PRE 2010 DOCSell'Al -:� 0
City of Fridley, Minn. 9717
BUILDING PERMIT
Owner: _ Harold Julian Builder Julian Construction
Address 2526 Thinks Dake_ Address Same
LOCATION OF BUILDING
No. _276._._....... Street Ric -e Creek RouI eva.rd_ ,._.__ Part of Lot _
Lot — 4 _ __ _ .__ Block —A Addition or Sub -Division _____
Corner Lot — Inside Lot —_X Setback -- Sideyard
Sewer Elevation ___ _ _ Foundation Elevation
To be Used as:
Dwelling Front 7Q' Depth 2.7.1 611 Height 201 � Sq. Ft. 14_0Q Cu. Ft. 28.E
Front _ 2 Q_1 Depth 22 t Height _ 1.6'__ Sq. Ft. 440 Cu. Ft.
Type of Construction _ /Frame Est. Cost _j0 .00 _ To be Completed —August 1968
00
SEWER LOCATION - Bask of Lot 1211 East of Manhole
WATER LOCATION — 761 Northeast of Manhole in Rice Creek Boulevard
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 m ance with a'�irovisions of
ordinances of the city of Fridley. ,/
In consideration of the payment of a fee of $ 54.00 , permit is hereby granted to Harold
JI i-1 a sm 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 upon violation any of the provisions of said
ordinance& r
f!T.BR'G?I�Tf�Ti! RF�!T.T.S'TFi'.
NOTICE:
This permit does not ewwr the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to an
the Building hapector for separate permits for these Items.
M
09LICATIQN FOR BlftT, ING PERMIT
CITY OF'FRDLEY, MINNESOTA
OWNER'S
ADDRESS
r:
ADDRE:ft:1
w
NO. ,STREB 61
LOT BLOCK_ ADDITION +OR SUBDIVISIO14
CORNER LOT • IN3IDE LOT ' 3ETBACICDEYAR6
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buildiig-`location drawn on these Certificates.
" d f i • , y� /�r Iy t
Db+aSrC1�:P;T;ION OF • BUXLDTNG, .
To'Be Used ,
�/ Front Deptb / T3eigbt__
e� Cy
Square feetCubic Feet �,
Front Q ` Depth � Height .
Square feet____ 0 Cubic Feet
Type of Canstsuctian.dzz� 4-U Estimated Cost 2,d u
To Be Comple
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 representations stated in this application
are true and correct.
DATE _� SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Si
/&e4C,C/ -. 0,
rl5— ,
C/,
,P ctj -e /'C
of 0 A/
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone 860-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
q
3
5
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O+`y�u
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Cy9
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C�90
•
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WATER HTR.
GAS
ELEG
Base
?
$
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
z $200
$
GAS FITTING FEES:
RATE TOTAL �
1st 3 Fixtures ..........................
�
x $2.00
$
Additional Fixtures ....................
1st
$
2nd
3rd
4th
° Future Connection Openings I
New Fixture, Old Openings 1
II
_
Connected with
Sewer
cesspool �
PARTIAL RATE SCHEDULE
PLUUMBING FIXTURE RATES:
NO.
RATE TOT L
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
z $200
$
GAS FITTING FEES:
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
t
City of Fridley:
8
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 applicatign are true and correct.
Kind of Building
Used as
To be completed about
Estimated Cost, $ /
Old—New. Building Permit No 0'Y �7 Permit A40
Signe
By
Business Phone No
ROUGH
FINAL
Description ................................................
TOTAL FEE $ %110.42
0-4.4
Application for Power Plants and Healing. 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
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 $ d
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 $
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
dot —7
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
Kind of
Used as
To be c ...Y....... , .,
Estimated Cost, $
Old—New. Building Permit No. �/� Permit No.
DESCRIPTION OF WORK
HEATING or POVVM PLANTS—Ste H Water,• arm Air—No
® oe
Trade Nam Size No.
Capacity. Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel-
BURNER
ue BURNER —Trade Name Size No
Capacity Sq. Ft. EMM BTU H.P.
(REMARKS -OVER)
ax Business Phone No
4
4
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
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
60
GAS BURNER (up to 199,000 BTU) ....................... 6.00 $ �7
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 2.00 $
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 76 — ,
City of Fridley:
Mal
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 / 19 01
Owner
Kind of Buil mg
Used as
To be completed about
Estimated Cost, $
Old New: uilding Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS -steam, Hot Water, Warm Air—No
Trade NameSize No. % d
Capacity. Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
04111�04e Business Phone No
97-81-h16o5i CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PEFC41T
Job Address 276 Rice Creek Byrd, 'ISE
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. 9-11-78 . 19
OWNER DIEGO
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 9-18-78
PARTIAL RATE SCHEDULE
ESTIMATED COST 20®00
PLUMBING FIXTURE RATES: N0.
a.
e
OLD - NEW BUILDING PERMIT NO.
n
PERMIT NO.
Number Fixtures
U
$
a
Future Fixture Opening
water
$
.ai
"
New Fixture, Old Opening
x $2.00
$
C�
m
x $5.00
m
b
w
Heater
MINIVEGASCo
water Heater - to 99,000 BTO
x $5.00
$
Tel. No.
100,000 BTU to 199,000 BTU
x $10.00
$
n
me
x $7.00
$
New Ground Run Old Building
x $5.00
$
p
"JI, p
.i
x $5.00
N
6
N
•.1
8
L N
i! N
N
FINAL INSP.
y
U
D
M
d
+++W
Additional Fixtures
ow°
w
w
uw40�
Gas Range to 199,000 BTU
x $10.00
$
APPROVAL FOR PERMIT
v
as�iec
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
S
MINI FEE FOR
MUM R ANY PLUMBING PERMIT I3 $7.50 PLUS $.50 STATE SURGE
State Surcharge
$ .50
TOTAL FEE
$ 8®00
-
REINSPECTION FEE
($10.00)
1st
d
r
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
M . New Fixture, Old Opening
Water
Job Address 276 Rice Creek Byrd, 'ISE
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. 9-11-78 . 19
OWNER DIEGO
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 9-18-78
PARTIAL RATE SCHEDULE
ESTIMATED COST 20®00
PLUMBING FIXTURE RATES: N0.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
n
PERMIT NO.
Number Fixtures
X $3.00
$
Future Fixture Opening
x $2.00
$
Company
"
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5.00
$
Signed By
MINIVEGASCo
water Heater - to 99,000 BTO
x $5.00
$
Tel. No.
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
ROUGH INSP.
Electric Water Heater
x $5.00
$
Date
e
GAS FITTING FEES:
'
FINAL INSP.
1st 3 fixtures
x '53.00
$
Date
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTU
x $10.00
$
APPROVAL FOR PERMIT
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
S
MINI FEE FOR
MUM R ANY PLUMBING PERMIT I3 $7.50 PLUS $.50 STATE SURGE
State Surcharge
$ .50
TOTAL FEE
$ 8®00
-
REINSPECTION FEE
($10.00)
52-84-8915.51
r.0 U
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK 276 Rice Creek Blvd
Number, Kind and Location of Fixtures Location
q
iiiC�7
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
0
NG
z
0p
F
N
WATER HTR.
GAS
ELEG
Base
x $3.25
$
Electric Water Heater
a $2.00
Ins
s
NO. RATE
r
1st 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
1st
x $5.00
$
Gas Dryer
1
5.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
2nd
TOTAL FEE $
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer
Cesspool
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 ................................................$
5.00
TOTAL FEE $
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 true and correct.
Fridley, Minn 3-26-69 19_
Owner Ben Diego
frame
Kind of Building
res
Used as _
To be completed about 3-31-69
Estimated Cost, $ 10100
Old—New. Building Pe o ° P® i
Signe
By t4,jNNEAPQL1S GAS M
Business Phone No
ROUGH
FINAL, (,—j 7— /
42
i
Building job °12533)
ADDRESS
DATE /n/G'JU TYPE 00 PERMIT Ido �
DESCRIPTION
Y
INSPECTION RECORD
DATE
DgDner
COMPLETED & APPROVED
DATE INSPECTOR
42
N?7527
Building Job Repart G09 Building .�®� Report
ADDRESS
DDRESS A-e-
)WNER /ZA-4-
MILDER 44
)ATE TYPE PERMIT NO.
)ESCRIPTION
INSPECTION RECORD
DATE REPORT
------------ --
All f -
r
OWNER
BUILDER
DATE TYPE PERMIT NO.
DESCRIPTION
IJAIC
Kcruma
COMPLETED & APPROVED COMPLETED & APPROVED
INSPECTOR
DATE
DATE
< 42
INSPECTOR
as
- N? (F12509
N 008091
Building Job Report Building J@b Report
ADDRESS k
ADDRESS
OWNERA OWNER
e
BUILDERBUILDER D
DATE TYPE PERMIT NO. ATE TYPE PERMIT NO.
DESCRIPTION DESCRIPTION
fl- n 1,A
t
INSPECTION RECORD INSPECTION RECORD
DATE REPORT DATE REPORT
L Cl
4-
e
COMPLETED & APPROVED COMPLETED & APPROVED --fN-SPECTOR
DATE INSPECTOR DATE
42
.Qff.n 42
M
a
r � `.� ►�Y � f� tet,- �'� �t�'
Sept. 10, 1969
Mr. $arold Julien
2526 Bunker Lake Blvd.
Anoka, Minnesota
RE: 276 Rice Creek Blvd
Permit Pio. 9917
Dear Sir:
Mrs. B. Diego called this date and said nothing has been done about
correcting defects in her home. In our phone conversation -last week
you agreed to make repairs as follows:
1. Repair shower leak
2. Install concrete steps at the north service door of the garage.
3. Refit all basement doors and windows so they open and close.
4. Repair leaks in plumbing at hot water boiler. s
5. Install drip cap and caulk windows on exterior basement windows
® on the south.
It is our understanding that Al's Plumbing Co. is no longer in business
so the responsibilty for the plumbing defects would gall on the general
contractor.
If you have any further .questions regarding, this please do not hesitate to
contact me in the office.
Yours very truly,
CLARENCE BELIS;,y
CB/bks Building Inspector
cc: B. Diego
LAW OFFICES
HALL, SMITH, cJUSTER, FEISEMA & HASBVITZ
WYMAN SMITH
LEONARD T. JUSTER
HENRY H. FEIKEMA
RONALD L. HASKVITZ
JAMES R. CASSERLY
CARL J. NEWOUIST
DOUGLAS HALL
OF COUNSEL
Al D. Bagstad
Building Official -Inspector
6431 University Avenue N.E.
Fridley, Minnesota 55421
CHARTERED
December 4, 1970
RE: Diego Residence 276 Rice Creek Boulevard
Dear Mr. Bagstad:
SUITE IOSO
BUILDERS EXCHANGE BUILDING
MINNEAPOLIS, MINNESOTA SS402
OFFICES IN: FRIDLEY & OSSEO
AREA CODE 612
TELEPHONE 339-1481
I reviewed your letter of December 1, 1970 with the enclosures.
It is my opinion that the City has no legal authority to become
involved in a dispute between the homeowner and his builder for
defected construction. These are matters that must be resolved
through civil procedures either by negotiation or suit between
those parties but the City should not be a party or a witness on
either side.
I would classify all of the complaints in the above category with
the exception of the failure to vent the kitchen range fan which
would be a code violation.
Therefore, it is my opinion that the only action the City could
take would be to enforce the venting of the kitchen range fan
and the other matters are matters that will have to be resolved
without interference by the City.
Very truly yours,
Leonard T. Juster
LTJ:mr
cc: Mr. Diego
Nasim Qureshi
City Engineer
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
PERMIT
P IT NO.
® 19990
r
�
U. COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 = �
1 CITY HALL FRIDLEV 55432
.___ll.' '•� 612-571-3450
R EIPT N
s —!✓
NUMBER
910-F15
REV.
DATE
7/11/89
PAGE OF
APPROVED BY
JOB ADDRESS 276 Rice Creek Boulevard N. E.
1 LEGAL
DESCR.
LOT NO.
4
BLOCK
4
TRACT OR ADDITION
Rice Creek Plaza North
SEE ATTACHED
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Diego 276 Rice Creek Boulevard
571-8358
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
D & D.Home Improvement 7401 Central Avenue N.E., Fridley 784<-7543
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 IR REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroot' Dwelling X22 Squares) 2nd layer
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
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
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$1®100.
SURTAX
$.55
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.
$27.0.0
PLAN CHECK FEE
TOTALFEE
$27.55
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIENPROPERLY
WHV LIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
BLDG INSP
n E
01
NEW [ ]
ADDN [ j R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address: � `7(o (Ce � RGet- 8 fild
Legal Description:
0
Effective 5/1/88
Owner Name & Address:- j
Address: i�<,AVe"
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVIM AREA: Length Width
Height
Sq.
Ft.
GARAGE AREA: Length Width
Height
Sq.
Ft.
DEM AREA: Length Width
OTHER:
Hit/Ground
Sq.
Ft.
Corner Lot [ ] Inside Lot ( Ft. Yd Setback Side Yard Setbacks
Type of Construction: go Estimated Cost: $ // 0""a
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
/ e- Width + 6' See Back Page
DATE: 1 - �� APPLICANT: Tel. # .51®75
Permit Fee
$ .2 i• 00
State Surcharge
SAC Charge
Driveway Escrow
$
Park Fee
$
Sewer Main Charge
$
$ .27S -r
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by & gineering
Agreement Necessary [ ] Not Necessary [ ]
01,
SUBJECTr?
City of Fridley
3 3 9 9 0
AT THE TOP OF THE TWINS
BUILDING PERMIT
��
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
'5
III PROTECTIVE INSPECTION SEC.
1 ; i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
10/23/03
10B ADDRESS 276 Rice Creek Boulevard NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
4
4
1 Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Evonne Strait 276 Rice Creek Blvd NE
435-640-0153
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Sela Roofing & Remodeling Inc 4100 Excelsior Blvd, St Louis Park, MN 55416
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
1050
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 & Garage (32 Sq) 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
OCCUPANCY LOAD
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
1 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
$3,705
$1.85
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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
$97.25
Fire SC $3.70
OR PERFORMANCE OF CONSTRUCTION
PLAN CHX-5FEE
TOTAL FEE
L enK SC $5.00
$107.80
SIGNATURE O CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN PROPERLY VALIDATED THIS IS YOJUR PER IT
G IN v
"ATE
SIGNATURE OF OWNER,IF OWNER BUILDER, (DATE,
01,
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 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: o-7 (D ` Ce CyreA
Legal Description:
Owner Name & Address: FV ow -e "S+rk - f Tel. # LL25--- ��-� S-3Contractor: SELAROOFItNG & REIVIODE iNG, INC. MN LICENSE #
Address: �rrr� v®u BL554 Tel. #
ED #0001050
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.
• 7"4WS6—Ui�y�'.�i�rl�i1�? tlr�csrr�Li"s�fa..:�—
Construction Type-- -. J'(
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
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ ,,, -,?,f Fee Schedule on Reverse Side
$ 3- P .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $1275 per SAC Unit
$ , 00 $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 [ ]