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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT x® 4275 Date: ..... __.._..._...._....__..__._ _ _ ._._ Owner: .............. ..... ......................... ... -....... .. _..._..... ._---....... ............ Builder Address------••........................ ..... .... _._ _ _. _ _ _...._...... Address LOCATION OF BUILDING No..13-YY Street.._._ - - -_.._ .. f�; ......_..... Part o Lot ............. .......... _.._...... ........................ Lot ............... .. Block ..... ............. /........._......._........ Addition or Sub-Divisio ..._..........-......._........ ..........................._.._.._......... _ Corner Lot ......................... _........ Inside Lot X .......................... Setback ...tom. ...'���.... Sideyard .-- .--- Sewer Elevation //T,fobe Used as: Type of Construction Foundation Elevation DESCRIPTION OF BUILDING Front _�`...._� Depth. Height_..f Sq. Ft �.�L.. Cu. -!_... . Front ..... .................. . Depth ................ . Height..... - - _ Sq. Ft ....._............._.. Cu. F't......................... .ffl.................. ..-----........... ... .. Est. Cos�.r.. yY.-r..._..._...... To be Completed ..... _.......... ..._ ...................... -........ 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 set forth d in compliance with all provisi of ordinances of the city of Fridley. /�� 17 12, In consideration of thea p yment of a fee of $..�......_.........., permit is hereby granted —... ........................ _...__._........ 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. Building Inspector NOTICE: This permit does not ,cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building inspector for separate permits for these items. City of Fridley, Minn. N9 9044 BUILDING PERMIT 7�- Date: OCTOBER 6, 1966 owner: DAVID K. ABRAHAMSON Bider SAME Address 1349 SKYWOOD LANE N.E. Address FRIDLEY, MINNESOTA 55421 LOCATION OF BUILDING No. 1349 Street SKYWOOD LANE N. E. _ _... Part of Lot Lot 6 _ _ Block 1 Addition or Sub -Division . SWANSTR0M ' S COQ Corner Lot _ – Inside Lot _.. $. Setback --- Sideyard Sewer Elevation ___ ___ — Foundation Elevation To be Used as: DET. GARAGE Front 20 DESCRIPTION OF BUILDING Depth 22 Height 10 Sq. Ft 440 Cu. Ft 4-.40- Front .40 - Front Depth Height Sq. Ft Cu. Ft Type of Construction FRABE _ Est Cost 1 _6 00...0.x__.. To be Completed 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 set fo and in compliance with ,�'1 provisions of ordinances of the city of Fridley. 11 ( h ,/ � Ii /) In consideration of the payment of a fee of $__L. 0 0 ' permit is hereby granted to—DAVID K. ABRAHAMSON 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 pari 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. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, hw alhnion for wiring, plumbing, gas beating, sewer or water. Be Sure to as the Buildlug Inspector for separate perm6s for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME DlazllkbfS _ �� �✓' � did ADDRESS DRESS LOCATION OF BUILDING N0. STREET /�E✓00/Z-- PART OF LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT K SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION 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 6� DepthHeight Sq. Ft. I/ Z) Cu. Ft. � Front Depth Height Sq. Ft. Cu. Ft. A Type of Construe tion,/'`, "° 3 Estimated Cost To be completed_ `� f�� t 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_ e�9 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE MIUVITY 1iAR..\1 AIR: RATE TOTAL Furnace Shell & Duct Work $12-00 $700 $ Ra=lacame nt of Furnace .— Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTL' each ad--. 30,000 BTU Replacement of Furnace Repairs & Alterations -up to $500.00 Re: -sirs & Alterations each add. $500.00 STr'A%f CR HOT I :ATi:R SYS aM : Boiler & ".:nes up to 100,000 BTU each ad n. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BUR\ER- to 3 gal. per hour each add. 3 gal. per hour $12.00 $ 4.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 4.00 7.00 6.00 $10.00 10.00 GAS BURN% R- from 1C0,000 BTU to 199,999 BTU $10.00 S (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: ist 3 Fixtures x'' $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING �i S FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS ; $ ALTERATIONS t REPAIRS_-) $ State Surcharge $ .50 TOTAL FEE $Q, Job Address 1349 Skywood Lane Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for tae 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. November 10 , 1976 OWNER David Abrahams on KIND OF BUILDING Wood Frame USED AS Home TO BE COMPLETED ABOUT November 11, 1976 oCTTMTT4`T1 nncm OLD - NEW BUILDING PERMIT NO. PERMIT NO. b'82 I - DESCRIPTION OF FURNACE/BUX-1ER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Dame Carrier Size No. 58ES100 Capacity Sq. Ft. EDR ETU 100,000Y.? Total Connected Load 100, 000 Kind of Fuel Natural Gas BURNER - Trade Name size No. =Gii INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date ($10.00) Kleve Heating & Air Cond. Company F L\AI. INSP. � Date � Signed Ey APPROVAL FOR PER+lTT �i • Tel. No. 941-4211 FEE FOR A'M'Y HEATING PERMIT IS $7.50 SUBJECT City of Fridley AT THE TOP OF THE TWINS P E R M r BUILDING R � • COMMUNITY DEVELOPMENT DIV. 1 PROTECTIVE INSPECTION SEC. - /?s // 91 1 i /"-'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 12/18/78 JOB ADDRESS 1349 Skywood� Lane. N.E. _ 1 LEGAL LOT No. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 SWanstrom's Court SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE David K. Abrahamson 1349 Skywood Lane N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Homestead Builders 4 ARCHITECT OR DESIGNER MAILADDRESS ZIPPHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS . ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ ElNEW X ADDITION ❑ ALTERATION 11 REPAIR ❑ MOVE REMOVE X 8 DESCRIBE WORK Construct a121 x 22' Addition and remodel kitchen 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. WA. WN Before digging cell local utilities TELEPNONE • ELECTRIC . GAS EtC. 4 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 264 3168 OR 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 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. $4.85 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,700 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. $30.67 NONE PLAN CHECK FEE TOTALFEE 7.67 $43.19 ATURE OF CONTRACTOR O AUTHO IZEDAGENT (DATE) WHEN PROPERLY VALIDATEDTHIS IS YOUR PERMIT BLDG, INSP - DAIE NATURE OF OWNER (IF OW ER BUILDER, (DATE) 01 • Ll IT hl' I-MULL'T APPLICATION FOR RESIDENTIAL BUILDING PEIMITS . (NEW., ALTERATIOPJS,. ADDITIONSS, OR REPAIRS) ot:►a�Ii: f}V ID �:. 'o'6f�ulLur�z:OfL„D�Y��' Address: I (A19- S 1`4 41w` dress: Tel. No. No.: I Pis Street: d **1 LOT: BLOCY.: ADDITION: /r.�� ' 1 ��. ��% Q0' to 47' CORNER LOT: INSIDE LOT: _ SETBACK: 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: - Front: Depth: Height: Square Feet: Cubic Feet: e� ISC-'1K-j 6- dx tiront: Square Feet: Cubic Feet: Type of Construe 'on: #+Ar Estimated Cost: $ )ao To Be Completed: ;Alt. A Alt. 8 Depth: Height: 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 represcatautions stated in this application are true and correct. See reverse de for additional_inf_ormation. DATE: �� - --6�-- / SIGNATURE: Stipulations: 3x 4-oae- ®8.00 3. it'll x 4 Z4 -OW 2SSwL r- G'od t CITY OF FRIDLEY APPLICATION FOR PLUMBING AND CAS FITTING PE R4IT Job Address �J 9 O e, Department of Buildings 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, Mn. , 19?9 OWNER �,, %< J_ -Lk E. &• �4�NGLl� msoh KIND OF BUILDING USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE I N 0 PLUMBING FIXTURE RATES: r ut N m Number Fixtures x $3.00 H tr C d• 4 Future Fixture Opening A $2.00 +1 W G+ x $2.00 -.0i $4 N N C M E � um Gf N C N 4 $5.00 $ 3a kHeater x O $ •N x $7.00 ,l�C�. New Ground Run Old Building .0 •N $5.00 $ ri Electric Water Heater O $5.00 $ O O "O� 4'c-� C. N .1 O O O t�1 , N x M N Date V2 V $1.00 m� w y 3 Q w° M w U w 3 v o lec $ each add. $100.00 or fraction $2.00 $ IMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARG State Surcharge $ .50 TOTAL FEE $ 9,6 n 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water Job Address �J 9 O e, Department of Buildings 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, Mn. , 19?9 OWNER �,, %< J_ -Lk E. &• �4�NGLl� msoh KIND OF BUILDING USED AS REINSPECTION FEE ($10.00) TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST PLUMBING FIXTURE RATES: N0. RATE TOTAL OLD NEW BUILDING PERMIT N0. PERMIT NO. Number Fixtures x $3.00 $3 , t) D Future Fixture Opening x $2.00 $ Company New Fixture, Old Opening x $2.00 $ Signed By Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Tel No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ ROUGH INSP. Electric Water Heater x $5.00 $ Date GAS FITTING FEES: FINAL INSP. 1st 3 fixtures x $3.00 $ Date Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $x:0.00 $ APPROVAL FOR PERMIT REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ IMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARG State Surcharge $ .50 TOTAL FEE $ 9,6 n REINSPECTION FEE ($10.00) P bw SUBJECT PERMIT NO. City of Fridley I V. r 19606 AT THE TOP OF THE TWINS BUILDING PERMIT r NREqEEL_NQ---' �y _ COMMUNITY DEVELOPMENT DIV. r i PROTECTIVE INSPECTION SEC. 1 1 i i 1 /•"1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/25/88 JOB ADDRESS 1349 Skywood Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 Swanstrom's Court Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David/June Abrahamson 1349 Skywood Lane N.E. 571-5755 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 3V. x 12". Deck (Approximately) 9 CHANGE OF USE FROM TO STIPULDATIONS See notations on plan 0 8 PERMTS REQUIRED FOR WARNI�� WIRING,�HEAT G`, PLUMBING AND SMS. Before digging call local utilities TELEPHONE - ELECTRIC - GAS EtL REQUIRED BY LAW 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,150 $1.58 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF NY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTIO T E PERFORMANCE OF CONSTRUCTION. $63.00 PLAN CHECK FEE TOTAL FEE $64.58 ATURE FCO RAC ORTHORIZEDAGENT /�•p(DATE) WHEN PROPERLY VA^ATED THI IS YOUR P MIT SiGNATUR OF U OWNER BUILDERt IDATEt BLDG WSP GATE P bw NEW 17 City of Fridley Effective 5/1/88 AMN I ] R-1 AND R-2 ALTER I ] Onnstruction Address Legal Description 5 � Building Permit Application A)2- Sy Owner Name & AddressIC JO ti c HO kA- &Yn.S d Tel. Cbntractor: %�? S G'Z �' Tel. Address: Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. vp 0�. •WL ME- io,41;4(01 "Rolla Width Height sq. Ft. GARAGE AREAL: Length I Widtt Height S3. Pt. DECK ARFA: Length 15 Width % 'D-1 Hgt/Grotnd'30" +k. Ft. MEL. (brner Lot I ] Inside Lot I I : Y Type of Construction: Approx. Completion Date: Side Yard Setbacks 90 Estimated Cost: s �� Alt. A Alt. B Proposed Driveway Width If Newning Desired: $ $ ! Width + 61. See Back Page DATE: �Z 2 ^ d a APPLI(XN1!: 41/ Permit P+ee s (0 Ov State Surcharge s SAC Charge $ Driveway P;scrow $ Park Fee $ Sewer !lain Charge TOTAL $ STIPULAlPICHS: CITY USE OILY Flee Schedule on Reverse Side $.50/$1,,000 Valuation $550 per SAC Unit Alt. RAO or Alt. "BO Above Fee Determined by Engineering *eement Necessary I ] Not Necessary I ] tv laU 1 SUBJECT _- P, E City ®f Fridley AT THE TOP OF THE TWINS BUIL ®I N G P E R M I �- 2 5461 r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ~ e PROTECTIVE INSPECTION SEC. r NUMBER REV IAT; DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J" 612-571-3450 910-F15 JOB ADDRESS 1349 Skywood Lane NE 1LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 Swanstrom's Court SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Abrahamson 1349 Skywood Lane NE 571-5755 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Peter J Attleson Contractor 3916 Willow Rd, Brooklyn Park, MN 55443 427-6431 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098630 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION l7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (44 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 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 $3,669 $1.83 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 PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $87.25 Fire SC $3.67 STRUCT N R THE PERFO MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE LUZ, '�47645.17 f7 License SC $5.00 $97.75 I NATURED CONTRACTOR OR AUTHORIZED AGENT ATE, WHEN PROPERLY BLDGfiNSP V DATED THIS IS YOUR PERMIT DATE S,GNATURE OF OWNEROF OWNER BUILDER) IDATE6 1 NEW [ ] Effective l/ 1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Wo ad Z4 Legal Description: y� c / Owner Name & Address: Dayt° / �`-a,, Tel. # S7` - S 7S--5– Contractor: PC IT, A.,t' �f 4-Cl,—CMN I ICENSE # 260�8 63a Address: rac, d� fi-/C Ijk% Tel. # 2% • �' 3� Attach to this application, a Certificate of Survey of tthe 3 lot, with the proposed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Yl lC !o4 s. -e i Cavo '4 s9. -tel- gz-'k-6 Construction Type:a Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE:LAPPLICANT: Tel. # 42 I.3 � CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.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 [ ] ff O - � Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received 763-572-3604 CITY OF FRIDLEY 'Bldf Date Rec d. DATE 0 YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER IkCONTRACTOR PROPERTY NAME:y t u OWNER/ ADDRESS: 3Q l,F ( CITY STATE ZIP 1 TENANT�—y� a PHONE: 6:i�'���� CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE WITH ADDRESS:r 1 q_1 +�`-� L --In CCITY��Gc�iyi STATE H4IP APPLICATION f pHONE ,(SSp� —25— FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: I ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL 9M DETAILED DESCRIPTION OF WORK PER MS 16B.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: D MODEL:66/ /Icy OV 0 `V SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 VIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 PERMIT FEEPR FOR UNDER 1?ERMIT IEEEf?I P3C TS OVER $500 Permit Fee $ - Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ _ : ` _ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Total = $ 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 ap atron 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 o rk whic re uires review and approval of plans. f� SIGNATURE OF APPLICANT _ NAME E L( TE ! O K$ASE,N©TE ,: SEPARATE PERMIfiS�°ARE RE. MIRED FOR BUILDING, ELECTRICAL A;;ND MEC14ANICA . WOkK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 57 V'4- to tas Building AND MATERIALS: BUILDING USING TH 1997 UBC FEE SCHEDULE) Permit Ivo.: OCCUPANCY TYPE Permit Fee $ j j sQ ,95 See Back Page for Fee Schedule Plan Review Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 c� 763-502-4^^977 FAX $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 1-1-08 ft + 6 ft = ft x $21 = $ Erosion Control DATE 9-99 - ®�j YOURE-MAIL ADDRESSQc5iP100IC 1NJYD)i Y !1 eM . LC _ryl SITE ADDRESS 13 `i 1 3. l-CA�If !t Sewer Main Charge THIS APPLICANT IS: ❑ OWNER qbNTRACTOR Total Due PROPERTY OWNER/ NAME: Kiln 1_'-'l ha -0-I ADDRESS: I,3L%e1 8k_ILt)0pd Lou* CITY Pr l 8 `fid l STATE_M_�J ZIP 56(431 TENANT PHONE: -7u 3-6x-7®1 - IJ NAME: ADDRESS: _1&51 %1 r Lt)C bCI L %� J&, P CITY Ie G MSTATE NN ZIP 5tAbcf CONTRACTOR SUBMIT A COPY OF PHONE lU?s-�l �(� ' aQCXD FAX -163 -1 t'Q' �l®()3 YOUR STATE LICENSE STATE LICENSE #C� OZ-C�.�S EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED NDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ EW HOME CONSTRUCTION ❑ ADDITION l')"AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: &ai),x -1 l.e2C,Pldol-L� 0 _ UUC: AA -��P� L� r SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ 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, ❑ Vinyl ❑Soffit ADDITIONS: & PORCHES SUBMIT: 11 Aluminum El Trim 1. 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 4es ❑No LOCATION OF WINDOWS j J,(1 1-GO(r) OR FOR NEW OPENINGS -DESCRIBE SIZE OF ASA tj n , �aX3 1tiilY(Y) �L_9yh/J OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LiMUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: USING TH 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ j j sQ ,95 See Back Page for Fee Schedule Plan Review $ j 65% of Building Permit Fee Fire Surcharge $ -7. 9.,(D .001 times the total job valuation Surcharge $ S, !IQ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5((00 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ r, Make checks payable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 1 hereby apply for a buildi permit and 1 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 wit a 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 he: accordance with the ap roved plan in the case of all work which requires review and approval of plans. � SIGNATURE OF APPLICAT1 T PRINT NAME n� 1 e V no o �'� _DATE_,;l-d3-C? APPROVED BY