PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT S® 4331
Date: --------._............._..
Owner:
---.._.................----------------•--...---.._............_-_..._...--_-••-._---..-.-.-_--.-_... Buder .........._....._..-----...._...._....__--•----.
..........................
.....
__..........._:�....i.__.....
Address ......................... _.......... ........- Address ....... ............ ................ _............ .__..__....._.
LOCATION _ OF BUILDING
No. 1-0 Street_.__ ....... v -.... _-- -. ----- .... ._ ............ ....._ Part
of Lot - -
Lot ..._.-- .................... Block .................... .................. Addition or Sub -Division
Corner Lot ..... ............................. Inside Lot ....................---............... Setback ............................. _.............. Sideyard
Sewer Elevation ....._............._......._.---.......---...-......................-------------------------- Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as:
� c a c ar l
_._..... _.._......... ........... Front ...f_....7..`� Depth _� Height.. Sq. Ft. l.../.... Cu. Ft.19.0..716
A�ce� .......... .. Front . Y:7..6 `Depth.®f .. .. fight ........................ Sq. Ft.. I... Cu. Ft. Sp p
Type of Construction............................................................ Est. Cost......I 9 919 j7 To be Completed ................. ..._...................... -........
In consideration of the issuance to me of a permit to construct b
the proposed work in accordance with the description above set fo'"
ordinances of the city of Fridley. r �e ,
in
I aa��''ee to do
ovisions of
In consideration of the
payment of a fee of $..ice....._--......., 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 upon violation of any of the provisions of said
ordinances. .1 _, ,
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.
Application for Power Plants and Hearing, CooUn . Ventilation, Rengoratton 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 do
Furnace Shell & Duct Work to 120,000 BTU ........... 8.00 $ ��
each add. 60,000 BTU ....................... 2.00
Replacement of Furnace ............................. 5.00 $
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. IDR Steam ......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
I
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
s
OIL BURNER—to 3 gal. per hour ........................
5.00
$
over 3 gal. per hour—See Fee Schedule
$
AIR CONDITIONING
GAS BURNER
(up to 400,000 BTU) .......................
5.00
$
GAS PITTING FEES:
NO RATE TOXAL
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
$
REMARKS -
h_
Dept. of Bldgs. Phone 0
-Al
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 completed about —
Estimated Cost, $
VW—New. Building Permit -No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name P Size No J��
EE
195-
195—
Capacity. 'u Sq. Ft-. /E.D.R BTU H.P.
Total Connected Loao�!/ G Kind of Fuel•
BURNER — Trade Name- � Size No
Capacity.
Sq. Ft. E.D.R BTU H.P.
Sign
By e
11 POST 1 M -12-58f
Business Phone No
a
Ary X VA 6X -O -c r
fVp
D-36 ,42
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E.H Construction No. Insulation
Guide
Windows I Doors Reference Glut. Wall Int. Wall Ceiling Roof T Floor 11 Kind How Applied
Yes- iNd- Yes 19_
J M I //e -P - , 'AIR-- I r ---.k U a 111:.].i. I I Q Lr :.L• 'l, 1, _ _.L
- .p -----
Win ows and Doors—Crackage and Area
r%oom I i.engtn 7 ytj
Width .Height No. of Lineal f . Area
No. of pane of pane lights of crack .q. ft.,
Width
No. of pane
rielght
Windows and ; oors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Co;f.1 Btu
Infiltration
Btu
30�®
Glass
Btu
Infiltration�''�
Coef-I
Btu
Infiltration
Net exp. wall "
Int. wall
Exp. wall
2
Ceiling
Glass
Net exp. wall
Floor4
151,
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
1 otal 13tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I F1.1 L, t4 A')v Room I Lenath b J Width / IJ Heiaht 9
Windows and(boors—Crackage and Area
r%oom I i.engtn 7 ytj
Wath y
Width
No. of pane
rielght
Windows and ; oors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. IL
96 Q e,
Btu
Infiltration
Coef.
Btu
Infiltration�''�
Coef-I
Btu
Infiltration
Glass
Exp. wall
j
Q336
Glass
Net exp. wall
0
Net exp. wall
Exp. wall
Int. wall
Ceiling
Net exp. wall-
4(f
Floor
-"
Int. wall
Floor
".,.
Ceiling
Floor
L
y
#17
Q
7qg
1 otal 13tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I F1.1 L, t4 A')v Room I Lenath b J Width / IJ Heiaht 9
Windows and(boors—Crackage and Area
wp.a. :1
r. - ..ro.. ,_"
Width
No. of pane
Height No. of Lineal ft. Area
of Dane Ilghte of crack sq. ft.
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack .q. ft.
Coef.
Btu
Infiltration
Coef.
Btu
Infiltration�''�
Coef.
Btu
Infiltration
Glass
Exp. wall
j
Q336
Glass
Net exp. wall
0
Net exp. wall
Exp. wall
Int. wall
Ceiling
Net exp. wall
4(f
Floor
Int. wall
Floor
".,.
Ceiling
ILL
#17
Floor
a 55 4
Total Btu.
Required aq. ft. E.D.R. or sa. ins. W.A. Leader area
e>� s ..1 M M 14 •www
wp.a. :1
r. - ..ro.. ,_"
Windows and Doors—Crackage and Area
1
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack .q. ft.
Coef.
Btu
Infiltration
Coef.
Btu
Infiltration�''�
Glass
Btu
Q
Glass
Exp. wall
_
r;
Exp. wall
Net exp. wall
0
Net exp. wall
Int. wall
Int. wall
Ceiling
Net exp. wall '
Ceiling'
Floor
Q
Floor
".,.
Total Btu.) (,ll)
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
0) Fl.l.0 /1P z4 Room I Lenath 1 _� Width 6 Heiaht ,S�''
Windows and Doors—Crackage and Area
m Room I Length / U,,
Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
1
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack .q. ft.
Coef.
Btu
Infiltration
1
Glass
Btu
Q
BAS
Exp. wall
_
Glass'
Net exp. wall
0
`
Int. wall
Ceiling
Net exp. wall '
lq3
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 JV.W. R
m Room I Length / U,,
Width
5 ®
Height $\<L
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane tights of crack .q. ft.
Coefa
Btu
Infiltration
BAS
_
Glass'
Exp. wall
Net exp. wall '
lq3
11'
Int. wall
Ceiling
Floor
Total Btu. pad -`.:y ffi� .� yh" 7'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
D-36 —42 '
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes Yes—No 19_
I- F1.1 /VI---. #7 .Room I Length 1/1 Width 0� 9., Height ey 11 1a FI_I V -F� w Ranm I Length le- Width Heiah0 fes,
Windows and Doors—Crackage and Area
G�
Width Hetght No. oL Lineal f . Area
No. of pane of pane Ilghte of crack sq. ft.
d
,ppane
/b
q
Coef. Btu
.Infiltration
Coef. I Btu
Infiltration
Coef.1
'351 7,611
Glass
D
S. "
Exp. wall
G
Glass
Net exp. wall
9q
hi 1 1639
Int. wall
Exp. wall
Net exp. wall
Ceiling
12
m Ia.
Floor
�yq
±f
Windows and Doors—Crackage and Area
G�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Width Height No. of Lineal ft. Area
No. of pane of lights of crack eq. ft.
,ppane
/b
q
Coef. Btu
.Infiltration
Coef.
Coef.1
Btu
Infiltration
(s
31 q
c
G
Glass
3 Ir
Exp. wall
Exp. wall
Net exp. wall
� tis
12
m Ia.
Net exp. wall
ko
4 OAT
Int. wall
b_
et
Cl Al
Jq
Ceiling
-
15-0
;
Floor
Ceiling
L 0
-��
Iq
1 otal Btu. IP'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FIALm. n--Jfri vRoom I Lensfth 1'47 Width )G,,) Height ' T,
Windows and , oors—Crackage and Area
G�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
9.
q
Coef. Btu
.Infiltration
Coef.
Coef.1
Btu
Infiltration
Infiltration
31 q
Glass
G
Glass
3 Ir
Exp. wall
Y`l
Net exp. wall
� tis
12
m Ia.
Net exp. wall
ko
Ceiling
i _ty
b_
et
Cl Al
Jq
Ceiling
-
15-0
;
Floor
Ceiling
37-
-��
�,='
1 btal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
G�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack I sq. fto
12— J woe 1A 0, 'L
Coef. Btu
.Infiltration
Coef.
Btu
Infiltration
.
Infiltration
31 q
Glass
G
�,
3 Ir
Exp. wall
®s®
Net exp. wall
� tis
12
m Ia.
Int. wall
ko
Ceiling
?
b_
et
Floor
?`
t-
-
Total Btu. I / 0 14,
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
.1? Fl.l /k `-%' n Room I Length R" Width �'' Heightq v,.
Windows and Doors—Crackage and Area
G�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of cracksq. ft.
3 q q r0 Z /� i I
Coef. Btu
.Infiltration
Glass
Coef.
Btu
Infiltration
Int. wall
3,'
Glass
®s®
, r
� tis
12
m Ia.
ko
Net exp. wall
., 0
Ax
Ceiling
d _
L,
Floor
Q Sc
9
Total Btu. I ('
Required sq. ft. E.D.R. or sq. iis. W.A. Leader area
Fl.1 Room I Length Width Height
Windows and Doors—Crackage and rea
G�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
.Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sa. ins. W.A. Leader area
City of Fridley
Application far Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
�j
F:
^
v
,�7
w
(a9
�U'
?
u1z
aU'
•
R
N
N
WATER HTR.
GAS
ELEI
ei
viC
4. C
U m
U'
K
O
Base
1st
2nd
_
3rd
4th
• Future Connection Openings
Connected with Sewer E]
New Fixture, Old Openings
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
67
Number Fixtures ...................... A 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 BTL) ...... x 2.00
New Ground Run Old Bldg. ............ x 3.25
Dept. of Bldgs. Phone SU 400
-7747
i_n 44— d /t �[)D 4V'i
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 applicatipn are true and correct.
f
Owners
Kind of Building
Used as
To be completed about
l
Estimated Cost, $
Old New Building Permit No- !� Permit o.
TOTAL
$ ® Signe&A'
$ BY
s
$ Business Phone No 6
$ ROUGH
FINAL
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ 06 51D
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description $
TOTAL FEE $ �`Q e a 2M 7-59
Furnace Shell & Duct Work ...........................$10.06 $
Replacement of Furnace ...........'.................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
11tH. WARM AER
Furnace Shell & Duck 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 ............... :......
&00'
$
Each add. 320 sq. ft. EDR Hot Water ..... ........
... 3.00
$
OIL BURNER to 3 gal. per hour ... ::... ... ... I .....
6.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 109,000 BTU) ..........................
6.00
$
over 189,000 BTU See. Fee Schedule
GAS FITTING FEES.
NO RATE TOTAL
1st 3 Fixtures ..... I ................
u$ 200
$
Additional Fixtures .................
x .75
$
Gas Range to 189,000 ...........
s$ 8110
$
AIR CONDITIONING
$'
FAN HEATING SYSTEM See Fee Schedule
ATING SYSTEM
$
ALTERATIONS & REPAID TOTAL M
$
UGH
City of Fridley:
The undersigned hereby makes application for a permit for the work hereie
specified, agreeing to do all work in strict accordance with the City OrdinanceE
and ruling of the Department of Buildings, and hereby declares that an the facts
and representations stated in this application are true and correct.
Fridley, 112inn MAY 24 19ZI 1S
Owner�°e 2 ,� . tol:04"E m "y
Kind of Building
Used as
To be completed about r' ?- 9 7/
Estimated Cost, $
OP New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name ��� �✓" ��•• Size NoAI/41!�'z 13% -
capacity 2 e' � Sq. Ft E.D.R. BTU ZZ
®�
H.P.
Total Connected Load Kind of Fuel s
BURNER — Trade Name Size No—
Capacity—,Sq.
o
Capacity .Sq. Ft. E.D.R BTU ILP,
Slue Fla rne Contractors, Inc.
6959 Washington Ave. So.
Edina, Minn. 55435
no s
zz
Business Phone No
(REMARKS -OVER)
11
SUBJECT
PER
City of Fridley
1819?
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
p/
r � � PROTECTIVE
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/10/85
JOB ADDRESS 210 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
2
BLOCK
3
TRACT OR ADDITION
Rice
SEE ATTACHED
Creek Plaza South SHEET
DESCR.
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
George Johanson same
571-0562
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Covenant Construction Co. 7716 67th.
Avenue N 55428 535-5.101
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
R-1
7 CLASS OF WORK
❑ NEW ❑ ADDITION ER ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
Roof can be 2nd layer but not 3rd.
Install ridged galvanized valleys.
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
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
THE
$1,788
$
WITH WHETHER SPECIFIED HEREIN OR NOT. GRANTING OF A PERMIT
a
.89
DOES NOT PRESU O GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O AN OTHER STATE OR LOCAL LAW REGULATING CON-
$29.50
STRUCTIO T P MANCE ONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
/�-pr
$30.39
SIGN CONTRACTOR OR AUTHORIZED _ IDATEI
,WHEN PROPERLY VALIDATED THIS IS YOUR PT
M
_ (7/ //fERp/
BLDG ]NSP DATE
SIGNATURE OF OWNERIIF OWNER BUILDER] IDATEI
11
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] t R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: -2 Z :7 P
Legal Description: C22 ��l 2 Zr (!�ni 0 z�� }� -
Owner Name & Address: 414P , L4 r -T.e9 4-1 Tel. #
Contractor
Address
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: to 0,-Y, � c' .l
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $
Approx. Completion Date: z7—/':F— 5�=> _
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT. Tel. #-�S'����
CITY USE ONLY
Permit Fee $ Z47a 50 Fee Schedule on Reverse Side
Plan Check $ 25$ of Building Permit Fee
State Surcharge $ ?)9 $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Hain Charge $
TOTAL $
0.3 c, Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS•
�y
SUBJE&
PER
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
27992
� �
1 L
COMMUNITY DEVELOPMENT DIV.
r F PROTECTIVE INSPECTION SEC.
1
CITY HALL FRIDLEV 55432
612-571-3450
CEIP
E
63
NUMBER
910-F15
REV
DATE
9/29/98
PAGE OF
APPROVED BY
JOB ADDRESS
210 Rice Creek Terrace
I LEGAL
DESCR.
LOT NO.
2
BLOCK ;
3
TRACTOR ADDITION
Rice creek Plaza South
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mai Dao
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Top Gun Inc. 5014 Parrish Ave42A-4S59
2012R211
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Jac REPAIR ❑ 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.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ZONING
SO. FT
CU FT
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL RE COMPLIED
VALUATION
SURTAX
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2142
81.07
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
PLAN CHECK FEE
TOT L FEE
$82,196
SIGNATURE OF CONTRACTOROR AUTHORIZEDAGENT iDATE,
Ezm,4�&7
SLO INSP.
7--c=
S-GNATURE OF O%NNEROF OWNER BWLOM IDATEI '
NEW 1 1 Effective 8/ 1 /95 _
ADDN 1 CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
CO -
Building Permit Application �R
ConstructionAddress: 4-10 R4u CAtt k T. 00 i —
Legal Description: —
Owner Name &Address:�2 Tel. #
Contractor: 7-0P GV 1J A)C B 1L/I®aA-4[SJ1Q)'C 0 _ MN LICENSE # ZWf-M2l !
Address: /zcS� M"? 553-74 Tel. # AlW–q,56 .
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length- Width Height Sq. Ft.'
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Side Yard Setbacks
Estimated Cost: $
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft.= Ft x $ _ $
DATE: �®�/ 79 _ APPLICANT: Tel. # �:�� 069
CITY USE ONLY
Permit Fee $ 1 Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ ® $.50/$1,000 Valuation
SAC Charge $ $850 per SAC Unit
License Surcharge $ $5.00 (ate 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: