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PRE 2010 DOCSCity of Fridley, r 6:6: Date: owner: , �a t Builder f -- Address Address LO T PV OF IL ING No. 9 Street Part of Lot Lot ____ _ _ Block 6r Addition or Sub -Division . Corner Lot Inside Lot � Setback y - _ Sideyard Sewer Elevation __.. Foundation Elevation DESCRIPTION OF BUILDING T be V < `� Front Depth Height 9 Sq. Ft. Cu. Ft Fron epth eight �� Sq. Ft. Cu. Ft. Type of nstruction xA Fast._ �o 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 city of Fridley. p,-�n _ 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 Bart Thereof, shall conform is all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings wi city limits and this permit may be revoked at any time�u violation of say of the provisions of said Building Inspector NOTICE.- Me OTICE:'e permit does not corer the condmedon, bohMan for wiring, phnabing, gas boating, sourer or water. Be wre to sou the Building Inspector for separate permits for dMe horse. 11 4 — //.I— F- 7 Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: 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 ............ 8.00 $ each add. 60,000 BTU 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ....................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ o GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $--/-L Z_o Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH s FINAL a $ See Fee Schedule TOTAL FEE $ �r Dept. of Bldgs. Phone SU 4-7470 Location S g 7 A S' (2, E 2,q City of Fridley: e 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. Fridley, Minn 0 A� - -,': , 19 LEY Owner a 1D r. r A P� G.0 ^/ f _' O x/ Kind of Building X t� A P�, 4 Used as To be completed about Estimated Cost, $ y' 1 0 - 070 11 Old Ne uilding Permit No. � Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -steam, Hot Water,arm Air No Z Trade Name & � k c:52 L Size No- C-1 r- F d ® r Capacity. Sq. Ft E.D.R.Z el BTU H.P. Total Connected Load !, �i 4 P a`, : Kind of Fuel a A:7 BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. � 4 Signe By� (REMARKS—OVER) « 2N► Business Phone No � v, er � a Glass Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. �D,3 ¢` HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS' MINNEAPOLIS. MINN. Weatherstrips A.S.H. , E. Infiltration Construction No. 's Exp. wall's Insulation Z.) 9 Guide . > -N 10 0- WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes -No Yes—No 19— :1 0-7 0 Int. wall FI.I 4 e' a,, t,,v e.. Room I Length - _.o Width 4 -,,- Height 0 II Ceiling Fl.l --- -:- Room I Length Width °° Height Windows and Doors—Crackage and,Area er � a Glass Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. , ¢` Coef. Coef. Btu Coef. Btu Infiltration Total Btu. 's Exp. wall's •a, �. Z.) 9 Glass . > -N 10 0- Exp. wall x M Ceiling , Net exp. wall ;? $ :1 0-7 0 Int. wall Ceiling _' e C> Floor Total Btu. I /,x c., ur o Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I ,g F1.1 x r F Room I Length ,,,:k ' Width ria Height ' Windows and Doors—Crackage and Area er � a Glass Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. , ¢` Coef. Coef. Btu Coef. Btu Infiltration' Total Btu. 'Glass Exp. wall's j F' Glass . > Net exp. wall Int. wall s o Exp. wall x M Ceiling , Net exp. wall Int, wall Ceiling �• ~s t d ,� Floor Total Btu. �, R, e,1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,e 171.1 m 5 Room I Length Width _ Height ` Windows and Doors—Crackage and Area er � a Glass Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. , Net exp. wall Coef. Coef. Btu Infiltration ' Glass Total Btu. 'Glass Exp. wall's j Exp. wall Int. wall Net exp. wall Int. wall 2 v Ceiling Ceiling Floor Floor Total Btu. ft. E.D.R. or sq. ins. W.A. Leader area R Windows and Doors—Crackage and Area er � a Glass Width Height No. of -Lineal ft. Area No. of pane of pane lights of crack sq. ft. , Net exp. wall Coef. Btu Infiltration v ,,, ' Glass Total Btu. Exp. wall's Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ias. W.A. Leader area FRoom I Length 1',6, Width a :. Height a Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Infiltration Iy' ,k; Glass" Exp. wall a �' . Net exp. wall` c, Int. wall �. Ceiling s + �.. °25 .pf Floor Total Btu. . Required sq. ft. E.D.R. or sq. his. W.A. Leader area =01 ^r c n .�4 Room I Length ef Width Height Win"An and Doors—Crackage and Area Width Height No. of Lineal ft. Area , No. of pane of pane Ifghts of crack eq. tt. Infiltration er � a Glass Exp. wall r v Net exp. wall Int. wall Ceiling v ,,, Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D66- 7qjjjW9 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind Yes—No Yes—No 19_ / FIJ ,O'� Room 1 Length f Width P Height 11 F1.1 Room I Length Windows and Doors—Crackage and Area Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq.ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Btu Exp. wall Net exp. wall 7 Int. wall Glass Ceiling .r:.y'y.F Floor 13 i a Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area , F1.1 v ,- - a . Room 1 Length / - Width : Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq, ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Coef. Btu Infiltration Net exp. wall 7 Int. wall Glass Ceiling .r:.y'y.F 3� f� 13 i a Exp. wall V y e �, Net exp. wall ,< ,': Int. wall Ceiling Floor' Total Btu. — , Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 A' t.z- Room I Lenath f'' Width -, Heiaht 7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq, ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r L MINNEAPOLIS, MILAN. Insulation How. Applied Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Wane of pane lights of crack sq. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu City of Fridley Appiicetion for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Op NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ S� Future Fixture Opening ................ x 1.20 $ p� ti O 'qa a ~ C'i s °� °'. w ?�? Z `a a • R • N WATER HTR. GAS EIEC $ 3 GAS FITTING FEES: m� i'n 3� ou uG �m a3 U°d Uma (90 Base 1st 2nd _ 3rd — 4th • Future Connection Openings Connected with Sewer New .Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ S� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Beater (Up to 200,000 BTU) ...... x 2.00 $ 2f° New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description.................................. ...........$ TOTAL FEE $ /f .5-D City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do 01l 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 applica are true and correct. Fridley, 1V inn 191 Owner Kind of Building = �"—�— Used as To be completed about = �� Estimated Cost, Ol New. Lding Permit No Permit No. -� Signep— By �— Business Phone No '561—,3 �® ° ROUGH FINAL— -V INAL 0 ` -V/1F. JD y 4 z 2M 7-59 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES _ RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Rate TOTAL $ 20.00 $ $ 10.00 $- $10.00 $10.00 $ Gas Dryer $10.00 $ * Air Conditioning - All Sizes y $ 1 Q.00 $ mpr All Others/4-pairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ CommerciaVindustrial 1 % of Value of Appliance or Work $�'C- State Surcharge TOTAL FEE $ .50_ G ') MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS--f-25— 4 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. /,-� �2 - 7- ,1991 BUILDING USED AS c ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name BTU HP Size No. _ EDR Fuel Total Connected Load Approved By 0A)� Rough -In Date Final Date - 9� FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. 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's connected Yes ( ) No ( ) 6. Has total heating BTU's of' All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date SUBJECT PERMIT NO. City of Fridley 2 5 5 6 6 AT THE TOP OF THE TWINS BUILDING PERMIT _ RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY .55432 612-571-3450 910415 10/3/97 JOB ADDRESS 5576 REGIS DRIVE NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nelson 5576 Regis Drive NE 571-1377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 350 73 Ave NE, Fridley, MN 55432 502-4777 20040630 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 [jj REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace 14 windows in home with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS 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 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. OWLG. 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 $9,443 $4.72 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- $162.25 Fire SC $9.44 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $181.41 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY ALI DATED THIS IS YOUR PERMIT _ 4 � BLOOfIt '0 GATE SIGNATURE OF OWNER oF OWNER BUILDERI IDATEI NEW [ ] Effective 1 / 1 /97 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:rj5"j(� • �E6L 51 . Legal Description: Owner Name & Address: _Mg_ }. MS. NEc d , Cecg� LklVe Tel. # J j 1.. I'3 Contractor:?-Q-(eaAL 0"? Ar1pg:2S%�4-4 MN LICENSE# Address: 3 , —M ge F. N E PCI IDIS. M r,� 5'S 3Z Tel. # '50Z -4-11:1 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 hf I��Vrli t rel �-IUME W LTu i�CKET" i e4 5usu" rrdrrR(hd , Construction Type: --�R Estimated Cost: $ (dee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Rix $ _ $ DATE: i -2— 'C11 APPLICANT:' TI rN S IS. Tel. S4 2000. CITY USE ONLY Permit Fee 9 $(�� Fee Schedule on Reverse Side Fire Surcharge $ 9 . .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ , 00 $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 T City of Fridley 3 0444 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. `COMMUNITY DEVELOPMENT DIV. - ______ �� r - PROTECTIVE INSPECTION SEC l NUMBER REV DATE PAGE OF APPROVED BY CITY HAL FRIDLEY 55432 61 2-571-3450 91041�10/26/99 JOB ADDRESS 5576 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Nelson 571-1377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Cedar Timberoof 1001 E Cliff Rd Burnsville 55337 808-1149 20147336 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 0 ADDITION O ALTERATION, &x REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (26 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2272 $1.14 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- $83.25 Fir SC $2.27 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE791.66 L FEE Licen $5.0V SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDAPEI HE P VALID67-M. IS IT _ kl� S G INSo /Y/O/jUR �RQJM � pAt S,GNATURE OF OWNER OF OWNER BUILDER, IDATEI All NEW[ J -' • Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ad�- ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �\ Construction Address: S'S' 74, /V�/ I) A � Legal Description: Owner Name &.Address: Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. # f�(c-4--21-1 a:Z -7 TENSE f _ AV /I 1 Tel. #/ LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Typezd& 4&2G aaee Estimated Cost: $ - , 'D (P 0 V�2 702, 6&7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: iQZC)jqq APPLICANT: Tel. #—"-I IL49 Permit Fee $ 93 • ZS Fire Surcharge $ 2-22 State Surcharge $ SAC Charge $ License Surcharge $ OD Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ L Lo STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above ' $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] City of Fridley SUBJECT �3 0?51i1'IM11 NU. AT THE TOP OF THE TWINS BUILDING PERMIT t � RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. �� f PROTECTIVE INSPECTION SEC. E i 1 S CITY HALL FRIDLEV 55432 NUMBER REV DATEPAGE O: APPROVED BY 1'' 612-571-3450 910415 3/21/00 10B ADDRESS 5576 Regis Drive NE 1 LEGAL LOT NO.BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 4 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald/Gretchen Nelson 5576 Regis Drive NE 571-1377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN Inc 3118 Snelling Ave S, Mpls., Mn 55406 721-6628 2179 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 ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage; Soffit/Fascia; Trim. 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. M8110d r 1HOM11OWner n- 10 rust ,'m 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION ZONING SO. FT CU FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $13,095 SURTAX $6.55 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PERMIT FEE $237.25 SAC CHARGE Fir SC $13.10 PLAN CHECK FEE/ TOT 1FEE Licens S $5.0 2 1.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi MEN PROP VALIDA D IS I UR P RMIT 4 ' ©� SIGNATURE OF OWNEROF OWNER BUILDER. tOATEi BL iNSP QatE �� NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY _ ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 4ponstructionAddress: 1� Legal Description: V / , l Owner Name &Address: /t�� n /� ��-e �ch �� /19�l5 o Al Tel. # -6--71-137;7 Contractor: Pal2d iW-61 ate Al U17i!.,, MN LICENSE # a/7g Address: 3//8 JN1%;A4 & AW& V / && AIA/ ,s�L Tel. # ((elg?) f Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction .Type: .5� ,S� offs-/' �4-seik, %rl 'P" Estimated Cost: $ / l� �`• 0 i,.iveway Curb Cut Width Needed: (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ = $ DATE: 3-- /6 __ 60 APPLICANT: Tel. #(.972);74 4o4 N Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ a 3 7,2 5 Fee Schedule on Reverse Side $ 13, / 0 .001 of Permit Valuation (1/10th%) $ ,e, 5-5- $.50/$1,000 Valuation $ $1050 per SAC Unit $ .5, oy $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ]