PRE 2010 DOCSCity of Fridley, NT 9927
BUILDING PERMIT
Date: Sept. 9, 1968
Owner: Harold Julien Builder Stene
Address 2526 Bunker Lake Blvd. Address Same
Anoka, Minnesota
t -ft 61 TIFIX .f i o i. 9 z, r .,..
No. 266 Street __ Rice Creek Blvd. part of Lot
Lot _ _6 Block 4 Addition or Sub -Division — Ricg Creek_Plaz North Addn.
Corner Lot _ Inside Lot __._ x Setback 35 ' -- Sideyard —
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Dzglliug Front ___..5Z'_ Depth 26' Height — _ 2D' Sq. Ft. _ 1'152_ Cu. Ft _.-Za,-040
Garage Front 20' Depth 22' Height lo, sq. Ft _440 _ Cu. Ft 4400
Type of Construction Frame Est. Cost _ _ `�22_.,..00—_ To be Completed
SEWER XIM LOCATION - Service in the rear- Stub location is at the manhole on
the northeast property line.
WATER LOCATION - on Rice Creek Blvd.- 158' N. E. of Manhole
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 m ance with all ons of
ordinances of the city of Fridley. 14 '/ r
In consideration of the payment of a fee of $ 47 . 00 , permit is hereby granted to.- _ILa
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 tune upon violation of any of the provisions of said
ordinances. r,
Official
Building
John. Breher
NOTICE:
'this permit does not cover the construction, Instalktion for wiring, plumbing, gas heating, sewer or water. Be arra to we
tits Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
0005-961
LOCATION OF
NO. Z (, ` STREET S
LOT BLOCK ADDITION OR SUBDIVISION
�`
CCR.'.\M LOT INSIDE LOT SETBACK 36" SIDEYARD
SEWER ELEVATION TOP OF TOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location: drawn on these Certificates.
To Be Used As:
jpro,YWV--`10 Front
DESCRIPTION OF BUILDING
S -Z -
Depth z �' _ Height 2-�
Square feet 13S?- Cubic Feet 2 I act e
0 .4Q-� R: Front Depth Z -- Height 10
Square feet q&10 Cubic Feet
Type of Construction r Estimated Cost Z 2100 0
To Be Completed VO Ax Y 5
The 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 representat`a s stated in
this application are true and correct. P _ �i
(Schedule of Fee Costs can be found on the Reverse deo)
YZI 12 9-0
x y
S
City of Fridley
Application for Plumbing and Comas Fitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location
q
Gl
C
$d
TOTAL.
Number Fixtures ......................
MM
Z
iZii�
Future Fixture Opening ................
Y
o�
S
6' Z
��
VI
GG� Z
U�
W
0
<
`Ga
W
�K
U'
Z
0p
F
N
WATER HTR.
GAS
EIEC.
Base
A
x $3.25 $
1
x $2.00 $
1
GAS FITTING FEES:
NO. RATE
12—
l
1st-
1
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings I
Connected with
Sewer E]
Cesspool
;711,11 1,11WIN ' • A KernI�pill
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL.
Number Fixtures ......................
x $2.00 $—�_
Future Fixture Opening ................
x $1.50 $
S
New Fixture Old Opening ..............
x $1.50 $
Catch Basin ...... .....................
x $3.25 $
d
Water Heater (Up to 99,000 BTU)
...... x $3.00 $
New Ground Run Old Bldg. ............
x $3.25 $
Electric Water Heater
x $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 $
REPAIRS & ALTERATIONS—Refer to Code
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 a ication are true and correct.
Fridley, & , 19
Owner --
Kind of Building
r
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No 7 Permit No. Y--7fo
i
Signer'
Business Phone
ROUGH t
FINAL
Description ........... $
TOTAL FEE $`�/' �/ az
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 ..........................$10.00
$
Replacement of Furnace .............................
6.00 $
Repairs & Alterations—up to $500.00 ..................
6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
MECH. WARM AIR
a�
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $�
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
$10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
10.00
$
Each add. 200 sq. ft. EDR Steam ......................
3.00
$
Each add. 320 sq. ft. EDR Hot Water ............. ....
3.00
$
OIL BURNER—to 3 gal. per hour 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) ....................... .5.00 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 2.00 $ !2 O v
Additional Fixtures x .75 $
Gas Range to 199,000 ........... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
TOTAL FEE $�
Dept. of Bldgs. Phone 560-3450
Location
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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 :2 19
Owner
Kind of Building
Used as
To be completed about V 3— (o
Estimated Cost, $ 6 '�
ON—New. Building Permit No. �C� Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
ZA
Trade Name �L'�'�- Size No o ' 0 C, O
Capacity Sq. Ft. E.D.R
Total Connected Load�p Rind of Fue d-
-2o
BURNER —Trade Name 2i1 -�� Size No i- coo
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Signed "4z
az Business Phone No- / � �z T
Original
PERMIT for Power P ants and Heating. Cool -
ing, Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be nstalle ltered—repaired
Make - -- - -, Sixe C) •ss� -;
Oil fired ; Coal fired ; Gas fired- �—; Gas Authorization No.
Remarks
Approved
Final Inspection
19_
Inspector
Permit O -W� 402.1
Fee $ , N. 4444
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. , 19.
a
Owner 1 .���x
Location c--2 6 t- ` '�
Kind of Builth
How Occupied'
Work to be Commenced ,19 --
To be Completed ,19_
Estimated Cost, $-S ° e --e
Old -New, Building Permit No. Ci C? ) -7
Permission is hereby granted to install—erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the spec; ations set forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
a - , Inspector of Buildings
42 2M11.67V
®ems 9. ✓9
I
November 13, 1970
'a. Ildrold Julian
M Bunker Lake Boulevard
ka, Minnesota
t. _ .tr lair. Julian:
rhe followisa; defects have not been corrected as of this date at 276 Rice
T
eek Doule;rFard:
1. 71 -Le basement vindo-w on the South still lea lks
2. '11 -ie kitchen rtazae-;e fan is not vented to outside air or through the roof.
3. The shoo7f.';t in the bacement leaks through its base into other rooms.
.n
The avers, Nx. & Mrs. Die -os also claim tho roof has boon lea%in,-, and a
=tee and faucets are dripping,. _
DPUXIIlAs departme:,it also checked 266 Rice Creek. Boulcvard and found tact spots
tlae ceiling,, appa�:ent'iy from a leak at the fireplace fl.ashiug'.
Since all the above iterow mere called to your Attention before these homes
were l year old, we fool. you have a. renponsibilit-y to tlae homeowners to correct
t Se itelfta. Therefore, wo. request that you correct the above conditions within
dazys
Should'you fail to do so, we shall tag, each code violation and note all
plaints and violations on your construction recol:d for future reference for the
ty of Fridley, which will be taken into consideration if you should apply for
a license renewal in Fridley.
We would lime to. see these conditions corrected to the satisfaction of all
concerned without fua:ther action being taken by the City.
If you have any questions, please feel free to cull ria at 560-3450.
Sincerely,
AT. )). .1-1At STAT
Building Official -Inspector
ADB/mh
CC: City En;;inoer
Chief Buildin; Inspector
1@ MMEG ASCO
53-84-S-915.51
City of Fridley
Appliceilan for Plumbing andG-cs. M 'Aag, Permit
Dept. of Bldgs. Phone SM -3450
DESCRIPTION OF VIORX 266 Rice Creek Blvd.
b
Numer, Kind and Locr.Kon of Fixtures 1'O�A� - -
Future Coaaac:ka Opaninp
>Sever[]
IXow Fixture. Old Openinp ccrzpool o
PARTIAL RATE SCHEDULE
.UTMBING 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
N
Water Heater 'Up to 99.000 BTU) • • • •
x $3.00
WATER 'TR.
GAs
i�
Electric Water Heater ..............
a $2.00
$
AS FITTING FEES:
NO. RATE TOTAL
Ist3Fixtures ..................
x$2.00
$ ,
u _
_nEG
o
7
u
7
i
7
v
N
se
--
in
t411
has
Gr
Lil
i
i
Future Coaaac:ka Opaninp
>Sever[]
IXow Fixture. Old Openinp ccrzpool o
PARTIAL RATE SCHEDULE
.UTMBING 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 13.25
$
Electric Water Heater ..............
a $2.00
$
AS FITTING FEES:
NO. RATE TOTAL
Ist3Fixtures ..................
x$2.00
$ ,
Additional Fixtures ...............
x $ .75
$
Gas Range to 199.000 BTU ...........
x 55.00
S
City of Fridley:
The undersigned hereby makes application for a permit for the- work her ei
specified, a;reeing to do all work in strict accordance with the Citi Ordinance
and riling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct'
Fridley, Man 5-29-75 19
Owner M. H. Gallagher
Kind.of Building Frame
Res.
Used as -
To be completed about 6-5-75
Estimated Cost, $ 10.00.
Old --1 Building Permit No. Permit No.
Signa gg
By MINNEGASCQ --
Business Mine No
ROUGH °
FINAL
.LPAIRS &: ALTERATIONS—Refer to Code .50 State Surcharge
Install Gas Grill 5,00
.Description ... ° ...... w .............
. ► ........... .
T02AL FEE S 5.50 •
Iri
P TNN.
SUBJECT
City ®f Fridley
/
21598
AT THE TOP OF THE TWINS
BUILDING PERMIT
i ,
O•
COMMUNITY DEVELOPMENT DIV.
L'�_�_�_
r PROTECTIVE INSPECTION SEC.
of
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/7/92
JOB ADDRESS 266 Rice Creek Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
6
4
Rice Creek Plaza North Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
BXNXNXH Ken Farber 266 Rice Creek Blvd NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Home Improvement Inc. 7401 Central Ave NE Fridley 55432 784-7543 4840
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE El REMOVE
8 DESCRIBE WORK
Reroof House (23 S uares) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be 2nd layer but not 3rd.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,219
$.61
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIO F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$31.00
Fire SC $1,22
STRUCTIO14 OR THE PERFO MANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
lua4 OL6�---License
SC $5.00
$.37.83
SIGNATURE OF CONI FOR AUTHOR T (DATE)
P ERY ALID TED THIS IS YOUR PERMIT
FgWHE
LDG $NSP QATE
SIGNATURE OF OWNER OF OWNER BUILDER$ tDATE$
NEW [ ) Effective 3/l/92
ADDN [) CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: ge�-
Legal Description:
Owner Name & Address:Tel. # 45 7�
Contractor: D & D Home Improvement, Inc. MN LICENSE # 4840
Address: 7401 Central Avenue N.E., Fridley, MN 55432 Tel. # 784-7543
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Comer Lot { J Inside Lot { ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: ge—Jh- ®� Estimated Cost: $1219
Approx. Completion Date: // ! �
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ = $
DATE:
APPLICANT: Tel. #
Permit Fee
$
Fire Surcharge
$
/
State Surcharge
$
- l
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Park Fee
$
Sewer Main Charge $
TOTAL $ 3
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO O -33
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (612) 881-9000 TEST RECORD
ADDRESS
THERI
VALVI
LIMIT
LIMIT
FAN
PILOT
IGNITI
PILOT
PRESSURE 3m 5" //4 e PERCENT CO2 9
INPUT CFH 75 PERCENT 02 bl
STACK TEMP. i / ® PERCENT CO
FORM 235 (REV. 11/89)
v
CITY
OWNER
INSTALLED BY
MODEL `/ ,,2 d/ Q 3 E — ;7
INPUT 7..5,_019 O_
VENT SIZE
TYPE OF LINER !®_AT/Qlar -
r�
LINER SIZE
FILTERS: SIZE Aw NUMBER
WIRING /
TEST TAG t/
LIGHTING INST.
DATE TESTED
COMPANY TESTING
NAME OF TESTER
�6,2 JJ
CHIlVMY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes N No ( )
2. Is free from rust or deterioration Yes N No { )
3. Has no foreign objects lodged within Yes (% No ( )
4. Is securely supported Yes (X No .( )
5. Meets all current Code requirements for size
and total BTU's connected Yes N No ( )
6 Has total heating BTU's of�l /�, cc 0
All other BTU's `� ��
TOTAL BTU's ! ! SSW
7. Has a liner been. provided for water heater
Yes ()
No
(�
8. Has combustion air been provided for water heater
Yes (
No
( )
Remarks:
List ALTERATIONS Being Done:
k rd 54v 4) /&�2
ee C"46��A�� Y �
HEATING CO:
Signed By:
Date:
!(3 AIR CGI`.wdDgg�ITIC�,-,II G GO.
„C�
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner -
Aiso Replacement Furnace
(Side.Vent - Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
*Air Conditioning — All Sizes $ 25.00
41-&
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
Commercial/industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE„ 56
I4I[NJ1 UM FEE FOR ANY HEATING/ COOLINGIVENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
"Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
I•
Effective On March 1, 1996
JOB ADDRESS 466 41a'' /( A &A C/
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.
®� ,1996
OWNER
BUILDING USED AS���
ESTIMATED COST 4'06 ® PERMIT NO. �� �C �♦
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_Circle One (Steam) (Hot Water)arm Air
--
Trade Xame Size No p ,3 -7
BTU 'Z .r-445 HP EDR
Fuel_ Total Connected Load
Burner Trade Nam Size No.
BTU_ HP EDR
HEATING COMPANY
Signed
Approved By
SE- D G' SICK
H'El,TING & Alfa CONDITIONING CO.
E910 WENTWORTH AVE. SO.
Rough—In Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
Final Date Jo
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
8. Has combustion air been provided for water heater Yes ( ) No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CHMINEY 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
O 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's connected
Yes (
) No
( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
8. Has combustion air been provided for water heater Yes ( ) No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SuBjE&
PERMIT NO.
City of Fridley
��-
AT THE TOP OF THE
BUILDING PERMI T
2� 6.
P
`
T
CEIPT
COMMUNITY DEVELOPMENT DIV.
e PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/15/98
JOB ADDRESS
266 Rice creek
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ken Farber 574-1947
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Peak Roofing 11506 S Oakvale Rd Minnetonka 55305 938-8150
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 O ADDITION O ALTERATION REPAIR O MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (25 S Tear -off
9 CHANGE OF USE FROM — TO
STIPULATIONS
Underlayment must comply with the 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
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
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
$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
Fire A $2.14
PLAN CHECK FEE TOTAL
'0
L S 5 6
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT 10 Ei
HE PR VALIDAT IS IS YOUR PERMIT
I
14�f�
�/, J
iNS� rj&TTTEEE
----
S,GNATURE OF OWNER ��F OWNER BWLDERL iDATE. -
a
NEW [ J Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -Z
BUILDING PERMIT APPLICATION � 6
ConstructionAddress:
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Legal Description:
Owner Name & Address: /'r' r Tel. #
Contractor: /7�1_ 4— "e. n f ; MN LICENSE # o?ooys 3e/
Address: (f,$ -'o 6 r, A/ S_ 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:
Construction Type: le.-- 0 � � Estimated Cost: $ 5-45Q, o U
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: % APPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ �"�. %�� 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: