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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: 44L Owner: Address_ ...... ................................. _..... .. _ .... _ _..._._. .._.._. Builder._.-----.._........__...._...._ Address w"?' ............. ......... _....... LO TI LD NG .. �9- No......... Street . / _:.._ &- Z. 20 ... Part of �r �s Lot ....._.! ......----.... Block .....__... )----.....--•-------..... Addition or Sub -Division - / Corner Lot ..._ ....................._........ Inside Lot Setback ........... ..........------.. Sideyard .....1 ......... ...1A_j..................... ..... Sewer Elevation ......................................... .......................................... .............. Foundation Elevation DESCRIPTION OF BUILDING To Used t 4-. ----•---_---._---. Front _.. Depth .._.. Height Sq. Ft. ii Cu. FWD", 0 . _.4 -'r......... Front .._ Depth .., ._ Height ..15 Sq. Ft. ' d.., Cu. Ft.. t 1 Type of onstruchon ....._...�.�P..�a,:�1 ,�L.--.�!i' �._... Est. Cos _..... �,.... _.....:... ........._. 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. In consideration of the payment of a fee of $.r` .._......__...., 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 upon violation -of any of the provisions of said ordinances. _ ....:_ �.. af-?. Building 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 items. ..x TH ERMIT DOES UTH In V10LA ION OF ANY PkI V ATE LA, • ® CC'&NANTS -1)' BUILDING RtSTjiv,: rION3_ APPLICATION FOR BUILDING PERV= CITY OF FRIDIEY, MINNESOTA e3 T? . t J' Owner 1 s Name b fi PA- I Builder Address %/ 1 "1 s 6410 4�-i t .S' Address :21 /7 LOCATION OF BUILDING Sg� Street ) cc �'� 131 v t of Lot No. ��o� Lot Block Addition or Subdivision Corner Lot Inside Lot Y,, Setback 3 'S-- Side -Yard /0 ' t -A4 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: le. Ci FronDepth Sq. Ft. ® / 7,S— Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft.. Type of Construction F Estimated Cost f 6 9 00 To be Completed ' i sem_/- 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 C� 11 � A a o SIGNATURE f � (A Schedule of Fee Costs can be found on the Reverse SicYd.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK If Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: rcgg Number Fixtures � xy xz 'a� N QJZ N w New Fixture Old Opening .............. w ? Catch Basin _ ':._ .. •........................ y WATER HTR. Water Heater '(Up to 200,000 BTU) ..... x 2.00 $ C) New Ground 1� Old Bldg . ............ x 3.25 $ GAS FITTING FEES:,` NO. RATE TOTAL :: ., x $1.50 $4 1st 3 Fixtures .......................... Additional Fixtures .................... R N GAS ELEC. m LL�(�9p Base 1 1st r 2nd _ 3rd _ 4th ' Future Connection Openings I Connected with Sewer New Fixture, Old Openings JI Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TTC)TAL Number Fixtures x $1.50 ...................... P 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 $ C) New Ground 1� Old Bldg . ............ x 3.25 $ GAS FITTING FEES:,` NO. RATE TOTAL :: ., x $1.50 $4 1st 3 Fixtures .......................... 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 applicationetr nd correct. Fridley, 'Minn (//-ll %% A ,, . 19-6-d Owner Kind of Building Jj o Used asBs©�G2�.rr To be completed about Estimated Cost, Old—New. Building Permit ROUGH ,/ / - 3-190 FINAL 42 2M 7.59 Application for Power Plants and Heating, 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 §.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 $ 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 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $$� ALTERATIONS & REPAIRS TOTAL FEE ROUGH— OUGH FINAL— FINAL Dept. Dept. of Bldgs. Phone SII. 4-7470 Location 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. 2 g Fr , hUn • e, , 19 / Owner Kind of B I _ A Used as To be completed about o 4�+-�� Estimated Cost, $. f" 74-6-v o Permit No. Permit No. /oZ 3-3 DESCRIPTION OF WORK HEATING or PO -,Ste of Wa ,�WarmAiro � RPLANTS Trade Name v2 -d - Size No 4(s , Capacity Sq. Ft. E.D.R. BTU _ H.P. i Total Connected Load Kind of FuelV BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) RAY N. WELTER HEATING CO Signed 4637 CHICAGO AVE. MINNEAm,POLIS 7. MINNESOTA By 4Z 2M 7-59 Business Phone No - City of Fridley SUBJECT -P NO 1345 A1� THE TCP OF, THE TWINS g l p N G PERMIT t R IP771NO ------ COMMUNITY DEVELOPMENT DIV. INSPECTION 1 PROTECTIVE SEC.p NUMBER REV. DATE. a PAGE OF APPROVED BY i /1`j CITY HALL FRIDLEY 55432 L .._.� s1.2seo•3450 910-F,15 4/16/76 JOB ADDRESS'- 255 Rice Creek Boulevar& N.E. F 1 LEGAL LOT N . BLOCK TRACTOR ADDITION SEE ATTACHED DESCR, 13 3 Rice Creek Plaza Forth Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PH NE Ronald Andrle 255 Rice Creek Boulevard 3 CONTRAC OR MAILADDRLSS ZIP PHONE LICENSE NO. Saone 4 ARCHITECT :R 0ES1 ER ,? MANIA'66R fSS c`� . ZIP a d LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. S �1a.. 6 USE OF BUIL NCi r, Addition to Dwelling 7 : OLASS ORmWORK ` ¢ p " 4tW ''^ Abp T t WAtLT i� iQN "[ &*"I PAIR ,: p 1060E ❑ 'REMOVE 8 DESCRIBE WORK Construct a 24' x 16' Addition to dwelling 9 CHANGE OF USE FROM w (3 , TO r STIPULATIONS t �, PERMITS REQUIRED FOR WIRING) SEPE RATE HEATING, PLUMBING AND SIGNS,, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF,CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. . Wood Frame THIS PERMIT SECOMES NULL AND VOID IF WORK OR CONSTRUCTION' ZONING, SQ. FT. CU. FT. AUTHORIZED ISNOT COMMENCED WITHIN 60 JAYS, OR IF CONSTRUCTION OR WgRK IS SUSPENDED OWABANDONED FOR A PERIOD OF 1120 DAYS AT R-1 384 4608 ANYTIME 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,000 4.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR.THE PERFORMANCE OF CON$TRVCTDN. � a S=X9 $28.26 ` PLAN CHECK FEE To7rAL 11- $32.26 E. OF CON TRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROP RLY+ VALIDATED THIS IS YOUR PERMIT R, ZSIINTURE A OF OWNER IIF OWBUILaEll� IDATEI BLDG. )NSP DATE APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA _ � q1 _ a7 OWNER' S NAME : ) 6 NRL I� A N D �, � BUILDER : Pb 1,inLD A &D -P L�' ADDRESS :ate- Rl� YLe-k ADDRESS : �? 5, /Q JCi= CX NO:.. o� i STREET: f C=am az-yb LOT.: ✓ BLOCK: -3___ . ADDITION: ?lCz-- CIPL--�/ a&2,4 /V6I2*N CORNER LOT: L— INSIDE ZOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of fyrvey.of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING j Lq P Front' 074 Depth' /6 Hei4aht: / �' Square Feet: 39q Cubic Feet' Front: Depth: Height: Square Feet; Cubic.Feet: Type of Construction: W®®L) Estimated Cost:_��� To Be Completed. Aueus'I / `'7(,=, The undersigned hereby makes application fow a permit for the work herein specified, agreeing to do all work in strict accordance with the City ^f Fridley Ordinances and rulings of the Department of Buildings, and heie:by declares that all the facts and representations stated in this application are true and correct. DATE: .4 - 13 7�-, (See Reverse Side For Additional Information.) ®�6 1 f"r- � Thy � L /04 XS f 1' b carh y Av, *6 afire and correct representaf iOO of a survey eAe b,,vW*r,es of ME a6are lW d, aN 4rat! bWd,;,p-, #rcrean , and oU rr5i6/e mawchmenh fVn or W.sod /anti: AS serve a t� rr� ftr�_._._ - cry p a SUB 02,6" WGINEEIVAIC7, INC. CITY OF FRIDLEY PERMIT NOr: 2004-01559 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/08/2004 572-3604 t'AX: (763)571-1287 ADDRESS : 255 RICE CREEK BLVD NE PIN : 143024220033 LEGAL DESC : RICE CREEK PLAZA NORTH ADD : LOT 13 BLOCK 3 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 3,700.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. INSTALL WOOD BURNING INSERT INTO EXISTING FIREPLACE. STATE LICENSED CONTRACTOR 1 APPLICANT FIRESIDE HEARTH & HOME 225 COUNTY RD 81 OSSEO, MN 55369 OWNER ANDRLE RONALD & ANN 255 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application 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 does not presume to give authority to violate or cancel the provisions of any other state or local law rejLulating constrychon or the performance of construction. nnlican Date / 1 Bldg BUILDING PERMIT FEE 97.25 FIRE SURCHARGE 3.70 STATE SURCHARGE, VALUE 1.85 LICENSE SURCHARGE 5.00 TOTAL 107.80 PAID WITH CHECK # 607808 I SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY C 4481q Effective 4/1/2004 ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address:�; L �� '�®?9®� Legal Description: Owner Name & Address: , go r -N An a�L r I e- �s"5 .�� L� � � � e k Y31 %ickTel. # Contractor. MN LICENSE # Address: Tel. # AJWde Attach to this application, a Certificate of Survey of the &a& 1 lot, with the proposed construction drawn on it to scale. ciao n. FahimA" ROSWAU% MN 65,ie�.+MI 55113 DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: DECK AREA: OTHER: Length Width Height Sq. Ft Length Width Hgt/Grou/nd Sq. Ft P.Je,�E� IJc�a ®a a+s v! i a�S t r ,J. ,, tee CrS Construction Type: Estimated Cost: $ 3 7 &-n I &-'� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: �--�� Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side $ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ J, $.50/$1,000 Valuation $ $1350 per SAC Unit $ ®C� $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 [ ] $ /0?- c STIPULATIONS: FROM :City of Fridley • `� Buil dz.n g • Inspections .763-572-3604 DATE SITE .AT)DR'PSS TH IS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STA171 LICENSE WITH APPLICATION FAX NO. :7635711287 Mar. 27 2906 12:34PM P2 BUILDING RESIDENTIAL APPLICATION CITY OF FRID.LEY YOURE-MAIL ❑ OWNER %CONTRACTOR. 1'mit N _. CIS Received By:. Date Rec'd: -� .Nt"= Z[ r /L!_p-v — Ar)DRF-SS: fS . CG BGG% �� — CTTY �� STATF Ir �T OOP'IWO & REI c66ELIIQIG II�It;' NAME: � EACELSIOR BLVD_ STATELICFNS P ADDRESS: r0 -T -JA 55416 _ CITY^ __.. _ STATE 7.iP_• A_ ... rI�oNE4?' �9�5 = 7��� r w _­ ­ - ...... PROPERTY 'TYPE ❑ SINGLE—FAMILY/NAW C'ONS'I'RUCTION SIlE ❑ I'WO FAMILY/NEW CONSTRUCTION STORIB.S !'ERIVLIT T�rpli,' Q ADDITIUN ❑ GAItAcTvsHED ❑ WINDOWS - ❑ BASEMENT FINISH ';@4()OF ❑ DRA.W Tfl.fi ❑ DECK ❑ SIDING ❑ OTHER _ ❑ SWIMMING POOL TYPE OIr WOW<: ❑ NEW ❑ ADDITION ❑ MAINTENANCTJREPAIR Q.RE.w►OPHLING DESCRIBE WORK BEING DONE: ���,•__ _ •• S7E OF IMPROVRMENT LENGTH WIDTH 1100FING O HOl1SR ONLY N5ZER OF SOUARES 'FTOUSE & OA um $lOS) MEAI f IEMQDEuscx suamrr: GARAGES ❑ A'I'TACM) GARAGE I. Propose bluer Plan PROPOSPI) SI7.E ❑ ORTACHED GARAGE 2. listProopal 1100Tl m - ••-- 3. List of su'ttcmracmbcrc u) be use(] PROPOSED HEIaf1': HEIGHT Sq. b't. SIDING ❑ vinyl ❑soffit lD Aluminum ❑ Trim ❑ Other ❑ Fascia FOR NFW (:ONSTRUCTION INCLUDING DFCKS, ADD,PTj.olg, �, i oRcH s stigma: I. Site Plun/Survay showing the cx1stine structures and proposal project WINDOWS WS 2. . Two $eta of construction plum VO �— 3. i nrtgy Calculations IN EXISTING OPENINGS ❑YcFi ❑No LOCATION OF WINDC)Wti OR FOR NEW 07F-1:)PSCIt.11ME SIZE OF OPENIN•O CHANGES & TYPE OF WTNJ)OW T() AA INSTALLh•D NUMBRR OF WINDOWS ALL FEES ARE BASED ON VALUATTON, INCLUDING '1UE COST OF LABOR AND lYMA'IT(MALS: (USING THE 1997 U.B.0 FIE, E SCHEDITLE) TOTAL .TOB VALUATION S OCCUPANCY TYPE PehTrtit Pee $ . W See Back Page for Fee Schedulc Plan Review $ 65% of Building Permit Pee Fire Surcharge _ 001 times the, total jot) valuation Surcharge $ _ da01 .0005 x Permit Valuatioln. Minimum $.50 License -Surcharge $ $5,00 (State •Licensed Residential Contractors) SAC Charge �+$ $1550 per SAC Unit (Plans to MWCC for determination) Curb Curt Escrow _ it + 6 fi = ft x S20 Erosion Control $ $450 Conservation flan Review Park la ee S _ Fee ] 3etelmined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Dile _ _ -S / - Make checkspaluble to: City of Fridley Attach THIS IS AN APPLICATION FOR A PEItMIr-NOT VALID UNTIL PRO(:HSSED i hereby apply for a building parniit and I acknowledge that the inforrnalion above 1S complete and accurate; that the work will be in confornmce. with the ordinances and codes of tho City of Fridley and with the Mittttesota Construction Cocios; that T understand this is nor. a permit but only an. application for a permit and work is not to start without a permir; chat the work will be in accordance with the approved plan in the case of, all work which requires rcvt(;.w a al of plans, SIGNATLIR.E OF APPLICANT _ �J � -`Pe.5o:�• .. PRINT NAM . G®C�1 DATE ®