PRE 2010 DOCSCity of Fridley, l
BUILDING PERMIT M 5585
Date: _ —f:t
Owner:a p
,�. ��.�,�%_..._ Builder w._....M.._......._.._.._.___.___ .
Address Address --
LO TIO - BYJLDING
No. Street y J _ w of t
Addition or Sub-I�ivsion _ _ z
Corner Lot _ _ _ .. _ Inside Lot "aback a "" r Sideyard—
Sewer Mevation Fc&dation Mevation
DESCRIPTION OF BUILDING
i,be "ATO
Front Jr:!� Depth - ;2--A ' Height J-40 Sq. Ft . C: L Ft.
From Depth Height _. Sq. Ft —. Cu. Ft.
Type of Construction -, Fust. Cost .=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 and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ , permit is hereby granted to..._.
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
one in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
dley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
w dty limits and this permit may be revoked at any
euponviola tion of any of the provisions of said
p- 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.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
owner `s Name .eiP/Vr f�i�dc'r,/AJ Builder
Address_ /// ST�1f z 17e_ Y�4 A'Z-. Address 5%
LOCATION OF BUILDING
No. ,6 4 // street S7Wfc /J e ALV-b��Part of Lot
Lot Block Additio / or ubdi.vision_�,_______
Corner Lot Inside Lot ack ide-'Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
be used as:
DESCRIPTION OF BUILDING
Front Depth � Z Height
sq. Ft cu. Ft.
Front epth -------_Height
sq. Ft. CU. Ft.— J
Type of Constructions a Estimated Cost r
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 ruling of the Department of Build-
ings, and hereby declares that all the facts and representations
stated in this application are true and correct.
DATE ®? r- / SIGKATURE� _ 0-1.te
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
SUBJECT
PER
1311
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECE
w_ COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
�
i "1 CITY HALL FRIDLEY 55432
I czlop
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
7-30-75
JOB ADDRESS 6111 Starl i to Blvd.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITI N,
QHi l l
Plat 2
SEE ATTACHED
DESCR.
13
3
Syl van
s
SHEET
2 PROPERTYOWNER MAILADDRESS
Bob Martin 6111 Starlite Blvd.
ZIP
PHONE
3 CONTRACTOR MAIL ADDRESS ZIP NE LICENSE NO.
Westlund Bras Construction 1823 Sky HIGH Drive New Brighfb
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
1R x 20 addition to hnmp
9 CHANGE QF USE FROM TO
STIPULATIONS
S�p�ROE PERMITS REV
se's
w�
HEATING, PLUMBING AND SIGNS-
0
TYPE OF CONST.
OCCUPANCY GRIJ
CUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
frame
VENTILATING OR AIR CONDITIONING.
wood
�.;.
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
360
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
�p
$8,136
4.07
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-
$28.40
STRUCTIO R THE PERFORMANCE F CONSTRUCTION.
' A
PLAN CHECK FEE
TOTAL FEE
(.c/j�
a
32.47
SIG URE OF CONTRACTOR OR AUTHORIZED AGENT ID TE)
HEN PROPERLY V
BLDG INSP
D.aED T IS S YOUR PE IT
- DATE. .
SIGNATURE OF OWNER IIF OWNER BUILDER) )DATE)
F�
•APPLICATION FOR RESI•DL'NTIAL., ALTi:RA1'ION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
: BUILDER: & 1e1 �? C!' 45rcI�
OWNER s NAr�E : � .� �. r � ,� .
ADDRESS :� SiL dam-! t��L , ADDRESS:
• '- ��-2
STREET:
LOT; j BLOCK:- � ADDITION: S
J
/P -L,121- Wi,115 R--'-11 Z,
CORNER LOT *INSIDE LOT: SETBACK: _ SIDEYARD:
Applicant attach to this fora. Two Certificates. -if Surve ..of -Lot and•proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: / b Depth:• Height:_
.• Square Feet: -3 60 Cubic. Feet•
• Front Depth: --Height:
Square Feet; Cubic Feet':
Type of Construction: �a4 Estimated Cost: �e
TO -Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeingto do all work in stiict accordance with the City of
Viidley 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.
. A )ATE; % �� SIGNATURE-
(See Reverse Side For Additional Information.)*
•q
SUBJECT PE
City of Fridley
1.6808
AT THE TOP OF THE TWINS
_
BUIL ®I N G P E R M I T 'l
i
I COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/5/82
JOB ADDRESS 6111 Starlite Boulevard
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
g
2
Sylvan Hills Plat 2 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Robert Martin 6111 Starlite Boulevard 571-1999
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Steve's Roofing 3631 Penn Avenue North 529-5356
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Reroof Dwelling
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE QF USE FROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
AS halt
VENTILATING OR AIR CONDITIONING.
P
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
I
I 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
$l� S32
$.9O
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-
$ 3l.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
CHECK FEE
TOTAL FEE
--- ;LAN
---�_
%®®e�` 0"
$31.90
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
�)
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
BLDG WSP DA E
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIO14 FOR RESIDENTIAL BUILDING PERMITS
(Neap, Alterations, Additioni, or Repairs)
OWNER:
ADDRESS: _ 6 �lI 6 L V0.
TEL NO:
BUILDER: 577E UE 6516'
ADDRESS: 3CP )!?Z n IN, N>
TEL 110: ✓;,z 1-5'3
G t j Construction Location
. STRECT NO: V �` 1 STREET: j, rAA t-;rc. 01..1%4
LOT: BLOCK: ADDITION:
Corner Lot: Insiiie Lot: 17? Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square Feet: Cubic Poet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: Estimated Cost: $ 1,732.
4b Be Cbr.ipleted:
Alt. A Alt. B
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 Delkxrtment of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: �J � g*Z SIGNMM:
Stipulation s
all
1
City ®f Fridley
SUBJECT
,.P•�TV�
22719
AT THE TOP OF THE TWINS
y
h4, U I L ®I PERMIT
BUILDING
1�I \
tj
RECEIPT NO.
by------t COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
c;
�'��
r � �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/14/94
JOB ADDRESS 6111 Starlite Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
13
2
S lvan Hills a SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Martin 6111 Starlite Bl NE
-vd
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Twin City Exteriors Co 9060 ZA9q-A7q7 2535
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
RO
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Check smoke detectors by bedrooms. fixi Any change in sash in bedrooms
shall meet rescue size.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
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
$5 LOO
$L. 6O
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-
$90.00
Fire SC $5.20
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License sc $5.00
$102.80
SIGNATURE OF CONTRACTOR ORAUTHORIZED AGENT (DATE)
PRO RLY ALIDATED THIS IS YOUR PERMIT
-1s -� !z
SIGNATURE OF OWNER IIF OWNER BUILDER] IDATEIBLDG
INS ryATE
all
1
NEW [ J
ADDN [ l
ALTER [ ]
Construction Address:
Legal DescA+ tian-
Owner Nam
Contractor:
Address: 5
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 3/1/92
Tel. # 5-7/- / �lG%
MN LICENSE # R!577,3
Tel. # z1%3 Z
Attach to this application, a Certificate of Su vey of the
K with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft .Yd . Setback Side Yard Setbacks
Type of .Constraaran: _ Estimated Cost: $,tel' � -
ApproR Compielron Date ¢ - Y
(Cost on B�ckJ
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: _ l APPLICANT: Tel. #�L7�
®® CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ ;3 �� $.50/$1,000 Valuation
SAC Charge $ $704 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [
TOTAL $
STIPULATIONS'��
a�
6Qy�� sari"""
M K,- 1 DS a -
Building
BUILDING Permit No.: 7�3
Inspections
RESIDENTIAL APPLICATION Received B
A29
763-572-3604
CITY OF FRIDLEY to
763-5024977 FAX
EFFECTIVE 1-1-09
DATE 14 0- 1 S - O c1
YOUR E-MAIL ADDRESS
SITE ADDRESS % I I S4 ote- c k+ R 1JL 12 d � >J
THIS APPLICANT IS:
❑ OWNER *ONTRACTOR
PROPERTY OWNER/
NAME: D 14 y - & �f- t �J '� 6
ADDRESS: 61I1 S+#n�,2Lt9k4- gLoc,., CITYyZ.,G, STATE MP -ZIP SS4�I
TENANT
PHONE: 7 Col- 5-36- D So
CONTRACTOR
NAME: SIO 12►m
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS: �S; % (p 14,,,A SOYi R&, %v-- 0 CITY W oOd L'L4,9:t STATE Mru ZIP 5S I 25
INSURANCE
PHONE (o `5 (- i $ - I S FAX &S -1 -
s1 -PROPERTY
PROPERTY TYPE
rMINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH AR OF ❑ DRAIN TILE
❑ DECK OS ING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION (fir-e-,(��5�
R
❑ MAINTENANCE/REPAIR ❑ REMODELING
n
DESCRIBE WORK BEING DONE: Ta -.VZ cj 4 lA 0�' � P- 1 `c£-- PLP -Ry0 �-
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
PHOUSE & 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:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS & PORCHES SUBMIT:
❑ Vinyl
❑Soffit
1. Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project.
❑ Other
❑ Fascia
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 IgM i�.1 C FEE SCHEDULE)
TOTAL JOB VALUATION $�rC� v���r �C``�N llgg OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
E WA ZM
�Kvo�
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= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks Dayable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMrr-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 work which requires review and approval of plans. —
SIGNATURE OF APPLICANT ( L-Zk A.1 - �JI -- PRINT NAME P u,�,rUill LUkTTtary.DATE S