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PRE 2010 DOCSFurnace Shell & Duct Work ...........................$10.00 Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............. 9.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDIT Steam $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDB Hot Water .. 10.00 $ Each add. 200 sq. ft. EDIT. Steam ...................... 3.00 Each add. 320 sq. ft. EDB Hot Water ...... . .. 3.00 $ OIL BURNER—to 3 gal. per hour ... ... ............. 6.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199,000 BTU) .............. '......... 800 $ over 199,000 BTU See. Fee Schedule ; GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .76 $ Gas Range to 199AM .......... it&w !t 00 $ CONDITION MG FAN HEATING SYSTEM See •Fee VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL EWE$ UGH 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 Ordinance; and ruling of the Department of Buildings, and hereby declares that all the facts, and representations stated in this application are true and correct. owner. "4r �1, s Fridley, Minn �3 � � � ,. 1W42— Owner, W42 Used as AL4r� r To be completed about 2. Estimated Cost, $ 'F�o rtd C014,1 -New. Building Permit No. Permit No. /9S7 team, Hot Water, Warm Air—No Trade Name— Size No- 5'/ 2- 2— Capacity. Sq. Ft. E.D.R. BTU .�� H.P. Total Connected Load Kind of Fuel BURNER —Trade Name Size No Capacity Sq. lit. E.D.R BTU Hyl. (REMARKS—OYER) Signed �LtrR Business Phone No % L� ' ! City of Fridley SUBJECT PERNU� - --••--a ®12'741 AT THE TOP OF THE TWINS BUILDING PERMIT EZTtPT-lq _0 Rc�3 COMMUNITY DEVELOPMENT DIV. / r L PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY ` 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 10/3/74 / JOB ADDRESS 4965 Roman, Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Carlson r s Summit Manor South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Phillip Anderson 4965 Roman Road N.E. 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 IX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a redwood deck patio 9 CHANGE QF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VEPAEP ENTILATING OR AIR CONDITIONING. Wood HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,500 .75 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- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $9.00 PLAN CHECK FEE TOTALFEE $9.75 SIGNATURE OF CONTRAC OR OR AUTHORIZED AGENT (DATE) n WHEN VALID IS YOUR PERMIT` ,I � BLDG INSP DATE NATURE F OWN I OWN R BUILDERI 1 EI APPLICATION FOR RESIDENTIAL, ALTERATICN, • OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA /l1 ADDRESS:• + 7nbM0.Aj QQ6 ADDRESS: Il' , NO:. STREET: j LOT: BLOCK: ` 3 ADDITION: (210�� 1UM IT�� 1 CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD: 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: 6 Front .& Depth: Height: Square Feet: Cubic Feet: 6� ► Front: ® Depth: Height: Square Feet; Cubic Feet: Type of Construction: CuAm C Estimated Cost: $ /r -0 -0 - To 0 To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stict 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: ' 3 / SIGNATURE : i (See Reverse Side For Additional Information.) 7# _ � r f 9 01 SUBJECT PERMI City of Fridley WRECKING 14941 AT THE TOP OF THE TWINS xTL P E R M I T r LTl- RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . � i A CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ��'��, -___ l J \ 612-560-3450 910-F15 10/4/78 JOB ADDRESS 4965 Rcman Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Carlson's Summit Manor South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Shwarek 4965 Roman Road N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Lumber King 5145 Oliver Avenue South 926-2656 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 Raze 16' x 22' Garage 9 CHANGEQFUSEFROM TO STIPULATIONS Area to be cleaned of all debris caused by wrecking garage. 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 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 1 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT -0- NONE 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 PERFORM E OF CONSTRUCTION. $10.00 minimum PLAN CHECK FEE TOTALFEE d�4/Q � - 7 $10.00 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) tVVptN RO1ERLY ALIDATED THIS IS YOUR PERMIT ' ` SIGNATURE OF OWNER 0F OWNER BUILDER) (DAT EI BLDG INSP DATE 01 City of Friffley MoMr.T Permit No. AT TME TAP OF THE TWINS Lq WRECKING PERMIT APPLICATION Receipt No. j --- L-- --, cOLsMUIdITY pE:vELGEWT leiV. a PFSOTECTIVia CiFO�ZCTIO°4 C1sl>T, i CITY HALL frKIDL.RY 0002 1 tSl3-C$6dQ'��3® RII� �� REV. DATE PAGE OF rROVED RY 800 Job Address 6s eo M & V1 OR C -r/ Legal Lot No. Block No. Tract Addition Desc. I no kA & /y t Property Owner/ one Address 00Ak 3 V d C Wim- 3 t� '2. (/� l Contractor Address p� Phone Description Front Depth Height Sq. Ft. Cu. Ft. of Bldg. �� ' 10 �,V,1), No. of Dwelling Units Taxes Paid Tax Receipt No. Estimated Cost of Wrecking To Be Completed 3 Utilities Notified: State whether notified and date . Minneapolis Gas Company I�IA Engineering Department 372-4850 Northern States Power Company Customer Business Office 330-5540 Northwestern Bell Telephone Co. Business Office 332-4112 Approved By Water & Sewer Department: All Bills ArePaidServices Are Disconnected N% The undersigned hereby makes application for a permit to wreck the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that ,all facts and representations stated in this application are true.and correct. f ,()0 Co Tactor ' 6 Date SA SUBJECT R City of Fridley A1,11 1494 AT THE TOP OF THE TWINS PERM, BUILDING ` RECEIPT . COMMUNITY DEVELOPMENT DIV. L r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-560-3450 910-F15 110/4/78 JOB ADDRESS 4965 Roman Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Carlson's Summit Manor South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Shwarek 4965 Roman Road N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Lumber King 5145 Oliver Avenue South 926-2656 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 ❑� X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct 24' x 36' Garage 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Wrecking permit issued for 16' x 22' Garage 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 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6, 255 $3.12 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- STRUC O OR THE PERFORMAKro OF CONSTRUCTION. $34,56 PLAN CHECK FEE TOTAL FEE $37.68 I.-I'SIQ&ATUREOFCONTRACTO OR AUTHORIZED AGENT (DATE)W N P OPERLY VALIDATED THIS IS YOUR PERMIT 6d SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) 4` BLDG INSP DATE CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PE1114ITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWI1i.R: ' �'�( �1 �l� e % t TWILDER: (� �w� e- r Address: Address:1� ®flloe/./t� S70 Tel. No. No. % �� Street:I� d>A1 LOT: BLOCK: —3—ADDITION: .� c l v �S U � S ��- � Y'o'► 1T (Y-11) 6 k CORNER LOT: / .. INSIDE LOT: ^ SETBACK: Back X SIDEYARDS: Applicant attach "to this form 7Wo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING , To Be Used As: cS 9 Front: Depth: Height:� l o Square Feet • � i Cubic Feet: (�,"i 0 Front: Depth: Height: Square Feet:' Cubic Feet: 62�",3 Type of Construction: Estimated Cost: $ 5-® ® To Be Completed: / ® C/4 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. 'See reverse sideNfor'additional information. /`\ w. A DATE: " L SIGNA`run: Stipulations: r CP y: - DR I D - -SO A R� V l - CARL N -�n 0 O-TRAINME.' I&VE"'S 3 rdo. STREET 7 14 75 7.6 75 15 4988 N 14 -,65 -1 {•9.9•''32.2 49 ZA a 76 '4 15 75- 40_2 4909_ 0.2 IJ 49;4 16, 8 17.0 40.2 4940 17.1 3 18 o- 14.9 .10. 402 40.2 40.2 ,4941 N.5 Q lit. 496i�Lg- ROMA 14" ,uae-.es - )". 1 4 '75 0.2 IJ 49;4 16, 8 17.0 40.2 4940 17.1 3 18 o- 14.9 .10. 402 40.2 40.2 ,4941 N.5 Q lit. 496i�Lg- ROMA 14" ,uae-.es - )". 1 4 3rd 3200 FRANCE AVE. S0. STREET N.E. 14 7>f 71 13 ; 7s J ; 76 79 VJ '� !id F4- N495Y rod n 40.2 N13 ! �- �tJ1.d lei .!i1I -I-. __J �z� ice, 14 15 16 IT 18 emmf 19 20 LUAW -� 10 9 8 7 6 8 4 �I - s ¢e: �� a o • • 4977 N '� 49 Of 14 N 17_0 1 a ro 402 4 494 "' "ma 40.2 I — ------- 04 ! 49Y9 "'d roro I 3 a 17 a /44 241 jj ROMAN I hereby owtify that the above to a survey of Lots One (1) `hroUgh Twenty (20)t Block Three (1).•CAM.0NIS-SUMUT MANOR SOUTH ADDITION. Anoka County* Nimeacte. shoving the location of the houses on said late. As surveyed by me this 18th day of April 1955 A. V. Si gnec>L - - Nianvsosa Reidatretion No. 2!K84 a' ROAD 0 W ►i ~tea CITY OF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 March 5, 1991 David Skwarek 4965 Roman Road Fridley, MN 55421 RE: Home Occupations Dear Mr. Skwarek: In the zoning district where you live, home occupations are permitted as an accessory use, provided that certain criteria are met. One of these requirements (City Code copy enclosed) is as follows: 1. No over-the-counter retail sales are involved. Recently we received information suggesting that you may be operating a tropical fish business out of your residence which is not in conformance with the restrictions. If this is correct, please comply with the City Code by discontinuing this activity immediately. Feel free to call me at 572-3595 if you have questions or wish to discuss this further. Thank you for your cooperation! Sincerely, Steven Barg Planning Assistant d SB:ls C-90-43 CITY OF FRIDLEY Effective May 1, 1990 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE -RESIDENTIAL I RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 S Gas Piping $ 10.00 $ (piping needed with new furnace) Gas Range $ 10.00 $ Gas Dryer $ 1(1.00 $ • Air Conditioning (all sizes) All Others/Repairs and Alterations I% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Work $ 10.00 $ S S I ®0 State Surcharge $ .50 TOTAL !LE S Reinspection Fee ($15.00) $ I �5 _® Rough Insp. AM,, Jud Date M �innegasco #342-5326 Final Insp. 00 W. Linden Avenue Date P. 0, Box 1165 Approval for Permit % 7-9 ' MN 55440-1165 S 0 ®-- `� S �--' -\�) Q� l Vim, 4� MINIMUM FEE FOR ANY HEATING !EAMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in made yard without written permission from adjoining m-►ghbor. Job Address `'F C � 1 ea QG Department of Buildings, 6431 University Ave. N.E., Fridley, HN 55432 City of Fridley Tel. #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 application are true and correct. Fridley, Minn.; 1� — iy , 19 OWNER KIND OF BUILDING USED AS -�- e TO BE COMPLETED ABOUT°, ESTIMATED COST 5 es� 0 OLD - NEW BUILDING PERMIT NO., PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Capacity Total Connected Wad BURNER - Trade Name Size No. Sq. Ft. EDR BTU HP Kind of Fuel Size No. Capacity S, Ft. EDR BTU HP �" �q_C Y Signed By MINNEOWS—co4 Tel. No. Fill out back side for stack verification on replacement furnaces CHIMNEY 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 connected Yes ( ) No ( ) 6. Has Total heating BTUs of All other BTU's TOTAL Rema rk s Company Signed By Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATIOV AND AIR CONDITIONING SYSTEMS AND DEV I `/S JOB ADDRESS -44�e /® M C9 A RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ that all the facts and representations stated in this application are A. true and correct. I a— i 0 ,1991 Gas Piping (Nfaeded with new furnace) $10.00 $ Gas Range Gas Dryer $10.00 $ $10.00 $ "Air Conditioning - All Sizes $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ ksf 0 Commercial/industrial 196 of Value of Appliance or Work $ State Surcharge $ .50— TOTAL FEE s - MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. i J BUILDING USED AS ESTIMATED COST �� L2 - PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Miran�gasco #342 -?,6 Signed By inn ani :..,r.._ VIVw. N -111 P. ®. Box 1165 Minneapolis, MN 55AA ^ Approved By Rough -in Date Final Date 2.9 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY 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 Remarks List Alterations Being Done: B l 1 %.� HEATING COMPANY Signed By Date -AfffP Jug 700 W. Linden Avenue R^ Minneapolis, MN 55440-1165 SUBJECT City of Fridley 28703 AT THE TOP OF THE TWINS BUILDING PERMIT ' , L 5723 M NITV DEVELOPMENT DIV. NO. r 1 ~ PROTECTIVE INSPECTION SEC. ® , G/ 1 � 1 . � 'v/'02/ NUMBER REV DATE PAGE OF APPROVED BY 1 /�"1 CITY HALL FRIDLEY 55432 IL"' �'� -A.. 612-571-3450 910-F15 12/3/98 JOB ADDRESS ' 4965 Roman Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Summit Manor - South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Skwarek572-8687 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Top Notch Exteriors 218 L n479-11RIAR 9005171151 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 qx REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house and garage; New window wra-ps 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCY GROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED 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 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 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 RE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $15000 $7.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC RGE PROVISION OF NY OTHER ATE O OCAL LAW REGULATING CON- STRUCT OR HE PER ANC CONSTRUCTION 224.75 FiCH SC $15.00 PLAN CHECK FE TOT EE Li 5 0 52.25 SIGNATURE OF CON'RACTOR A ZED AGENT 1OATEi EN RO I THIS IS Y PERM I S-GNATURE OF OWNEROF OWNER BUILDERt iDATEi OLD9 INSP p.TE lb NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ®� ConstructionAddress: Legal Description:�� Owner Name & Address:, Do L),e w Tel. MN LICENSE # Contractor: 7c �� L, ,_ �E� ,� �b� -50 y Address: Tel. —3 6 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: &�f uJ t"j, �"4�- License Surcharge \\ $ 0 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Construction Type: Erosion Control Estimated Cost: $` ®® Park Fee $ (Fee Schedule on Back) Driveway Curb Cut Width NPPAPA• DATE: J� —a3 —5 Ft -L A Ft - Ft v Q: Ma Tel. &,--7 STIPULATIONS: CITY USE ONLY Permit Fee $ c , CJS" Fee Schedule on Reverse Side Fire Surcharge $ 00 .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge \\ $ 0 $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: Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit N0. _ Received By: Date Rec'd: 15r - DATE S /b —O6 YOUR �EJ-MAIL^ ADDRESS SITE ADDRESS %�%6S o�ea�I • ®J T-_ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE ❑ OWNER OCONTRACTOR NAME: t� h'el D�.II,"t7cc; 9': ADDRESS: yV6� CITY. PHONE: 4051- 3 3-% a! TEO STATE LICENSE # A03'66210 AEXP DATE '� 3 (- 07 � ADDRESS: 3 oa A7,9 Aa6I H 7/,,; / CITY 3�y�Icy�o f.G� STATE -44656020 PHONE�i r � - 3�7 FAX 7� 3 � �d6 e% 1i y ®' SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMU Y/NEW CONSTRUCTION STORIES ❑ ADDITION ❑ GARAG ❑ BASEMENT FINISH ,IROOF ❑ DECK ❑ SIDING ❑ SWIMM TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCEREPAIR ❑ REMODELING DESCRIBE WORK BEING SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES are S GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TVPP OF WINDOW TO BE INSTALLED ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �c '41-7(o -OCCUPANCY TYPE 2 HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS ❑ WINDOWS ❑ DRAIN TILE ❑ OTHER HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations Permit Fee $ l ,O -S' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ a-0 L] .0005 x Permit Valuation Minimum $.50 License Surcharge $ �'. $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( } Total Due $ Make checks payable to: City of Fridley Attach Stipulations 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 application 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 of all work which re and approval of plans. J / 'E' SIGNATURE OF APPLICANT PRINT NAME��%�? l�Jy`Y�/�� DATE