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PRE 2010 DOCSCity ®fFridley, Minn. _ BUMI)ING PERMIT N® 6347 I/ 41 Date: —'_'6_ 3 62;&2 /) Owner: d f Builder Address - Address 4 ICAPION OF BUILDING No. ® Street __ _ _ Partg,Lot Lot 7_ Block — Addition or Sub -Division _ Corner Lot _ Inside Lot Setback__ _ ,. .off ®_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T)ot UV. / Front _ Depth _ Height Sq. Ft IA_,O u. Ft&OZ Front Depth eight Sq. Ft. __._ Cu. Ft. Type of Construction Fst. C yl- be Completed Zwl 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. Cy In consideration of the payment of a fee of St , 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 atanyupon vi of any of the provisions of said ordinances. Building Inspector NOTICE This permit does not corer the construction, instaWan for Widne, phtmbing, gash mwar or water. Be sure to we the &rihdng hopeetar for separate permits for then items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDIEY, )MRMSOTA f� Owner's Name i✓ !�� Builder Address 3 oeo /—, -1-CVC � �6 LOCATION OF BUILDING No. �?�� f Street &-Z�"S i dam— Part of Lot LotBlock Addition or Subdivision Aur�vrs�9'i'iS /-210A/ Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Sq. Ft. /604 Cu. Ft.� 1,. FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction �Oe✓w%-iA.f' Estimated Cost�'Z, zd� To be Completed / e,3 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordl-winces'and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 69CrX 'L SIGNATURE / (A Schedule of Fee Costs can be found on the Rever Side.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK�� Number, Kind and Location of Fixtures Location. PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ......................J� x $1.50 Future Fixture Opening ................ 1, x 1.20 New Fixture Old Opening .............. x 1.00 Z_Y x 3.25 Water Heater (Up to 200,000 BTU) ...... Z � New Ground Run Old Bldg . ............ � Z � � O Z U' Z Z a � F • N WATER HTR. GAS EIEC. Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings Sewer E] Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ......................J� x $1.50 Future Fixture Opening ................ 1, x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin .... ....................... x 3.25 Water Heater (Up to 200,000 BTU) ...... x 2.00 New Ground Run Old Bldg . ............ x 3.25 GAS FITTING FEES: NO. PATE TOTAL 1st 3 Fixtures .......................... 4 x $1.50 $ 4, �® Additional Fixtures x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ • �® City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, %Minn Owner Kind of Building Used as To be completed about0� Estimated Cost, $ Z -4, Old ew. uilding Permit ROUGH FINAL �4339.42 2M Business Phone No. Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and '1 Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 �1 14 o V� GRAVITY WARM AIR: I RATE TOTAL 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 ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................ Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... Furnace Shell & Line—to 640 sq. ft. EDA Hot Water ... Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. EDR Hot Water .................. OIL BURNER—to 3 gal. per hour c ... ................... 8.00 $L'� 2.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 $ 2.50 $ 2.50 $ 5.00 $ 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. MAR 14 i „ Eridlev.,lbfinn_ � 19 — o � Owner Kind of Build' ! Used as To be completed Estimated Cost, ew. 'lc HEATING er 14 over 3 gal. per hour—See Fee Schedule Trade GAS BURNER (up to 400,000 BTU) ,•. ................. 5.00 $ GAS FITTING FEES: 1st 3 Fixtures ...................... Additional Fixtures ................. Gas Range to 200,000 BTU .... ...... AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL, NO RATE 79L _ x $1.50 $ _ x .50 $ _ x 2.00 $ See Fee Schedule $ TOTAL FEE $ d �® P Permit No. 6 3 Permit No DESCRIPTIO OF WORK Warm Air—No "I_ Size No Capacity Sq. Ft. E.D.R d BTU H.P. Total Connected Loa r �� Kind of Fu BURNER — Trade Names Size No 4 - Capacity Sq. Ft. E.D. �?�' BTU H.P. GI;O. SID ICK FITC. & AIIr-COR!®. CO 1001 Xenia Av. S. Minneapolis 16, Minn. Signe _ By 2M Business Phone o (REMARKS -OVER) 401,0 D-56 -916R�. 7 9 pl"481=�ow4l HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied No I e No 19— / F1_I/ , � / , A/ Id Room I Length /-a—(*--Width /, Height ? II % F1.1 97-9 %�. ,I Room I Length ed Width �P Windows and Doors—Crackage and Area /3 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. wa .gg oG.ZZ zg ® it 49 ZT Coef. Btu Infiltration Btu Infiltration 3 e Glass s 1,3 ,;V Exp. wall 7 ?3 , - Net exp. wall : Exp. wall (p ? ••' wa+ o' X_- tl S,4.soy5® /� Ceiling ,, Floor / Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 Fl_1 R.. I ,V—W;,1tb Pk— Hnio}it 5 Windows and Doors—Crackage and Area /3 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. t� 1-3 .gg oG.ZZ zg ® it 49 ZT Coef. Coef. Btu Coef. Btu Infiltration 3 e Glass s 1,3 ,;V Glass , - Net exp. wall Exp. wall 1 91 3x Int, wall Net exp. wall ,, Floor / Int. wall Ceiling Floor 2K Total Btu. ` I Y,1,f Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / 171.1 mss/ sj Room I Length o Width .SY Height Windows and Doors—Crackage and Area / Width Height No. of Lineal Area No. of pane of pane lights of crack aq. ft. t� 1-3 Coef. Coef. Btu Infiltration 2 3 e Glass 1,3 6rySp Exp. wall , - Net exp. wall 1 91 3x Int, wall Ceiling Floor / Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width HeightNo. of Lineal ft. Area No. of pane of pane lights ofcrack sq. ft. �6 Coef. Btu Infiltration 2 Glass zfleO Exp. wall 6 le Net exp. wall 91 3, Int. wall Ceiling Floor / Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ./ FI_I Rmm I Length // Width -17. Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane ofpane lights of crack sq. ft. Coef. Btu Infiltration Glass zfleO Exp. wall 6 le Net exp. wall 91 3, Int. wall Ceiling Floor / Total Stu. ID Required sq. ft. E.D.R. or sq. his. W.A. Leader area Room I Length Width// Height Windows and Doors—Crackage and Area Width Height No. of I Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall 6 le Net exp. wall 91 3, Int. wall Ceiling Floor / Total Btu. ired sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley SUBJECT P 136'76 AT THE TOP OF THE TWINS BUILDING PERMIT i � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 � NUMBER REV. DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 1 "1 612-560-3450 910-F15 7/30/76 - JOB ADDRESS 5501 Regis Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Parkview Oaks lst Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon Jones 5501 Regis Drive N.E. 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 I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 261 x 301 Garage 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Get signed release form from neighbor to build without a survey. Stay 4.5 feet or more from east property lines. Convert old garage to living space within one year from date of permit. SEPERATE PERMITS REQUIRED FOR WIRING, WARNING _ . HEATING, PLUMBING AND SIGNS. Before digging CaA IK21 U6" 83 TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING; VENTILATING OR AIR CONDITIONING. wood Frame 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 R-1 780 7500 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I 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. $5,772 $2.89 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- $31.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $34.09 e- SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT •�/l J/J/r P PERLY VALIDATED THIS IS7YO PERMIT/ V'— oyA,WH BLDG. (NSP DATE S NATURE OF OWNER IIF OW UILDERI M 'U 3� APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER ' S NAME :,, &--1 lV QAi' �� did S BUILDER: ADDRESS: g G / 6 64 5 ' 4,e ADDRESS: NO:. STREET: ' LOT: BLOCK: ADDITION: r ��' Nis lS�_ �� sod• 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. DESCRIPTION OF BUILDING To B0 Used As: Front • c>2 1� Depth: 36 Height: Square Feet: Cubic Feet: % (6 n" C) .Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: �Zglstimated Cost:- = c76 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 representation stated in this application are true and correct. I- DATE: �� SIGNATURE: (See Reverse Side For Additional Information.) A� jvt.0 �`�� ei7aC �r eF ✓jeGiJ) �� 7 F7 C ICE OU LTER Lt.N.. moi;-:;o� E- D i4R4 v�J?:E't5 -' =•F R LAl". j_z''A rf OF' -'O'N- F!.OTA - LAr ESrCjge :300 LYNr; M!,NNIEAPC) LIS I A'.0R -. ';370 rror'g Califdtatr .;;r Lx t } f 3 -'t• r ._' .. .. - ham. Allw- U /rC f fI4 , owner of the property located at /,t9F If,-G/S IOR6 ff/.4,4 , have no objection to the . i - City allowing the' construction of a 6 /,OW G_F to be located at ZG-01 t5 r�(,1 without the required certificate of survey that the City ordinarily requires for all new construction. X 1 Ignature Address Date Witness 4 City of Fridley SUBJECT PER 14-99 AT THE TOP OF THE TWINS PERMIT /' r i. BUILDING ECEIPT NO. 1 _ 6 ______ COMMUNITY DEVELOPMENT DIV. 1 i PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 1.J NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F1$ 5/15/78 108 ADDRESS MN 55432 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3Oaks,, 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP D Jones 5501 Rerive NE Fricilt-y. NIN 55432 PHONE 3 ACTOR AIL ADDRESS ZIP PHONE LICENSE NO. Ted Hines (Hines Bros. Masonry, Inc.) 6629 Oliver Ave. S 866-3212 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK IR NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Masonry 4 Franklin Fireplaces 9 CHANGE OF USE FROM TO STIPULATIONS 1. Call for footing inspection. 2. Call for damper inspection. 3. Builder agrees to co-sign permit by 5/22/78, and 10 �L 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 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 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 $1,500.00 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAG CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -g.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 1 ) PLAN CHECK FEE TOTALFEE 10.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (D TE) t v EN PROPER LY V' I AT D THIS IS YOUR PERMIT J O 5/1 5/15/78 _ SIGNATURE O WNER OF NER BUILDER) DATEIo BLDG. )NSP DATE (J P ®R u CITY OF FRIDLEY APPLICATION FOR RESIUL-NTIAL BUILDING PEIMITS (NEW, ALTERATIONS, ADDITIONS, .OR REPAIRS) OTA711DR:��)� Addres s: > C: - 'Cr Ir No. % LOT: Street: P BUILDER: C/ Address: r �c!� l[3 � � � L' %� /7 LJ� •-SCJ • Tel. No.: l,( 6- BLOCK: ADDITION: ja-I � 6&s f5r. 4W. CORNER LOT: INSIDE TAT: SETBACK: SIDEYARDS: Applicant attach to this form trio Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUI LDI.NG 7'o Be Used AT C�� /� ��o� • Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: TM Es 'hated Cost:�� To Be Completed: -��/ Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SKEET) The undersigned hereby makes application for a permit for the work herein specified, agrecing.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 cor ect. See reverse side r additional information. DATE: 'J SIGNATURE:,�I�'! 7 Stipulations: p® La �-•� lj SUBJECT PER O. City of Fridley 15 4 0 6 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/20/79 JOB ADDRESS 5501 Regis Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Parkview Oaks lst SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon Jones 5501 Regis Drive N.E. 574-0020 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 8 DESCRIBE WORK Construct a 22' x 16' Deck 9 CHANGE QF 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 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 $700 $. 5O 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. $7.50 PLAN CHECK FEE TOTALFEE $8.00 IGNATURE OF CONTRA OR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT l� �l3 SIGNATURE OF OWNER IIF ER BUILDERI IDATEI BLDG INSP GATE lj CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: �J ADDRESS: TEL NO: STREET NO: STREET: BUI LDER : 15a4-9-0— ADDRESS: TEL NO: Construction Location 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 L�"Front: ��- Depth: C � Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: ( �� Type of Construction: IJuoob leIg Estimated Cost: $ ju 7o Be Oompleted: 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 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 ereby declares that all the facts and representationry gstated in this application are true rrect. DATE: ( ` SIGNATURE: Stipulations: CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL IIUILDING PERMITS (New, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: /C A/0 V J 0 Af x' --'S BUILDER: -:5'k M 15 Address:. '��r Address: Tel. No. �%: Z'— zQ No. :S1® % A LOT: rl CORIMR LOT: Street: BLOCK: � ADDITION: I14SIDE TAT: SETBACK: SIDEYARDS: 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: Depth: Square Feet: Cubic Feet: Height: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ To Be 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 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 represen tions stated in this application are true and cors ct. See reverse side -or additional information. DATE: SIGNATURE: Stipulations: SUBJECr P E R M I T NO. City of Fridley0 311 AT THE TOP OF THE TWINS BUILDING PER I T i • RECEIPT COMMUNITY DEVELOPMENT DIV.�� r PROTECTIVE INSPECTION SEC. i CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY �j 612-571-3450 910-F15 x/20/90 JOB ADDRESS 5501 Regi: Drive N,E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Parkvi.ew Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dorothy Alderman 5501 Regis: Drive N,E a 574--0310 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 O NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Change garage roof frozg flat to 4/12 pitch. 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. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 750 $ 88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT F PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $41.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $41.88 +4 IGNATURE OF CONTR#VORO UTHORIZEDAGENT IDATEI WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT va SIGN T RE OF NER IIF OWNER BUILDERI IDATEI BLDG INSP NEW [ ] ADEN [ ] ALTS [ ] r ,- Construction Address: ? Legal Description: R-1 AND R-2 Building Permit Application Effective 1/1/90 N) <<-q 3 � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. nES=PTICN OF 33r LIVIM AREA: Length Width Height Sq. Ft. GARAGE AREA: length Width Height Sq. Ft.2�9) DECRC AREA: Length �+ Width Hgt/Ground /Sq. Ft OTMM: (I I_ .� N CA S_! r �- (, ,n m p �. t i! rl� r i' ">}.nr, C / i It° L Corner lotV4 Inside lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ % -7 �-J 0 Approx. Completion Date: t� 106 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ n/ Width + 6' See Back Page DATE: "7 06 APPLICANT: Tel. # Permit Fee State Surcharge $$ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Marge $ STIPUTATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ,,r-isr—AL 8"t. Fss C,ry Lors TOPOQR"IC MAPP-NG k C. E.COULTER PLATTING LAND 5URVEYOR FARM supvEys LAKES -MORE REGISTERED WINDER LAWS OF STATE OF MINNESOTA JUDICIAL L:CK�:ikD BY ORDINANCrs OF C:Iry OF MINNE-.POL'S 3300 LYNDALE AVE SO MINNEAPOLIS 8 MINN TAYLOR -.0370 *urbepor's Certificate - 11 - 0, <,,; L a;4- 'i I a; 7 L m � C:. r r.. + �*��ri f �.. � of . , ,r � �.' Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 1 d I Ls See Back Page for Fee Schedule CITY OF FRIDLEY Dat MSP ® 201 763-502-4977 FAX $ .001 times the total job valuation Surcharge $ EFFECTIVE 7-1-2010 License Surcharge 97;9 �� S� J1 DATE 7 —16 YOUR E-MAIL ADDRESS SO� �''cl F� i'V SITE ADDRESS SSD t (Q��S n THIS APPLICANT IS: ❑wy(/� CONTRACTOR PROPERTY OWNER/ —Ot-WNER NAME: l—W /C� 1e) V TENANT ' ADDRESS: SrS/1�O1 O 1 5 � CITY-&!Aq STATEWZIP 5S'VJ 2 -- $ PHONE: CONTRACTOR NAME: T STATE LICENSE # 'yQ (p EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE � ADDRESS: �% 3'0 Aq l9'r L� CITY or�I 4I y ^- STAT4WZIP s -Y? AND CERTIFICATE OF INSURANCE IV 1 PHONE 7%3 — J"5' 2 - FAX �7 — �lZ PROPERTY TYPE 5t INGLE FAI. LkEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK &IDING ❑ OTHER B SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: V wee, ,-r F FXSC SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl WSoffit ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim Fascia and proposed project. ❑ Other 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑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 $ • CDO OCCUPANCY TYPE Permit Fee $ 1 d I Ls 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 $5.00 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 $ /17. • Make checks payable to: City of Fridley Attach 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 on site; that the work will be in accordance with the approved plan in the case of reQu4cs review and approval of pl �L r, SIGNATURE OF APPLICANT I� x.VT/RG— NAMEifr/ hr1'r LAWS 00) DATE APPROVAL INSPECTOR SIGNATURE PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK