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PRE 2010 DOCSCity ®f Fridley, Minn. BURDINGT N® 836 Date: // r Owner:l Builder I/_ -AL: Address Address � �� LOCATIO OF UILDING No. Street Part r Lot Lot __1 /_ Block Addition or Sub-ply)- Corner ub=Di Corner Lot _'i Inside Lot _ _ S_etback!� � %` �` Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To as: civ Front ! J Depth �- Height LL— Sq.F't./ Cu. Ft.�� � Front. Depth Height _ Sq. Ft. Cu. Ft. Type of Constructiony dlr Est. �f _ 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 t forth and in compli�ce 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 violeaton of any of the provisions of said ordinance. Building Inspector NOTICE: This permit does not cover the construction, installation for whing, plumbing, gas beating, sewer or water. Be sure to see the Building hnWedor for separela permhs for these items. s APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY', MINNESOTA e OWNS- R ° S NAME f4 L a �� `A - P N .S BUILDER ADDRESS ^6 c M/4IV I''Cake//, ADDnss a P1�1 LOCATION OF B ING f No. Street Part of Lot.J,?, Lot Block Addition, or Subdivisions Corner Lot Inside Lot Setback–.. Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To ,be used as r Front DepthHeight Sq. Ft. Cu. Ft. �--�i Front Depth Height Sq. Ft. Cu. Ft. Type of Construction// ,� Estimated Cost To be Completed The undersigned hereby makes aFplication'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. DAT: )\—mss= I 9 1 `1 6 SIGNATURES (Schedule of Fee Costs can be found,on the Reverse Side). City of Fridley_ SUBJECT - AT THE TOP OF THE TWINS BUILDING P E R M I T .15971' r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ,`j j 612-571-3450 910-F15 10/14/80 / JOB ADDRESS 4924 Roman Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 C.'arlson's Summit Manor South SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Dale Hoskins 4924 Roman Road N.E. 560-2101 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK E NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK e 9 CHANGE OF USE FROM TO STIPULATIONS SEPERAT"E PERMITS REQUIRED FOR �� , Ii EATING, PLUMBING AND �eA!���C�, f GNSo WARNiNG Before digging Iocal call u,r': i, TELEPHONE - ELECTRIC - GP, Et . REQUIRED EY Lic%tW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 224 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 $8,350 $4.18 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- $51.00 \ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE lk $12.75 $67.93 SIG T RE OF CONTRACTOR O AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS Yy OUR PERM /� CK� J1�i.E , i q INSP F)A T' A RE OF OWNER 11 WNERSUILDEAI M %TEI IBLDG CITY OF FRIDLEY� APPLICATION FOR RESIDfI`ITIAI_ BUILDING PERMITS (New, Alterations, Additions*, or Repairs) OWNER: ���_ jam, �bS�' i n! .� BUILDER. �C ' ADDRESS: ADDRESS: TEL NO: O 1 TEL 1d0: Construction Location STP -M, T NO: q- STREET: � 0 LOT: % (� BLOCK: > ADDITION: Corner Lot: 1/^ 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 o -Y4 Front: Depth: Height: O Squane.Feet: `Z2 Cubic Feet: Fronts Depth: Height: Square" Feet: Cubic Feet: Type of Coir tructi.on : \N maw FE`''D m Estimated Cost: $ Sb Be Covapleted: `� 1\"t I Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET 'axle undersigned hereby makes application for a permit for the vork' 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 ons stated in this application are true and correct. DATE: 0� a; \-kj(Q SIGNATUitr.: Stipulations: y ma �w . `� .. w. -.e., r., ..ate-..-... 3 ... .. �. ....,. ... a..... .... _. .. w. ..♦ .. ..LL]W SCALE- r -W PILOT* ,, AVENUE 49th. AVENUE 1 N.E.: t2tat ti„ n`uave is a survey -of 1-ts On" (1) t'arrn;U.h i•ttrNn (16). • 7 hez"::y Ecti r.i^;' /, es Bloc *Ona (1). ��,,y;L;1': ti:r:aT Y9;0;, ";CU :ii ADi:iiI�:.. AanF a County. i Ino ata. shawi.;, th.: locution of the houses on nr:id Iota. As surveyed by we this 25th day of Ywroh 195K A. D. a i inaF.sote iiGcJatration ho.25bi2 , . o . v ' CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE rn NO. RATE �. rn x m $ o • $2.00 N New Fixture, Old Opening water $2.00 $ 4 A $5.00 $ b E4 b+ o $5.00 sa 100,000 BTU to 199,000 BTU •.1 $10.00 ti r."{ to a x Heater $ o x c m x xo u $ GAS FITTING FEES: M ( $4 1st 3 fixtures x O $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ P,BPAIRS $ ALTERATIONS .{ O N i1 R V NN N vI ~ U A W i7C y :i q W N W U co $ C7 £ REINSPECTION FEE O a5 leC (x10.00) is 2nd 3r3 { 1 ' 4th 1 {G) = Future Connection Opening Connected with Sewer i*l = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL *mer Fixtures x $3.00 $ �u=are Fixture Opening x $2.00 $ iQ % a New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ hater Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ P,BPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE (x10.00) Job Address/Q ;j wo Department of Buildings City of Fridley Tei. #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 appliW-7 are true and correct F idley, Mn. 19�' OWNER "Do � � /�/ O S KIND OF BUILDING /C_'L /4 — C USED AS ( ` G o C- TO TO BE COMPLETED ABOUT —4-4 ESTIMATED COST -0 1-3 0 4'. O O OLD - NEW BUILDING PERMIT NO. PERMIT NO. -_'5" / Company !� /� K �� ✓ '` !3 / w Signed By Tel. No. �5 7/ / 7-3 ROUGH INSP. Date FINAL INSP. 4-14-001 Date C 4 - Date APPROVAL FOR PERMIT IKI MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE SUBJECT PER City of Fridley 17954 AT THE TOP OF THE TWINS BUILDING PERM r � ; ______ COMMUNITY DEVELOPMENT DIV. R CEIPT NO. ti: r -I PROTECTIVE INSPECTION SEC. ` �/'�'1,•� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF OVED BY --_.� L 612-571-3450 910-F15 5/6/85 JOB ADDRESS 4924 Roman Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16 Carlson' S Summit Manor South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Hoskins 49.24. Roman. Road N.E. 572-8789 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 Construct a 141 x 10' Addition to Duelling 9 CHANGE OF USE FROM TO STIPULATIONS WARNING SEPARATE PERMITS Rr-YUIRED FOR Before digging call lWIRING, HEATING, PLUMBING AND SIGNS,IMI �tlli���� TELEPHONE - ELECTRIC - GAS UP, REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood ,Frain THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 1 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 $7,550 $3 .78 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $68.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PAN CHECK FEE TOTAL FEE $17.13 $89.41 SIG�URE OF CONTRACT R OR AUTHORIZED AGENT CONTRACT R OR AUTHORIZED AGENT (DATE) WHEN PROPERLY V I13 TED THIS IS YOURFRMI �� f W SfGNATURE O WNER SIF OWNER BUILDERI Lt.ATEI ­61- DG INSP �l E NEN [ ] City of Fridley Effective 4/1/84 ADDN. [LI' R-1 AND R-2 ALTER. [ 7 Building Permit Application Construction Address: Legal Description: A� Owner Name b Address: -E - Contractor: SIC ® �z Tel. # _� ®7 7 Contractor: Tel. # Address: 1 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 1!�4 Width 1 g- Height Sq. Ft. I Y O GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [uT'- Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE:�� APPLICANT: �� � �� �� �����°`'��------_ Tel . # 7 2-- 9 7 g �_. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ a Fee Schedule on Reverse Side $ 25$ of Building Permit Fee $ $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering $ q �a Agreement Necessary [ ] Not Necessary [ j CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. a. w New Fixtures $ 5.00 U Future Fixtures x e $ Mater a al S Beer Dispenser S 4.00 h G a w 1ba [1 $ Catch Basin a w $ Heater $ 5.00 $ Hydraulic Valve w $ Sump or Receiving Tank $ 5.00 $ w Oi B� " $ 7.00 $ Hot Mater Heater $ 5.00 $ Gas Range $ 10.00 w C G w C •.4 S p" U N 6 r It of Value of Fixture or Appliance $ Reinspection Fee S State Surcharge O u 5 M i� TOTAL a $ oP O o w A O w N u a� N 3 w i� w ii .c o lec N a� a� .as lot 2nd 3rd 4th (R) - Future Connection Opening Connected with Sever (') - Nov Fixture. Old Opening Mater RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 S Future Fixtures $ 3.50 $ Old Opening, New Fixture S 1.50 S Beer Dispenser S 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Mater Leader $ 5.00 $ Hydraulic Valve $ S.00 $ Sump or Receiving Tank $ 5.00 $ Mater Treating Appliance $ 7.00 $ Hot Mater Heater $ 5.00 $ Gas Range $ 10.00 $ GAS Dryer $ 10.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee S State Surcharge $ .50 ($15.00) TOTAL FEE $ oP Ettectave Aug. 1, lytll Job Address C/?, -2 C,1 Mfr 7C%, Department of Buildings City of Fridley Tel. 1571-3450 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, Mn. OWNER V40�L / �. r C-14 A4_ C - KIND OF USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD NEW BUILDING PERMIT NO. PERMIT NO. Company Signed By a r Tel. No. ��-7 z 6 7 9 ROUGH INSP. Date FINAL INSP. W - �-- a40 Date APPROVAL FOR PERMIT ��v't 4 MINIMUM FEE FOR ANY PLUMBING PERMIT I 510.00 PLUS THE $ 50 STATE SURCHARGE u SUBJECT City of Fraley d74 609 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV PROTECTIVE INSPECTION SEC r I � � NUMBER REV DATE P AGE OF APPROVED BY ��"S CITY HALL FRIDLEY 55432 �" •�� 612-571-3450 910-F15 10/1/96 JOB ADDRESS 4924 Roman Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1C 1 Carlson's Summit M nor South Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Hoskins 4924 Roman Rd NE 572-8789 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 X 8 DESCRIBE WORK Reroof Part of House (10 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED 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 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 $825 $•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- F SC $.82 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $32.00 re PLAN CHECK FEE T �FEE $33.32 SIGNATU OF CONTRACTORR UTHORIRI E NT IDATEI PRO Y VALI A THIS IS YO R PERMI DG INSP DATE SIGN U EOF OWNERIIF C IDATEI u NEW [ J Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:Cr Legal Description: Owner Name &Address: �� d� ,�S�yj� Tel. Contractor: - MN LICENSE # Address:- 7,0/v ;T' /0 Tel. # i�—� 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: A! Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $_.Z t Approx. Completion Date: �- (Cost on Back) Driveway Curb Cut Width Needed: Ft. +,/6 Ft = Ft x $ _ $ DATE: &ZZ1 APPLICANT: a Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control CITY USE ONLY $ 0Q Fee Schedule on Reverse Side $ c ,� .001 of Permit Valuation (1/10th%) $ SC's $.50/$1,000 Valuation $ $900 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PE city ®f F ridley 5 4 6 9 AT THE TOP OF THE TWINS BUILDING PERMIT P RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. Z16r 1 . � NUMBER REV DATEPAGE 9/5/97 OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 4924 Roman Road NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16 1 Carlson's Summit Manor South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Haskins 4924 Roman Road NE 572-8789 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Cjj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install replacement.bay window (11" extension, "S" braces) 9 CHANGE OF USE FROM TO STIPULATIONS Install per manufacturer's specifications. 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 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 $900 $.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- $32.00 Fire SC $.90 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $33.40 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY VAPDATED THIS IS YOUR PERMIT leelO SLOG SP _ GATE SIGNATURE OF OW NER iiF OWNER BUILDERI (DATEI NEW ( � ADDN [ ALTER ( J ConstructionAddress : CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 7157 :kf Effective 1 / l /97 Legal Description: C ry✓ L a - Owner Name& Address: Grt r/9�.�/ �. ,�� Tel. i" Contractor:� MN LICENSE # Address:_ /ZD6- M" AJV %c dfi 4) 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:_Bid V LJI NZ) ,o (�SC Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: $ ('7 APPLICANT- Tel. #7 CITY USE ONLY Permit Fee $ c-�- 00 Fee Schedule on Reverse Side Fire Surcharge $ 90 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 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 $ atPULATIONS: SUBJECT PFridley City ®f � � AT THE TOP OF THE TWINS BUILDING PERMIT r *ECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910415 10/13/9 !OB ADDRESS 4924 Roman Road NE 1 LEGALLOT NO. 16 BLOCK 1 TRACTOR ADDITION Carlson's SEE ATTACHED Summit Manor South Addn SHEET DEscR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Hoskins 4924 Roman Rd NE 572-8789 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 Reside House (Vinyl) 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer's specifications state it it not required. 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 $1,700 $.85 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- $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $56.55 SIGNATURE OF CONT RACTOR OR AUT ORIZEDAGENT IDATEI PROPERLY V IDATED THIS IS YOUR PERMIT kWHEN CD INSP gaiE SIGN TUREO NERoF OWNER BUILDERI IDATEI NEW ( ] Effective 1/1/97 ADDN ( ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: po'n-./4-ry Legal Description: Owner Name &Address: S�� r a✓s Tel. # c72 —F R1 Contractor: 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 GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Gi OTHER: - �^ se Jia A 0�s — Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Estimated Cost: $ (Fee Schedule - on Back) Driveway Curb Cut Width Needed Ft.'` + 6 Ft DATE: Zd --47 5 7 APPLICANT: �-� f�� Tel. # STfPULn'CIONS: CITY USE ONLY 3 Permit Fee $ 5,1,0C? Fee Schedule on Reverse Side Fire Surcharge $ 1� °%�_ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 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 $ .5^-�� STfPULn'CIONS: te. sue�ecT PER Fridley City of Fr WRECKING 6 8 0 6 AT THE TOP OF THE TWINS PERMIT r 1 REC NO. I �• COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 � � NUMBER REV DATE PAGE OF APPROVED BY i i CITY HALL FRIDLEY 55432 ��'-';•J ---. 1 Jr 612-571-3450 910415 7/24/98 JOB ADDRESS 4924 Roman Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 1 Carlson's Summit Manor South Add'n. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Avskins 4924 Roman Road 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Wrecking garage (24'X18') 9 CHANGE OF USE FROM TO STIPULATIONS All demolition debris, including foundation & slab, shall be removed from s 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 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 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 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. $15.00 PLAN CHECK FEE TOTAL FEE (] TUREOFCON TRA OR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY ATTHIS IS YOUR PERMIT V DED Xd"6��/ NAG . ,2�-- BLDG SP w d BATE NATURE OF O ER OF OWNER BUILDERI IDATEI� �� te. CITY OF FRMLEY 6431 University Ave NE Fridley MN 55432 572-3604 Effect' a 1/1/98 MOVING [ ] WRECKING PERMIT APPLICATIONG� l Job Address: q d, m f},) Legal Description: Owner & Address: L 61 Tel. # contractor: 341111 Tel. # Address: 1f A6)9 /D State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Cu. Ft. GARAGE: LengthWidth Height Sq. Ft. Cu. Ft. w_ X OTHER: Length Width Height Sq. Ft. Cu. Ft. Estimated Cost $ Approx. Completion Date UTILITIES City Water/Sewer Minnegasco N S P U S West NOTIFIED: 572-3529 [ ] 372-4720 [ ] 330-5500[ ] 663-6000 [ ] Water Bill Paid: Yes [ ] or Collect [$ Moving Route: ] Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. ALL DEMOLITON DEBRIS, INCLUDING FOUNDATION & SLAB. SHALL BE REMOVED FROM SITE. 3 jdKOA - Date Signature Moving: Principle Building into Fridley .... $300.00 Accessory Building into Fridley .... $ 42.00 Through or within the City ...... $ 20.00 Move a building out of City ...... $ 80.00 Wrecking: For each 1,000 cubic feet or fraction .. $ 1.25 For structures which would be impractical to cube the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. 62U PERMIT FEE: 6 --- STIPULATIONS: Minimum Fee: $20.00 Minimum Fee: $15.00 I/ suB�Ecr . a City ®f Fridley 2 F77;6� AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT O. I �• COMMUNITY DEVELOPMENT DIV. � _____ 1 ~ PROTECTIVE INSPECTION SEC. 6 r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV 55432 612-571-3450 L 910-F15 9/14/98 JOB ADDRESS kfi 4924 Roman Rd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 lCarlson's Summit Manor South Ad SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Hoskins Same 572-8789 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 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 O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 3.2' x 24' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO 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 I 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 $14,592.00 $7.30 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGEFIre bC PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $224.75 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOT FEE $246.64 SIGNA ,URE OF CONTRA ,T R OR AUTHORIZED AGENT IDATEI E PR V LID T IS IS RP MIy/%/, D G INS ! gATE N SIGNATURE OF OWR pF OWNER BUILDERI 3 i ATEI I/ NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: XeM AN A(o-1) -0 Legal Description: Owner Name & Address: Contractor: Address: Tel. # S MN LICENSE # 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 GARAGE AREA: Length 3 X Width Height DECK AREA: Length Width Hgt/Ground OTHER: Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: APPLICANT: Tel: # Sq. Ft. -— Sq. Ft. Sq. Ft. _% Z `U Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ Tel. # TOTAL STIPULATIONS: 7� CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ , 3^ .001 of Permit Valuation (1/10th%) State Surcharge $ 7 jo $.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: CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE g'J'q J Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas e /a 7 rye/ *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1 1998 /1 JOB ADDRESS q 47 Z q Yl0- () , The undersigned hereby makes application for a permit for the work herein Rate TOTAL 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 $ 30.00 $ representations stated in this application are true and correct. Z. , � ,1998 $10.00 $ OWNER $10.00 $ BUILDING USED AS $10.00 $ ESTIMATED COST a0O • u0 PERMIT N0. $ 25.00 $ Iff DESCRIPTION OF FURNACE AND OR BURNER State Surcharge TOTAL FEE $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load $ .50 Burner Trade Name Size No. BTU HP EDR HEATING COMPANY J4 cc, Ijc. 41'F %./"J S MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. lav PLUS THE $.50 STATE SURCHARGE r j REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date4e *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. f� �� aFbLAQEEMeENT FF �AC,E S /� �� �� _ ���� '/�e ;76 List ALTERATIONS Being -Done: HEATING CO: Signed By: Date: CHIlNNEY 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 () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported . Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's 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: �-/ OCDe73 IEW [ ] CITY OF FRI LEY ,DDN [ ] 6431 University Ave NE, 'dley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: V gA� �-6n/ flq- C-> Legal Description: Owner Name & Address: J- P -6, - Contractor. G '74. Tel. # , ^K- P- �o --?7 MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: 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 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x —=$ DATE: APPLICANT: ��'l 2, - — 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 TOTAL $ �6 Fee Schedule on Reverse Side $ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1450 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 [ ] $ ® .� STIPULATIONS: