The URL can be used to link to this page

PRE 2010 DOCSCity ®f Fridley, Minn. N° 10388 PUILDING PERMIT Date: Sept. 3, 1969 owner: Anthony Guerre— Gerald Glenn Bl Same Address 1202 Hathaway Lan, N V- Address Same LOCATION OF BUILDING No. 5530 Street Regis Drive N. E. Part of Lot Lot — 8 Block 4 Addition or Sub -Division _ Parkview Oaks 1st Addn. Corner Lot Inside Lot — X Setback 35' -- Sideyard 51 - 1 &' Sewer Elevation ___ 95 4.7 9 MXXK11N=2ftWdd= 95 7.7 9 Ton of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 42 Depth 28' Height 20' Sq. F�L 1034 Ca, Ft, Garage Front 20' Depth 2Z' Height 10' Sq. Ft. 440 Cu. Ft. 44.00 Type of Construction Frame Est. Cost __ 20 000.00To be Completed SEWER LOBATION - 46' South of Manhole WATER LOCATION - 57' South of Manhole 11' South of Sewer 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 compligoe with all provisions of ordinances of the city of Fridley. / A $100.00 Sewer Cone on Charge In consideration of the payment of a fee of $_MAQ __ .., permit is hereby granted to Gerald rl Qnn Blders to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ Ejolding Inspector Clarence Belisle / j NOTICE: Thle permit does not cover the construction, hutallatien for wiring, plumbing, gm healing, sewer or water. Be sure to we the Building inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA J - OWNER'S NAME BUILDER ADDRESS ® ADDRESS LOCATION OF BUILDING kzO NO. -STREET LOT BLOCK ADDITION OR SUBDIVISIOI �?4-O'LcA-c� 6441, CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this Form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To. a Used As. 'Front. . Depth 4$! Height -26 Square feet �� t Cubic Feet Front �O r Depth Height 10 Square feet0 ;;j1 Cubic Feet Type of Construction_ h Estimated Cost To Be Complet 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 deolaros that all the facts and representations stated in this applipation are true and correct. o DATE ��T SIGNATURE� Z I I (Schedule of Fee Costs can be found on the Reverse Side.) 611 w Q PARTIAL RATE SCHEDULE GRAVITY WARM AIS: RATE TOTAL Furnace Shell & Duct Work .........:................. $10.00 $ Replacement of Furnace ............................ 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... &W $ Replacement of Furnace ............................. 6.00 '$ Repairs & Alteratioaa--up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 STEAM or HOT WATER SYSTEM Furnace Shell & Eines--to 400 sq. ft. EDR Steam .... AM . $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..,. 10.00 ®® . Each add. 200 sq. ft. EDR Steam ................ ..... 3.001$— .00'$Each Eachadd. 320 sq. ft. EDR Hot Water . ... ........:... 3.00 $ OIL BURNER --to 3 gal. per hour ...... ... .... ... 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ..................... 9:00 ® 0 over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO SATE TOTAL 1st 3 Fixtures ..... ............ u$ 200 Additional Fixtures ................. x .76 $ Gas Range to 198,000 ........... ` it 5" $L- CONDiIONING FAR HEATING SYSTEM ATING SYSTEM ALTERATIONS & REPAIRS See'Fee Sehednb TOTAL FEE ® � 4-777=77-11=104ift Dept. of Bldgs. Phone 8604490 City of Fridley: 1 ,N 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 refiling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, 38m Owner vz�- Kind of Building/-� Used as To be completed about Estimated Cost, Ol&effZuIlding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam H�Waarzn Air—No Trade Name Size No 0 Pm--5 . Capacity �- Sq. Ft. E.D.R o BTU H.P. Total Connected Loan / Kind of True BURNER — Trade Name Size NQ Capacity Sq. FL E.D `; H.P: BY z4eim�— Bus1hess Phone (REMARKS -OYER) /0 � ENTRAL SUPPLY CO. HEAT LOSS CALCULATIONS 2929 Fourth Ave. So: TA. 40705 Minneapolis 8, Minn. ]A.GSI�u.V.E.Weatherstrise PII , Construction No. �� Insulation id Windows I Doors Reference II Out. Wall I lrvt.�'Walll Ceiling Roof I Floor Ij K_ind How Applied Yes,NoYes—No 11 19—' 2 t Fl. �� Room Length 2Fl. Width ' :- j a Height1s oom I length Width Height Windows and Doors—Crackage and Area I Windows and ors Crackage and Area Width Height 'No. of lineal h. Area Wilt Height "io. of Li.teol ft Area No. of poM of pane lights of cock $4. ft. I No, of pone 1 of µand GgMs of 'rock sq. ft. - '*'-------t-- 72- Coef ! Btu I ' --� Coef Btu Infiltration - J C- -- ..� 1 l '0 Infiltration „ �- / at a p D r Glass 33 T.,S' �C o Glass ; Y's Exp; wall Exp. wall Xo Net exp `° a j a-ex.P +h Int. Wall dr��%_ Z -1b sr /off l �';t d i a es 4m. wall ' +^a "� - Floor - --- F—.ra' t Floor Coil. Total Btu. _.•_ .- ~ —��fj ?, i, Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area sf Required ft. E.D.R. yr s _ _ i I _ q sq. q ms. W.A. leacr,�r area ►� Fl., a,l Roam length Width a Height �i` /f FI: ( Room I Lers:,th 2�V .Yidth Windows and Doors--Crackage and Area Width HeIgM No. of lineal h: _ Area No. of "ane -1 of paM IigMs ' of crack sq. h. i Width Height No. of lineal ft. Area No. of pan* of pane iights of crack I sq. h. _ Coag Btu Infiltrotion Coef Btu Coef Btu Infiltration �� Exp. Exp. wall' o o, . Glass Int- wall Y Dil -710 . 4, Int. wall Floor A ,� E41 wall j' 7 `�, Net! exp. wall / e Int.' wall Flo :'r CKeiI;. Windo and oars--Crackuae once ,area Width HeIgM No. of lineal h: _ Area No. of "ane -1 of paM IigMs ' of crack sq. h. i _ Coag Btu Infiltrotion Coef Btu Infiltration - Glass Glass 2 - Z' / Exp. Exp. wall' Net exp. wall Int- wall Y Dil -710 . Floor Int. wall Floor i Coil. r- T t'' - Re wired sq. ft. E.D.R. or sq Ins. W.A. Leader area Required sq. ft. E.D R. or s inc 1• Room I length+ Width Height I FI.Room I Length ,e Width Height/7..: Windows and oors—Craeka a and Areo I d ,-rer� - ----"� g i Windows on -Doors _ Crackage , Width Height No. of Lin*a k. Area Widih Helgh� tvo. of �i -`- A? I No. of P. of paM lights of crack sq. ft. No. of pan* of pan* i_ghta Coef Btu A'filfration . o a® 31ags 1 o :xp; wall ' 13 Jeti exp, wall L►' >s otdll Btu. (red sq, ft. E.D.R. or sq. ins.,W.A. leader area Total Btu. Required sq. ft_-E.D R., or sq. his. W.A. Leos , ( i _ Coag Btu Infiltrotion Glass Exp. wall Z' / 72-1 —Nev. exp. wall Int. wall Floor - r- Coil...� 1D a xs Total Btu. Required sq. ft_-E.D R., or sq. his. W.A. Leos , ( i i CENTRAL SUPPLY CO. i WAT LOSS CALCULATIONS 2929 Fourth Ave. So TA. 4.0705 Minneapolis 8, Min". .i p I A 5 H.V.E. ,ji� - insulation Weatherstrips, Construction No. Guide -- Aindows I Doors 'Reference IIOut, Wall Int. WaIII Ceiling Roof 'I Floor i Kind How Applied y s—No ! Yes --No 1 19—T FI. { •r;J Room Length Width Height Fl Room Length Width Height j O indows and Doors--Crackage and Area' {' Windows and Doors -.-Cr ockage and Area Width HeightNo. of Lineal ft. Area l� Width Height "to. of lineal ft. Area a. of parte of pane tiyhtt � of cratk sq_. ft. � � No. of'pane� pane �. i��hts �- of Trac_ k ; .. sq, ft.t -C cel ! Btu � - ---+ -� Coef Btu' nfittrotion Q' 6'' O I Infiltration / .._.'_' T rs it ` ,�a lass . 3' '; y o II Glass .A . Exp. wa l J4xp• wall - - - E ot sxp. w - - - s /- it B q Met r3.. int. wolf int. wall - _ door -- /e� ;P o I Floor __- 27 Gail. -I Y 3 / jjj X a ry Ceil. r7 Total Btu. —�- iLDi y/ m t, Total Btu. Required sq..ft. E.D.R. or sq. ins W.A. Leader area Required sq. ft. E.D.R. sq. in W.A le�czr areo ! FI. { Room I Length —Width /I-- Height Fl.� hoom j Lel, 4idth 1.3 Height'#* ,Wj indcws and Doors--Crackage and Area^ -- No. of 1. *at ft. lights ' of crack Width Height No. of Lineal ft. Area No. of pane of pane lights of crock sq. h: i p I Y71 RZY09-e� 7 infiltration Ceil: Coef Bt Coef ! Btu iinfiltration Glass ;,0 7 4 �.. 'Glass d - 0 1 J �� Exp. wall j -int. wall Cell. �1' _ *I Net exp. wall - • __ - - _— _ "�.,�_..�. -lie:. I. Ceil. y Int. wall I n ! Total Btu. Floor I' Required sq. ft. E.D.R. or sq. ins. W:A. Leader err a ® s Ceil. -i 11/. - indows and Doors-Cracker,ie and A eaV Width Heigh : No. of oone of pane '1 No. of 1. *at ft. lights ' of crack t Arae aq. ft. Net exp. wall Y71 RZY09-e� 7 infiltration Ceil: Coef Bt i ~Infiltration Gloss -rt— Glass ;,0 7 IIExp. wall .2. T' Net exp. wall - 0 1 J Int. wall Floor j -int. wall Cell. �1' _ �-�- ='i - • __ - - _— _ "�.,�_..�. -lie:. :Total Btu.--i-�-� Re uired s ft. E. R. or ser. ins ` ' E :'ut- r-, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �,; f' q q• ' _-_- Fl. ( c Room I Length 'Width Height / FL { om_I Length JVidth . Height TW -4 inaows and Doors -Cracker .t area .Windows and Doors—Crackage and Area gz Width Height No. of Lienal ft. Area j Width Height ;�No. of t. i A:. No. of pave of pons lights of crack aq. ft. i No4 of parte of pan�Il lights of - _a H }2-0 Infiltration ' Btu Glass Exp. wall Net exp. wall Coef Btu infiltration Ceil: ra I' Gloss / I Exp. wall Net exp. wall J j -int. wall Floor I. Ceil. y 3 2 I n ! Total Btu. I' Required sq. ft. E.D.R. or sq. ins. W:A. Leader err a Infiltration ' Btu Glass Exp. wall Net exp. wall Int. wall Ceil: Total Btu: i►' O Required sq. ft. E.D.R, or. sq. ins. W.A. tetaw.: CITYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 September 29, 1986 Keith Hanson 19 Fast St. Albans Road N. E. Hopkins, M 55343 RE: Non -Compliance of the Fridley City Code at 5530 Regis Drive N. E. Dear Mr. Hanson: On September 22, 1986 it was confirmed by an on-site inspection that the property at 5530 Regis Drive does not meet the minimus standards necessary to maintain a pleasant and prosperous suburban environment. While major code requirements are satisfied, the following item does not comply with the performance standards of the City Code: 1. Debris in wooded area in back yard. I unaerstand that there may have been score extenuating circumstances for this to have occurred, however, your quick action to correct this situation would be a great improvement for your property and the entire community as well. An inspection will be conciucted on or about October 9, 1986 to determine comial iance. If you have any questions or concerns, please feel free to contact me at the Fridley Civic Center, 571-3450. Sincerely, Richard W. Wiersma Code Enforcement %V/1mn C-86-438 .N. 5027 Origin Permit for IFLUMBING AND GAS WTING qq),d, N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit !/ inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., /1 DESCRIPTION OF WORK II Number, Sind and Location of F=turt es Storiest 0 3 U Z O a�4a m m F Zm m m Y 0 = m m d}d 3 F Y Z Z G IL� m O C Z O w p t440 m U m z rc C J m f Ii. O Q W m ZQ O C WATER HTR. GAS ELEC. Basement >st 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings Permission is hereby granted do the plumbing and gas fitting in the building descried i the statement dreto attaff6d, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection inspector. Final Inspection Date 2 , inspector. 42 IM—."9-v City of Fridley 19-&1 Owner l Z Location Kind of Building JAOe- — Used as To be Completed , 19_ Estimated Cost $ Old New. Building Permit No. l Date Inspector of Buildings. No. Make oris PERMIT for Dower Plants and Heating. Cool- ing, Ventilation. Refrigeration and Air N Conditioning Systems and Devices DESCRIPTION OF WORK Plants lLb LO Q to be installed—altered—repaired S* ze PA -S�' ; Oil fired ; Coal fired—, Gas fired � ; Gas Authorization No. Approved by. Final Inspection Date , 19_ Inspector / Z- Y-3 Permit 4626 Fee $ ®% U f9 Office of the Inspector of Buildings, City of Fridley City of Fridley, Minn. /10,/ ®d , "_6 Owner C• a LE -0 A A Location • :J j c) DECD I s I_1 1 ✓� Kind of Buildi»,g F If R rn E, How Occupied 6 W L LU AJCo Work to be Commenced—,19— Approved ommenced ,19_ To be Completed—, 19— Estimated Cost, Old -Building Permit Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon the press condition that the person to wh0A it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentidhed shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set frth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings 42 2M19.877V City of Fridley Application fcw Plumbing and Gas Rning Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures y N I yy�X' Z 'ej pZ �rZ Ou�l J wU' UN' Z • i t N WATER HTR. GAS ELEG �O Base 1st 2nd 3rd _ 4th • Future Connection Openings Connected with ure New Fixture, Old Openings Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: 140. RATE TOTAL Number Fixtures ...................... 5? x $ iP 4 . o c Future Fixture Opening ................ x $ / .Sd New Fixture Old Opening .............. x $ /• fid Catch Basin ...... ..................... x 3.25 $ 97. coo Water Heater (Up to 4®9,998 BTU) ...... x $ • a a New Ground Run 011d. Blilg. ............ x 3.25 $ use zu / (eat, Q . a� GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................Z x $ $ 2 00'0 of , o� Additional Fixtures .................... x --' W $ e76- »9' 0Od Gas Range to 9 BTU .............. x $ �• od REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ , C) E) Dept. of Bldgs. Phone SII 4-7470 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 ®® _, 190 Av��Owner - Kind of Building e J iid, '_ Used ash To be completed about Estimated Cost, $ Old—Afe7Building Permit No 3 91!� Permit No. -667,? 27 Signed By Business Phone No• 7 �� ROUGR FINAL It - 2 & ? e' .0600,aA2 " J r CITY OF FRIDLEY INSPECT -ION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On August 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES, NO, RATE TOTAL JOB ADDRESS � E,3 o R F- R t 9 Now Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range" Gas Dryer** Back Flow Preventer Required )Yes No Type $7.00 $4.00 $5.00 $7.00 $7.00 $7.00 $7.00 $10.00 $7.00 $10:00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr. ' ALL OTHERS AND/OR REPAJRS AND ALTERATIONS C) 1.5% of Value of Fixture cirAppliance Stato Surcharge ,50 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 Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. Owner S ® ";La '1996 Building Used As, Estimated Cost PERMIT NO. / /' PLUMBING COMPANY N SIGNED BY TEL NO, Approved By Rough—In Date Final Date T. M11NIMUM jVC!`-ULi ANY FLUMUNVALtkAb PERP 1T It TOTAL FEE PLUS JW- $.50 STATE SURC -WGE **COMBUSTION AIR: SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. 1:*T.......... . . . . . . . . . . Urinal Wash Floor Shower Tray rain Auto. Washer as Water Heater a Ran Ran Gas IEW lea Stodes Base me ntl.t'.N', i, in - �1.1`11 i t ' 1-- - owl RE IBM - Floor I Floor 2 77: PLUMBING FIXTURE RATES, NO, RATE TOTAL JOB ADDRESS � E,3 o R F- R t 9 Now Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range" Gas Dryer** Back Flow Preventer Required )Yes No Type $7.00 $4.00 $5.00 $7.00 $7.00 $7.00 $7.00 $10.00 $7.00 $10:00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr. ' ALL OTHERS AND/OR REPAJRS AND ALTERATIONS C) 1.5% of Value of Fixture cirAppliance Stato Surcharge ,50 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 Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. Owner S ® ";La '1996 Building Used As, Estimated Cost PERMIT NO. / /' PLUMBING COMPANY N SIGNED BY TEL NO, Approved By Rough—In Date Final Date T. M11NIMUM jVC!`-ULi ANY FLUMUNVALtkAb PERP 1T It TOTAL FEE PLUS JW- $.50 STATE SURC -WGE **COMBUSTION AIR: SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. I SUBJE& PERM City of Fridley '3115 5 AT THE TOP OF THE TWINS BUILDING PERMIT REC COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/11/00 10B ADDRESS 5530 Regis Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 4 Parkview Oaks 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brenda Berends 5530 Regis Drive NE 763-571-2061 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Affordable Remodelers, Inc. 4807 Dusharme Drive, Brooklyn Center, MN 55429 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-535-6269 20054435 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION 11 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Window Replacement 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 IJAiform Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE O 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 BO DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO, D LG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 $9,100.00 {�T �Y31 $4.55 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- I$181.25 Fire SC $9.10 TR CTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK %E TOTA FEE Lice C $51 QO , $ 99.90 iGNATUREOFCONTRACTOR ORAUTHORIZED AGENT IDA`TEi HE PROP ALIO ED HIS IS V UR PERMIT QbG INSP S-GNATURE OF OWNER pF OWNER BUILDERi (DATE, I JUL-10-2000 16:59 FROM CITY OF FRIDLEY TO 5356933 P.01/02 NEW [ } Effective 1/1/2000 ADDN [ } CITY OF FRIDLEY (763) 672-3604 Bldg ins p ALTER [ l SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 1 Construction Address: � 53 C) Legal Description: Owner Name & Address: _ bOL n 6L- v&U-7t 6& Contractor: AFFORDABLE REM MN LICENSE #_2,Q 0.5 ��.5 Address: 4807 DUSHARME DRIVE Tel. # 7�e3, 5 5,5-6,Z6q BROOKLYN CENTER, MN 55429 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: 1-12 Construction Type: C r1 - 1Vstimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ %e DATE: 7-11-00 APPLICANT: 66t" �. Tel. # 7& 3 -53 5 - (p 2-6 CITY USE ONLY - Cali (763) 672-3604 for Permit Fees if mailing in application Permit Fee $ 181. ZS-- Fee Schedule on Reverse Side Fire Surcharge $_. n. /6 .001 of Permit Valuation (1/10th%) State Surcharge $ -I/ S S� $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ GI C� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ ee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ j Not Necessary [ ] TOTAL $ z�- STIPULATIONS; Building Inspections 763-572-3604 763-502-4977 FAX SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 7-1-2010 Permit Received YOUR E-MAIL ADDRESS P rg-40 6c~-, ,'k Cd 0,(3 ( CQo-a, OWNER 43CONTRACTOR 1�j e - -J W a STATEPAV\ ZIP S 5-112. CONTRACTOR NAME: 0) &F -a -W+_ <.% AVN 0 - C_ SUBMIT A COPY OF STATE LICENSE#_ ® (Q®cg - 5�•� EXP DATE Z 2 - YOUR STATE —� LICENSE, BOND AND STATE BOND # Z L, ::J� D 5' r �j 3!g� EXP DATE ! 3 f 1 CERTIFICATE OF ADDRESS:—IS ''- 3. r✓ < CITY a ---P-5 STA TELl- _ZIP� INSURANCE PHONE FAX -v PERMIT TYPE I AINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 1 ❑ NEW 014EPLACEMENT - DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. $35.50. _ BATH SINK/LAV _FLOOR DRAINS —BATHTUB _ GAS PIPING (NEED CITY LIC) _ CLOTHES WASHER _ KITCHEN SINK _ DISHWASHER _ LAUNDRY TRAY FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE SHOWER SWIMMING POOL _ WATER CLOSET TWATER HEATER ($35) _ WATER METER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED _ WATER PIPING _ WATER SOFTNER ($35) _ BACKFLOW PREV. ($15) FOR IRRIGATION OTHER I hereby apply for a plumbing 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 qRplication for a pe and work is not to start without a permit on site; that the work will be in accordance with the approved plan in as of a which requires review and app oval of plan t. SIGNATURE OF APPLICANT PRINT NAM°�D DATE I.L11 APPROVAL INSPECTORS SIGNATURE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977