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City oFridley, Y, Minn. e BUILDING PERMIT ,® s s 5 � Date: d Owner:`.. __ .e ....... ..�<.. rte. .._ Builder Address ----_............._......._....---.___.._..._._...._..__._......._.._...._._..._ _ Address: .................................................... _.._.__._......._. __._._-_-•--•--......._........ LOTIOI OF BUILDING Street .. .. �.,.. ......... Part of Lo - - ..._. ta..... _...... _...... •-._.......... ........... _._............. _.... r Lot ._:... ......__ ....... Block .... - . ........ .._............. Addition or Sub -Division .. �" .. ,F Corner Lot ................ .......... _.... .... Inside Lot ... _ ......: Setback...�� ........... ......... Sideyard ..::... ._.:..........:_..... ........... .._.......... : Sewer Elevation ..------............................... ..... ....... -....... ................... .............. Foundation Elevation .............................. ...... .......... ............... ................... ......._.. DESCRIPTION OF BUILDING To be Used as: Front ' - -.Depth 02J."Height -,;96 Sq. Ft:Cu. Ft. ................... ._............. ....................... . Front .................----.. Depth ......... eight Sq. Ft....._.....:...;..:.... Cu. Ft....__................. of Construction �'"' �u,. St. Cost.:... ,gyp Type _ - .. � ' ...... 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, repair and moving of buildings within the city limits and this permit may be revoked at any upon violation f any of the provisions of said ordinances.f a �? fl 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. AND .� r RNs-. APPLICATION FOR BUILDING PERMIT CITY OF FRIDIEY, MINNESOTA Owner's Name ZBuilder Address Address LOCATION OF BUILDING No. Street Part of Lots Lot Block Addition or Subdivision/ 1-4 ad I_U44ou Corner Lot Inside Lot Setback Side -Yard SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Sq. Ft. ___�,®,��5. � Cu. Ft. ,tel C5, cc Front Depth Height Sq. Ft. Cu. Ft. Type of Construction t��_i _ Estimated Cost To be Completed kke, i q 6 0 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 ap 1ica.tion are true and correct. DATE & v SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley, Minn. BUILDING PERMIT ? (6P29 7 7 Date: #""'" Owner: Builder tA,1— Address Address �-- LO TION OF BUILDING No.. _ Street Part t Lot _� _ _ _ Block Addition or Sub -Division Corner Lot Inside Lot _ __ Setback Sideyard Sewer Elevation - _ Foundation Elevation DESCRIPTION OF BUILDING To as: Front Depth —/— Height Z40 Sq. Ft. Cu. Ft. Frog Deptheight Sq. Ft. Cu. Ft. Type of Constructio r.. _ _. Est.. Co� 04 o 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, 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. _: �► .. NOTICE: This permit does not sorer the construction, huskWon for *1riA& phowq l+g, ties heatln& sewer or water. Be sure�to son the Building Inspector for sopartlo permits for thea hems. Date: June 9s 1965 Owner: Robert Aatidenberg Builder R. K. Strom Comnans Address 6288 Forrest Ave. No. (Temp.) Address MM Wimptka H lgbla Drive LOCATION OF BUILDING No. 609 street Rice Creek Terrace N. E. Part of Lot Lot _ �Block 3 Addition or Sub -Division Rice Crk. Terrace,, Plat 7 Corner Lot Inside Lot Setback Sideyard Sewer Mevation Foundation Elevation To be Used as: Front Depth Height Sq. Ft Cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction Est cost + __ To be Completed TOM: Stoma damage rebuild 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 ;Jl provisions of ordinances of the city of Fridley. -Z —, In consideration of the payment of a fee of 2 1 n — nn --, permit is hereby granted to R• K. Strom Co. to construct the building or addition as described above. This rmit' is granted upon the express c�ndit3on that the person to whom it is granted and his agents, employees anworkmen, in all work L in, around and upon said buildingor any part thereof, shall conform in all respects to the ordinances of ey,nesota gg lmoving of buildings ancea. dty limitsanthis permit may be revoked at any time upon violation of any of the provisions of said Allen Jensen I Building Inspector NOTICE: Uh permit does not corer the constmetion, InsteMon for whing, phanhing, sae hosting, sewer or water. Be ams to we the Building inspector for separate parodic for these duos. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'SNAME �� �,' BUILDER ADDRESS AX-a,��e��` moi/ �® ADDRESS 0%1®/..oma / LOCATION OF BUILDING Part of Lots LOT -3 $LOCK ADDITION OR SVB1jIVI5i0N - e rlo Y 7 Corner Lot Inside LOT—_X—Setback�side-Yard_ SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; �7 Front Dspt$ AT Height Sq. Ft. ,� F Y� Cu. Ft. Front Depth �Height Sq. Ft. Cu. Ft. Type of Caxzstruction Estimated cost�� To be completed- �^ 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 (Schedule of Fee Costs can be f'ou�nddj Qon the Reverse Side). 4 30/��i� SUBJECT PERMIT NO. City of Fridley ® _178 178i3- AT THE TOP OF THE TWINS BUILDING PERMIT 7 - r R,EC_E ; COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBERREV. DATE PAGE OF APPROVED BY '.j 612-571-3450 910-Ft5 4/5/85 JOB ADDRESS 609 Rice Creek Terrace N.E. 1 LEGAL LOT NO. 3 BLOCK 2 TRACT OR ADDITION SEE ATTACHED Rice Creek Terrace Plat 7 DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Daniel Gourde 609 Rice Creek Terrace N.E. 571-5768 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Greco Construction 41 - 70th.way N.E., Fridley 571-1914 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install Bay Window 10 t 2 "1 x 411111 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PFR 9iS REQUIRE® FOR WIRING, i LUMBiNG AND SIGHS® 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,450 $1.23 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. $38.50 PLAN CHECK FEE TOTAL FEE $39.73 .T URE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PRO PERL ALI DATED THIS IS YOUR PERMIT s "������... BLDG INSP n E SIGNATURE OF OW NER IIF OWNE 0DATE) NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. I ] Building Permit Application Construction Address: tnQ 5 Ce/z�f� Legal Description: 4®7 3 Si v cls 0, 1048 -7 - Owner Name & Address P4/yl FL A. Go Ulf Dr Tel. # 5W -LP" Contractor: GRFC® COV97_224 c77061 Tel. # Address: y!C- 7®ZFf tvAE BJP- If 41-S 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 Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: I Estimated Cost: $ Approx. Completion Date: OA 6 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: _Js�or $ $ See Back Page for Explanation DATE: '�APPLICANT:C ( Tel. #%1� -CITY USE ONLY Permit Fee s�V Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ �a $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ r Agreement Necessary [ ] Not Necessary TOTAL $ STIPULATIONS: e We SUBJECT PERMIT.UQ,,,,,. City of Fridley- - ® 17 51 AT THE TOP OF THE TWINS BUILDING PER IT r CEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. ® r 1 - PROTECTIVE Jp 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/31/84 JOB ADDRESS 609 Rice Creek Terrace N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 3 2 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan Gourde 609 Rice Creek Terrace N.E. 571-5768 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 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 C� ALTERATION. ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be the 2nd layer .but not the 3rd. Install ridged galvanized valleys where necessary. 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 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 $1.1000 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT TY TO VIOLATE OR CANCEL THE DOES NOT PRESUME TO GIVE TH!OR PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHERS TE LOCAL LAW RE ULATING CON- $17.50 E CONSTR CTIO . ICJ PLAN CHECK FEE TOTAL FEE �fl 8 �/ $18.00 SIGNATURE OF CONTRAVOI09 AUTHORIZED AGENT (DATE) WHEN PROPERLY IDATED THIS IS YOUR PERMIT BLDG WSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) We CITY OF FitIDLCY Effective Aug. 1, 1981 � • APPLICATIM FOR RESIDENTIAL BUILDING PERi-11ITS (New, Alterations, Additions, or Repairs) OWNER: -DA "i C--�0 (,C R- ® e - ADDRESS: � ®�/ - #?%Ce C48 e,< /e A-2 TEL n0: ' / --�-7 ,6 k BUILDER: ADDRESS: TEL NO: -7 9'/- --Is-'l Y / Construction Location STRMT NO: O o STREET: ` LOT: BLOCK: ADDITION: 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. DESCRIPTIO;' OF CONSTRUCTION Front: Square feet: Front: Depth: Cubic Feet: H eight : Depth: Height: Square Feet: Cubic Feet: _ Type of Construction: 16 s4 / - lb Be Completed: ( b e�-- c� d Estimated Cost: $ /,, 0 e� . Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE F.EVERSE SIDE OF SHEET . Ilie undersigned hereby makes application for a permit for the %:vrk 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 represenLitions stated in this applic DATE: � � ® �{ �f SIGNATUF.B : Stimulations: 6 V� ., SuSiECT . City of Fridley 27972 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. 6 • COMMUNITY DEVELOPMENT DIV. _ f � � PROTECTIVE INSPECTION SEC. 6311 NUMBER REV DATE 19/25/98 PAGE OF APPROVED BY -'-I•� CITY HALL FRIDLEY 55432 l 612-571-3450 910-F15 JOB ADDRESS 609 Rice Creek Terrace NE ' I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 1 Rice Creek Tgrranp Plqt 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan Gourde571-5768 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 Ilk 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. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOF ES 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 SUSPENbED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERT#Y 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 WITHW ETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2142 $1.07 DOES N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCT N R TH RFORMANC OF CONSTRUCTION $74.75 Fire SC 2.14 PLAN CHECK FEE TOT EE .96 SIG ATURE OF CON.RA ORORAUTMO RIZED AGENT IOATEI _v EN ROP BL INSP IM ALID THIS IS Y R PERMIT TIATE SIGNATURE OF OVVNEROF OWNER SUILDERI IDATEI 0 01, NEW ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ece ( art T -p- rac•P Legal Description: Owner Name & Address: Dan bo,arO� Tel. # Contractor: Mot MN LICENSE # Address: 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: y� O�� ��(AV ©� N�stimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # TOTAL STIPULATIONS: S� CITY USE ONLY Permit Fee $ ��- �� Fee Schedule on Reverse Side Fire Surcharge $ , / .001 of Permit Valuation (1 / 10th %) State Surcharge $ 0 -7 $.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: S� J SUBJECT PERMIT N City ®f Fridley AT THE TOP OF THE TWINS I K U I ®I I� PERMIT BUILDING 89R 2 5 LJ L � • COMMUNITY DEVELOPMENT DIV. y r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/7/94 JOB ADDRESS 609 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 1 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Dan/Shirley Gourde 609 Rice Creek Terrace NE 571-5768 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Franzen Construction 4250 5 Street NE -4071 2744 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 15' x 37' Deck 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors adjacent to all sleeping areas and in basement. See notations on plan. VVA R N I Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 $69500 $3.25 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $99.00 Fire._ SC $6.50. STRUC O OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE I-E License SC $5.00 $113.75 SIGNATURE OF NTRACTOR OR AUTHO&ED AGENT (DATE) W N P LY VAL AT S IS YOUR PERMI 6-81-91 BLDG INSP r1ATE SIGNATURE OF OWNER (IF OWNER BUILDER) IOATE) J NEW ( I Effective 1/ 1/94 ADDN CITY OF FRIDLEY ALTER (( SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Qq__ E C��EE k ��2 Legal Description: Owner Name & Address: S�I,��� ('A�,v;�;�� Tel. #� j-`7(�a?, Contractor: MN LICENSE # �q4 Address: �� 5 �--1 �� A-). e�:-Tel. # 72IS ��'7 / 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 Sq. Ft. Length Width Height Sq. Ft. Length / 5 ' Width ' ® Hgt/Ground j Sq. Ft.�5' Comer Lot j ] Inside Lot ( Ft. Yd Setback Side Yard Setbacks � Type of Construction: glTf C2 L) F�c y- Estimated Cost: Approx. Completion Date: �o of zS 16324 (Cost on Back) Driveway Curb Cut Width Needed: —F". 6 Ft = Ft x $ _ $ DATE:. - APPLICANT: , Tel. # I&D -7120 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 $ $800 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or All. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [) Not .Necessary j ] TOTAL STIPULATIONS: ,.. � - APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On March 1,1996 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS C -� �'° `e k l`P/z %V New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing'to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 1996 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner YI e`®' Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 c Building Used As Cof I -P b n Gas Range** $10.00 Estimated Cost o PERMIT NO. Gas Dryer** $10.00 _ Back Flow Preventer Required { )Yes (} No Type $15.00 PLUMBING COMPANY�I Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1910 1.5% of Value of Fixture or Appliance SIGNED BY Approved ByALk Rough—In Date Final Date State Surcharge $ .50 �iMINIMUM FEE L13 ANY PLUMBING/GAS PERMIT TOTAL FEE $ 0,�� PLUS THE $.50 STATE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS C� RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) ,199 Gas Piping (Needed with new furnace, $10.00 but not re lacem�) OWNER �N �a-A P Gas Range f �_ $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ _ ESTIMATED COST 3 5_0 � PERMIT NO. /3Y 41 *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One -(Steam) (Hot Water) (Warm Air) Trade Name Size No. CommercialAndustrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name _ Size No. _ BTU HP EDR • TOTAL FEE $ �S . �� HEATING COMPANY 670 7J Al MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By el No. 6�,5/ YO e 3 PLUS THE $.50 STATE SURCHARGE ®G� 4STAK REINSPECTION FEE $42.00/Hr ApprovedRough—In Date FinalDate*Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE FORERIFICATION ON REPLACEMENT FURNACE written permission from adjoining property owner. CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: L Has been carefully examined Yes O No ( ) 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's Yes No Yes No Yes () No ( ) Yes ()No() 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: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 FAX: (763)571-1287 PERMIT COOtO0636� DATE ISSUED: 05/04/2004 ADDRESS : 609 RICE CREEK TER NE PIN : 143024120060 LEGAL DESC : RICE CREEK TERRACE PLAT 7 : LOT 3 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 5,264.00 NOTE: REPAIR CHIMNEY STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE FIRE SURCHARGE 125.25 5.26 GARLOCK FRENCH ROOFING (1423) 2301 E 25 ST STATE SURCHARGE, VALUE 2.63 MINNEAPOLIS, MN 55406 LICENSE SURCHARGE 5.00 (612) 722-7129 TOTAL 138.14 PAID WITH CHECK # 45841 OWNER GOURDE DANIEL A & SHIRLEY A 609 RICE CREEK TER NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worts will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law re g c ion or the performance of construction. AD licant . Date Bldg Ins, Date -f ti Q'C'DADA TD DUDl►dTTQ DD/1TTTDrn LYID 1III1DTl II MMD T'L7AAT n1QQf'DTnVT1 AT7(1VT: NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 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 r 1)oA ^ . c3 Construction Address: LM r -i 06 '�6VY(Abe Legal Description: Owner Name & Address: Van CrOlA YA2 Tel. # -7 0 3 cz7 9 -G IA Contractor elle e--° V'n ViA MN LICENSE # Address: 'X0A X01 I;I(V \ 4if-P ? Tel. # Le Q, a 1-01 LMNG 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 Sq. Ft. Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: Aim Estimated Cost: $ ® o Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: LI-Zg'O� APPLICANT: 'C� �Q - 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 Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 $ �-Z)' 6 STIPULATIONS: Building i Inspections 763-572-3604 r DATE SITE ADDREss THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMff TYPE TYPE OF WORK: CITY OF FRIDLEY YOUR Permit Received By: Date Recd: COMPANY NAME: CONTACT PERSON: pEpMABLE INDOOR -A10 JAIL1 # J�j STATE LICENSE # 2619—COOK R PALILEVA AnnRFSS' 0,00 RAPIDS'. MN 55 STATE ZIP �1l���. " FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE 13 NM PLACEMENT (3 AUMAT10WREMODEL PER MS 168. 5 the permitov— fee is a inimum of $15.00 or 5% of the total cost up to 5500.00, whichever is fir, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect' only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS 5500. FEES ARE BASED ON SI0.00 PER FDC7 URE. EXCEPT WHERENOTED FIXTURES: MWICATE TOTAL NUMBER OF EACH BELOW) MODEL: SIZFJBTU EgWpment Installed MFG: MFG: _ MODEL: SlzErsTu MFG: *�A/C 525.00 _,_._ MODEL: FIREPLACE (CTAS) $15.00 SMMTU GAS RANGFJOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW NI HTP,GRIs o.00 OAS HTR $10.00 A01LER 535.00 _FURNACE $35.00 POOL HEATER $35 t!0 HE CHWWEY LINER $10.00 ✓ DUCT WORK $1Q00 _ GAS DRYER $10.00 GAS PIPING $10.00 VENTILATOR $15.00 ---- Permit Fee $ Number of fixtures @ $10.00 x $10.00 Surcharge 150 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures r@ $35.00 x $35.00 = S State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is not a permit but only an appli o for a permit and workAs not to start without a permit; that the work will be in accordance with the approved plan in the case of P&Ark which r review and a4roval of P190s, SIGNATURE OF City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 741_1�7')_IAM Building PLUMBING Permit No.: -U Inspections RESIDENTIAL APPLICATION Received By: A 763-572-3604 CITY OF FRIDLEY Date Rec'd: J DATE 3 YOUR E-MAIL ADDRESS SITE ADDRESS SON-,c as 0_&meee Daniel Gourde THIS APPLICANT IS: ❑ OWNER )6CONTRACTOR 609 Rice Creek Terrace Northea PROPERTY NAME: Fridley, MN 55432 OWNER/ ADDRESS: 7635715768 rE ZIP TENANT PHONE: CONTRACTOR Nom: NORBLOM PLUMBING CO- STATE LICENSE;# (612)ES274033 SUBMIT A COPY OF YOUR STATE ADDRESS: STATE ZIP LICENSE WITH PHONE APPLICATION PERMIT TYPE XSINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK�IG�ce GtJa�i✓ /�i�rG✓ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This.should_reflect only.the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = 410R.PROMM WHERE LABOR EXCEEDS-:Si00;_FEES ARE BASED ON $10.00 PER FDn UR$EXCEPT:W*MREND.IED-:FIS:-�DMIC-ATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV _FLOOR DRAINS _ SHOWER—WATER PIPING _ —GAS PIPING-�CrITUCUM) _ SWIMMING POOL _WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) _ _ _ DISHWASHER _LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ _ WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00-1 x $35.00 = $ State Surcharge = $ .50 Total = $ 3 . SD THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an ap tion for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case all work requires review and approval of plans. b3k-7 SIGNATURE OF APPLICPRINT NAME O/�OI00% DATE 3 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977