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PRE 2010 DOCS. -*E, 2319 1 City of Fridley, IM C1ON F NG No. Street _ Part f Lot Lot ock Addition or Sub -Division �. w A Corner Lot _ Inside Lot _ Setback Sideyard _ v Sewer Elevation A e I0 ._._ Elevation 00 J-®° 4 D To/' o F %'oo r%rv6 DESCRIPTION OF BUILDING To U Front Depth Height Sq. Ft. Jd�w Cu. Ft � Front Depth Height $""" Sq. Ft Cu. Ft Type of coon - Est11"!To be Completed ArF'EARiJNCI 'JP MIS- APPROVED VARIANCE WITH OTHER SU1LiiN'Q� IN 'i :ik BLOCK. In consideration of the issuance to me of a permit to construct the buildin described above I agree to do the proposed work in accordance with the description above fo and in plian with a'll provisions of ordinano� 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, S�iinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �' ', /--A Building Inspector NOTICE: 1Ws perndt dons not cover the eonstrneHon, hntaMon for whing, plumbing, gas beating, sower or wrier. Be sore to we the Buildhig Inspector for sopen to permhs for these Roma. City of Fridley Application for PlumWng and Gas F*Nng Pcmat Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK �� J Number, Kind and Location of Fixtures City of Fridley: The undersigned hereby .makes application for a permit for the work herei 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 fact and representations stated in this application are true and correct. Fridley, Minna X �/1' , 19 Kind of Building L 01 Used as To be completed about PLUMBING FIXTURE RATES: Number Fixtures .............— NO. RATE TOTAL x $1.50 U N -4--C' Future Fixture Opening ................ 17 a x 1.20 $ � c��°d x 1.00 $ Catch Basin .... . ..................... Water Heater (Up to 200,000 BTU) ...... Zx x 3.25 2.00 �p F N WATER HTR. GAS ELEC:. Base 1st 2nd 3rd 4th ° Future Cons►ection Openings New Fixture, Old Openings I Connected with Sewer Cesspool El City of Fridley: The undersigned hereby .makes application for a permit for the work herei 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 fact and representations stated in this application are true and correct. Fridley, Minna X �/1' , 19 Kind of Building L 01 Used as To be completed about PLUMBING FIXTURE RATES: Number Fixtures .............— NO. RATE TOTAL x $1.50 U N -4--C' Future Fixture Opening ................ 17 a x 1.20 $ � New Fixture Old Opening .............. x 1.00 $ Catch Basin .... . ..................... Water Heater (Up to 200,000 BTU) ...... Zx x 3.25 2.00 $ $ p New Ground Run Old Bldg. ....... .... x 3.25 $ Estimated Cost, $ Old New. uilding Permit ROUGH GAS FITTING FEES: NO. RATE TOTAL FINAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...........................$ TOTAL FEE $ F– =. By ,A� %Z/e Business Phone N 5 M SUBJECT PERM. City of Fridley161.69 AT THE TOP OF THE TWINS BUILDING PERMIT P RECEIPT N • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �� I � S CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 5/11/81 JOB ADDRESS 8101 Ruth. Circle N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. lO 5 Rourdeaux's Spring Brook SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Kenneth Jorgensen 8101 Ruth. Circle N.E. 784-8479 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sane 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. SEPERATE PERMITS REQUIRED 'FOR WONG. 6 USE OF BUILDING HEATING, PLUMBING AND SIGNS. Residential 7 CLASS OF WORK ❑ NEW ElADDITION ElALTERATION ❑ REPAIR ElMOVE ElREMOVE X 8 DESCRIBE WORK Construct a second accessory arae (30' x 24') 9 CHANGE OF USE FROM TO STIPULATIONS Special Use Permit approved by City Council on 4/22/81. Stipulation that when present garage is converted to living space that the driveway be removed. Detached garage can never be attached to the dwelling unless frost footings are ins-talled. DRIVERAY DEPRESSION ESCROW: 18' + 6' = 24' x $13.50 = $324.00 IN#MG. Before digging cell local utilities TELEPHONE - ELECTRIC - OAS Ett. REQUIRED BY LAWS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 720 7200 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 $61504 $3.40 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- $25.50 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE NONE $32.20 SIGNATURE OF CO T ACTORAUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER (IPSVJNERB LDERI IDATEI BLDG INSP DATE M CITY OF FRIDLEY APPLICATIO;I FOR RESIDENTIAL BUILDING PER14ITS (New, Alterations, Additians., or Repairs) OWMER: , ,� �p � � �� DUILD'ER: ADDRESS: KZd Z �� I-� ADDRESS: TEL NO: 9SyzX Fe� TEL NO: Construction Location STRIMT NO: STREET: /� �-� �°��/ Q_ f LOT: �� BLOCK: � ADDITION: �JU_J1 PGS ��I' a� 5PA?�1 r 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 - 46 cf-- Front: 30 Depth: Height: l Q Square. Feet: 122 ( Cubic Feet: _2,200' Front: Depth: Height: Square - Feet: Cubic feet: Type of Construction. (J_)C,)0f) Estimated Cost: �� 0 r To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: 0� • 6 $ 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. DIME: SIGNATURE: Stipulations: ��ri�f� C-� ��/►'L �T 14c0P/2. 6-4 0 /,J AI -J,2 - 8 b u, �J& ,42 F C -4,v di4 r4C, e �� 77) LiS6 Cl -<JL - SS ' ENGINEERS AND SURVEYORS ' . LAND I®UgVEYINO 5011-5 TESTING CIVIL & MUNICIPAL ENOINEEWN.O LLNO PL.i.NNINO T 0 G418-5r,T" AVENVE N. MIMNEAP01.15 7t, MINtd. KE -t- 3637 ilk Y7/ a / R.u-Tr� rf PtE Mir Rt by CERTIFY THhT THIS 15 ATP,:.'£ AMD CM2Pl:CT RFt`USENTXTI M OF K SL,^VEY OF TkE 50UNDMIES OF THE. LILL40 P.BOVE DESCRIBLD, AND Or -19F LOCM IMI OF ALL DOIL0114GS. IF A*IY, TVIE: j1 SUBJECT IT -No. City of Fridley ® 18857 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ( `L _____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � ` CITY HALL FRIDLEY 55432 NUMBER REV. DATEPAGE OF APPROVED BY L 612-571-3450 910-F15 4/6/87 JOB ADDRESS 8101 Ruth Circle N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 5 1 Bourdeaux's Spring Brook Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kenneth Jorgensen 8101 Ruth Circle N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Chris' Construction 240 Longfellow Street N.E. 784-7142 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 0 NEW ❑ ADDITION ❑ ALTERATION C7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. 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 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 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 $1,800 $•90 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S RUCTION ORH FORM CE OF CONSTRUCTION. $29.50 _ -� PLAN CHECK FEE TOTAL�5b • 40 SIGN TURE OF CONTRACT R OR AUTHORIZED AGENT (DATE) VtiyiN PROPERLY LIDATED THIS IS YOUR/PERMIT BLDG RVSP n TE� SiGNATURE OF OWNER IIF OWNER BUILDER) IDATEI j1 NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address:YC%1 Legal Description: �/ �1 Owner Name & Address: ��/�' &AtM# ^`� �� Tel . # Contractor: e Tel. # Address: 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: �� 's'OO� Estimated Cost: Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: ` ��"� r% / - /'7 S� Tel. CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By:1)1(4 763-572-3604 $ ' Plan Review CITY OF FRIDLEY 763-502-4977 FAX $ r . b .001 times the total job valuation EFFECTIVE 1-I-2010 $ 1 �r � License Surcharge $ DATE % ` �r v YOUR E-MAIL ADDRESS $ SITE ADDRESS fo t V kO' EA- /i- E_ $ THIS APPLICANT IS: ❑ OWNER VICONTRACTOR $ PROPERTY OWNER/ NAME: fy\ Ar'o \J $ TENANT ADDRESS: CITY l�R'ey STATE ZIP —� $ Agreement necessary ( ) Non Necessary ( ) PHONE: -T&-3 - AW -- 51 2- k CONTRACTOR NAME: � -S- SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # �i _ Ct EXP DATE AND CERTIFICATE OF ADDRESS: / CITY CA sI J l STATE-, ZIP—'S--.-3t'5-- IP'S--.-3t`fINSURANCE INSURANCE PHONE 41, — � � �— FAX �'/ 5� —44R7-0 0 qJf PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 241DING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR MODELING DESCRIBE WORK BEING DONE: R t - s C 1 avg C <kAr� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT �OIJ ROOFING Q HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, tVinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum 11 Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ ��QSIG THE 1997 U.B.0 FEE SCHEDULE)OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ r . b .001 times the total job valuation Surcharge $ ? .0005 x Permit Valuation Minimum $.50 License Surcharge $ �� $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due a Make checks Davable to: Citv of Fridlev Attach Stivulations 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 of to start without a permit on site; that the work will be in accordance with the approved plan in the case o=wo hich ruires revw and approval of plater s r SIGNATURE OF APPLICANT PRINT NAME /' k2C �( �S� 1� DATE �' 3G (�