PRE 2010 DOCSCity of Fridley, Minn.
BUELDING PERMIT
N���Z MUM,
Address .....................................
N® 3421
Builder .... .. A -An -42-e.
............
Address.... ...............................
LOCATION OF BUILDING
No. ..6.1.9. Street .. .mfr... ... .. d. .. Part of Lotr ............ .. .............. /�
Lot ... / ....... Block .. ............. Addition or Sub -Division 6W4e ..
Corner Lot .. �4 ....... Inside Lot ............ Setback w�.�. �a— c! Sideyard
. ..............
DESCRIPTION OF BUILDING
To be Used as
� P 0 4
. `........ ..) Front��� Depth Height ��..®f Sq. Ft� Cu Ft.5-: �5�
Front ........ Depth ........ Height ........ Sq. Ft......... Cu, Ft. ........
f� 0-4.
Type of Construction ................... lkt. Cost..4. ; ........... To be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree. to do
the proposed work in accordance with the description above setfo a��pliayxce with all provisions of
ordinances of the city of Fridley. / ,
..:..,,.rs.v.s.........................
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 with-
in 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 cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
-:� %JP6 7
City of Fridley, Minn. N° 8286
BUR DING PERMIT
Date: July 293 .1965
Owner: PAUL YAGU Builder J. E. DU00S
Address 6r, Rice Creek Terrace Address 1909 Rice Creed Road
Fridley, Minnesota New Brighton, Mimesota
LOCATION OF BUILDING
No. 617 Street RICE GREEK TERRACE Part of Lot
Lot lra _ Block 2 Addition or sub -Division RC Terrace Plat #7
Corner Lot _ Inside Lot _ Setback Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Est. Cost _ 22 2 000 *00 To be Completed
Storm Rebuild
In consideration of the issuance to me of a permit to
the proposed work in accordance with the description abo
ordinances of the city of Fridley.
I above I agree to do
with a�l provisions of
In consideration of the payment of a fee of S 10:00 _ _ _, permit is hereby granted to J, E, RU -00S
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 aII work.
done in, around and upon said building, or any part thereof, shall conform in aII respects to the ordinances of
Fridley, Minnesota gg location, construct�Ton, alteration, maintenance, repair and moving of build�sg�
w city ]imits�anthis permit may be revoked at any time upon violation of any of the provisions of said
ALLEN G. JENSEN
Building �
I i or
NOTICE
ihb pgm* don no eewr the eondmdlon, hutdbdon for whb& phmbk& gas huem& nww w water. Be are to no
tiro SuMns fir. for aparato pamdts for thea hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDL*Y, MINNESOTA
OWNER'S NAME/%AfL A1s2Sy �. VA / (I BUILDER�r h � � 110 S
ADDRESS 0/7 G 6 199e T�/P/ZADURESS �01 91
LOCATION OF BUILDING
N0. STREET PART OF LOT
LOT C3 C- BLOCK T o ADDITION OR SUBDIVISIONW_1V
CORNER LOTINSIDE LOT 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 Certif cater.
641A 19
DESCRIPTI0N OF BUILDING
To be used as;
Front Depth Height
Sq. Ft.Cu. Ft.
Front Depth- .Height
Sq. Ft. Cu. 'Ft.
Type of Constructions E 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.
(S Cie1dule o ee Costs can be foyPnd gxf the Reverse Side',
0 R I H
SUBJECT
PERMIT NO.
City of Fridley
o 8
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
TNO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
VECEIP�
fffJ PROTECTIVE
1 � �
"t CITY HALL FRIDLEY 55432
NUMBE
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
91b -F15
5/18/88
JOB ADDRESS 617 Rice Creek Terrace N. E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
1
2
Rice Creek :Terrace Plat 7 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ellard Briesemeister 617 Rice Greek Terrace N.E. 571-3614
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 ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (22. Squares )
9 CHANGEOFUSEFROM TO
STIPULATIONS Roof can be the 2nd layer but not the 3td. Install ridged galvanized
valleys.
On all new roofs or tear -offs and replacement roofs,
State Code requires that 2 layers of 15 Ib, felt,
mopped together, be installed to a point 24 inches
up from exterior wall line, or the use of other
approved underlayment membrane.
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
$1
$.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
F100
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
TOTAL FEE
$27.55
AT F TRACTOR OR AUTHORIZED AGENT - (D
WHEN PROPERLY (DATED T IS IS YOUR PERMIT
DATE)
�d
� i ! ��g
BLDG (NSP
siG ATURE OF OWNER IIF OWNER BUILDER) ATE(
NEW [ ] City of Fridley Effective 5/1/88
ADDN [ ] R-1 AND R-2
ALTER [
Construction Addri
rl Description
Building Permit Application
Owner Name & Address:_ &,t74c�2 37 Tel. # v%i 3
Contr actor : Tel. #
Address:
Attach to this appl icat ori,:;,:a ;4 a of ic:ate o_ f , ,Survey of the
lot, with the proposoed. bo" Yistyruct on -drIawn on it to scale.
DESausTioa dF IMPROm+mr
LIVING AREA: Length Width Height Sg. Ft.
GARAGE AREA: Length Width Height Sg. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
-Kr- Y,®®#='f/'1/'�" -21 ;?-
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ I100
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired: 1 $.
Width + 6'
Alt. A Alt. B
$
See Back Page
DATE: !� �� APPLICANT:.2�, ���z L�-7 Tel. #
CITY USE COY
Permit Fee $'� �'� Fee Schedule on Reverse Side
State Surcharge S $.50/$1,000 Valuation
SAC Charge $ $550 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ 7
TOTAL
STIPERMIONS:
w
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
RESIDEI4TIAL
RATE
TOTAL
Job Address_ �/�
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $
20.00
$ qp .QQ
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping $
10.00
$
Tel. #571-3450
(piping needed with new furnace)
Gas Range $
10.00
$
The undersigned hereby makes application for a permit for the work herein
Gas Dryer $
10.00
$
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.
* Air Conditioning (all sizes) $
10.00
$
Fridley, Minn. _ p7, 19
All Others/Repairs and Alterations
_�%'
OWNER
1% of Value of Appliance or Work
$
KIND OF BUILDING X-�Lai
COMMERCIAL/INDUSTRIAL
USED AS
1% of Value of Appliance or Work
$
TO BE COMPLETED ABOUT --
ESTIMATED COST 3! , �
State Surcharge
$ .50
az
TOTAL F=OLD
$�
- NEW BUILDING PERMIT NO. PERMIT NO.
Reinspection Fee ($15.00)
$
Rough Insp.
Date
Final Insp. —.3— y —
Date
Approval for Permit
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 frcm adjoining neighbor.
DESCRIPTION OF FURNACE/BURNER 410-5& ?60-Q 3-6
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.7�fJ
Trade Name Size No.
i
Capacity ��/ Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
i
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company .
Signed By
Tel. No.
Fill out back side for stack verification on replacement furnaces
SUBJECT
city of Fridley
971
AT THE TOP OF TME TWINS
BUIL®ING PERMIT
NO.
__ _ COMMUNITY DEVELOPMENT DIV.
e m
`v ------
INSPECTION SEC.
7�6 6
r PROTECTIVE
1 �
=
1 it CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
10/20/98
JOB ADDRESS
617 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
2
1 Rice Creek Terrace Plat 7 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Briesemeister
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Advance Alum. Supply Inc. 7701 Main St NE Fridley 55432 571-3440 7983
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 O ADDITION ❑ ALTERATION Rk REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (21 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlaymen¢t 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 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1799
$.90
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
$56.75
Firs SC $1.80
PLAN CHECK FEE
TOT FEE
LIce e SC 5. 0
.45
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi
O Y VALIDA
E HIS IS YOUR PERMIT
QP
SIGNATURE OF OWNER OF OWNER BUILDER, IDATEi
B OgAtE
NEW [ ]
ADDN [ ]
ALTER ]
S 612 571 2260
ADUANCE ALUMINUM
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
.577/--/ -&-e7
Effective 111/98
ConstructionAddress: 61 7 /C / G c L: �z�!ir T.� .-i /�:�'c •r
Legal Description:
Owner Name & Address: /�,�?.,�/ /,�jp /��,r-/L Tel. #
Contractor: ,.t.,r c.v,., wG.,.., vP�c, i-,. MN I..ICENSE # 79113
Address: 70 w /ia1,4 2e Tel. # S�' / — 3 yy®
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: Estimated Cost: $_ /221
`21
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 17t = Ft x $ _ $
DATE: V �.j g APPLICANT: Tel. # S7/-3j�'yt>
TOTAL $�q.7�;-
STIPULATIONS: ��
03
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ ,
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 90
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$. O ®
$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 $�q.7�;-
STIPULATIONS: ��
03
SUBJECT
PE O.
City of Fridley
2 4418
AT THE TOP OF THE TWINS
BUILDING D C D
A A
I T
Ir
r GR'Y1
RECEIPT NO.
� .v ___�__ COMMUNITY DEVELOPMENT DIV.
J PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED SY
1 612-571-3450
910415
5/7/99
10B ADDRESS 617 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Rice Creek Terrace Plat 7
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Ellard Briesemeister 617 Rice Creek Terrace NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Advance Aluminum Supply Inc. 7701 Main St NE, Fridley, MN
55432 571-3440
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 CX REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reside house; trim
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
$8,000
$4.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC C GE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$137.25
F SC $8.00
PLAN CHECK FEE
TOT EE
Lice e SC $
$154.25
SIGN TORE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI
WHE P D R L
2oudr.00�
B OG INSD .
THIS IS V
45 i /- 7117
OAiE
SIGNATURE OF OWNER IIF OWNER BUILDER, -.DATE.
iv= VYL J
ADItN ( )
ALTFR ( )
Description:
$ 612 571 2260
ADURNCE ALUMINUM
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES It -1 AND R-2
BUILDING PERMIT APPLICATION
Llitective 1/ 1/98 81
Name & Address: 4 A D 14, el yd ,*.4; y ,�2 Tel #
;tor: dA,o` /_zec. MN LICENSE #
720 Tel.#_S /-3y'YD
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF1T4PROVEMENT
LIVI
4G AREA:
Length Width
Height
Sq. Ft. !
GAR
kGE AREA:
Length Width
Height
Sq. Ft.
DEC
AREA:
Length Width
Hgt/Ground Sq. Ft - j
OTH
R:
Constriction
Type:.
Estimated Cost: $ 10oy
(Fee Schedule
on Back)
Driveway
Curb Cut Width
Needed: Ft. + 6 Ft =
Ft x $
_ $
DATES
%
APPLICANT:
Tel. #�/—
CITY USE ONLY
Permit Fee $ )37>c�r Fee Schedule on Reverse Side
Fire St rcharge $ . ®6 .001 of Permit Valuation (1/10th%)
State S rcharge $ $.50/$1,000 Valuation
SAC C arge $ $1000 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Drivew2Ly Escrow $ Alt. "A" or Alt. "B" Above
Erosior Control $ $450.00 Conservation Plan Review
Park Fi e $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ )
TO AL $
STIPULATIONS:
I
11
suejEcr
P MIT NO.'
City of Fridley
31030
AT THE TOP OF THE TWINS
P,
BUILDING
PERMITr
y
RECEIPT NO
` COMMUNITY DEVELOPMENT DIV.
- ------
i PROTECTIVE INSPECTION SEC.
"
1 ,
= CITY HALL FRIDLEY 55432
NUMBERREV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
6-5-00
JOB ADDRESS 617 RICE CREEK TERRACE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Rice Creek Terrace Plat 7
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ellard Briesemeister '617 Rice Creek Terrace
571-3614
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION j] REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Repair Existing Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
For stipulations see attached plan.
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
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
$1,000.00
$.50
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-
Fire SC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$38.75
$1.00
PLAN CHECK FEEL
TO A FEE
$40.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
WH PROP
Bl INSP
VALID T D TBHIS ISP T
�� TE
S.GNATURE OF OWNER OF OWNER BUILOERi IDATEI
I
11
NEW []
ADDN []
ALTER [ ]
Construction Address:
Effective 1/1/2000
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 r1
BUILDING PERMIT APPLICATION �,v q
Legal Description:
Owner Name & Address: 4ELp-D 45;- 7255C Tel. # 7./
Contractor:41l'o'/ MN LICENSE #
Address: Tel. #
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.
Construction Type: it 0 Estimated Cost: $ ,/
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: Ic"f APPLICANT • Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
STIPULATIONS:
Permit Fee
$
%�
Fee Schedule on Reverse Side
Fire Surcharge
$
l C,) 0
.001 of Permit Valuation (1/10th%)
State Surcharge
$.50/$1,000 Valuation
SAC Charge
$
$1100 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 [ ]
C
TOTAL
$
-'a -
STIPULATIONS:
Building
BUILDING
Permit No.: Li
'
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Da d•
DATE 1 A f 105
YOUR E-MAIL ADDRESS tA.*Y50.�C1S—
SITE ADDRESS l- " zrt cl -f za (a cj
THIS APPLICANT IS:
0 OWNER CONTRACTOR
PROPERTY OWNER/
NAME: I I 'Q S C'i' 1rYC t
ADDRESS: n CITY
STATE P ZI
TENANT
a �
PHONE: IUJ–�7 T +CLI y
NAME: Renewal By Andersen
CONTRACTOR
SUBMIT A COPY OF
STATE LICENSE #_1920 County Road "C" West
YOUR STATE LICENSE
ADDRESS: Roseville, MN 55113 t
STATE ZIP
WITH APPLICATION
PHONE License #20130983
0 SINGLE FAMILY/NE` 651-264-477%
PROPERTY TYPE
0 TWO FAMILY/NEW C
0 ADDITION 0 GARAGE/SHED 0 WINDOWS
PERMIT TYPE
0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE
0 DECK 0 SIDING 0 OTHER
0 SWIMMING POOL
TYPE OF WORK: 1-101
NEW 0 ADDITION
MAINTENANCE/REPAIR 0 REMODELING
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DESCRIBE WORK BEING DONE: aS �^�'/ -M bh
�HOEIGH�TS
SIZE OF IMPROVEMENT LENGTH WIDTH
Ft.
ROOFING
0 HOUSE ONLY
BASEMENT
REMODELING SUBMIT•
NUMBER OF SQUARES
0 HOUSE & GARAGE
1.
Floor Plan
GARAGES
0 ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
0 DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
0 Vinyl
0 Aluminum
OSoffit
0 Trim
ADDITIONS
1.
& PORCHES SUBMIT:
Site Plan/Survey showing the existing structure
0 Other
0 Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 8 SSS OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Atta(
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
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approve
plan in the case of all work vhich require eview and approval of plans. t
SIGNATURE OF APPLICAI, RINT NAMEOI 1 { , y -,5e i1�7 DATE
LV
$
�—
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Atta(
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
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approve
plan in the case of all work vhich require eview and approval of plans. t
SIGNATURE OF APPLICAI, RINT NAMEOI 1 { , y -,5e i1�7 DATE