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: