PRE 2010 DOCSDate: - ® ( V
Owner: 2a.� Builder
Address
-'q �X'�
N? '7017
LO TI N OF j BUILDING
No. °) Street P of t
Lot _ _ _ Block ___ Addition or Sub-Divisio D �' _
Corner Lot Inside Lot ®� Setback , I Q -5E 49— Sideyard'
Sewer Elevation �� ®® Elevation � 3 ��y
-tee ell F rlA*I
DESCRIPTION OF BUILDING
In consideration of the issuance to me of a permit to c the uilding described above, I
the proposed work In accordance with the description above t in compliance r f
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 time uponvation of any of the provisions of said
ordinances. o _ � /1
Building Inspector
NOTICE:
Ibb paean does not corer the coestneeflon, hntdlation for whdng, phnabhng, gas heating, sower or water. Be sore to we
the Bulldh* Inspector for operate pennhs for those hem
Street Bart of Lot
Lot., y.. Block Addition or.. -Subdivision
Corner LotInside Lot Setback Side -Yard
SEWER ELEVATIQN FOUNDATION ELEVATION
_
Applicant attach to this form Two Certificates_of;Survey, of Lot and proposed build-
ing location drawn on these, Certificates.
"•i. DESCRIPTION OF BUILDINGw
To- bo used as:
Front Depth Height
-sq.' it Cu.. Ft.
Front . r Depth Height .
Sq. Ft. Cu..rFt,,,
_...«-
Type of Construction Estimated Cost;
To be Com' plated
The undersigned Hereby makes application for alpermit-for the .work herein specified,
agreeing to do all wo;k in.strict accordance with'the City of,Vridle'y Ordinances and
rulings,.ef.the rDepartment ofsBuildings, and:.hereby.declares that all the facts and
representations stated in this application are true and correct.
DATE
('Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
ApFtication for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: / NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ ` 5�
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) ...... x 2.00 $
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: yNO. RATE +TOTAL
1st 3 Fixtures ..........................—E — x $1.50 �/
$ c 5- Q
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $�
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.
Fridley, Minn
Owner
Kind of Building
e
Used as
To be completed about
Estimated Cost, $
01 New. uilding Permit No Gj Permit No .\, -
12
Signe
t
By
Bus' s Phone
ROUGH
FINAL
d a 2M 7-59
N
y
�Z
O
J
w
V'
Z
Z
`
WATER HTR,
C70
a:
Base
r
I
t
�'
1st
2nd
_
3rd
4th
• Future Connection Openings
I
Connected with
Sewer �
New .fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: / NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ ` 5�
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) ...... x 2.00 $
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: yNO. RATE +TOTAL
1st 3 Fixtures ..........................—E — x $1.50 �/
$ c 5- Q
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $�
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.
Fridley, Minn
Owner
Kind of Building
e
Used as
To be completed about
Estimated Cost, $
01 New. uilding Permit No Gj Permit No .\, -
12
Signe
t
By
Bus' s Phone
ROUGH
FINAL
d a 2M 7-59
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 2S0 Rice Creek Blvd.
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $
20.00
$ 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
Gas Dryer $
10.00
$
specified agreeing to do all work in strict accordance with the City Codes
ana 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
$
Fridley, Minn. �e.p:telnber 1 R 19
All others/Repairs and Alterations
OWNER Gerald Sadowski
1% of Value of Appliance or Work
$
KIND OF BUILDING Frame
COMMERCIAL/INDUSTRIAL
Residential
USED AS
1% of Value of Appliance or Work
$ -
TO BE COMPLETED ABOUT
2
State Surcharge
$ .50
ESTIMATED COST ,150.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
TOTAL FEE
$ 20.50
Reinspection Fee ($15.00)
$
DESCRIPTIO14 OF FURNACE/BURNER
Rough Insp.
Date
HEATING or POWER PLANTS, Steam, Hat Water, Warm Air- No. Hot water
Final Insp. //2 -6
Trade Name Carrier Size No. 61SWB150
Date
Capacity Sq. Ft. EDR BTU 150,000- HP
Approval for Permit
Total Connected Load Kind of Fuel Natural Gas
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 Company . De endable eating A/C
PLUS $.50 STATE SURCHARGE
Signed By
Attach stack verification form with. replacement Furnace permits 757-5040
*Air Conditioners can not be placed in side yard without Tel. No.
written permission from adjoining neighbor.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 65432
672-3604
Effective On August 1, 19%
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES:
NO. RATE TOTAL JOB ADDRESS
Now Fixtures
7.00
Old Opening, Now Fixture
$4.00
Beer Dispenser
$5.00
Blow Off Basin
$7.00
Catch Basin
47.00
Rain Water Leader
$7.00
Sump/Receiving Tank
$7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$7.00
Water Heater - Gas"
Gas Range"
p0'00
Gas Dryer**
$10.00
Back Flow Preventer Require* d )Yes No
Type —
$15.00
Reinspection Fee $42.00/Hr,'
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or. -Appliance e_2()
State Surcharge $ .50
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 Building Division, and hereby declares that all the facts
and representations stated In this application are true and correct.
INS-/
Owner
Building Used As
, 7Y -1Y24
0 -
Estimated Cost41 o . . PERMIT NO. 4�Sl
PLUMBING COMPANY-ji 4-jA C
SIGNED WYTEL NO.
7,Fav -
Approved By Rough -In Date Final Date
TOTAL FEE $-:2 (1 PLUS THE 9-50 STATE SURCHARGE
"COMBUSTION AIR. SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES.
7
SUBJECT
PER .
City of Fridley
2 8 2 6 8
AT THE TOP OF THE TWINS
BUILDING
PERMIT
1 1
RECEIP
• _ COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
F
o
NUMBER
REV
DATE
PAGE OF
APPROVED BY
�"—'1 CITY HALL FRIDLEY 55432
�"--A-If ��'
612-571-3450
910415
10/15/98
JOB ADDRESS
250 Rice Creek Blvd
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9
4
Rice
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Jerry Sadlowski574-1426
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Peak Roofing 11506 S. 0938-8150
90045301
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 25 S Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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 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
1 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 Ti-IIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT
2142
$1.07
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$74.75
Fir C $2.14
PLAN CHECK FEE
TOT FEE
Lice SC
5.
2.96
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT AATE, I
2hWEN O
I A THIS IS YOUR PERMIT
(f
SIGNATURE OF OWNER of OWNER BUILOERL tOATE,
Bl SNS
OAtE
7
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: C>? 56 l c Cf r—f-e -e- lv o -I -
Legal Description:
Owner Name & AAdddress:jevw X �a �s s- lc , ` Tel. #
Contractor: E'er- /�o�;�, MN LICENSE #
Address: //S!a C% I e /f�;1 —0
AttachAttach 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: a 5—re,
Construction Type: o Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: APPLICANT: /��� Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ d 06
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.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 [ ]