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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PE I RMIT N® 5304 Date: �W4 6z r i 9 Owner: Builder - a . _ Address _ _ _ Address--- ,�aa OCAIOF ,; ILDING No. i' Street _y��_ ._._.� Part Lot .Block Addition or Sub -Division -- Corner Lot _ __ Inside Lot Setback Sideyard Sewer Elevation ___ ___ _ _ _ Foundation Elevation _._ DESCRIPTION OF BUILDING To Used Front Depth Height Sq. Ft.CU. Ft., •" ,(.� Depth •�" H -ght Sq. Ft. ; Cu. Ft. Type of C fraction MSN Est. Co tin. 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 city of Fridley. i� 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 respecis 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. r'' Building Inspector -- NOTICE: This permit does not cover the construction, installation for wift,'plumbing, ga's heating, sewer or water. Be Sure to see the Building Inspector for Separate permits for these item:. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA owner is Name Builder - Address Address.. ,o ---- Pv LOCATION OF BUILDING c No. �, o Streets -u /'0.—�-_____Part of Lot 1 Lot (`7 Block l Addition or Subdivision � /l ®, Corner Lot Inside Lot ; 0 Setback Z Y Side -Yard fo- 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 a"e., 2- 8-0 , 6 7 n ® Front ( Depth 2 - Height Sq. Ft. /® �� Cu. Ft. ight Sq. Ft. o 6 Cu. Ft. Type of Construction, Estimated Cost `�1„r c9 ca o i 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 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. DATE Z- SIGNATURE . /I - (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Appkation for PhnWmg and C�n F*Hng PenWt Dept. of Bldgs. Phone SU 4-1 DESCRIPTION OF WORK Number. Ki -d and Location of Fixtures Location--- PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $1.50 $ -�-_-= Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening ....... . ...... x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ......—A x 2.00 ®� 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 $ /2-22'6® City of Fridley: r s 6A OY 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. Fridley, Minn � �Ar 19" Owner t'o Kind of Building ' Used as To be completed about - Estimated Cost, $ U `® `'' Oldjq Building Permit No's ® Permit No. Signe By Business Phone No ROUGH % ' ��- FINAL d'a 2M 7-59 gQ N N Z =} Z O Z 00 F N WATER HTR. GAS ELEG oo� Base 1st 2nd _ 3rd _ 4th • Future Connection Openiags with Coaaected I Sewer o New .Fixture. Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $1.50 $ -�-_-= Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening ....... . ...... x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ......—A x 2.00 ®� 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 $ /2-22'6® City of Fridley: r s 6A OY 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. Fridley, Minn � �Ar 19" Owner t'o Kind of Building ' Used as To be completed about - Estimated Cost, $ U `® `'' Oldjq Building Permit No's ® Permit No. Signe By Business Phone No ROUGH % ' ��- FINAL d'a 2M 7-59 bt� Application for Power Plants and' Heating. Cooling, Ventilation, AeMgeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, 1. 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 R.00 $ Repairs & Alterations—up to $500.00 .... ............ 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM DESCRIPTION OF WORK 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 Sq. Ft. E D.R �' B% BTU H.P. GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ /Z GAS FITTING FEES: NO RATE TOTAL — Signe 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM --VENTI-LATINCY-SYSTE - — ALTERATIONS & REPAIRS I ,1 ROUGH— FINAL— See OUGHFINAL See Fee Schedule $ TOTAL FF E $ Dept. of Bldgs. Phone SU. 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. dley, Minn JUL 211961 19 - Owner .,&::Z 9 Kind of Building —=-- Used as To be completed about o`er Estimated Cost, $ ®O' ew. uilding Permit No.-�Permit No. ziw�6 DESCRIPTION OF WORK HEATING Warm Air—No- Trade Nam SizeNo2.:rA 55/f Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected Load 41,1,,,90f'3-1Kind of Fue BURNER — Trade Nam v'' t " Size No 5'9 7 `® Capacity Sq. Ft. E D.R �' B% BTU H.P. GEO. SE ICK H d G. & Alft-CONN. CO r e% 1001 Xenia Av. S. Minneapolis 16, Minn. — Signe •42 2M 7-59 Business PhoneTo (REMARKS -OVER) Windows and Doors—Crackage and Area (YMe Width Height No. of Lineal f . Area No. ane f p ne light. of crack sq. It c�of CC lull D-56 � s ®! �B 7 ?� 3 G HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS -Coef.1, NH OLIS. :MINN. Weatherstrips A.S. Guide de.E, ,-0 3 ® 0 Construction No. Insulat n '� W— i ows ^ae ,—Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind ow. Applied, Y No s� I No 19_ / 9 RD i F1.11 Room I Length 1), Width I Ceiling Room I Length / Wid h Leight Windows and Doors—Crackage and Area Koom I Length 6 Width Height No. of Lineal f . Area No. ane f p ne light. of crack sq. It c�of 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 -Coef.1, Btu Glass `® ,-0 3 ® 0 Exp. wall -5 Glass _L4 - Net exp. wall -d�3vl Net Int. wall Exp. wall Ceiling � v I Net exp. wall Floor / TotarEtu. Ily % Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.11 -Q L .),V Room) Lenscthi/v Width q1—Height Windows and Doors—Crackage and Area Koom I Length 6 / J� / Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Windows and Doors—Crackage and Area ®^ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. -Coef.1, Btu Infiltrationj Coef. Btu Infiltration Glass Glass Exp. wall Net exp. wall Net exp. wall / 9 RD i Int. wall Ceiling C) Ceiling Y, Floor 0� C� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / r1. Koom I Length 6 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 3 Int, wall . Ceiling C) Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Haight No. of Lineal ft. Ar4 �!v No. of Panq of pane lights of crack sq. t. Y Coef. Btu Infiltration Glass 0 Exp. wall Net exp. Int. wall Ceiling J Floor Total Vill. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length Width J J Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Ar a No. of pane of pane lights of crack sq. ft. 3 C Glass Exp. wall V06 Net exp. wall d 7 Int. wall Ceiling L 1)--x// Floor Total Irtu. Kequired sq. tt. r..U.K. or sq. His. w.aa. Leaser area Fl. ? , � , Room I Length / ® Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane light' of crack sq. M. -2- 3 / ,� Coef.1 Btu Infiltration -' Glass 170 n Exp. wall Net exp. wall Int. wall Ceiling 0 }� // /� �°� ✓;7a 0 Floor Total Btu,. 113 1� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area--' 63-8b-879001 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE ..\`:-mer Fixtures r1ut=e Fixture Opening New Fixture, Old Opening Catch Basin :cater Heater - to 99,000 BTU 100,000 B -J to 199,000 BTU Water Softener New Ground n Old Building Electric Water Heater GAS FITTIXG FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTER4TIOtiS First $100.00 each add. $100.00 or fraction x $3.00 q $2.00 X >1 Cr $5.00 X $5.00 U $10.00 Y 0 x Water C m $5.00 uc M N A i Id w Heater 0 -iC r C Cl EH -4rs X .0 54 O H 4 C 8 U C N ..0j rs . 4 W r U H M r 1 G w tn rNj 3 $4 O 4 .00 v] �-4 r.. M �M U w 7 ti 4 0 t7 Ky C7 4j o as Fle, 1st I d4er nd (R) a r.:ture Connection Opening Connected with Sewer (=y - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE ..\`:-mer Fixtures r1ut=e Fixture Opening New Fixture, Old Opening Catch Basin :cater Heater - to 99,000 BTU 100,000 B -J to 199,000 BTU Water Softener New Ground n Old Building Electric Water Heater GAS FITTIXG FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTER4TIOtiS First $100.00 each add. $100.00 or fraction x $3.00 X $2.00 X $2.00 x $5.00 X $5.00 x $10.00 x $7.00 x $5.00 X $5.00 x $3.00 x $1.00 x $10.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) $5.00 $2.00 TOTAL S S S .50 S Job Address 210 Rice Creek Blvd. Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 6-18-81 , 19 OWNER BUCNANAN KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 6 -25 -81 - ESTIMATED COST 50.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. f�o� Company` Signed By Tel. NO. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT a W� MINIMUM FEE FOR ANY PLUMBING PER'4IT IS $7.50 pLUS $.50 STATE SURCHARGE r CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION♦ REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TOTAL Job Address % %� �/� ° u J $ Z.0,00. $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ell Go Tel. #571-3450 $ 10.00 $ 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 $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ 10.00 $ Fridley, Minn. �Q , 19 OWNER bU L L f } pb1 L) JQ ✓1i' / I $ KIND OF BUILDING d'y! USED AS % $ TO BE COMPLETED ABOUT r� / C1y —r ESTIMATED COST State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit _0-4d Q INIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. $ .50 ///'' OLD - NEW BUILDING PERMIT NO. PERMIT NO. / U V/ DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name C--- Size No. Capacity Sq. Ft. EDR BTU ✓-!!;/ ® V HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By c Tel. No. Fill out back side for stack verification on replacement furnaces 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 connected Yes ( ) No 6. Has Total heating BTU's of All other BTU's TOTAL Remark s Company Signed By Date R a /91M 1 _ Or dl Io I/C£ CFz"K6/ve/ Mr. & Mrs Henry W. Parker— - 216 Rice Creek Blvd. N.E. Fridley, MN 55432 CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL RATE TOTAL Job Address 210 Rice Creek Blvd. Furnace Shell and Duct Work, 20.00 Burner (Also replacement furnace) $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. * Air Conditioning (all sizes) $ 10.00 $ 10.00 Fridley, Minn. 9-8— 19 88 All Others/Repairs and Alterations OWNER William VanDe Riet 18 of Value of Appliance or Work $ KIND OF BUILDING Frame. .._ . COMMERCIAL/INDUSTRIAL USED AS RPg i ri an t i a l 1% of Value of Appliance or Work $ TO BE COMPLETED ABOUT 9 —1 3 — 8 8 $3,500 .0 0 ESTIMATED COST State Surcharge $ .50 OLD NEW BUILDING PERMIT NO. PERMIT NO. TOTAL FEE $30.50 Reinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough Insp. Date HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Final Insp. Trade Name Carrier Size No. 58SSBO80 Date Capacity Sq. Ft. EDR BTU 8 0 , 0 0 0 HP Approval for Permit Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 Company Airco tc, & ond. PLUS $.50 STATE SURCHARGE Sig ne4 B 1. Tel. Na.781-2111 *Air Conditioners can not be placed in side yard without written permission frcm adjoining neighbor. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The f 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 connected Yes ( ) No ( ) 6. Has Total heating BTUs of All other BTU's TOTAL Rema rk s Company Signed By Da to SUBJECT ITN City of Fridley 26608 AT THE TOP OF THE TWINS B U I L ®I N G E R M I T r ` RECEIPT NO. `y _ _ COMMUNITY DEVELOPMENT DIV.��� � PROTECTIVE INSPECTION SEC. r � e NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7 14 98 JOB ADDRESS 210 Rice Creek Blvd. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 Rice Creek Plaza North Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Peggy Van DeRiet 210 Rice Creek Blvd. 574-0160 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Rpigidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK (21 Sq) Reroof Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 I 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 1751 .87 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- Fire SI, $1.75 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $56.75 �d PLAN CHECK FEE TOT FEE - -..I // - I 9 _37 SIG TUBE ONTRACTOR OR AUTHORIZED AGENT IDATEI N ROP B G IN pr-- ALID T THIS 1"OUR PERMI JI f1ATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] ;; ; CITY .,OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �C ��� U T 1 Legal Description: Owner Name & Contractor: ldrAss: 02GG % VCt I') _ le 2�` —Tel. # MN LICENSE # Address:. Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: ' Length Width Height Sq. Ft. DECK AREA: OTHER: Length ` Width Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ f (Fee Schedule, on Back), Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 7 APPLICANT: Uj Tel. #_ 47Y 0 1 CITY USE ONLY Permit Fee $- 9S Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ `% $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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 City of Fridley i AT THE TOP OF THE TWINS BUILDING PERMIT � a. ------COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 ; a CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF i.._.�1.� '•� 612-571-3450 910-F15 5/4/99 JOB ADDRESS 210 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 17 4 1 Rice Creek Plaza North Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP PHOT P�fMIT NO. 29388 RECEIPT NO. APPROVED BY SEE ATTACHED SHEET William Van De Riet 210 Rice Creek Blvd NE 574-0160 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Kingdom Exteriors 5255 East River Rd #210, Fridley, MN 55421 572-0001 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 Reside House; aluminum fascia/soffit; window & door trim 8 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. Install soffit ventilation to meet the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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. DWLG. UNITS OFFSTREET PARKING I 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 VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9,800 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE PROVISIONS OF ANY OTHER STAT O OCAL W REGULATING CON- STRUCTION OR THE PER M ONST CTION $162.25 R PLAN CHECK FEE Lice SC $5 T E FCON•AACTORORAUTHORIZEDAGENT 1'044'- _r#VHE:NfPRO9.ffRj9 $4.90 Firp sC $9.80 DT FEE $181.95 THIS IS YDUR PERM( 10ATEI ` s SL G INSp PATE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� 2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Tel. # %% fie Contractor: A—Ji? c� <� �v MN LICENSE # Address: �� Tc.s �7 �c z�� AV ?,/G? Tel. # % 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: C '2'� nsG;. So4PEstimated Cost: Construction Type: -,:-DI .� tL�`&A�;cA0�--9V(Fee Schedule on Back Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: % APPLICANT: ��� Tel. # ����� Z, CITY USE ONLY Permit Fee $ — Fee Schedule on Reverse Side Fire Surcharge $ 80 .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ CSU $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: