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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: .,�� .. �!,..,....... Owner ....................................... Address ...................................... N® 3544 Builder Ae., .. ......... ........... 71 Address .... ... .a .............................. LOCATION OFBUILDING . No. /..[.. Street ... .. .. . . ............. Part of Lot .................. ........... . Lot ... .... Block .... ....... dition or Sub -Division .. . Corner Lot . , ...... Inside Lot M ........ Setback Sideyard A5 t.................... ................ DESCRIPTION OF BUILDING To Used as: ` t Front fl ... rDepth AZ3�. CHeight%� :10. Sq. Ft.16 A.. Cu. Ft. ?Q.0 4 .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... ]list. Cost.l.F.F �t .. . .. To be Completed .................... In consideration of the issuance ,to me of a peimit to Wbssrlbed above, I agree to do the proposed work in accordance with the description ab a slane with all provisions of ordinances of the city of Fridley. ........................... In consideration of the payment of a fee of$.�......., Perim re y 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 of 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-jeparate permits for these Items. City of Fridley, Minn. BUILDING PERMIT Date: Sept. 4, 1969 Owner: Charles L. Babcock Bider Address 741 Quincy St. Address N° 10391 Same (Imperial Garages doing the slab) Same LOCATION OF BUILDING No. 6741 Street_ X Quincy St. N. E. Part of Lot Lot _.._ 8 _.._. -- Block 5 Addition or Sub-Division—Brookview Terrace Corner Lot _ x Inside Lot __ Setback 251 . Sideyard _ 71 Sewer Elevation ___ _ _ — Foundation Elevation DESCRIPTION OF BUILDING - To be Used as: G�arage Front 24 ' Depth 221 Height 10, Sq. Ft. 528 Cu. Ft, 5280 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost — $1500.00 _ To be Completed 913/70 Surfaced Driveway required... 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. /"P xaxr–a In consideration of the payment of a fee of $ 9.00 . pmt is hereby granted to Charles L. Babcock 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 the provisions of said ordinances. l Clarence ;Belie NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas hooting, sewer or water. Be sure to see the Building Inspector for separate permits for these Rena. APPLICATION FOR.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME dAm 4cs 4 BUILDER:F � L ADDRESS ��� , ���1�7� ADDRESS LOCATION OF BUILDING No. 6 74 / STREET L�ero as XJ, A- LOT BLOCK 6 ADDITION OR SUBDIVISION, 64&��e� CORNER LOT INSIDE LOT SETBACK SIDEYARD 7 r SEWER ELEVATION TOP OF FOOTING 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 GDepth Height A0 Square feet Cubic Feet ,� ZeC-) Front Depth Height Square feet Cubic Feet Type of Construction )`X" �e Estimated Cost To Be ComAleted 11"5117 r 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/ �J SIGNATURE __�Z / �....G (Schedule of Fee Costs can be fouxid on the Reverse Side.) 0 Ll CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 4ESIDMiTIAL ` RATE TOTAL 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 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work $ 20.00 $ 10.00 6®/ $ 10.00 $ $ 10.00 $ C' $ 10.00 $i_ State Surcharge TOTAL FEE ►reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for PermitA—H—'L MINIMUM FEE FOR ANY HEATING PERMIT IS $15-00- PLUS 15.00PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. E1 S $ .50 Job Address 6011 'A\ at) y a 1-\0 \1 � - 10 - E - 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 application are true and correct. (i Fridley, Minn. + , 19 %q OWNER Ll e,. -(22 'b'zi lJC'_.C')Q,V KIND OF BUILDING�� 6Y\� USED AS TO BE COMPLETED ABOUT�'�a '1 ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air-c�No. Trade Name A�('\�G Size No. j pS-S'kln Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU ` l�®� HP /i 1 Company I�� Signed- Bit Tel. No. Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. 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 Da to SUBJECT PERMIT NO. City of Fridley�0 AT THE TOP OF THE TWINS BUILDING PERMIT Ir � RECEIPT NO . ______ COMMUNITY DEVELOPMENT DIV. - PROTECTIVE INSPECTION SEC r NUMBER REV DATE PAGE OF APPROVED By /'--1 CITY HALL FRIDLEY 55432 %J 612-571-3450 910-F15 6/30/95 JOB ADDRESS 6741 Quincy Street NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 5 Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Chuck Babcock 6741 Quincy Street NE 571-5938 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D & D Home Improvement Inc 7401 Central Ave NE, Fridley HN 55432 784-7543 4840 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 Xp REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (2nd Layer) 20 Sq 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,500 .75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $1.50 STRUCTIO OR HE PERFORM NCE OF CONSTRUCTION $35.00 PLAN CHECK FEE TOTAL FEE or ) License SC $5.00 $42.25 SI NA URE OFCONTRACTOR ORAUTHORIZED AGENT IF (b-ATE W PRO,.,RIL-Y/VALIDATED THIS IS YOUR PERMIT 1 lti"✓ L.4!2.G INSP -+vl'Ymr- MATE SIGNATURE OF OWNER0F OWNER BUILDERI IDATEI NEW [ ] Effective 1/ 1 /94 ADDN { ] CITY OF FRI DLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-202�,�� Building Permit Application Construction Address: &Zvz- Legal Description: Owner Name & Address:GIG Qct` Tel. # Contractor: D c D Home Improvement, Inc. MN LICENSE,4 4840 Address: 7401 Central Avenue NE, Fridley, MN 55432 Tel. x,`784-7543 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: - _ imated Cost: $ Approx. Completion Date: Ton Back) Driveway Curb Cut Width Needed: Ft. + 6 -Ft = Ft x $ = $ DATE: — APPLICANT: Tel. # Permit Fee $ D C) CM USE ONLY Fee Schedule on Reverse Side Fire* Surcharge $ / S) .001 of Permit Valuation (1 / 10th %) State Surcharge $ • 2S $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ S.12 $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 PE City of Fridley26712 AT THE TOP OF THE TWINS BUILDING BVIIT ' , O T COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. /'3 q:!5may_------� r o NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/21/98 �j JOB ADDRESS 6741 Quinc St 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 cj Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Babcock 571-5938 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Northern Crest Inc 8245 POLK St. NE SR.Lk.Park 55432 792-9364 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 X❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (23 S) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $.96 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1918 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 SC $1.92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $62.25 PLAN CHECK FEE TOTAL FEE License SC $5.00 $70.13 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN PROPERLY XALI DATED THIS IS YOUR PERMIT BLDG NSP PATE SIGNATURE OF OWNER I IF OWNER BUILDERI IDATEI M ADDN CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Coh6thidtioriAddress: d J/A P—V Effective 3/1/96 Legal Description: Owner Name & Address: F6TA to _CIL Tel. # Contractor: Motgler4 6peSJ:7 _mw&, MN LICENSE # 00 Address: &C9 UK s± � N Tel. # L 1 cr, p� T _i Z" Attach to this application, a Certfficate of Survey of the �r_13J 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: Comer Lot Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Constructiow., Far, o ff- A, :1e,0 h!!L54 ' Estimated Cost: $ -'Zs' V 2118 Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Neede d:, Ft. + 6 Ft =.-----Ft x $ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ .001 'of . Permit Vahikion (1/10th%) State Surcharge $ 49(p $.501$1,000 Valuation SAC Charge $ $900 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 Dettrmined by Engineering Sewer Main Charge $ Agreement Necessary'[ Not Necessary TOTAL $ rl ®. 1 STIPULATIONS: ej6 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 k'AX: (763) 571-1187 PERMIT NO.: 2004-02319 DATE ISSUED: 12/22/2004 ADDRESS : 6741 QUINCY ST NE PIN : 143024140024 LEGAL DESC : BROOKVIEW TERRACE LOT 8 BLOCK 5 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOW/DOOR REPL VALUATION $ 3,977.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. APPLICANT PROBUILT AMERICA 2211 11TH AVE EAST ST N ST PAUL, MN 55109-3080 (651) 770-5570 OWNER SCOTT HULPIN 6741 QUINCY ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law re ulatin construction or the performance of const ,7 p Date Bldg Insp. BUILDING PERMIT FEE 97.25 FIRE SURCHARGE 3.98 STATE SURCHARGE, VALUE 1.99 TOTAL 103.22 PAID WITH CHECK # VISA SEPARATE PERMITS REQ(JIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 12/0°9/2004 17:13 FAX 6317700495 WINDOWWORLD- �_, I? 001/002 �B �v NEW J CITY OF FRIDLEY Effective 4/1/2004 ADDN j J 6431 University Ave NE, Fridley, MN 55432 (763) 672-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: _ 'I r,, <;, j,t? i i Owner Name $ Address: Contractor. C 1 U i jC7YL a u2)1 -,,Y Tel. # % c2, / % MN LICENSE #.�-' '�, el h d": Sr t+'T, [e� TCI. # , al / `��%' cs'+� ,.(G,� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LPANG AREA Length �._ Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type:rr �IClC iJ� "Y��� �� Estimated Cost: s l 7_% GG Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x S = $ DATE: APPLICANT:�� Tel. # S f` "Z70 SS'70 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. CITY USE ONLY - Permit Fee $ I ,:�) Fee Schedule on Reverse Side Plan Review 65% of Permit Fee Fire Surcharge $ .__- . 4d' .001 of Permit Valuation (1/10th%) State Surcharge $_ $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit Llcense Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut 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 Necessaryj J TOTAL $ —/(" ST EW ATIONS: 20/Z0'd ABIGlad d0 Al I0 bS:eT t700Z-L0-D3Q m "f"I'M --o ., SUBJECT City of Fridley 2722 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEI T NO. COMMUNITY DEVELOPMENT DIV. y �] PROTECTIVE INSPECTION SEC. E ; i E 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY j 612-571-3450 910.F15 6/21/02 JOB ADDRESS 6741 Quincy Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 5 Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thai Yang 6741 Quincy Street NE 763-574-9894 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 [j ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 3' x 8' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WAR & 28 IVINU Before di�9in all wo- g Call for tY locations 46q002 REQ t11 ® BYLAW 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 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 $276 $ •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 $23.50 Fire SC $.27 PLAN CHECK FEE TOTAL FEE $24.27 SIGNA R RAUTNORi2EDAGENT iDAApTTEE, yy E PROPERLY VALIDATED THIS IS YOUR PERMIT wC�ON-RACTOR SIGNATURE FOWNEF10 ERB ERT 96ATE. B G SNS (TATE 01 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: (P-7 t4 I Lt(yl C—y s T- 0 • C Legal Description: Owner Name & Add��ress: ! tla l `i -an & Tel. # � Contractor. OCA') t ISP t- 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 9 Hgt/Ground r Sq. Ft OTHER: Construction Type: �" C-edAd(.- Estimated Cost: $ Slit/- g 9 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: 10[62- APPLICANT. Tel.�24 3% -S-7/-'987(f -'989( Call (763) 572-3604 for Permit Fees if mailing in application or 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 Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Resideri ial Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by•Engineering Agreement Necessary [ ] Not Necessary [ J STIPULATIONS: MlNDEaF2qGjNERjZjN(3r C ., t:. ENGINEERS AND SURVEYORS LANDSURVEYiNe SOILS TESTING yy CIVIL MUNICIPAL ENGINEERING LANG PLANNING G418--SGTN AVENUE N. 44 MINN EAPOL15 77. MILAN. oo KE 'T- 3637 ' ' v!*E- N U E_' E. 5 4:.3 1 e- 5 C Lu to 1 T -V� 'n' =92 o:--.51" 90W 3 a G -100 - " \1 + I ©7 i TF - WE KEPLE5Y CERTIFY THkT THIS 15 X TRUE AND CORRECT REPRESENTATION OF N SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DE5CRI BED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON , AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON 5XID LAND. DATED THIS - DP, -f OF e K- R.O. I-) MINDER ENGINEERING CO., INC. ENGINEER -5 N%c) sup-vrm yop-.s by Building NMC CAL Permit No.:/2 001-62 50 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CIT" O LEY D � ' DATE R '1.`) -oil YOUR E-MAIL ADDRESS SITE ADDRESS to THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: n(' ®14- E.A. OWNER/ ADDRESS: _CITY STATE ZIP TENANT PHONE: SQ 9L_ -a j2.Z �- CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: Ia�� d•-I� YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 0 Main SX- M CITY STATE ZIP. APPLICATION PHONE -7E)+_ FAX -754-2902 PERMIT TYPE 0 SINGLE FAMILY ❑ TWO FAMILY 13 TOWNHOUSE TYPE OF WORK. [3 NEW JKRREPLACEMENT ❑ ALTERATION/REMODEL PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. ('Phis should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) MFG: MODEL: �lLsr-I% to SIZF/BTU Equipment Installed WO: MODEL: SIZEIBTU MFG: MODEL: (GAS) $15.00 . SILEIBTU _GAS RANGE/OVEN $10.00 A/C $25.00FIRFIREPLACE TO AIR IXCHANGEER $IS -FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 UNIT HTR $10.00 _AIR BOILER $35.00 '-CHIMNEY LINER $10.00 ,--AMACE $35.00 GAS DRYER $10.00 _,GAS _POOL HEATER $35.00 -VENTILATOR $L5.00 DUCT WORK $10.00 GAS PIPING $10.00 ■ ��i"+'a�i�i"i��45L2^�rt1Y4.31'cT�ft^l�^3'3�Q`�..1'li Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @$35.00=x $35.00 = $ 3S.00_ State Surcharge = $ .50 Total = $ 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 wo w ich requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME �i� w A�u D DATE IZ % City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977