PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date:
Owner: .. ::. ....... _ :1 .... Builder
Address Address
....._................. .. __....... _..._.: ... _ ...._._....._..
t
LOCATkON PF, UILDING
No. _ ..._....,.., Street Part Q$ Loi ..._._...........
Lot
.............. Block Addition or Sub -Div
....._... ision
Lot .....-....�.....- Wit" ..--......_. t
Corner Lot ..:....................-----... Inside Lot ---- t ,,.:. Setback ., ............. Sideyard .... ............._...........:._............._......._..
SewerElevation....._............._............._......_.------------...---_..._..--------........_........ Foundation Elevation .................... ... _......... ... _.........
DESCRIPTION OF BUILDING
To Used as
�".
Front '-- Depth --�-. Height 4- ,�
._ . ... Sq. Ft..: � .; Cu. Ft.. � +
.: Front
,'_.. Depth . ".>- Height ... Sq. Ft. .....
� Cu. Ft......_...
Type of C nstruction- "....: Est. Cos ...,...............To be Completed ............. ....................................
AoR1�F
vto�A�-
QTS AND
pnES NST
THIS P ANY pRIvND GDyENA
!ON s -TRIG
13UILDING RE
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
city of Fridley. ��;�+
ordinances of the.-.._...._.._...__.._.._.�_..._._
In consideration of the payment of a fee of rmit 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 timye-,up n o7ation any of the provisions of said
ordinances. .~"" , �
..._. 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.
4
e
Owners Name— Builder , -44
Address`.5� Address
LOCATION OF BUILDING
No. `iF,S 41 Street
° erg- ,1� Part .of Lot
Lot Block � � Addition or SubeDi'v-. '1.-'.
Corner Lot Inside Lotet Back Side -Yard
KWER ELEVATION FOUNDATION ELEVATION
^.pplicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION. OF BUILDING
To be. ,used as: p _.
Front Depth Height
Cu-.; Ft:
Front C) Height
Ft: 6 L/
..(�Tpe of Construction , , Estimated Cost
To be completed
The undersigned hereby.:makes application for a permit for the work herein specified,
agreeing to do all work in striot accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application'eite true and correct.
47
SIGNATURE
(A Schedule of:.Feq�.costs can be found on the Reverse Side:)
Application for Power Plants and'. Heading, Cooling, Ventilation, .Rehigeralioml and
Air Conditioning Systans 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 ............
each add. 60,000 BTU ... ..................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ... ............
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam, ......
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
Each add. 200 sq. ft. EDR Steam ......................
Each add. 320 sq. ft. EDR Hot Water ..................
OIL BURNER—to 3 gal. per hour ........................
over 3 gal, per hour—See Fee Schedule
8.00 s ---L- 00
2.00
$
§.00
$
5.00
$
2.50
$
Dept. of Bldgs. Phone SU. 4-7470
Location 434 Rice Creek Terrace
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, Alin Sept. 15 19 6 0
Owner
Don Schwartz
Kind of Building Frame
Used as Dwelling
To be completed about 12-15-60
8.00 $ Estimated cost, $ 5 00.00
8.00 $ —.New. Building Permit No. t v'%1L Permit No.
2.50 $
2.50 $
DESCRIPTION OF WORK
5.00 $
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
GAS BURNER (up to 400,000 BTU) .......................
5.00
$
5.00
GAS FITTING FEES:
NO RATE
TOTAL
1st 3 Fixtures ......................
x $1.50
.S0
$--i-.5-0
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
$
14.50
ROUGH
FINAL
Trade Name Waterbury Size No 3 GL 112
Capacity Sq. Ft. E.D.R 1121000 BTUH P
Total Connected Load 47852 Kind of Fuel Nat. Gas
BURNER — Trade Name Size Noo-
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
S* Pli Midland Hea ing Co.
B es.
<Z No_UN 9 2M 7-59 Business Phone213
7��
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E. Construction :` Insulation
Guide
WindowsI Doors Reference Out. Wall Int. Wall Ceilingi' Roof Floor Kind How Applied
Yes—No Yes—No 19_
FU A,� Room I Lenath o Width Height II RA A- , -, Room I Lenatth Width / Z— Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
Width
No. of pane
Height
of pane
No. of Lineal ft. Area
lights of crack sq. ft.
Net exp. wall o -FZ
Coef.
Btu
Coef. Btu
Infiltration
Btu
74
40 ® 6
Glass
Btu
Infiltration
1366
Exp. wall
-:�/
6
Glass
Net exp. wall
o
Exp. wall
i6zlo
Int. wall
/0 X
Ceiling
Net exp, wall
>_
Floor
/
®
® 6-71
1 otal litu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.1 / Room I Length f® Width /.7 -Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width
No. of pane
Height
of pane
No. of Lineal ft. Area
lights of crack sq. ft.
Net exp. wall o -FZ
Coef.
Btu
Infiltration
Coef.1
Btu
Infiltration
Coef. Btu
Coef.1
Btu
Infiltration
1366
%
®
6
Glass
Exp. wall
Exp. wall
i6zlo
Exp. wall
/0 X
Net exp. wall
Net exp, wall
>_
/
Int. wall
Floor
Ceiling
Ceiling
1,6*/
Floor
Floor
1 otal litu.
Requir Esq. ft, E.D.R. or sq. ins. W.A. Leader area I If
F1.1 (11614 Room I Length / Width 74Heiaht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Area
sq. ft
Exp. wall
Net exp. wall o -FZ
Coef.
Btu
Infiltration
Coef.1
Btu
Infiltration
Coef. Btu
9 -!L -
Exp. wall®
3a
1366
Glass
Int. wall
Exp. wall
Exp. wall
x r
Floor
Net exp. wall
®
>_
Ceiling
Int. wall
Floor
Ceiling
1,6*/
Floor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Area
sq. ft
Exp. wall
Net exp. wall o -FZ
Coef.
Btu
Infiltration
-tee)
Glass 2
Coef. Btu
9 -!L -
Exp. wall®
3a
Net exp. wall - -
Int. wall
Exp. wall
Ceiling d
Net exp. wall
Floor
Total Btu. I
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l 71=1 Room I Length /E Width f Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft.
No. of Dane of pane ,isof crack
Area
sq. ft
Exp. wall
Net exp. wall o -FZ
Int. wall
Ceiling
Floor
Coef. Btu
Infiltration
3a
Glass
Exp. wall
Net exp. wall
-Zoo ,®
Int. wall
Ceiling
Floor
Total Btu.
Requirej4q. ft. E.D.R. or sq. itis. W.A. Leader area
F1.1 Room I Length / z, Width / Height
Win ows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
d —2 V1 :2A 1 2— 1 4-s
Infiltration
Glass,
Exp. wall
Net exp. wall o -FZ
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sa. ins. WA. Leader area
SUBJECT
RM IT
City of Fridley
a 15
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
6-14-79
JOB ADDRESS
434 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
4
Rice Creek Terrace SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Brad Harrisson 434 Rice Creek Ter. Fridley 55432 571-1915
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D v-Ko Home imp. 1325-42nd Ave. N.E. Columbia Hts. 55421 788-5850
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Resirlwtdal
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Trim.Install Aluminum siding and
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
h1uminun
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
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. U14ITS
OFFSTREET PARKING
I 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 THIS TYPE OF WORK WILL BE COMPLIED,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,
00.00
$1.75
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORM CE OF CONSTRUCTION.
$21.00
PLAN CHECK FEE
TOTAL FEE
22.75
SIGNA URE OF CONTRACTOR OJAUTHORIZED AGENT (DATE)
SIAPRO��A T THIS IS UR PE MIT
)��W
fSIGNATURE
BLDGI DATE
OF OWNER OF OWNER BUILDER) IDATEI
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: BUILDER: —x�
ADDRESS:
ADDRESS:
TEL NO: TEL NO:
Construction Location
STREET NO: � STREET:
ry
LOT: BLOCK: ADDITION:ld
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Squane.Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:'
Type' of Construction: :� 'i Estimated Cost: $
To Be Completed:
' Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
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 corregt.
DATE: SIGNATURE:
Stipulations:
` Zl
City of Fridley
SUBJECT
1562
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
CEIPT N
�
`L _ COMMUNITY DEVELOPMENT DIV.
g
r PROTECTIVE INSPECTION SEC.
-3
1 �
i ���,•� CITY HALL FRIDLEY 55432
l
APPROVED BY
NUMBER
REV.
DATE
PAGE OF
.... j4," �r
j 612-571-3450
910-F15
13/17/80
JOB ADDRESS
434 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
T RACT OR ADDITION SEE ATTACHED
DESCR.
6
4
Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bradley Harrison 434 Rice Creek. Terrace N.E. 571-1915
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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 9 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install a wood burning stove and chimney
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPAN^v I_❑AD
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
1
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
$600 ,
$� CJO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGN TURE OF NTRACTORO AUTH IZED AGENT (DATE)
WHEN PROPERLY IDATED TaHI IS YOUR
Qom'
�A
�P�ERMIT
2
/
ONUREOF
Ld / /
BLDG INSP qA TIE
NN OF OWNE WILDER) - (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
S
OWNER: /` ' _ /�e:® �c��� BUILDER:
ADDRESS:, c /�?�� %P,.• ADDRESS: eaten
TEL NO: 5%/ / � / � TEL NO: "4 �.
Construction Location
STRF,T NO: _ STREET: %( s c_ e
7�
t
LOT: � BLOCK: ADDITION: /�L� �-� �.✓C/�•���
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
garont: Depth: Height:
Squane.Feet: Cubic Feet:
Front: Depth: H eight: _
Square -Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
IlUe 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.
a
DATE: 1 A ��---- SICSNATL3RE:
Stipulations:
k �
f•r1-ir war*ItM
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
` RATE TOTAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
$ 20.00 $ a 0=
$ 10.00 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit ," t
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00,
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
$ .50
Job Address _ 4439 p 1 (ce, Cre &., Te rco e,
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
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, Minn. �� °s ( , 19 ge
OWNER M(-+ t'Y� �m i�ClAt r t f4a r �[{�$f�r% Scy)
KIND OF BUILDING c� e7 C�(Y11 Ila e1/ jER'1 e-
USED AS D z' L.
TO BE COMPLETED ABOUT
y
ESTIMATED COST
OLD BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name (�Qx `d`3 YY10. '(,i'r Size No. C ® Cl
Capacity V Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company 3 Y lac (p
Signed' By � �✓+� �/
Tel. No. Da ()Q��
Fill out back side for stack verification on replacement furnaces
CHIMNEY 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
(A
No ( )
3.
Has no foreign objects lodged within
Yes
No ( )
4.
Is securely supported
Yes
(?r)
No ( )
5. Meets all current Code requirements for size and
total BTU connected Yes (Y) No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
`l r
Remarks A 'S �
Company
Signed By /s l
Date
-..:,`�R1N:1w�v}2. h....... ..w ..wtw:.......:i, '. �. �...: ...`.. .......: ._ v.v .... _ .. `:>:.........3:.. a . . ..... ...... .. .. .. .... ... .. . .....�.. ...... .v; i2il.. .... v .. ..2 .)...... vv.........>.:,52..
C17YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
March 29, 1993
Owner/Occupant
434 Rice Creek Terrace
Fridley, MN 55432
RE: Property at 434 Rice Creek Terrace
Dear Owner/Occupant:
In addition to responding to citizen complaints regarding property
maintenance concerns, the City of Fridley conducts a program called
Systematic Code Enforcement. This program is designed to provide
fair and equitable code enforcement, improve the City's appearance,
and maintain property values by creating a more attractive suburban
environment. Under this program, all properties in the City will
be periodically inspected to ensure that they are in compliance
with the Fridley City Code.
A recent inspection of your property revealed that not all Code
requirements are presently being met. Listed below is an item
which does not comply with the Code:
1. Discontinue outside storage of utility trailer located on the
grass in the front yard. (Fridley City Code does permit such
storage in the side or rear yard.)
Your prompt attention in correcting this problem would help us in
our effort to improve the City. A reinspection will be conducted
on or about April 19, 1993, at which time compliance is
anticipated. Please call me at 572-3595 if you have questions or
wish to discuss this further. Thanks for your cooperation!
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -93-81
4_
SUBJECT
P T NO.
City ®f Fridley
27502
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
��
1
1 i
NUMBER
REV
DATE
PAGE Of
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/1/98
JOB ADDRESS 434 Rice Creek Terrace
M -I
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
6
4
Rice Creek Terrace Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Brad Harrison
571-1915
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Stock Roofing Inc. 289 Liberty ST NE Fr780-3961
3112
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 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
20
Reroof house and garage 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.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
I 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 THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMITkam
$1714
$JS $.86
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS NY OT TE OR LOCAL LAW REGULATING CON-
$1.71
STRUCTIO O E PERFORMANCE OF CONSTRUCTION.
$64.32
Fire SC
PLAN CHECK FEE
TOTAL FEE
Lic nse SC $5.Q0
$64.32
SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT IDATEI
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
13LVP INSP
��ATE
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
NEW • [ ] Effective 1/1/98
ADD`N `[ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUI
,l DING �P RMIT APPLICATION
i°3 41/LC 0 � C_. iC t x TIL °� `�1'�4
ConstructionAddress:
Legal Description:
Owner Name & Address: Tel. #_
Contractor: S7' 4 c���� w ��'� MN LICENSE #
Address: �z `i �,�'��j1
Gam'«, �'� Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
,� ll Z
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: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE:
APPLICANT: Tel. #
Sewer Main Charge $
TOTAL
STIPULATIONS:
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 [ ]
�� 1>,1414) 1 ��
Permit Fee
i
$
Fire Surcharge %, `, %
$_b t;
State Surcharge C- 3
SAC Charge
$
License Surcharge
$ sy Co
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL
STIPULATIONS:
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 [ ]
�� 1>,1414) 1 ��