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PRE 2010 DOCSCity of Fridley, Mims BUEWING PERMIT Date: J!— Owner: ! Owner: y Address ........... N4 48 Builder Address L CATI NOF UIL 'ING No. Street _ P t _ Lot _. __ Block _ - _ _ Addition or Sub -Division Corner Lot _ _ Inside Lot _"' ... Setback .... _ Sideyard Sewer Elevation _ _ _ __ _ _ Foundation Elevation DESCRIPTION OF BUILDING To Used Front "' Depth Height Sq. Ft. /:'cu. Ft.`s"` ," _ Fro Depth Height QSq. Ft. Cu. Ft. Type of nstraotion Est. C-�_....�. 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 $ , 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, re and moving of buildings within the city limits and this permit may be revoked a t any timpon vola of 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 we the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name ®i 0 z_/ /,17,1 Builder S Address 6 -�5- a s s �` _ _ Address LOCATION OF BUILDING No. -' Street_ I�' CJ�E'E c� 7-E,ff . Fart of Lot /Ice' Lot Block Addition or Subdivision P� 4T -`� Corner Lot Inside Lot Setback Side -Yard SEGJER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front jz - C Depth Z: ® _Height Sq. Ft. / -676 Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction, "-14/-) A-- Estimated Cost To be Completed nie 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 ,Y Ss �� / SIGNATURE_________, (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Permit Dept of Bldgs. Phone SU 4-747 DESCRIPTION OF WORK Q S - &�e Number, Kind and Location of Fixtures Location 47O Ol K r Number Fixtures ...................... x $1.50 V� Z Future Fixture Opening ................ 2 Z New Fixture Old Opening .............. p Z Z O 2 , U' Z • 3 WATER HTR. x 3.25 $ CLC��f NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $---L-,5'—O Additional Fixtures .................... x .50 $ O a uf 63 �d a �K (�YO F N GAS ELEG Base 1st 1 2nd 3rd 4th Future Connection Openings Connected with Sewer Cj New .Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ /c<0 Future Fixture Opening ................ x 1.20 $ 16 New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 210 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $---L-,5'—O 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 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 facl and representations stated in this application are true and correct. 11 Fridley, Minn Owner Kind of Building _—-727 j�,1� e Used as ��— To be completed about AN Estimated Cost, $ i( eel Old—New. Building Permit No -_:5 / Permit No � -1 By----&-Zk Business Phone ROUGH 7-/" r q- j FINAL 42 2M, HOUSE HEA ING TEST RECORD ADDRESS 6'4 LOOR '3 TY SUBUR OCCUPANT OWNER �� i t� ifs �' HEAT LOSS SOLD BY DATE HTG. INST. GAS CO. METER BAD INSTALLED BY I _ ' � r � Electrical Work By Gas Line By TYPE OF HEAT GA FA b HW STEAM SPACE HTR. UNIT HTR. OTHER GASSIG� MAKEMAKE OF BURNER _ Model Model Serial 62 2-96 Max. BTU Rating— INPUT MAKE OF FURNACE CONVERSION Model --- CONTROLS 4r THERMOSTA at Plug Vent Size Valve KIND OF LINER IZE NONE Limit Draft 'Hood Regularor Limit Setting Filters Size Number Fan Setting ZChimney Location InsideOutside Pilot Type r Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring e`� Pilot Timing 0e; - Draft Test Tag L.W. Cut Off ®D,t_ressure— Lighting Inst. ff Pressures 21, Perceent 02 D e ested Input CFH_ 1 0 PTesting ,-- JP 2 y Stack Temp. Percent CO Name of Taster Form 235 vii i yr rmwLci IIVJrCIJ I IVIV ulv. 6431 University Ave NE Fridley, MN 55432 572-3604 tneaive un uanuary i, i yyu APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas Gas Range NO. RATE. Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 ,$7.00 $ 7.00 $.7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance TOTAL JOBADDRESS State Surcharge $ .50 TOTAL FEE $_ 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 statedin this application are true and correct. Owner \ 01QIL Building Used Asyl , Estimated Cost �n� PERMIT NO. PLUMBING C MPANY - ��U (D SIGNED BY TEL N0.CC S -U�d Approved By 9 Rough—In Date ' Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE e at � . .Urinal bh w . ..... �TraY ....`..`.•.•..::•. Wash Floor. :�..`',`;':` I r �•�•��'��`•:'< `�� f1.1#y . (�' 4n ,.:,..,,:.:•... Drain .::, Auto �"•'� Washer Gas •;sc;'� Range W r e ate Heat r 'es cSto Gas le Bas eme nt vt. d c Floor 1 P Floor 2 F loor 3 I Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas Gas Range NO. RATE. Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 ,$7.00 $ 7.00 $.7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance TOTAL JOBADDRESS State Surcharge $ .50 TOTAL FEE $_ 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 statedin this application are true and correct. Owner \ 01QIL Building Used Asyl , Estimated Cost �n� PERMIT NO. PLUMBING C MPANY - ��U (D SIGNED BY TEL N0.CC S -U�d Approved By 9 Rough—In Date ' Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 LICENSE AGREEMENT The undersigned Paul Steen , being the fee owners of certain property located in Fridley, Minnesota, at 525 Rice Creek Terrace , and legally described as: 14-30-24-21-0054 hereby grant to the City of Fridley, Minnesota, and that the City's employees, a license for the purpose of gaining access across the above-described property to a retaining wall and other structures adjacent to Rice Creek. This license is only for the purpose of allowing the aforementioned persons access for maintenance purposes. This license is intended to last ten (10). years from the date of its execution, and is not transferable or useable by any persons other than those designated herein. By accepting and using this license, licensee hereby agrees to repair any and all damage caused by the City or its employees while using this license on the above-described parcel. Signed: Paul Steen •st+��v-- �� and swo7 to be , rng" a this ay of - ljam. 4,-A4j) /A 1998. N ,. '" •... P i"N Y A KER�KES y NMAYR'G' C -MI SOTA jrEPt�J COUNTY - SUB�E& City of Fridle 32748 Sy AT THE TOP OF THE TWINS BUiLDIN PERMIT r RE tErPriqO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED Br CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/2/02 JOB ADDRESS 525 Rice Creek Terrace NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 4 4 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Green, 525 Rice Creek Terrace, Fridley, MN 55432 763-572-2148 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sela Roofing & Remodeling, 4100 Excelsior Blvd, St Louis Park, MN 55416 1050 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 612-823-8046 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Re -roof / install tar & gravel 9 CHANGE OF USE FROM TO STIPULATIONS Send roof system specs. 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANQONED 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 $g 995.00 $4.50 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- $9.00 Fire SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �� -S �'-a- PLAN CHECK FEE Lice ns $5.00 TOTAL EE $ 5.75 SIGN TURE 00 CON'RAC TOR OR AUTHORIZED AGE N T (DATE' HE PR - Y VALIDATE THIS IS YOUR PERMIT _,00 BOG NSP DATE SIGNATURE Of OWNERof OWNER BU4DER1 iOATEI NEW I l Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: S Z Qco- 6�L c Q Legal Description: Owner Name & Address: Tel. # Contractor. SELA ROOFING & REMODELIN61 MN LICENSE # 4100 EXCELSIOR BLVD. Address: ST. 6QUIS PARK, MN 554 Tel. # ID #000105Q 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: a I Estimated $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ _ $ DATE. APPLICANT: _ Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 015 Fee Schedule on Reverse Side Fire Surcharge $ . ® 0 .001 of Permit Valuation (1/10th%) State Surcharge $ 4 5(3 $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ 57,ob $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 $ CS, STIPULATIONS: SUBJECT PP�f1G1T'T-� City of Fridley 3 3556 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. �• _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 . i CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED BY 763-571-3450 910415 5/27/03 JOB ADDRESS 525 Rice Creek Terrace NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 4 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sue & Dave Green 525 Rice Creek Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Hoffman -Weber Construction 18 66 Way NE, Fridley, MN 55432 763-670-9959 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20374580 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ ❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE X B DESCRIBE WORK Reside House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering or take pictures. Caulk and flash all exterior openings. 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 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 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 $4,800 $2.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $111.25 Fire SC $4.80 R CTION OR THE PER NC OF CONSTRUCTION PLAN CHECK FEE TOTALFEE ice se SC $5.00 $123.45 OF S UR9 96,P0500AACTOR OR AUTHORIZED AGENT iDATE HEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG -NSP DA PE S-GNATURE OF OWNER -IF OWNER BUILDER. iDATE. 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) 5714287 Fax BUILDING PERMIT APPLICATION Construction Address: L-'�25 SLE LaEZ--P— ► 'Ei2t- Legal Description: 510 k -AV Owner Name & Address: 51,.E N,�fl 'QrN\3E L P—Er--7� Tel. # Contractor. �Ab--J— v --J C,-23 r—"2 �IrY>� MN LICENSE # 7-0 5i L154'9 L-) Address: t %- v --y N -f S E -F 9:AQ L -e)" Tel. # 76 ;� - 67 o >711s� ? 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. 4 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: V -- (4" S& Construction Type: V I PJ `P L- Estimated Cost: $ ZOO Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: w, A7 APPLICANT:. Tel. # (w 76 a-` 2�I 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. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] TOTAL $ / �, STIPULATIONS-