. IDATE7 BL NSP nATE l 011 NEVA' [ ]' K Effective 5/10199 g ADDN [ ] CITY OF FRIDLEY �Vr ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: &?j Q Lj%n '2&-r( ).2,,; i8 (lfl(U vSH3� Legal Description: Owner Name & Address: Contractor: Address: Attach lot, wil LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: RENEWAL BY ANDERSEN 350 -73RD AVE. NE FRIDLEY, MN 55432 ( 612) 5024777 LICENSE #20130983 Tel. # to) of •tea • d� �� MN LICENSE # Tel. # of the scale. Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. A%_.._ 1. _ . _ e—_ _ _t_ 4 1 _ , ,•1t „—•'-1• Driveway Curb Cut Width Needed: DATE: APPLICANT: C' p"VI - co Estimated Cost: $ 0 , Ft. + 6 Ft = Ft x $ M9 Tel. # TOTAL $ STIPULATIONS: S err 7"✓S/� J� CITY USE ONLY Permit Fee $ 0 �j' Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $'� TM $.50/$1,000 Valuation SAC Charge $ f 8 t $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 [ ] TOTAL $ STIPULATIONS: S err 7"✓S/� J� iffl, SUBJECT P City of Fridley 33494 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. i COMMUNITY DEVELOPMENT DIV. v ______ *0� r PROTECTIVE INSPECTION SEC. c�/IJ NUMBER pEV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55032 L 763-571-3450 1 910-F15 5/6/03 JOB ADDRESS 6350 Quincy Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 7 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wesley C Johnson 6350 Quincy Street NE 763-572-0878 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 D NEW O ADDITION D ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlaymert 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 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 @ $2,315 $1.16 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 � 73 $86.73pE OF CON' OR Ay�TNOp ZED AGENT DAiE=LD6 ERLY VALIDATED THIS RPE M T VNATU ' S,GNATURE OF OW R -OWNER BUIL i iOATE� QAiE iffl, NEW ,�' CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: L 1�� ®i c -i no ew -Q,+. Q t Legal. Description: Owner Name &Address: We 1Qer C. .�c�� ! -lo �%LuvteaS�. J%. Tel. #763-5'ia- 082F Contractor. Owne vr- 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: Yl _ yoor b LA.5 e_ y- 0 d&.V!39je. A D Ob 'meq F- ' Construction Type: Estimated Cost: $1�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 0 3 Tel. # 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 $ 3 a dr $_ 3d TOTAL $ 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 [ ]