PRE 2010 DOCS-3 �7�32,5
City of Fridley, Minn. N9 9456
BUILDING PERMIT
Date: Sept. 18, 1967
Owner: Jo4n, J. Clutter Builder Swanstrom Company
Address Address 1350 Skywood Lane
LOCATION OF BUILDING
No. 1324 Street „_ Skywood Court _ part of Lot
Lot _ _.__ Block 1Addition or Sub -Division _____ Swans trom 1 s Court Addn .
Corner Lot Inside Lot — A Setback 35 ' — Sideyard
Sewer Elevation _— Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 42' Depth 261/28"t 20' Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _622, 000 _ To be Completed 111/68
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 d is compliance with ail p oma of
ordinances of the city of Fridley. � 1
9
$100.00 Sewer Connection Ch rge
In consideration of the payment of a fee of a 41.00 , permit is hereby granted to Swanstrom`s
the
Company to construct the building or addition as described above. This permit is granted upon
express condition that the person to whom it is granted and his agents, employees anworkmen, in all work.
done in, around and urn said building, or any part thereof, shall coffiorm in all respects to the ordinances of
Fridley, Minnesota reg d� 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.
CLAREN'CE BELISLE
NOTICE:
This peewit does not cover the construction, tnctalWon for wiring, plumbing, gas heating, sower or anter. Be sure to we
the Building inspecior for separate permhs for these Items.
AP? uIC11VU..r1 i FOR BUILDING M311 I.T
C!' Y OF SrRxJ:,3 y NiN10SOCTA
OWNER'S NAME� RF; s 1. DER � I
ADDRESS ADDRESS 1. S
LOCATION OF BUILDT?%
N0 ./.�� CwET �,,•� C��� ` =-PART OF LOT
LOT 5' BLOCK __. ADDITION OR SUPDIVISIO �( 4a
CORNED, LOT INSIDE LOT c/ SETBACK SIDE -YARD /e)'
EWER ELEVATION �� FOUNDATION ELEVATION
47,
Applicaht attach to -this form Two Certificates of Survey of Lot and proposed
building location draum on theseCertificates.
y
DESCRIPTICI OF BUILDING
To Be Use , :�s .
Depths Height ✓(�
Sq. Ft. Cu. Ft,
Front Depth Height
Sq. Ft. Cu. Ft.
O
Type of Construction if -yl^"zY ed Cost 'P';� 0C)
Z;;
To Be Completed Q,�� 40
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.
DATE/ f ��� SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
SUBJECT
PERMIT
City of Fridley
1817
AT THE TOP OF THE TWINS
BUILDING PERMIT
�
CEIPT
COMMUNITY DEVELOPMENT DIV.
r 1 PROTECTIVE INSPECTION SEC.
1 � �
CITY HALL FRIDLEY 55432
�.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/23/85
JOB ADDRESS 1324 Skywood Court N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
3
1
SwanstrcmaS Court Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Clutter 1324 Sky -wood Court N.E. 571-4783
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
Reroof Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be the. 2nd layer but not the 3rd.. Ins:ta,ll ridged galvanized
valleys.
1Z 4 P i
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
$�50
$� rj0
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-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$15.50
"X . SIGNATU OF CO TR CTOR RAUTHORIZEDAGENT (DATE)
WHEN PROPEVY VALIDATED THIS IS YOUR PERMIT
8' 3 rr
s
BLDG INSP
S' ATUREOFOWNER (IF O ER BUILDER) ATE)
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] FR -1 AND R-2 I
ALTER. ( ] Building Permit Application
Construction Addri
Legal Description
Owner Name & Address: J a !4N C lUT TIW Tel. # �� 7 - g�
Contractor: J ® HN 0)-Q IT�hT Tel. #
Address: /3 �q JCKYW Ob CRT AJ,M
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
G -d
Type of Construction:
Approx. Completion Date:
Estimated Cost: $ 6 •
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: 0 7 a� 0'5' APPLICANT:UL Tel. # '/,8�
CITY USE ONLY
Permit Fee $ Is -.6)0 Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 6-6 $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
TOTAL $
Agreement Necessary [ ] Not Necessary [ ]
/� . S7J
STIPULATIONS•
SUBJECT
ERMIT NO.
City of Fridley
21682
AT THE TOP OF THE TWINS
BUILDING MIT
t
� 6 _ COMMUNITY DEVELOPMENT DIV.
v _ PROTECTIVE INSPECTION SEC.
6
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
12/1/92
JOB ADDRESS 1324 Skywood Court NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
3
1
Swanstrom ts. Court Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John/Marcella Clutter 1324 Skywood Court NE 571-4783
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Custom Remodelers Inc. 8729 Central Ave NE Blaine MN 784-2646 1748
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
S DESCRIBE WORK
Construct a three season porch.
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations. on plan. VAR 92-23 approved 11/23/92 to reduce side yard
fl= 10 feet to 7 feet. Add smoke detectors on each.level of home if not already
installed.
WARNING
Before digging call for
all utility locations
454-0002
REQUIRE® BY LAW
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 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
VALUATION SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3f693 $1.85
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$63.00 Fire SC $3.69
STRUCTION THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
License SC $5.00 %$73.54
SIGNATURE OF NTR TO ORA HORIZED AGENT ATEI
EN PROW A DATED THIS IS YOUR PERMIT
BLDG iNSF' )ATE
SIGNATURE OF OWNER t IF OWNER BUILDERi IDATEi
VAR #92-23
John/Marcella Clutter
I. k e-
ao
N
S
c
c'u
L Q=T P*LA--:t-ft-�
J
sv SITE PLAN
NEW [ ]
ADDN k -
ALTER]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
l 3 '�- q S
Effective 3/1/92
Legal Description:
Owner Name & Address: C'-! Lc.` -ear Tel. #/- ,V7,F,3
Contractor: �� �, tea® �-� MN LICENSE #4000 / 7
Address: S 74.9j e e2n d �Al i r 1414. XAj Alt l Tel. # !-9 O Y�
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: C'o
Comer Lot [ ] Inside Lot { ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. b Ft =
DATE: APPLICANT -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park . Fee $ --0-
Sewer Main Charge. $ —4e�'
Side Yard Setbacks
Estimated Cost: $ ®�
(Cost on Back)
Ft x $ = $
Tel. #
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$1,000 Valuation
$700. per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above.
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
SUBJECT
PER R
City of Fridley
2 0 0 8
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
__--� COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
572-3604
1
d/
p
NUMBER—
REV
DATE
17/17/01
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 1324 Skywood Court NE z
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Swanstrom's Court Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Clutter 1324 Skywood Court NE
763-571-8582
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Titus N Winger Contracting Inc 17715 12 AVe N, Plymouth, MN 55447 763-475-3175
d ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20270544
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
Reroof House (27 Sq) Tear -off
9 CHANGEOFUSEFROM
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. OWLG. UNITS
OFFSTREET PARKING
1 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
$2,761
$1 •38
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-
$83.25
Fire SC $2.76
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT FEE
Licens $5.0
92.39
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEq
EN ROP VALIDATE THIS IS/�/yjOUR PERMIIST[]
�j p
BLO INSV rsAyt
S.GNATURE NEA0f OWNER BUILDER. IDATE.
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: /j 2 =/ .j-
"Wep es r -A 'AJ
Legal Description:
Owner Name & Address: JdJ.,%��'-cr Tel. #
Contractor:
e-1 -P �„ +° �, . MN LICENSE #.20Z >®J-
Address: 2' .V 1A A AJJ JY,9 Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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. FL
Length Width Hgt/Ground Sq. Ft
Construction Type: Ple - AG.'r Estimated Cost: $ ev
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ .=$
DATE: APPLICANT: _��, Tel.#
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$� Fee Schedule -on Reverse Side
$ �2 , % (a .001 of Permit Valuation (1/10th%)
$� $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ , ®C) $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 [ ]
. V, t
JZITY OF FRIDLEY INSPECTION DIViSION �S Effective On January 1, 2002
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
OWNER Jb�1
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner - BUILDING USED AS
Also Replacement Furnace $-30.00
(Side Vent - Fill Out Back) ESTIMATED COST r� PERMIT N0.
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement) DESCRIPTION OF FURNACE AND OR BURNEIZ':� `h
Gas Range $ 10.00
;sex
No. of Heating UJJ its l Circle One (Steam) (Hot Water),. rm r)
Gas Dryer $ 10.00 $ Trade Name_rte/ Size No._'fl1.&P "7.27ic1W. U ;
BTU HP EDR
*Air Conditioning - All Sizes $ 25.00 $ Fuel
—Total Connected Load '
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
1% of Value of Appliance or Work $ BTU HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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 an
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts'�and
representations stated in this application are true and correct.
TOTAL FEE $ �J
DATE f 71,
ELAINE HTG. A/C ELECT., INC.
13562 CENTRAL AVE. N.E.
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO ANOKA, MN bSSp�}
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE Signed e^, �- TEL #���J
FAX #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved By Rough-in Date Final Date..
written permission from adjoining property owner.
. R,
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When re In acing an axisHng furanep, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. _Yes No ( )
The venting system is plasBcJPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes V No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes o No( )
The exisfing cem6ustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes Oy No( )
When required to install a new cnmhustinn air -it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes q No( )
When installing a naw venting--gys em, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes o No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes kNo ( )
Appliance Tyne and Si7e/Cnmmnn Vent and Vent Cennectnr Information
Appliance #1 Type l IV V\ - BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted .or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter ' inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameterin ;Type
Appliance #3 Vent Connector Height ft Length ft Diameter ? irijype
., .
13562 CENTRAL AVE. N.E.
HEATING CO: ANOKA. MN 5 304 (�
Signed By: en, Date:
p 1 -�
of
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, NIN 55432
6Mr_M_11112 ! w:v wwii1u54A o F44A
ADDRESS : 1324 SKYWOOD CT NE
PIN : 243024340035
LEGAL DESC : SWANSTROMS COURT ADD
: LOT 3 BLOCK 1
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOW/DOOR REPL
PERMIT N .:2004-00904!
DATE ISSUED: 06/15/2004
VALUATION : $ 1,700.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317
OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS.
INSTALL ONE EGRESS WINDOW TO MEET CODE.
STATE LICENSED CONTRACTOR 1
APPLICANT
SCHWEICH DAVID CONSTRUCTION (202626
21716 KENRICK AVE
LAKEVILLE, MN 55044
(952) 469-3222
OWNER
CLUTTER JOHN J & MARCELLA A
1324 SKYWOOD CT NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
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 provisio s of any other state or local law
regulating construc 'on or thZ performance of construction.
ApplicantA7 Z Date
SEPARATE PERMITS REQUIRED FOR
BUILDING PERMIT FEE 59.58
FIRE SURCHARGE 1.70
STATE SURCHARGE, VALUE 0.85
LICENSE SURCHARGE 5.00
TOTAL 67.13
PAID WITH CHECK # 34160
OTHER THAN DESCRIBED ABOVE.
f63a?y
NEW [ ] CITY OF FRIDLEY Effective 4/1/2004
ADDIS! [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
R M - �
Construction Address: (32-q 6�-Lj, W(OOJ �'���' 1�-3 G
Legal Description:
Owner Name & Address: 31 fli-p S12v ® -vn Tel. # Sl 14 --7 �4 )
Contractor: —bftjjih cWi)-e °I, MN LICENSE#oi®5�69&XgL,
Address:201 to E{'l✓1..8'7 c nA. .i �� , � y Tel. #9S3 -4bq-3-2-aa-
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: Leng Width HgVGround Sq. Ft.
OTHER:
C v7j
Construction Type: Estimated Cost: $ i _ /
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
77 DATE: APPLICANT: Tel. #
Call (763) 572-3604 for Permit Fees " mail ipg in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY UZe�jonReverse
Side
$ 1' ? _
$a
65% of Permit Fee
001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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:
Building
MECHANICAL
Permit No.QC07 -00'
.
InspectionsRESIDENTIAL
APPLICATION
(Z--.
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: ® �—t
DATE—'7-1 I 10� YOUR E-MAIL ADDRESS
SITEADDREss �� ��-i �� c7t N E -
THIS APPLICANT IS: ❑ OWNER ONTRACTOR
PROPERTY
NAME: ill q Vl
OWNER/
ADDRESS: 2_ S" 9-) ell 01 -t N rrY �' 1 ex u� STAT ZIP SS`IL
TENANT
PHONE: '1 G2 5-13 Z�t 6
CONTRACTOR
CoMpANy NAME: EATING & AIR CONDITIONING LLC
SUBMIT A COPY OF
CONTACT PERSON: 7 O WentWOrth AVe.
STATE LICENSE # Minneapolis,IV
YOUR STATE
LICENSE WITH
ADDRESS: OO CITY STATE ZIP
APPLICATION
PHONE FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
[3 NEW "%REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK Q,�eW 1,a CL '&Ma (_L � A C . &A A � S ����( '� �e�✓ � .
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG:r(Q Cx MODEL: rNvIMVV 3120_4,-7 1 SIZF/BTU 70 000
MFG: l 4 -An dl r��_ MODEL: XC ,L3 f3� �_.r SIZE/BTU ZC> G U
a
MFG: MODEL: SIZEBTU
A/C $25.00 FIREPLACE (GAS) $15.00 RANGE/OVEN $10.00
_GAS
AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
NEW
BOILER $35.00 i= FURNACE $35.00 UNIT HTR $10.00
CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00
_POOL
EDUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00
PERMIT FEE PROJECTS FOR UNDER $500
PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $
Number of fixtures @ $10.00 t x$10.00=$ 10.Co
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00 x $25.00 = $ ZS IJv
Number of fixtures @ $35.00 1 x $35.00 = $ => 5 c o
State Surcharge = $ .50
Total = $ -7 o. S G
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
s.
approved plan in the cas ll.work which Xqq ' es,revi,ew and approval ofplans.
r ) p C
SIGNATURE OF APPLICANT ti_J`PRINTNAME_ bY1AOt� b �JCJj(W\U SATE 01
► V
PLEASE NOTE: SEPARATE PERMITS ARWREQUIRED FOR BUILDING, ELECTRIC AND MECHANICAL. WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
12
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
PLUMBING
PennitNo.-QPT7 S2i
Building
Inspections
RESIDENTIAL APPLICATION
Received By:
Date Rec'd:4A (Q (v-1
763-572-3604
CITY OF FRIDLEY
DATE f7 — f CYOUR E-MAIL ADDRESS
3� if SKy
SITE ADDRESS J
THIS APPLICANT IS: 0 OWNER WONTRACTOR
PROPERTY
NAME: 1 adv �— PA
OWNER/
ADDRESS --1,3,?-,/- yw CITY STATEi % 6 -r -c° � rs� ZIP /
TENANT
PHONE: n % t( - 7 ? `f (
CONTRACTOR
NAME: SAS tvg '
STATE LICENSE # �C9.�ji�L EXP DATE f Z - 36 '®`�
%'GIP
�f S�:N
SUBMIT A COPY OF
YOUR STATE
ADDRESS: `% �l ' � '4'ef vC.0 CITY��'Ma'i STATE
s
LICENSE WITH
PHONE �]y FAX
APPLICATION
,� /'
SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
PERMIT TYPE
TYPE OF WORK:
0 NEW LACEMENT
DETAILED DESCRIPTION OF WORK �5t4Ce 1444 6kr6 "
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever. is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) WATER PIPING
— BATH SINK/LAV _FLOOR DRAINS _SHOWER WATER SOFTNER ($35)
POOL
BATHTUB _ GAS PIPING (xrm clrrlrcm) _ SWIMMING
CLOTHES WASHER KITCHEN SINK _ WATER CLOSET —BOR N ($15)
_ _ IRRIGATIOOW
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35)
WATER METER —OTHER
_ ;. Wi t , ;.. ft�, .� r
f fixtures
Permit Fee $ Number o @ $10.00 x $10 00 $
Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ x.50
Total = $ 6 s
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 requires review and approval of plans. . j
' l ` /CZ
may, PRINT NAME G� DATE
SIGNATURE OF APPLICANTS _
r
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977