PRE 2010 DOCS�27 City of Fridley
?' Application for Plumbing and Gas Fitting Pe=rmit
Dept of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORTS
Number, Kind and Location of Fixtures Locatio Sd
ffi
x
1.20
$
`�_
x
1.00
Y F
Catch Basin ............................
Z
3.25
$
Water Heater (Up to 200,000 BTU) ......
W
z
z
*
R
N
WATER HTR.
GAS
ELEC
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$. , '�S—
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
�O
$
Base
t
r
1st
2nd
3rd
4th
• Future Connection Openings
Connected wfth
New Fixture, Old Openings I
Sewer
Cesspool ❑
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ ii_5
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
1 x
2.00
$ 0 0
New Ground Run Old Bldg. ... ........
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$. , '�S—
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS --Refer to Code
Description ................................................;
TOTAL $
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, Minn 9 19_
Owner 19—
Kind of Building ���-� ���_ , 19—
Used as
To be completed about
Estimated Cost, $
Old -9 Building Permit N
,QW11 POST iM-12-58
Ax ! l e�2,
n � ,
IL\
City ®f Fridley, Minn.
BUHDING PERMIT NO. (6:1
Date:
J
Owner: ..Ned4otder
Address
J'OcAI B WING
No. P 2
r Ell
Lot Block 7-3: Addition or Sub -Di vistO
"back
Comer Lot Inside Lot
Sewer Mevat ion Fourdation mevation
DESCRIPTION OF BUILDING
To as:
Front Depth Height Sq. FLitu Cu. Ft.
Fro i$ DepthHeight Sq. Ft. — cu. Ft.
Type of Construction dec" Est.To beCompleted
CON7
In consideration of the Issuance to me of a permit to construct the building described above, X agree to do
the proposed 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, Mlnnesqta(;',;regardin; location, construction, alteration, maintenance, repair and moving of buildings
within the city,AWt6' and this permit may be revoked at anyoF$009 violatiou of any of the provisions of said
ordinances.
-AfAA Building Inspector
NOTICE:
TW permit 4*n not eover the construction, installation for vArk& phmblng, gas h*dhi& sewer or water. Be sum to see
the Building hupeder for sopen" pwndft for thus bmw
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name4 uilder
Address Address r—
LOCATION OY BUILDING
No. s Street A!/4,WA MJ Part of;Lot /%,o z fz
Lot _____Block Addition or Subdivision ) �,� �/,e11f17A'211 R:5 fe1A
Corner Lot Inside LotSetback 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.
To be used as:
DESCRIPTION OF BUILDING
Front Depth_ ,.Height
Sq. Ft. iCU. Ft.
Front Depth Height
Sq. Ft . Cu. Ft .
Type of Construction s Estimated Cost _ a zi 0, 6 a
Tobe Completed
The undersigned hereby makes application fora 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 �/- SIGNATURE �d d
(Schedule of Fee Costs can be found on the Reverse Side).
a
itj,99IM'I M
Date:
Eli re 5777� -0 1 A. 9-R! ON
9O3-57
N® 6521
No. ���r StreetZT art of
Lot _ . _ _ ___ Block — — Addition or Sub-Division"
Corner Lot _ Inside Lot _ _ Setback 4?A � �JL! ___ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
T
19t
&1J ® ea' Front Depth Height Sq. Ft. WCu. Ft.
Depth t _ Sq. F't. Cu. Ft.
Type of Construction __ Est. _ �`� 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. p
If
In consideration of the payment of a fee of $ __�`� , permit is hereby granted to construct the building or addition as described above. This permit is granted upon
to—
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done 3n, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota reg location, construction, alteration, maintenati ,repair and moving of buildings
within the city ]imits ands permit may be revoked at any aay of the provisions of said
ordinances.
(NOTICE:
This permit doss not cover the construction, hotalHtien for wiring, plumbing, gas heating, sowar or water. Be sure to we
the Building Inspector for separate permits for these Nems.
SUBJECT -
PERMIT NO
City of Fridley
AT THE TOP OF THE TWINS
BUILDING P
PERMIT
RECEIP:LNd: J
• ______ COMMUNITY DEVELOPMENT DIV.
L
1 PROTECTIVE INSPECTION SEC.
I
p
� ,
CITY HALL FRIDLEY 55432
NUMBERREV.
ATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
JOB ADDRESS 150 Rickard Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
1
2
Elwell's Riverside Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Larry Addison 150 Rickard Road N.E. 571-9470
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Lloyd's Home Improvement Inc. 1012 - 421i Avenue N.E. 788-5602
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
x
8 DESCRIBE WORK
Construct an 18' x 14' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
WON digging call loll utiiithes
P TELEPHONE
- ELECTRIC - GAS Etc.
� G,
411�� REQUIRED BY LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
252
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
$4.58
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$9,150
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-
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$80.50
PLAN CHECK FEE
TOTALFEE
$20.13
$105.21
SIGNATURE OF CONTRACTOR RAUTHORIZE A NT 1' DA
HEN PROPERLY VALIDATED THIS ISIS UR ERMIT
/7�
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
BLDG INSP. GATE
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIM F014 RESIDENTIAL BUILDING PEW41TS
(New, Alterations, Additions, or Repairs)
4 '
Pw/ V— w•
OWNER: BUILDERze
l
r
ADDRESS: ADDRESS:Je
TEL N0: _ �) �/ % U TEL NO: _ �j l - �'� o
Construction Location
- STRMT NO: 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.
DESCRIPTION OF CONSTRUCTION
�Q F� Front: Depth: Height:
Square. Feet: 'Z.S�'� Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet: _
Type of Construction: Estimated Cost:
7b Be C3brapleted: �J
s
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
Mie 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.
DAM: SIGNATUME:
Stipulations: r
(Flit
P.
SuB.,ECT
City of Fridley
('PE4*m
`3 509
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• ______ COMMUNITY DEVELOPMENT DIV
r PROTECTIVE INSPECTION SEC
�i
i
s
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
812-571-3450
910415
7/5/95
JOB ADDRESS 150 Rickard Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1-2
2
Ellwell's Revised Heights Plat
2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Larry Addison 150 Rickard Road NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
RKNPUM Richard Hastings Co. 6331 Riverview Ter NE, Fridley,
MN 55432 574-9966
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Reroof House & Garage (27 Sq) Tear-off
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION E-K REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
See above
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 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
3pp��pp�� inn $2,025
1.01
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$54.00
Fire SC $2.03
PLAN CHECK FEE
TOTAL FEE
"✓� 7` ���`�License
SC $5.00
1 $62.04
SIGNATURE OF CONTRACTOR OR UTHORIZED AGENT IDATEI
HEN PROPERP VALIDATED THIS IS YOUR PERMIT
BLD '/ ;gyp A
QA fE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/ 1/95
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: /5' `&AAD k
Legal Description:
Owner Name & Address: _Ll+,Z x1 Tel. #
Contractor: X , c4A2/2 4,4 S NA/cS Co.
MN LICENSE # `f oS/
Address: /.33j 1'��`v�,� �,`� tc t� Tel. # 51 ' X 96
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: Length7 Width Hgt/Ground Sq. Ft.
OTHER: /
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction: '7; A P- v FF 4- iz® o F
Approx. Completion Date:
Side Yard Setbacks
Estimated Cost:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $
DATE: i S APPLICANT: L- Zi /� Tel. # J-/
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
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/$1,00 Valuation
$850 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 [ ]