2015-05000Permit No. :
CITY OF FRIDLEY *2 15-050 0
DAT0 E ISSUED: 11/17/22 015
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
572-36U4 N'AX: (763),UL-4y"/"/
PIN : 133024320019
LEGAL DESC
UNAVAILABLE
FIRE SURCHARGE
: LOT 9 BLOCK 1
PERMIT TYPE
BUILDING
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE
ROOFING
VALUATION : $ 2,004.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE.
KICK -OUT FLASHING REQUIRED PER SECTION R903,2006 I.R.C.
CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH
FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY
LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED.
CALL FOR FINAL INSPECTION WITHIN 10 DAYS AFTER COMPLETION.
TEAR OFF AND REROOF HOUSE ONLY -13 SQ
APPLICANT
THE WINDOW STORE HOME IMPROVEMENTS
2924 ANTHONY LANE #115
SUITE 270
ST ANTHONY, MN 55418-
(763) 746-8960
Minnesota State License #: GENR-BC631932
OWNER
CARLSON JOHN
1039 64TH AVE NE
FRIDLEY, MN 55432 -
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 180 days or if construction
or work is suspended or abandoned for a period of 180 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 work
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 provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
BUILDING PERMIT FEE
83.25
FIRE SURCHARGE
2.00
STATE SURCHARGE, BLDG VALUE
1.00
LICENSE SURCHARGE
5.00
TOTAL
91.25
Payment(s)
CREDIT CARD 0878 05000
91.25
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
INSPECTION TYPE
ICE & WATER BARRIER
FINAL
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
1039 64TH AVE NE
133024320019
UNAVAILABLE
LOT 9 BLOCK 1
BUILDING
RESIDENTIAL
ROOFING
PERMIT NO.: 2015-05000
DATE ISSUED: 11/17/2015
PERMIT APPLICANT:
THE WINDOW STORE HOME IMPROVEMENTS
2924 ANTHONY LANE # 115
ST ANTHONY, MN 55418-
(763)746-8960
VALUATION
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 5 PM
DATE INSPECTOR INSPECTION TYPE
: $ 2,004.00
DATE INSPECTOR
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
First Data - POS
TRANSACTION RECORD
CITY OF FRIDLEY BUILDING
6431 UNIVERSITY AVE NE
FRIDLEY, MN 55432
United States
TYPE: Purchase
ACCT: Visa $ 91.25 USD
CARDHOLDER NAME
RONALD VOSIKA
CARD NUMBER
############0878
DATE/TIME
17 Nov 15 15:10:52
REFERENCE #
002 0104926 T
AUTHOR. #
01575G
TRANS. REF.
2015-05000
Approved - Thank You 100
SIGNATURE
Please retain this copy for your records.
Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
Page 1 of 1
https://globalgatewaye4.firstdata.com/vpos 11/17/2015
1111712015 10:48 The Window Store
• Y I'. 1 1 111 rI
ALN., FEES ARE
Plan Review
Fire Surcharge
Surcharge
License Sumbarge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
ON 'VALIDATION, INCLUDING THE COST OF LABOR AND MATERIALS.
n, AJUSI)VV'1;1't Titer 1997 TJ.1LC FEB SCHFiDUL E)
65% of Building Permit Fee
.001 times the total job*valuation
.0005 xPennitValuation Minimum $.50
$1.00.(State Licensed Residential Contractors)
$2100 per SAC Unit (Plans to MWCC for determination)
ft + 6 ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to. City of Fridley Attac
'THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the in bzTma len above is complete and accurate; that rho :work will be in
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conformance with the ordinances and odes of the City of Fridley and with the Minnesota Construction Codes; that I undetitand this is not a
permit but only an application for a pe it and work is not to start without a permit on site; that the work will be in accordance with the
approved plant in the case of all rk w i ew and approval of pians.
2 t
•f- t
SIGNATURE OF APPLIO ZPXM NAME 1 t:�r DATE 1
APPRnVAT. TAICAFfTOR AMNATMr, nn TV
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Building
13T_TXY DING
PermitNo.•
Inspections
RESED NTIA L APPLICATION Received By:
763-572-3604i'I'
OF �i`iIl.7I aT+�Y
Date Rev'd: d; B
763-502-4977 FAX EFFECTIVE 07/01/2013
DATE
YOUR EMAIL ADDRESS
SITE ADD1iESS
VIS APPLICANT IS;
❑OWNER
PROPERTY
`CONTRACTOR
NAME: PIIONry � ..
OWNERI
ADDRESS: CITY
^' STATE [P
TENANT
CONTRACTOR
NAVI1r: IOWA&"
SUBMIT A COPY OPSTATE
LICENSE # �j[.(j) Cl
EXP DATE
YOUR. STATE LICENSE
`�
CITY STA IP .
AND CERT IFICAT E OF
INSURANCE
ADDRESS:
FAXPROPERTY
TYPEY;
tPHNEGL
FAMILY/NEW CONSTRUCT ION SIZE
0 FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
GARAGE/SHED INDOWS
❑ ADDITIONO CI W
13BASEMENTr FINISH OOF 13 DR41N TILE
13DECK Jv VDINQ Q OTHER
NT. SwI 4MWG POOL
TYPE OF WORK-
❑ NEW HOME CONSTRUCTION Cl ADDITION
MAINTENAN • AIR D REMODELING
DESCRIBE WORK BEING
SIZE OF Ilv[PROVEMENT
LENGTH WIDTH
HEIGHT . FT
HOUSE ONLY
BAS REMODELING SUBMIT.:
NUMBER OF SQUARES
D OUSE & GARAGE
I. Existing Floor Plan
GAR
❑ ATTACHED GARAGY3
2. Proposed floor plan
PROPOSED SIZE:
O DETACTIED GARAGE
3. List of mucturad members to'be used
PROPOSED HEI0HH'T:
FOR NEW CONSTRUCTION INCLUDING DUCKS,
SIDING
❑ vinyl
❑Soi%t
ADDrrIONS MTP: •
I . Site PlvdSurvey showing the bxEsting atructures
O Aluminum
O Trim
and proposed project
In Other
❑ Fascia
2, Two acts of construction plans
pry"
3. Energy Calculations
IN EXISTING OPENINGS OYas ONo LOCATION OF WINDOWS
FOR WINDOWS --PROVIDE U -VALUE AND
OR FOR NEW OPENINGS-DESCRME SIS OFMANUFACTURE
— -
STICKM ON WINDOW,
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALN., FEES ARE
Plan Review
Fire Surcharge
Surcharge
License Sumbarge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
ON 'VALIDATION, INCLUDING THE COST OF LABOR AND MATERIALS.
n, AJUSI)VV'1;1't Titer 1997 TJ.1LC FEB SCHFiDUL E)
65% of Building Permit Fee
.001 times the total job*valuation
.0005 xPennitValuation Minimum $.50
$1.00.(State Licensed Residential Contractors)
$2100 per SAC Unit (Plans to MWCC for determination)
ft + 6 ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to. City of Fridley Attac
'THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the in bzTma len above is complete and accurate; that rho :work will be in
c
conformance with the ordinances and odes of the City of Fridley and with the Minnesota Construction Codes; that I undetitand this is not a
permit but only an application for a pe it and work is not to start without a permit on site; that the work will be in accordance with the
approved plant in the case of all rk w i ew and approval of pians.
2 t
•f- t
SIGNATURE OF APPLIO ZPXM NAME 1 t:�r DATE 1
APPRnVAT. TAICAFfTOR AMNATMr, nn TV
A(h4A(/N�ApiDj/'�1)V�ljt(//E�►{C/pI/lA,M1{Cj� WO��jR(q/�T('�6jr