PRE 2010 DOCSCity of Fridley,,. Minn..
BUILDING PERMIT
Date: - August 5, 1969
Rec. #
Owner: Random Incorporated Builder Random Incor2orated
Address 700 -77th Street Circle Pines Address Same
LOCATION OF BUILDING
No. _ 8181 Street Ruth Circle Part of Lot
N° 10357
Lot ._.__2. Block ____5 Addition or Sub -Division Rc)r eauxI s 8Y ri ng Rrank
Corner Lot — Inside Lot X Setback 351 Sideyard 151
UM Elevation X651..66_ _ _ 854,66 ,ApproX.
Wye Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
3welling Front 40 t — . Depth 281 Height 20_ Sq. FL 112 0 Cu. rt 2- 4
raga LL -
Front _22__ Depth _ 24 1 Freight _ 10.! _ Sq. Ft. 528 Cu. Ft.
Type of Construction - FramQ Fst. Cost 818,90Q -_ To be Completed gO 7 aYS
SEWER LOCATION: 521 West of Manhole
Note: 5/8 Subfloor and Pilaster.
WATER LOCATION: 621 West of Manhole
Provide Hard surfaced driveway.
In consideration of the issuance to me of a permit to constru the building described above, I agree to do
the proposed work in accordance with the description above set f and in compliant all provisions of
ordinances of the city of Fridley. e
R1n0-00 Better Cnnnaaljon C!ha.rge
In consideration of the payment of a fee of $ n 7 - nn , permit is hereby granted to Rn-na nm T-nnnrr,nrated,
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 violation of any of the provisions of said
ordinances. _'� t
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be mne to see
the Building Inspector for separate permhs for these items.
,:
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNEC 'S NAME A/C' BUILDER /91
ADDRESS 7vD ?7 S i x C `,/� DRE S
LOCATION OF BUILDING
NO.
STREE°I'
LOT BLOCK ADDITION OR SUBDIVISION®!S'p R/L` a
I
CORNER LOT INSIDE LOT SETBACK ��` r SIDEYARD f
SEWER ELEVATION TOP OF FOOTING
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:
Front Depth c Height"
Square feet Cubic Feet F)'
Front o Depth Height
Square feet, r - °_Cubic Feet
Type of Construction �� Estimated Cost
To Be Completed 1?e
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 applicat' on a e true and correct o
DATE ® SIGMA
(Schedule of Fee Costs can be found on the Reverse Side.)
I 4 4. �(
a
DevicesAir Conditioning System -and
GRAVITY WARM AIR:
IRATE TOTAL
Furnace Shell & Duct Work .........:.................
$10.06 $
Replacement of Furnace ............. I...............
6.00 f
Repairs & Alterations—up to $500.00 '.................
6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
CH. 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 .............. 3.00 S
STEAM or HOT WATER SYSTEM
Furnace Shell & lines—to 400 sq. ft. EDR Steam .... .$10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $
Each add. 200 sq ft. EDR Steam ........... ....:...... 3.00
Each add. 320 sq. ft. EDR Hot Water . ... ............ 3.00
OIL BURNER—to 3 gal. per hour ....: ' ... ... ......... 6.00 $
over 3 gal. per hour—See Fee Schedule
.✓ ® 4)
GAS BURNER (up to 199,000 BTU) .......:.............:.. 8.00 $�
over 199,000 BTU See. Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 100 $
Additional Fixtures .................. x .75 $
Gas Range to 199,000 ....... x$.800 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM _
ALTERATIONS & REPAIRS TOTAL FEE ' 00
UGH
FINAIe /D - 7 " i /
Dept. of Bldgs. Phone 880 -MW
City of Fridley:
The undersigned hereby makes application . for a permit for the work hereic
specified, agreeing to do all work in strict accordance with the City Ordinance:
and waling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct. //''
s�dley, RA'inn- �. ,- ISO
Owner
Kind of
Used a.
To be completed about
Estimated Cost, $
Oldj¢New�Building Permit No. f! / Permit No.
DESCRIPTION OF WORK
HEATING or PO N1�Sbwn, Hot Water, Warm Air—No /
Trade Nam size No
Capacity Sq. Ft. E.D.R BTU HP.
Total Connected Load Zlt Kind of Fuc
BURNER — Trade Name Size Noo-
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OYER)
SUBURBAN
SIB RB AIR "OAID1T161Vt
Sgned
Nupoui H
>g
Business Phone No
e+J
w
�
TOTAL
Number Fixtures
x $200
$
i z • !
Future Fixture Opening..
'3_ $1.50
x
Z
Bg Z
U
Q
$
(
$
(�
a
3 O
9
F
0
N
WATER HTR.
GAS
ELEG
Base
$
°
New Ground Run Old Bldg.
x $3,26
$
Electric Water Heater
z $200
S.
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures .... .... .... ......
lst
$
?additional Fixtures ..... ..............
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
2nd
3rd
—
--- -
4th
° Future Cal Openings Connected with— -- Now Mzture, Old Cesspool
I El
PLUMBING FIXTURERATES:
NO. RATE
TOTAL
Number Fixtures
x $200
$
i z • !
Future Fixture Opening..
'3_ $1.50
x
$
�' o
New Fixture Old Opening
x $1.50
$
Catch Basin ..
x $3.26
$
Water Heater (Up to 99,000 BTU)
x $3.00
$
°
New Ground Run Old Bldg.
x $3,26
$
Electric Water Heater
z $200
S.
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures .... .... .... ......
.. x $200
$
?additional Fixtures ..... ..............
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Come
Description.................................. .............
TOTAL FEE
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, Minn- A -U L V 3 T 2Ir 190
Owner . flAnon Homes . ,rjN c. -
Kind of Building F�AMia
Used as
To be completed about NeygMa-g
Estimated Cost, $ i3 DO
Old—New. Building Permit No.—! C3,, —3-5- —Permit No. 7 -
Signed - 5mrs �i°t3G ��F1 �T6 IIe1C.
By-, 71'
Business Phun No. 71M. -1000
ROUGH
FINAL & ✓f - %/
Origin Permit for rLUM61NG AND GAS FITTING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit..
Number, Kind and Location of F=turt es
Stories
u~i
o
Q J
3 0
Q
z
C
nX
m
` O
m
z
1Q
Q
m
R
x
Z
'm
x m
'
4 y
3
z§
K O
o u
o
I
m
x Z
°o 'a
J C m
u o
3
4 a
K J
m
a
W
(
WATER HTR.
GAS
6LEC.
Basement
ist
2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
n
Permission is hereby granted - CO do the plumbing and
gas fitting in the building described in the statement hereto d7tached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
az 1M ---"9-v
N? 5002
c1f�e�3
Permit
Fes$ 4 --SO
City of Fridley
Owner ® 4
Location
Kind of Buildi�rg /.
Used as
To be Completed 1 ,19
Estimated Cost . / ` 0-1c)
Old -New. Building Permit No.
Data
V
Inspector of Buildings.
Original
PERMIT for Power Rants and Ideating. Cool=
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No.ea
pg Plants
to
a installeraltered---repaired
Make
Oil fired—,- Coal fired ; Gas frred ; Gas Authorization
Remarks
Approved by
Final Inspection Date , 19_
Inspector
Permit N° 4584
Fee $ / 7 • Liz?
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.; -
Owner
Location �l �/ 2 J_ �e� n -
r
Kind of Building
How Occupied--�''
Work to be Commenced 191-1
To be Completed / / / 19-64
Estimated Cost, $ e" _S�-C . 0--e
Old -New, Building Permit No. / 0$3 -
Permission is hereby granted to to install,--erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
,Inspector of Buildings
42 2m 11-67 v
suedEcr
-PER
City of Fridley
5 44 4
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
rp
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r tr OOe—_-� PROTECTIVE INSPECTION SEC.
H)50)
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
Ao f "•j 612-571-3450
910-FlS
8/29/97
JOB ADDRESS 8181 Ruth Circle NE
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
5
Bourdeaux's Spring Brook
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Roger Peet 8181 Ruth Circle NE
717-0769
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 4
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment 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
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
$2,085
$1.04
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-
$74.75
Fire SC 2.09
CTION OR THE 0SMANCE OF CONSTRUCTION.
�—L 1 _ \
PLAN CHECK FEE
TOT EE
7.88
9NGNATLVEOFCONTRACTORORAUTHORIZEDAGENT IDATEIEN
OP
RLIDA
BLO Z
A HIS IS YOUR PERMIT
•
GATE
S,GNATURE OF OWNER of OWNER BUILDERI IDATEI
NEW [ )
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor: S L --�-
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
-I—
Effective 1/1/97
`L/ �)9 �
Tel. # `1. 1 -1 O
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
Length
Width
Length
Width
Length
Width
Height
Height
�- 6 S
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Estimated Cost: $ 2 0 2 j - 6�: C�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft =. Ft x $ = $
DATE: C�'� APPLICANT:_Tel. # CI
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
$ Cq .001 of Permit Valuation (1/10th%)
$ oy $.50/$1,000 Valuation
$ $950 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 [ ]
$ �l, e;
Effective On May 10, 1999
CITY OF FRIDLEY INSPECTION DIViSION
017431 University Ave NE
APPLICATION FOR POWER
PLANTS AND
HEATING, COOLING, VENTILATION,
'. Ridley, MN 55432
q(72.3604 REFRIGERATION
AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
c�lEDut�fc
OWNER i�IA �A k►
�'-ttesidenlial Rate
TOTAL
BUILDING USED AS
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00
s-3-6,06
SD 0 06 PERMIT NO, I ��
(Side Vent - FIII Out Back)ESTIMATED
COST .
Gas Piping (Needed with new furnace, $ 10,00
S
t3F FURNACE AN �It
but not replacement)DESCRIPTI®N
Gas Range $ 10.00
$
No. of Heating Units Circle One (Steam) (Hot Water) arm Air
(n
~ Gas Dryer $ 10.00
$
Trade Name ,� Size No.
HP EDF
BTU :'2c_, 900 � —
;Air Conditioning • All Sizes $ 25,00
$
Fuel )V- Q� o,2�!2 Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No,
HP EDR_
1% of Value of Appliance or Work
$
BTU
t
-ammercia V industrial
$
The undersigned hereby makes application for a permit for the work herein
1.25, of Value of Appliance or Work
specilied agreeing to do all work in strict accordance with the City Codes an
State Surcharge
$ .50
rulings of the Build! ng Division, and hereby declares that all the facts and
representations slated in this applicallon are-true and correct.
$ �Q . S[a
River City Sheet Metal,
TOTAL FEE
9929 Bluebird St. N.W.
_
o
Coon Rapids, MN 55433
mIMMMM p FO NY HE TIN / O GJVENT
HEATING Cot754 2-908
FRIQ RATI N/AIR CONDITIONING PIEI 2 .
Signed DATE
p�uS THE g,Sp STATE SURCHAEGE
REINSPECTION FEE $47.00/Hr
9, *Air Conditioners can not be placed in a side yard without
Rough-In Date Final Date
Approved 4SIQEF
ri `wItten permission from adjoining property owner.
FI O T BAG FICAIION ON REP A MENT A
SUBJECT
r
ERM NO.
City of Fridley
31907
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
o
RECEIPT NO.
U' e _ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC-
612 36®4
i"'1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-34,50
910-F15
6/18/01
10B ADDRESS 8181 Ruth Circle NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
2
5
Bordeaux's
Spring Brook SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Marvin Makie 8181 Ruth Circle NE
763-780-1992
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Window Lite Home Imp. 8400 89 Ave N, Brooklyn Park, MN 55445 763-425-2227
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20039258
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW O ADDITION O ALTERATION J REPAIR 0 MOVE O REMOVE
B DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM
TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior
sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Permit WsP®c$ion Cards
W'11 B8 Mail®d
TO Homeowner To Post
SEPARATE PERMITS ARE REOUIRED 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 ABANQONED 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
$13,216
$6.08
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.
$237
Fre SC $13.22
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
.25
PLAN CHECK FEE
AL FEE
Lice C $5 0
1$261.55
SIGNATURE OF CONTRACTOR OR AUTHORIjEO AGENT IDATEI
E P LY V LID ED THIS IS�YOU PER
OG INSP /v/•J/n OAdf l
S-GNATURE OF OWNERaF OWNER SUILOERI IDATEI
NES 04 oo j��3 7d 5l
ADDN [ ]
ALTER [ ]
ConstructionAddress: —[
Legal Description:
Owner Name & Address:
Contractor:, /`� `nLo
Address: /J'7 0- S?9
EM MAY 2 3 2001 Effective 1
CM OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 44/o 515
BUILDING PERMIT APPLICATION
Ir
`W/
Tel. # % 3-
,0-/
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
Length
GARAGE AREA:
Length
DECK AREA:
Length
OTHER:
DESCRIPTION OF IlVIPROVEMENT
Width
Height
Width
Height
Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type:C4` Estimated Cost: $ /,,;T 4 o2 .
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. # 21 /-4p�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
oil
SUBJECT
PER
do City ®f Fridley
0 9 2 4
IF AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
v e__�__ COMMUNITY DEVELOPMENT DIV.
f 1 PROTECTIVE INSPECTION SEC.u4l
1 a
CITY HALL FRIDLEY 55432
NUMBER
pEv
DATE
PAGE OF
A0PROVED BY
'
L J` 612-571-3450
910-F15
5/9/00
JOB ADDRESS 8181 Ruth Circle NE
T LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
5
Bourdeaux's
Spring Brook SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mary Makie 8181 Ruth Circle NE
780-1992
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Window Lite 8900 89 Ave N, Brooklyn Park,
MN 55445 425-2227
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 C2 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Window Replacement
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms
and on all levels of the
dwelling per Section 310.9.1.2 of the 1997
Uniform Building Code.
Pe fill 0 1.�
n fards
Will Be? Mall®d
l DMODWIner To post
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
$7,966
$3.98
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 FAL
FEE
Licen $5.0
7170.20
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE,
HE"VAL10,43F.D THIS IS YOUR
/PERMIT
BLCA INS MATE
SIGNATURE OF OWNER,IF OWNER BUILDER, IDATEI
oil
J
NEW [ ] 10rr -.:— , /IJ99
ADDN [ ] CITY, OF FRIDLEY ,
ALTER [ ] SINGLE FA 1ILY AND DUPLEXES R-1 ANA�
BUILDING PERMIT APPLICATION A
'l D
ConstructionAddress
�C.1
���a RU�, rckc
Legal Description:
Owner Name & Address: M or q QYKAe, Tel. # htx8) 1$0 - 15RZ
Contractor: W i n bow MN LICENSE
Address: $C(OD 99+h tiV C. fV RmoK.� n Pct K, rA y45Te1. # (ilk �1Z5'ZZ Z %
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:
I ��� 00
Construction Type_: Ge.M n� Estimated Cost: $ Q (�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: LA -25-2-000
Permit Fee
$
Fire Surcharge
$ r
State Surcharge
$ J, 9
SAC Charge
$
License Surcharge
$ 5'r
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
CITY USE ONLY
Cel. # huz) ' iz-2ZZ 7
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.501$1,000 Valuation
$1050 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 [ ]
0
TOTAL $
STIPULATIONS:
-17
5P,42 7
s�-
30ding
hspections
763-572-3604
'ITE ADDRESS
WS APPLICANT IS:
qa.. I CITY OF FR I DLEY
BUILDING
REST DENTYAL APPLICATION
CI'T'Y OF FRIDDLEY
.-00 YOUR E -
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICA'T'ION
PROPMTY TYK
PERMIT TYPE
TYPE OF WORK:
D OWNER. OOMACTOR
qcf
Permit NO.: r =
Received By:VC,
Date Recd:
NAME: (� t �►. c � � �
ADDRESS: CITY STATE ZIP
PHONE:
STAT£ LICENSE E)W DATE
DESCRIBE WORK BEING
MPA:4
GA&t GEES
PROPOSED SIZE:_
PROPOSED EEIGHT:
.%DING
o Vinyl
❑ AlumiM=
0 Other
W�FflO�F'S
IN E7QS7XNG OPENINGS ❑Yes ONO
OR FOR NEW OPENINGS-DESCME SIZE OF
OPINING CHANM &
TYPE OF WINDOW TO BE INSTALLED
VALUATION, MCL.UI ING COST OF
U
(USING TVE 1997 .B.0 F'EE SCHEDULE)
❑ HOUSE & GARAM
❑ ATTACKED GARAGE
0 DETACHED GARAGE
pSofit
II Trim
❑ Fascia
LOCATION OF WR=WS
NUMBER OF
Q DRAIN TILE
1] OTM
Permit Fee
Flan Review
Surcharge
Fire Surcharge
License Surdwge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Foe
Sewer Main Charge
V
�a
Ft.
>vnT:
1. Eadsft Floor Plan
2. Pmpmd iicer Pico
3. List of smmDual members to ba: used
FOR NEW CONSTRWMN INCLUDING DEW,
ADDITION&
1. Sim Plaa Sinvey sha*ft die adstinastruebm
and PmPWW Prodmt
2. Two SCU of aonsnuaxim PIM
3. Eaeigy Caivdations
See Back Page for Fee Schedule
65°f0 of Building Permit Fee
(.0005) times the total job valuation — Mk i mum $.50
.001 x Permit Valuation (1/10°!0)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Pians to MWCC for determination)
_ft+68= 8x$20=$
$450 Conservation Plan Review
]Fee Determined by Engineering
Agreement necessary ( ) bion Necessary { )
Maize checks payable to: City of Fridley Attar
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTM PROCESSTD
I hereby apply for a building Permit and I acknowledge that the information above is c ornplete and accUl'atei that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Mi nxiewm Construction Cedes; filar I understand this is not a
permit but only an application for a permit and work is not to start without a per=mit; that the work will be in accordance with the approved
plan in the case of all work w' vires review and approval of plans_ — ®�
SIGNATUitE OF APPLICANT7P�f NAM£
i
Engineering
WATER AND SEWER
Permit No.: F-0
763-572-3552
PERMIT APPLICATION
Received By
763-571-1287 fax
CITY OF FRIDLEY
EFFECTIVE 1/1/2010
Da 'd:
q
APPLICATION DATE: I ' L l YOUR E-MAIL/FAX:
THIS APPLICANT IS: pp❑ OWNER CONTRACTOR _
JOB ADDRESS: ®1 % v itys
NEW CONSTRUCTION PERMIT# (IF APPLICABLE):
PROPERTY
r v1o�
NAME: rh j(LI a Q 0 0 1 i L
OWNER/
ADDRESS:I 1 C�cGc CITY �7rjl� STAT a/11�PZIP
-�
TENANT
PHONE:
CONTRACTOR
NAME: 00
SUBMIT A COPY OFADDRESS:
STATE
r" ilk
Q C/'� 3 0 r�i� [ !0 CITY O IJ In STATE ZIP J� � '7YOUR
LICENSE WITH
PHONE 71a1 5'/9 jq D-7 CELL PHONE: 7423 -Q - 1
APPLICATION
_
STATE LIC # STATE BOND: EXP DATE:
1. Narrat' a/written de4c ' tion:
Ll �' tC l9 Co.-%Ae,-k a < W17111 kh q®evc
2. Please attach sketch showing curb line, utility line, building, etc. with distances on back page.
3. Stipulations: I),AQ_
Z: C,4-z.L 2&,3--5?Z-3552
PERMIT TYPE
U. SEWER CONNECTION PERMIT $50
U WATER CONNECTION PERMIT $50
1.1 WATERLINE REPAIR $40
1 SEWER LINE REPAIR $40
C; ADD STATE SURCHARGE $.50 �>
I: SAC CHARGE @ $2100 =
TOTAL $
OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING
NEW WATER METER COST - SEE UTILITY BILLING
SPECIAL ASSESSMENTS - SEE FINANCE
WATER TAP - SEE ENGINEERING
NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / EVENINGS, WEEKENDS & HOLIDAYS $125/HOUR-BILLED
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but
only an application for a perm' notto start without a permit.
!.jwor�is
' .. s�� 6
�i�
SIGNATURE OF APPLICANT � PRINT NAME: DATE:
APPROVED BY: RATE: l 3 /�
COPY GIVEN 0:,.1s UT LITY B LLING (only if new meter) Ci PUBLIC WORKS F] ENGINEERING
`® City of Fridley
Engineering Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3552
FAX: 763-571-1287
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