PRE 2010 DOCSCity of Fridley, Minn. �
BUILDING PERMIT No 3548
Date: .... 9... J .....
Owner .......................... ............ Builder ..........
Address ....................................... Address .........:......................... .........
LOCATION OF BUILDING
� � t
No. . �,...... Street ..... ........ Part of ........... .....
Lot ..i ..... Block ..... Addition or Sub-DivisionC.i+K/C
Corner Lot ............ Inside Lot 'i....... Setback 30 4 Sideyard ./ ,'.: ................
DESCRIPTION OF BUILDING
To Used � � � a ,� ,'a
,* �s «.
Front I '� Depth Heigh 5q. Ft. Cu Ft. i9poi2i
.................... Front ........ Depth ..... Height ... Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... St. Cost. To be Completed ...................
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 $ ..�... 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 with-
in the city limits and this, permit may be revoked at any time upon violation of any'pf the provisions of said
ordinances.
Building Inspector
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.
City ®f Fridley, inn. N° 8587
BUHDING PERMIT --�2 YIP
Date: NOVEMBER 52 1965
Owners JAMES HOLMEN Builder GORCO CONSTRUCTION
Address 6701 Quincy St. N, E. Address
Fridley 32, Minnesota
LOCATION OF BUILDING
No. 6 7 01 Street Quincy St. N. E. Part of Lot
Lot _ _122 331ock 5 Addition or Sub -Division Brookview Terrace
Corner Lot Inside Lot % Setback — Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Det. Garage Front 16 Depth 22 Height 10 Sq. Ft. 352 Cu. Ft 3$520
Front Depth freight Sq. Ft. Cu. Ft.
Type of Construction Fri Est. Cost AL 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 21 provisions of
ordinancxs of the city of Fridley. ®, a-- a _.
In consideration of the payment of a fee of 4 00 , permit is hereby granted to GORCO CONSTRUCTION
the
to construct the building or addition as described above. This permit is granted upon
express oDndition that the person to whom it is granted and his agents, employees and workmen, in all work
Aone in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of 7Fridley, Ntiaaesota regarding lavation, conatruct4on, alteration, maintenance, repair sad moving of buildings
whin the dty limits and this permit may be revoked at any time upon violation of aay of the provisions of said
inaacvas.
ALLEN G. JENSEN
Building Inspector
NOTICE:
This permit does not cover the eondruaHon, buteMon for wiring, phmbing, gai heathog, sower a water. Be sore to ere
the Bundhm Inspector for "penis permits for thus Rena.
r - - 4.c
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME a = ra zt: , , BUILDER
WDRESS
LOCATION OF BUILDING
i:inz Street Part of Lot
LOT K ADDITION OR SUBDIVISION -
Corner Lot Inside LOT 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:
' Front l Deptl J_�Z Height
Sq. Ft. I �, I 71 ®.--)— Cu. Ft. -- �� 0
Front DepthHeight
Sq. Ft. Cu. Ft.
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 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 f
L � - SIGNATURE
(Schedule
of Fee Costs can be found on
the Reverse Side).
G9
SUBJECT
IT N
City of Fridley
15 6 6 9
AT THE TOP OF THE TWINS
BUILDING P E R M I T
r
R NO.
�
• __ COMMUNITY DEVELOPMENT DIV:
,: - ---
SEC.
r � � PROTECTIVE INSPECTION
9
1 . i
`---1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
14/17/80
JOB ADDRESS 6701 Quincy Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
12
5
BrookvieW Terrace SHEET
2 PROPERTY.OWNER MAILADDRESS ZIP PHONE
George W. Colstrcm 6701 Quincy Street N.E. 571-6580
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
roof structure
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys.
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
$700
$•50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGN EOFCONTRACTOR (DATE)
PROPERLY VALIDATED THIS IS YOUR PERMIT
�TGENT
-W�HEN��
gr BLDG INSP DATE
S NATUR OWNER qF OWNER BUILDERI (DATE)
G9
CITY OF FRIDLEY
i
AP-PLICATim 1 -OR RESIDEN-ml_ RUILDING PERMITS
(New, Alterations, Auditions, or Repairs)
OWNER: BUILDER:
ADDRESS: k Zc) ADDRESS:
TEL X10: s" 0`_6_T TEL NO:
Construction Location
STRIMT NO : �0' ?O j STREET: n U I W L�-- S/• p X z
LOT:BLOCK,: S ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIO14 OF CONSTRUCTION
--- Front:
Square Feet:
Front:
Depth:
Cubic Feet:
Depth:
Square -Feet: Cubic Feet:
H eight :
Height:
G
Type of Construction:/��-�S� Estimated Cost: $�0 '
To Be Cbmp-leted:
Alto A Alt. B
Proposed Driveway Width If New Opening Is Desired: $
SEE REVERSE SIDE OF SHEET
The undersigned hereby makes application for a pezmit for the cork 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 arg true and correct.
DATE:�c,v SIGNATURE:
Stipulations:
S V�bb
CITY OF FRIDLEY Effective Date May 1, 1988
.APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND � 1 ®1 7 -3
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
-RESIDENTIAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
18 of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work
RATE TOTAL Job Address
$ 20.00
$
$ 10.00
$
$ 10.00
$
$ 10.00
$
$ 10.00 $
State Surcharge
TOTAL FEE
Reinspection Fee $15.00)
Rough Insp.
Date
Final Insp,
Dat
Approval for Permit
P
MINIMUM FEE FOR ANY HEATING PERMIT I$15.00
PLUS $.50 STATE SURCHARGE jS"S-e
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Department of Buildings, 6431 university Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this applications are true and correct.
Fridley, Minn. /y/��CG ZZ 19�
OWNER '�, o l._ a e -,s / /�-(� 6�
KIND OF BUILDING (,(/CPW L/
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST 'Q 00 Cl� UC.T I.�=,,Z1G fa��I
r
OLD - NEW BUILDING PERMIT NO. PERMIT NO. 123
DESCRIPTION OF FURNACE/BURNER
PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name
Capacity
Total Connected Load
Sq.--�Kt. EDR
Size No.
BTU HP
Kind of Fuel
No.
Capacity q. Ft. EDR BTU HP _
i
% Company
Signed By
i
Tel. No.
U
F�1.1'"
out back sid r ikation on replacement furnaces
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
_ Yes ( )
No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed By
Date
01
SUBJECTER
N
City of Fridley
o 19944
AT THE TOP OF THE TWINS
BUILDING PERMIT
_MIT
r
REC
-COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
�
r PROTECTIVE
�
`1 `
�� -'>;,� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED By
---•�
L 612-571-3450
910-F15
6/9/89
JOB ADDRESS 6701 Quincy Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
12
5
Brookview Terrace SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
George Colstrom 6701 Quincy Street N.E. 571-6580
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Kerchner Construction 3630 - 153rd Avenue N.W., Andover, Nit`]' 55304 422-9644
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
Construct a 221- x 14' Addition and a 16' x 8' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations On plan. Variance approved for rear yard setback from
25' to 17'
. Ild I SEPARATE PERMITS REQUIRED FOR
Before digging cal1 foul. in liffes WIRING, HEATING, PLUMBING ANIS SlQ t,
TELEPHONE- ELECTRIC - GAS Etc.
REQUIRED 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
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
j
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
$ 16, 2O0
$8.10
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-
$180.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PL N CHECK FEE
TOTAL FEE
$188.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
*WHEN PROPERLY VALI TED THIS IS YOUR
Com// /PjE�RMIT
I�ahAa lif
Om
SIGNATURE OF OWNER IIFOWNER BUILDER) (DATE)
-
BLDG INSP
01
NEW [ ] Effective 5/1/88
ADON [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address: 6701 S -7e. %o
Legal Description: 7-e f
Owner Name & Address: [ if C^ q 615 �,��.-�___ Tel. # 15-;7
Contractor:1 ,ell >%�G e Xe .1rrz Tel. # baa -1'd
Address: 36 5e) �s� �` `� 200 AJ sY 06L 49Z
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
rps -IIPTION OF STI'
LIVnVx AREA: Length ?2 ` Width 19 Height %3 ' Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length !lam Width Hgt/Gr= d Sq. Ft.
07HER•
3ise 14 4k 7.:.aw.-I 6 V1441-zr
Corner Lot [ ] Inside lot[ Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost:
Approx. Completion Date: 5-2zo/92
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
L����/j � Wil 6' See Back Page
DATE: % `1 - �% APPLICANT': Tel.
Permit Fee $ 180-W
State Surcharge $ g,14
SAC aiarge $
Driveway Escrow $
Park Fee $
Sewer Main charge $
CITY USE CNLY
Fee Schedule cn Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Za�v-
1 1 31C
/80.00
WA
SUBJECT
P.E.RNHfi°WO
City of Fridley2
fro
5 8 10
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEPAGE
OF
APPROVED 8Y
612-571-3450
910415
2/18/98
JOB ADDRESS 6701 Quincy Street nE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
12
5
Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
George Colstrom 6701 Quincy Street NE
571-6580
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 1i ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install bay window in existing opening
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Install smoke detectors to meet the State
Building Code - on each level adjacent to the sleeping areas and in each
sleeping area.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST,
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
S0. 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
@
$ 75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,500
.
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-
$48.50
Fire SC $1.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$50.75
S NATURE OF CO NTR TO R A ORIZED AGENT (DATE,
i
WHEN PROPER
• BLO INSP
Y/-VALIDATED THIS IS Y04JR PERMIT
�1ATE
S,GNAT F OW Rii WNER BUILDERI IDATEI
WA
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 0? J ��
BUILDING PERMIT APPLICATION
ConstructionAddress: � Z,�U V4
Legal Description:
Owner Name & Address:-- C/�i Tel.
Contractor: 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 EUPROVEMENT
LIVING AREA: Le Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: l,zL�
_ Sq. Ft.
_ Sq. Ft.
_
Sq. Ft.
.IV/11—
Construction Type: C00 -c9 (�—' l &,�U2� Estimated Cost:
Driveway Curb Cut Width Needed: + 6 Ft =
(Fee Schedule on Back)
Ft x $ = $
DATE: APPLICANT: Tel. #
TOTAL $
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
'/'�0O
Fee Schedule on Reverse Side
Fire Surcharge
$
f. S�
.001 of Permit Valuation (1/10th%)
State Surcharge
$
`%S
$.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:
SUBJECT
City of Fridley
JE� 347
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
COMMUNITY DEVELOPMENT DIV.®t
INSPECTION SEC.
r PROTECTIVE
1 � °
CITY HALL FRIDLEY 55432
NUMBER
REV
OTE
PAGE OF
APPROVED BY
1 J` 612-571-3450
910_F15
10/21/98
JOB ADDRESS 6701 Quincy Street NE
1 LEGAL
LOT NO.
BLOCK TRACTOR ADDITION
SEE ATTACHED
DESCR.
12
5 Brookview Terrace
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
George Colstrom
571-6580
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Arrow Roofing 4938 Welcome Ave N Crystal 55429 560-1680
20149748
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 O ADDITION O ALTERATION Rk REPAIR
O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garage (25 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
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
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
$2142
$1.07
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-
ST UCTIQN OR THE PERFORMANCE O CONSTRUCTION
7
$74.75
Fire SC $2.14
PLAN CHECK FEE
TOTAL FEE
11
License SC $5.00,
1 $82.96
° GNAT RE OFCON'FACTORORAUTMOpIZED4GENT +DATE+
WHEN PROPERLY ALIDTED THIS IS YOUR PERMIT
Bl0 +NSo -
,�- "
gATE
tE
S�GNATUAE OF OW NER,iF OWNER BUILDER) +OATEi
NEW [ ]
AADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 16 % 0
Legal Description:
Effective 1/1/98
, #�f'83 4 -1
Owner Name & AAdd�dress: Tel. #
Contractor: C/® �� MN LICENSE #z o/
Address::7:7 L 6 j rj�/ `Q 15 C � Tel. # Z 9�j
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:
Len
Width,H_gt/Ground Sq. Ft.
OTHER:
�` .� S l `6 "
Construction Type:
na
Estimated Cost: $
-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE:
APPLICANT:
Tel. #
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
$
$1000 per SAC Unit
License Surcharge
$ S,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
STIPULATIONS:
From: unknown Page: 2/2 Date: 1/5/201010:37:06 AM J
Building
MECHANICAL
Permit No. 6
Inspections
RESIDENTIAL APPLICATION
Received B
763-572-3604
CITY OF FRIDLEY
0 2
763-502-4977 FAX
EFFECTIVE 2.19-M
DATE 110&12010 YOUR E-MAIL ADDRESS dave@davesheatingandair mm
SITE ADDRESS 8701 QUINCY ST NE
THIS APPLICANT IS: O OWNER 000NTRACTOR
PROPERTY
NAME: JESS HERNANDEZ
ADDRESS: 6701 QUINCY ST NE CITy FRIDLEY$TATE MN ZIP 56432
OWNER/
TENANT
PHONE: 783`354'8800
CONTRACTOR
COMPANY NAME- DAVE'S HEATING, AIR 8 ELECTRIC
—
SUBMIT A COPY OF
CONTACT PERSON: AMY MADVIG
YOUR STATS
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 1801 37TH Mfg NE CITY COLUMBIA HEIGHTS STATE MN ZIP 55421
APPLICATION
PHONE 783-781-8901 FAX 763-789-8601
PERMIT TYPE
ZNGLB FAMILY CI TWO FAMILY O TOWNHOUSE
TYPE OF WORK:
13 NEWF./—�SPLACEMENT I7 ALTERATION/111iMODEL
DETAILED DESCRIPTION OF WORK REPLACE EXISTING FURNACE WITH BRYANT MI#3599AV038060
FEES ARE BASED ON $1000 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: ' ° SIZEIBTU ° M
MFG: MODEL: S12EtBTU
MFG: MODEL: SIZE/BTU
VC $25-00_, -FI REPLACE(GAS)$1g.00 _GAS RANGEtOVEN$10.00
(RTO AIR EXCHANGEER $IS (WOOD) $35.00 __NEW GAS GRILL $10.00
hIREPLACE
BOILER $35.00 RNACE $35.00 PAS UNIT HTR $10 00
CHIMNEY LINER $10.00 SDRYER $10.00,HEATER $35.00
POOLVENT[1.ATOR
DUC WORK $10.00 GAS PIPING $10.00 $15.00
Numb#r.offixtures @ $10.00 z $10.00 = $
Number of fixtures @ $.15.00 x $15:00 " $, _
Number of fixtures. @ $25.00 x $25.00 - $
Number of fixtures @ $35.00 1 x $35.00 = $ 35.00
State Surcharge - $ 50
(MMIMUM FEE $35.50 Total = $35.50
THIS IS AN APPLICATION FOR A PERMIT NOT VALID (UNTIL PROCESSED
I hereby apply for a bu' 'ng permit and 1 acknowledge that the information above is complete and accurate; that the work will be in
conformance with the r=,s and codes of the City of Fridley and with the Mipnesota Construction Codes; that I understand this is
not a permit but only tion for a permit and work is not to start without a permit; that the work will he in accordance with the
approved plan in the we 1 work w ' equires vig approval of pl s.
SIGNATURE OF APPLI NT ov�RINT NAME TE '
P.LEASENOTE' SEPARATE EERtaS ARE REQUIRED YOR BUILOLNU I;LLLA-KM;AL, ANN M=nAN1 M, Wur*m
Ci Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-504977