PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn, No 2 R 0 7
Date j��.��..�."�'...............
Ownea-1 Builder ............................
Address......................................... Address .........................................
LOCATION OF. BUILDING
y a.
No. . 01 ....... Street. I A .. . ' .........�`% .............. Part of Lot .......................
Lot ..... • 0........ Block .....'fir........ Addition or Sub-Divisio
® Q ,
Corner Lot ............ Inside Lot .. Setback Sideyard -4 ............... .
DESCRIPTION OF BUILDING
To be Used as:
/
. (; 1A .. .. Front 14.r � ... Depth,9►1�. ... Height Sq. Ft. /140. Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft.........
jj//0�
Type of Constructio .... .... Est. Cost /. IO ............... 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 village of Fridley.
�const ation of the payment of a fee of $..^.. , permit is hereby granted t ......
4'!' 1i°... ..... 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 village 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 separate permits for these items.
SUBJECT
PE --
City of Fridley
_
F
AT THE TOP OF THE TWINS
PERMIT
13828::
BUILDING
RE
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE .INSPECTION SEC.
0 3
1 . i
CITY HALL FRIDLEY 55432
f ,•J
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
10/15/76
JOB ADDRESS 624 1 Rainbow Drive N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
2
Sylvan, Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gunlogson 6241 Rainbow Drive N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Verne Parks Construction 850 Woody Lane
757-4943
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 masonry Ste
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide adequate frost footings
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Masonry
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 CO CT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND O DINANCES GOVERNING THIS T E F WORK WILL BE COMPLIED.
$700
WITH HETHER SPECIFIED HEREIN NOT T E GRANTING OF A PERMIT
$.50
DOES OT PRESUME TO GIVE AU GRIT O VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PRI IONS OF ANY OTHER ST TE O OCAL LAW REGULATING CON-
STRU TION OR THE PERFORM CE ONSTRUCTION.
$7.50
PLAN CHECK FEE
TOTAL FEE
$ 8.00
SIGNATURE O NTR TORORAUTHORIZEDAGENT IDA 1
WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
BLDG-INSP
DATE
' SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) I
CITY OF ERIDL.EY
APPLICATION FOR. RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME: BUILDER:
ADDRESS: U �� //�J �G �� ADDRESS:
NO:. �' 7 / STREET:
LOT: �� BLOCK:
(J
ADDITION: �Jj LUr4 7'I LGS
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front:
Depth:
Square Feet: Cubic Feet:
Front:
Height:
Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: �1'g5oxl ' Estimated Cost:
.*To Be Completed: ,d
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict 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 ap atiq�t
are true and correct. I � /
DATE: / (h SIGNATURE:
(See Reverse Side For Additional Information.)
69
UUM
SUBJECT
P
City ®f Fridley
10_ �.. 16 0 5 4
AT THE TOP OF THE TWINS
BUILDING P E R MI "
r
RECEIPT NO
`y ____ COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
® 7
1 �
i .CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
P
PAGE OF
APPROVED BY
612-571-3450
910-F15
12/11/81
JOB ADDRESS
6241 Rainbow Drive N.F.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
2
S�jvan Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Williard D. Balling SAME
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Minnesota Exteriors 295 Highway 55 Hamel Mn 478-6001
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 E)( ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Aluminum Siding, Soffit, Facia & trim
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
`t
5,`700
/%/ $2.70
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
R8IUSIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC ION OR THE PERFOR OFZTRUCTIO
33.00
PLAN CHECK FEE
TOTAL FEE
$35.70
SIGNATURE OF CONTRACT OR AUT RI2ED AGE T (DATE)
),*EN PROPERL ALI D TH IS YOU MIT
11-1/
//
SIGNATURE OF OWNER IIF OWNER BUIL DER) (DATE)
BLDG INSP DATE
UUM
SIGNATURE
REPLY:
DATE SIGNATURE
ORIGINATOR -DETACH AND .RETAIN
CITY OF FRIDLEY
ARPLICATioN FOR RESIDENTIAL_ BUILDING REMITS
(116w, Alterations, Additions,, or Repairs)
01111ER: �
ADDRESS
TEL NO: 5-7
B'UILD'ER,. .1�YGL���c��r �' v
ADDRESS:
TEL 110: o r-' /
ConstructionLocation
STRLGT NO: 10 _ l ( STREET:
LOT: BLOCK: 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.
DESCRIPTION OF CONSTRUCTION
front:
SgnaLe.Feet:
Depth: H eight :
Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction:
To Be Coripleted: -(2-
Proposed
(7-Proposed Driveway width If New Opening Is Desired:
Estimated Cost: $ `7` V V
Alt. A Alt. B
SEE REVERSE SIDE OF SHEET .
7lie undersigned hereby makes application for a permit for the tnrk'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 applica re true and cor - ct.
DATE: � f( SIGNATURE: ���
Stipulations:
f
I
Building - j, I
Inspections
763-572-3604
DATE_,/ Q — v
SITE ADDRESS _
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PHONE:
MECHANICAL
.
RESIDENTIAL
CITY OF E1
YOUR E-MAIL ADDRESS
Permit No.:
CITY„ STA ZIP
ADDRESS: ns
IVlllllledlw, ivnJ
v V`fLV CH 1, STATE ZIP
PHONE - 1W
------
.__-- FAX
k1INGLE FAMILY ❑ TWO FAMILY
❑ NEW REPLACEMENT
of
❑ TOWNHOUSE
❑ 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. (This 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:
SIZEBTU
Equipment Installed
MFG: MODEL:
SIZEBTU
MFG: MODEL:
SIZE/BTU
$25.00
_FIREPLACE (GAS) $15.00 ,
GAS RANGEIOVEN $10.00
GAS GRILL $10.00
,A/C
IRE XCHANGEER $15
AIR TO AIR E
REPLACE (WOOD) $35.00
NEW
GAS UNIT HTR $10.00
BOILER
LINER $10.00
FURNACE $35.00
GAS DRYER $10.00
POOL HEATER $35.00
$15.00
_CHIMNEY
DUCT WORK $10.00
GAS PIPING $10.00
_VENTILATOR
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.
L_ x $35.00 = $
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 al yrork which requires review and approval of plans.
SIGNATURE OF
City ®f Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977