Loading...
PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT n ° 4904 Date: ........... .._ ' t . . Owner: :: :. .._.... Builder Address ... L T mfluo'-Pll ING No.. ...... Street _.. ..� ...::. :_:....... Part Lot ....._ .. _.w .._..__...__...._...__....._...._ .. Lot ................. .....- Block ..------...----.....---------......-........ Addition or Sub -Division :. Corner Lot ................................... Inside Lot .... ............... Setback .....--,•--. _........ Sideyard . - ........................ --------..... ...... SewerElevation ...... ........................ ...._............. _.............. .......... :.._....................... Foundation Elevation ................................................. _....................................... DESCRIPTION OF BUILDING To beused as. �- Front .. Depth - Height Sq. Ft. . T .... . ......... ...... ................... ...... Fron Depth .._ ..... a ht �. Sq. Ft. ...................... Tye of Construction . ::.: Est: Cost :.. ..... : :... " To be Competed ...... 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. 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 tim on violatiori� any -of the provisions of said ordinances. .r`? Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. 4 APPLICATION FOR BUILDING PMW CITY OF FRIDLEY, MINNESOTA f • sac �' '. Ti x No. LOCATION OF BUILDING of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback -Y -0 -Side -Yard. /® SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building. location. To be used as: Type of To be Completed DESCRIPTION OF BUILDING Sq. Ft. Cu. Ft. Front D epth Height Sq. Ft. Cu. Ft. MAP ted 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 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. 4-.1 (A Schedule of Fee Costs can be found on the Reverse Side.) NIA City of Fridley A►ppiication for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SU DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location O < Number Fixtures ...................... x $1.50 $ Z ad z O~ New Fixture Old Opening .............. a $ aw{ 5< °'. w Z Z a F $ N WATER HTR. GAS ELEC 3Fi NO. RATE TOTAL. ��F x $1.50 $ 3r oa $ ac t�m a3 t9 °d Urn UO Base 1st 2nd _ 3rd _ 4th ° Future Connection Openings Connected with I Sewer � 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) ...... Z x 2.00 $ O CJ 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 $—,/ ��_ -'6�d 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 gorrect. Fridley, Minn Kind of BuildinT?F ., e Used as To be completed about Estimated Cost, $ -ma�New. Building Permit No ® Permit No. Signe By Business Phone No ROUGH FINAL 42 2M 7-59 d [ 0 Application for Power Plants and Healing. Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ........... . .. . NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM RATE TOTAL 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ V/-/'- 2.00 $ 5.00 $ 5.00 $ 2.50 $ 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 $ GAS FITTING FEES: NO RATE TO L 1st 3 Fixtures ...................... x $1.50• $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN DATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE 71EMARKS: s i Dept. of Bldgs. Phone SII 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. Owner/ ZL a Kind of Building Used as To be completed about Estimated Cost, $--::�71 DESCRIPTION OF WORN 195- 195- 195— HEATING Warm Air—No ho Trade NamSize No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load ® z' Kind of Fuel BURNER — Trade Nam -f>'= Size No Capacity Sq. Ft. E.D.R _,�' -� /.�BTU H P. GEC). S,OGWICK H T G. & AIR-COND. C® ®� 1001 Xenia Av. S. Minneapolis 16, Minn. Sign A? _ By 11 POST 1M-12-58 Business Phone No Windows and Doors—Crackage and Area /47 _ Ji L I} Width Height No. of Lineal ft. Area No. of one of pane lights of crack sq. ft. v 17 r� _ HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Coef. MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, I Construction No. t� Insulation Guide CiT ' Exp. wall d Windows'nt. Doors Reference Out. Wall IWall Ceiling Roof Floor Kind How . Applied es o I es ,jNo 19— V( / Fl.1 Room I Lenstth//.. Width f,, Height 3. 11 1 F11-', !/rte Room I Lensrth , I Y Width z-- Height Windows and Doors—Crackage and Area /47 _ Ji L I} Width Height No. of Lineal ft. Area No. of one of pane lights of crack sq. ft. v 17 (1 Coef.1 Btu. Coef. Coef. Btu Infiltration I '� ¢ t� 7 Glass!--- CiT ' Exp. wall d Exp. wall Int. wall Net exp. wall Net exp. wall Int. wall Floor Int. wall 7, Floor Ceiling ' "t �f �� ,!i C _ Floor Total Hiu. I _14 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area "-.. 1.1 / Room I Lenath '5 Width /,1 Height -''Windows and Doors—Crackage and Area /47 Width Height No. of Lineal ft. Area No.of pane tights of cracIL sq. ft. WidthHeight No. of Lineal ft. Area No. of pane ofpane lights of crack sq. ft. v 17 (1 Coef.1 Btu. Coef. Btu Infiltration Infiltration I '� ¢ t� Glass Exp. wall f CiT ' Exp. wall d Exp. wall Int. wall Net exp. wall Net exp. wall) Int. wall Floor Ceiling s 7, Floor Ceiling) Total Btu. V v (11 U Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I If 1 F1.1 I o L) Room I Length /5 Width/ Height Windows and Doors—Crackage and Area /47 Width Height No. of Lineal ft. Area No.of pane tights of cracIL sq. ft. Width HeightNo. of Lineal ft. Area No. of pane of pane lights of crack sq. ft.�� °' 4 17 (1 Coef.1 Btu. Infiltration Coef. Btu Infiltration Glasse '� ¢ t� 34 - 4- Exp. wall Glass Glass CiT Net exp. wall d Exp. wall Int. wall Net exp. wall Net exp. wall) Int. wall Floor Int. wall Total Btu. Y" ? / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area _ Width HeightNo. of Lineal ft. Area No. of pane of pane lights of crack sq. ft.�� —of 17 (1 JCoef-1 Coef. Btu Infiltration '� ¢ 34 - 4- Glass Glass CiT Exp. wall d Exp. wall / ?s Net exp. wall Net exp. wall) Int. wall Int. wall 7, Floor Ceiling) Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area PF _1 e$ �,. ) Room I Length "7 Widtlff- Heistht Windows and Doors--Crackage and Area _ Width Height No. of I Lineal ft. Area No. ffyypane of pane lights I of crack sq. ft. —of JCoef-1 B Infiltration :r Glass CiT Exp. wall y c%f Net exp. wall Int. wall Ceiling 7, Floor Total Btu. Required sq. ft. E.D.R. or sq. his. W.A. Leader area Room I Length Width Windows and Doors—Crackage and Area W[dth Height No. of Lineal ft. Area o. o pane of pane lights of cr ck sq. ft. r FM Btu Infiltration vle, A.�ry Glass j jam' Exp. wall +f J Net exp. wall y, 0 / Int. wall Ceiling 16J A P-6 Tl / it C 6 eJ Floor •/ I I Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area b52-84-- 915.51 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 216 Rice Creek Blvd Number, Kind and Location of Fixtures Location 07 E x $2.00 �1 /2 12 x�^ Z~z �e2r�Z pZ $ Oy�1 -10 $ V z x $3.00 • WATER HTR. GAS ELEG Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Q�J? x $ .75 $ Gas Range to 199,000 BTU .............. O F N 1 5.00 m Base G Ds Dr3 er 1st 2nd 3rd 4th ' Future Connection Openings _ Connected with I Sewer � New Fixture, Old Openings Cesspool p PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ... ........................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Gas Dryer 1 5.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $----5 - —0() 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 txue and correct. Fridley, Minn 10-24-68 19_ Owner H 'arker Kind of Building f raTlie Used as res To be completed about 10-29-68 Estimated Cost, $ 10.00 p Old—New. Building Permit No Permit No. Si j� ° By Business Phone No ROUGH City of Fridley, Minn. N° 10 2 3 3 BUR DING PERMIT Date: May 15, 1969 Owner: Henry W. Parker Builder Same Address 216 Rise Creek Blvd. N E Address Same LOCATION OF BUILDING No. 216 Street - Rice CreekLBlvd . — Part of Lot Lot 16 Block 4 Addition or Sub -Division _Rice Creek Plaza Addition Corner Lot _ Inside Lot _ _ Setback _ _ Sideyard Sewer Elevation _ _ -- Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 261 Depth 241 Height 10 t Sq. Ft, 624 CtL p -L 6240 Front Depth Height Sq. Ft. — Cu. Ft. Type of Construction Frame Est. Cost �2, 200 _To be Completed _ 8 Months 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 wi all provisions of ordinances of the city, of Fridley. A/ _ . In 4i , In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to Henry W. Parker 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 andmoving 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. �-2-Zr Hen Mdhic' NOTICE: Tide perndt does not cover the construction, installation for m6ing, plumbing, gas heating, sewer or water. Be sure to oft the Building hupoctor for soparalo permits for then Boas. APPLICATION FOR BUILDING PERMIT _ CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING NO .,,,•�5'T'$Bk�T �` G LOT�$LOCK ADDITION OR SUBDIVISIONS CORNER LOT INSIDE LOT A�SETBACKS SI$ET'OU)44/. SEWER ELEVATION TOP OF FOOTING ApplicaMt attaeh to this form Two Certificates of Survey of Lot and proposed buiiding:lgoation drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As:. •;,..Front �� Depth Height /® ,...,., Nuaare feet Cubic Feet Front Depth Square feet Cubic Feet Height Type of 0onstruction Estimated Cost 00. x, To Be The u44exstgne4 hereby makes application for a permit for the work herein ppooifie4, Weeingg to do all work in strict accordance:.with the City of Fpi4lgy Ordii%anops and rulings of the Department. of Buil4iw, and hereby ,declares that all the facts and representations stated :i4i ` this applioe,tion are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on ke Reverse Side• Land Plalinmy CRS -Ai hreay AC57 Att. Land Sur VIIPY Soils reshby HNGI NEER[ NG, INC.. Mlnncsola Civil &,tfunici al AW4066 Enyincers E Sur veyof Er I A PIC C,?, V3, Ilggs a -ro oqj coat, sjvtloa p PGG-OdO.Zd On.Tjs 2uj4sjxO O.ZpunH GAT qavo joj 11v JO ISOO JOO-z 04 suoiiu� v zo a '000-c� jo � Z • Jul lea TO jo jjq,7 To OJOO-Z ®� Zoj to Imatro q eq4 0 Jrv. Punoj2 qq, JO'OUZT TO a 0 -e., elqv2 uj,�?Eu Xlp�n - Fir— Jns zorrrr, rh PIC C,?, V3, Ilggs a -ro oqj coat, sjvtloa p PGG-OdO.Zd On.Tjs 2uj4sjxO O.ZpunH GAT qavo joj 11v JO ISOO JOO-z 04 suoiiu� v zo a '000-c� jo � Z • Jul lea TO jo jjq,7 To OJOO-Z ®� Zoj to Imatro q eq4 0 Jrv. Punoj2 qq, JO'OUZT TO a 0 -e., elqv2 uj,�?Eu Xlp�n - Fir— Jns zorrrr, w W SUBJECT PERMIT City of Fridley 1616 7 AT THE TOP OF THE TWINS BUILDING PERMIT r RE O. COMMUNITY DEVELOPMENT DIV. h r PROTECTIVE INSPECTION SEC. G 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 216 Rice Creek Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16 4 Rice. Creek Plaza North. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Henry W. Parker 216 Rice Creek Boulevard N.E. 571-1909 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 0. ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside dvrel ling and add brick front 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 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 $5OO $. SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SIGNATURE OF CONTRACTOR O iORIZED GENT (DATE) N,WHEN PROPELY VALIDATED THIS IS YOUR PERMIT d' 91' vd BLDG INSP ATE SICT UOF O N R F OWNER UILDERI (DAT ) T. W CITY OF FRIDLEY APPLICA'rioN FOR RESIDINTIAL BUILDING PcmiiITS (New, Al terations, Additions, or Repairs) OWNER: e, ie, BUILDER: ADDRESS: aI� � � ce- �z� 2e.���G,�r� ADDRESS: r� TEL ova: �" 7 /— / �o _ TEL No:1�;� 0 % Construction Location STRL•"GT_,NO: STREET: LOT: BLOCK: _ ADDITION: i Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF COPISTP.UCTION •2(C -e Front: �uS Square. Feet: Depth: height: Cubic Feet: Yront: _. Deptin: Height: - Square" Feet: Cubic feet: Type of Construction: To $e Oompleted: Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ Alt. A Alt. B SEE REVERSE SIDE OF SHEET I.5ie 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 the facts and representations stated ui this application are true and correct., DATE: SIC:NnTUFE: Stipulations: q APPLICATION FOR RATE SCHEDULEI 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) CITY OF FRIDLEY Effective Date May 1, 1988 POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES All Others/Repairs and Alterations 18 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TO'T'AL Job Address �L\ `o &c, -o \< `l' `u c� $ 20.00 $ 0 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ 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 $ )® .00 Fridley, Minn. C?- `a® , 192a State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp.P/� Date y, Approval for Permit MINIMUM 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. OWNER f` Qn1C 1,I KIND OF BUILDING USED AS ��si 60 CA! ---3- 70 Ta BE COMPLETED ABOUT 9 - 'L3 p ESTIMATED COST �3 t000 $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. $ 30. DESCR.PTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. c2 Trade Name Cw - ! Q(- Size No. Capacity 01a -�Oc\ Sq. Ft. EDR BTU � HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP 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 ( ) 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 Rema rk s Company Signed By , Date SUBJECT P City ®f Fridley 2 6 6 8 0" AT THE TOP OF THE TWINS BUILDING PERMIT r T , R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � 1 � � r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/17/98 JOB ADDRESS 216 Rice Creek Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Henry Parker 216 Rice Creek Blvd 571-1909 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION )] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 27 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, 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 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2085 $1.04 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- $74.75 Fire SC $2.08 STRUCTION OR THE PERFORMCE OF CONSTRUCTION. PLAN CHECK FEE T L FEE A. .87 IG TUBE OF CONTRAC R OR UT ORIZ AGENT IDATEI HE PR Y VALI THIS I MI 011 BL INSP Ir �P 'r QATE SIGNATURE OF OW IERIIFO UILDERI IDATEI NEW ADDN ALTER ConstructionAddress : Legal Description: Owner Name & Address: Contractor: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION l �' Effective 1/1/98 v� MN LICENSE # Address: , Fee Schedule on Reverse Side Tel. # .001 of Permit Valuation (1/10th%) $ ,D - Attach to this application, a Certificate of Survey of the $ $1000 per SAC Unit $ lot, with the proposed construction drawn on it to scale. s Alt. "A" or Alt. "B" Above $ OF IMPROVEMENT j ) $ DESCRIPTION LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Le Width H t,/�G� round 1 Sq_ Ft. A�'�9�/ OTHER: c� -- l J Construction Type: Ti k �. -7 S�;Estimated Cost: $ T (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. ; 6 Ft = F $ _ $ DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion, Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: Tel. # -5: ? / I CITY USE ONLY ! 1 $ Fee Schedule on Reverse Side $p G .001 of Permit Valuation (1/10th%) $ ,D - $.50/$1,000 Valuation $ $1000 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 [ ] s 12 2 ?- 4�