PRE 2010 DOCS19'-�'/i
City ®f Fridley, Mim.
BUILDING PERMIT N® 7380
Date:
Omer: Builder
Address __w _ . __ Address
jLOC ON,01 JJUIL
NG
No 7% 0 Street Lot
Lot _ _Block
Addition or Sub -Divi ions =�
Corner Lot _ Inside Lot Setback _.��s,L_._____ Sideyard .1J,..._...r
29— 15
Sewer Elevation 712 • a 7 ^-• Elevation d 2
r0P of r=007-IAI&
DESCRIPTION OF BUILDING
��-s„��r �. Front_ _h%sq. Ft.V -
It Depth t sq. n
Type Of Est Coft 4W V To De Completed
R4W2t -b
In consideration of the issuance to me of a permit to construct uilding described a ,to
the proposed work in accordance with the description above set in com e th ovIsions of
ordinrtnces 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
” pennh does not cover the construction, ieataliadon for wining, plumbing, gas heating, amver or water. Be core to as
the Building h gmftr for saperafe permhs for t6s:e hang.
0
APPLICATION FOR BUILDING- PEMEET
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME
ADDRESS ADDRESS
LOCATION OF BUILDING
No. Street Part of Lot
Lot_ Block Addition or Subdivisi
2. �
Corner Lot Inside Lot Setback
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Tao Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates:
DESCRIPTION OF BUILDING
To be ed as:
Front ,/� -,!:5) Dapth ,%� Height
Sq. Ft. ;7U Cu. Ft.
Za Frontes -,�57 Depth �� Height —
Sq. Ft. Cu. Ft..
Type of Construction
To be Completed
timated Cost
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 he facts and
representations stated in this application are a and co ect..
DATE S SIGNATURE.
(Schedule of Fee Costs can be found on the Reverse Side).
SUBJECT
P
City of Fridley
21336
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RICETT N
COMMUNITY DEVELOPMENT DIV.
v _ PROTECTIVE INSPECTION SEC.
01_
r e
NUMBER -
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
5/14/92
JOB ADDRESS 5560 Regis Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
EIS 6
4
Parkview Oaks First Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mos sma.n
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Right way Roofing 11304 Red Fox Drive Maple Grove MN 5578678 3999
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
Reroof House & Garage. (23 $quares) 2nd Layer.
9 CHANGE of USE FROM TO
STIPULATIONS
Roofing can be. 2nd layer.but not 3rd.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. 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 21 9
$t.61
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
4
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-
$31 a'��
Fire 5C $1 22
ANCE OF CONSTRUCTION.
TRUCTION OTi7tA4J
PLAN CHECK FEE
TOTAL FEE
�_ (�
'
1 L
$5,0. -License SSC
$ 37.83
SGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
HZPIp7E11RL AbI TED THIS IS YOUR PERMITSIGNATURE
Z BL GATE
OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ]
ADDN [ ]
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
zIf-,(S bIfs
Effective 3/1/92
Legal Description:
Owner Name & Address: -10 Z>S VYL a, h Tel.
Contractor: ' _t_q - a c 0 Ca � i k �4 MN LICENSE # � I CC
Address: t 3 6 y Y^ Tel. #
Attach to this application, a Certificate of Survey of the
K 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 Ground
Sq. Ft.
OTHER:
- � 42 fir?
� �_t S � �
A P A C_,F _ � -3
I-) k) D
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: r o o° u, ; } , �, o_ f er-4F Estimated Cost: $
Approx. Completion Date: S_- 157 - 17Z f"?/% ®'
Driveway Curb Cut Width Needed:
DATE: S- I `(- ( Z APPLICANT:
Permit Fee
$
31-0,o
Fire Surcharge
$
f , .22
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Park Fee
$
Sewer Main Charge $
TOTAL
STIPULATIONS:
Ft. + b Ft = Ft x $
SC -6V VOU'CS
CITY USE ONLY
(Cost on Back)
= $
Tel. # -S 7-'12JCQ
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or. Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary ( ]
Building
MECHANICAL
Permit No.._)(0 r
InspectionsRESIDENTIAL
APPLICATION
Received Byi_
763-572-3604
CITY OF FRIDLEY
Da 'd: p
FAX
1763-502-4977
EFFECTIVE 1-1-2010
DATE to -a 3 --1 Q YOUR E-MAIL ADDRESS
SITE ADDRESS D lrl
THIS APPLICANT IS: Q OWNER IiMEONTRACTOR
PROPERTY
NAME: 0.u�A
OWNER/
ADDRESS: SS &Q 6 KC,'t 5 ®r . CITY &. a %v STATE ZIP
TENANT�6
PHONEE(�3 - 57o1 -a y
CONTRACTOR
COMPANY NAME: W ' z pa S (2
SUBMIT A COPY OF
CONTACT PERSON: cry - Q>q
YOUR STATE
STATE LICENSE # ?,LL OS 1 1(J x-13 EXP DATE g 1 ti 110,
LICENSE WITH
ADDRESS: aac)(' f )low S4. dJ C CITY STATE 4ZIP
APPLICATION
PHONE76,9 -C�-95- -??y.-)- FAX 'Ifo
PERMIT TYPE
UeNGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW andPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL 3 2006 ASHRAE HANDBOOK
Equipment Installed MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
_A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
NEW
_BOILER $35.00 _FURNACE $35.00 UNIT HTR $10.00
CHIMNEY LINER $10.00 _GAS DRYER $10,00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
h
$fib
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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 work which requiresre w' A and approval ofpbanns.
SIGNATURE OF APPLIC � 1 `�- PRINT NAME - S- E �06Z DATE �'a
r
APPROVAL INSPECTORS SIGNATURE DATE
':.� , ..
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977