PRE 2010 DOCSCity ®f Fridley, Mm.
BUHDING PERMIT w® .6616
s &10 cA Builder
Address
-SA' e [L -r I LOCATION F BUILDING
No. Street Part o t
Lot _ Block Addition or Sub -Division
�® v
Corner Lot Inside Lot — �1 Setback M____ deyard
Sewer Elevation — Foundation Elevation
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 seforth and in con/i.Hance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $j:C , 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, Mitmesota 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. _ ---,%
Building Inspector
NOTICE.
Ufa permit does not cover the construction, iastaQatien for whing, phmbing, gas headn& "War or water. So sure to see
the Building Inspector for separate permhs for these hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
i
ADDRESS Arod ADDRESS z4r-a
LOCATION OF BUILDING
No. Strae.t II Part of Lot
Lot Block Addition or Subdivis on ,,�• y ��
Corner Lot Inside Lot A -*O" Setbacks oS' Side Yard
SEWER ELEVATION FOUiTDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing
uild-ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
�e�
Front Depth ?X � Height
Sq. Ft. (® Cu. Ft. -
Front / Depth Height
Sq. Ft. Aja Cu. Ft.
Type of ConstructionEstimated Cost
To be Completed
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.
s
DAiE SIGNATURE
('Schedule of Fee Costs can be found on the Reverse Side).
a p
City of Fridley
Application for Plumbing and Comas Fitting Pornrit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
............... x $1.50 $
Future Fixture Opening ................ x 1.20
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 2' -
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL s
1st 3 Fixtures ..........................� x $1.50 $—/ r - V'
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
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.
U
Owner
Kind of Building
Used as
To be completed about
V
Estimated Cost, $
Old New uilding Permit Permit o.
ROUGH � � 7 — (�
FINAL
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Business Phone
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2nd
3rd
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' Connected with
• Future Connection Openings
Sewer
e New Fixture, Old Openings Cesspool 0
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
............... x $1.50 $
Future Fixture Opening ................ x 1.20
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 2' -
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL s
1st 3 Fixtures ..........................� x $1.50 $—/ r - V'
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
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.
U
Owner
Kind of Building
Used as
To be completed about
V
Estimated Cost, $
Old New uilding Permit Permit o.
ROUGH � � 7 — (�
FINAL
az 2M
Business Phone
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SUBJECT
PERMIT N
City of Fridley
X679
AT THE TOP OF THE TWINS
BUILDING PERMIT
'
r
ECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 . r
CITY HALL FRIDLEY 55432
NUMBER
REV. DATEPAGE
OF
APPROVED BY
612-b60-3450
910-F15
15 7 4
JOB ADDRESS
130 Satellite Lane N.E.
1 LEGAL
LOT NO. BLOCK
TRACTOR ADDITION, SEE ATTACHED
DESCR.
3 1
Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Robert Lee 130 Satellite Lane N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sam
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Garage resent` garage converted to bedroom
7 CLASS OF WORK
❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Detached 24 x 26 garage
9 CHANGE QF USE FROM TO
STIPULATIONS
.1. Provide a hard surface driveway.
SEPERATE PEONIITS REQUAREO FOR I RING,
HEATING, ,pLA N SING NO S1GAo
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
wand fraMm
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED ISNOT COMMENCED WITHIN 60 DAYS, ORIF CONSTRUCTION
624
6,240
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.
$3 3O%.2O
1.65
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
12.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
3.65 ti
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHE -PROPE LY
LI EDT IS. IS. YOUR PERMIT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
- BLDG_INSP. DATE
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME • //) /_ BUILDER:
r
ADDRESS: 13 D J 7C L ` , i --e 1.4,-1 e ADDRESS: 'f
NO:. J 3 0 STREET:
LL I /-C Z'/ -a ^,/If
LOT: �BLOCK: ADDITION: 'J'1; ,Z
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.
To Be Used As:
DESCRIPTION OF BUILDING
Front:. Depth: 2-6 Height:
Square Feet: 2 Cubic Feet:_ i 2 `9
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: W 0 D D F2 6 e Estimated Cost: D
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stiict 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: f� 4 / I/q�YSIGNATURE:---
(See Reverse Side For Additional Information.)
/ d-zi
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997
6431 University Ave NE
Fridley, MN 55432. APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Si
Tel No.
Approved By �CU Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOJ STACK VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
JOB ADDRESS . Ly'
RATE SCHEDULE
_
The undersigned hereby makes application for a permit forthe work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace
$ 30.00
$
representations stated in this application are true and correct.
(Side Vent -- Fill Out Back)
® /®' ' ,1997
Gas Piping (Needed with new furnace)
$10.00
$
OWNER / 6
Gas Range
$10,00
$
BUILDING USED AS
Gas Dryer
$10.00
$
ESTIMATED COST PERMIT NO. �C
*Air Conditioning — Ail Sizes
$ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
Al Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water) arm Air
Trade Name W,4jc,6 Size No.
Commercial/Industrial
BTU e' - HP EDR
1.25% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
.50
Burner Trade Name Size No.
BTU HP EDR .
TOTAL FEE
1
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Si
Tel No.
Approved By �CU Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOJ STACK VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
CMAMY 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( Jy No { )
6 Has total heating BTU's of .9 If
All other BTU's Pau
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks: .
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
Yes 44 No { )
Yes" No ( )
SUBJECT
City of Fridley
26217
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
',
R EIPT NO.
I _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
e ,
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE Of
APPROVED BY
612-571-3450
910-F15
6/12/98
JOB ADDRESS 130 Satellite Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bob Lee 130 Satellite Lane NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Mike Lunemann Construction 11617 Zane Cir, Champlin,.
MN 55316 421-7726
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20045212
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House (15 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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
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
$.62
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,251
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-
$43.00
Fire SC $1.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTf$/49.87
flog�
Licen C $5
0
IG TURE OF CONTRACTOR ORA'11,
HORIZED AGENT (DATE,
E P P
je�pf
,g INSP
VALIDAT D HIS IS YOUR PERMIT
DATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 l/
BUILDING PERMIT APPLICATION
ConstructionAddress:--
Legal Description:
Owner Name & Address: Tel. #
Contractor: VM f!k� C �� e _ _ _ _ _ �,�n MN LICENSE # 1000 1 C -Z 12 -
Address:
ZAddress: //y / '% Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Le gt Width Wt/Ground Sq. Ft.
OTHER: '() /L -'Ll - S e_
Construction Type: 4,° �..,��� Estimated Cost: $ L l�S%
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: / APPLICANT: IP14.r LaVNr~ri Tel. # 2 %
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
$ -496-2
,
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
Building
BUILDING
Permit No.. - ° _
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: l i
763-502-4977 FAX
EFFECTIVE 1-1-09
DATE z/ D YOUR E-MAIL ADDRESS
SITE ADDRESS / '3
THIS APPLICANT IS:
,OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: -5-e-e— j �
TENANT
i
ADDRESS:_1 3 0 S
hTe LL,* fiQ LN. CITY ��'�. !d/., 1, STATE//°/ ZIP�.i 3 Z
PHONE: 7 L 3 --3-2/_— 7 6 '7 9
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE .
AND CERTIFICATE OF
ADDRESS: CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
X51NGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ,MOTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION 0 u e,b CUT—
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: &F4 L my S cop-6
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
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,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
11 Aluminum
❑ 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 ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
SAC Charge
CagbXut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= P-7 ftx$22=$6CI -4
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary { )
Make checks savable to: Citv of Fridlev Attach
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 on site; that the work will be in accordance with the
approved plan in the case of all wgk,which requires review and approval of plans.
SIGNATURE OF APPLICANTr a�L -mow � � PRINT NAME 14 L r DATE /
y