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PRE 2010 DOCSVfflagq of Fridley, Minn. BUHMING PERX[T N? 787 Office of INSPECTOR OF BUILDINGS owner Architect Fridley, Minn.,— 19 Builder LOCATION OF BUILDING No, .1&i_4U� —Part Of Lot Lot -A Block _- Addition or Sub -Division J, DESCRIPTION OF BUILDING Front Depth Height— Stories Manner of Construction To be used as To be completed Estimated Coat �A -1 Permit is hereby granted 0 the building.. described in the above statement. This permit Is granted upon the express condition that the person to whom It Is granted, and his agents, employees and workmen, In all the work done in, around and upon said building, or any part thereof, shall conform In all respects to the ordi- nances of Fridley, Minn., regarding the 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. --- Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duty sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, this — _2" .7"" day of A.D. 19_",'-7?-- J City of Fridley 53-84-5915.51 v Application for Plumbing and G= Fitting Pemdt Dept. of Bldgs. Phone 560-3480 DESCRIPTION OF WORK 4869 NE. Main S$. Number, Kind and Location of Fixtures L°caiion 47 3 d X $1.50 � � x $1.50 12 � y �a � u� Z u. c U < �U' d w �U' Sn Z �U' O • F • N WATER HTR. GAS ELEG Base 3.00 1st 2nd 3rd 4th _ • Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... 1 Additional Fixtures .................... ffm Gas Range to 199,000 BTU .............. install (1) gas lite REPAIRS & ALTERATIONS—Refer to Code x $2.00 $ X $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ x $3.25 $ s $2.00 $ RATE TOTAL x $2.00 $ 2.00 x $ .75 $ x $5.00 $ 3.00 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. Fridley, MinnJulV 15, 1970 1 19_ Owner Eugene Fischer Kind of Building frame Used as residence To be completed about JulY 20, 1970 Estimated Cost, $ 10.00 X Old—New. Building Pe o Permit By Business Phone No MINNEAPOLIS GAS 09L ROUGH FINAL % I / 9 Description ................................................$ TOTAL FEE s -5-A-0 42 City of Fridley SUBJECT PE ® 12884 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT N0. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �:1�C3j 00 1 = i CITY HALL FRIDLEY 55432 NUMBER REV. DATE 13/19/75 PAGE OF APPROVED BY 612-560-3450 910-F15 JOB ADDRESS 4869 Main Street N.E. 1 LEGAL L02T41028 BLOC($ /} TRACT OR APJITj014 Uth Addition SEE ATTACHED DESCR. I sr— ii J/��w SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Leland Martin 4869 Main Street N.E. -T—CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Company 2513 Central Avenue N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK re -roof 9 CHANGE OF USE FROM TO STIPULATIONS SOEP T WIRING, HEATING, PLUMBING ING ANU.. SIGNS* 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 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 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. @775.00 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .5O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON 6.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. A 4 I S PLAN CHECK FEE TOTAL FEE $6.50 / SIGNATUREOF CONTRACTQ'RpR AUTHORIZED AGENT (DATE) WHEN PROPERLY V I TED H IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) 01 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY On F FRIDLEY, MINNESOTA fOWNER'S NAME: :� �F+ �% r� o'i ��- BUILDER: o( 1 ') L> G"�%S o ,J /f'/ 1 ADDRESS.: / O S T . sV_if ADDRESS • �� ol) '/T �'� �/9 C_ ✓� v NO • . o% / STREET: LOT: .2-J/ BLOCK: ADDITION: 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: Square Feet: Depth: Height: Cubic Feet•. Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: �� �L�^. T - Estimated Cost: $ � `� 010 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. DATE: S TGNATURE • (See Reverse Side For Additional Information.) 6 t'l. Z--) 4 i -- SUBJEET City of Fridley 30452' 0452` AT THE TOP OF THE TWINS BUILDING PERMIT ' • -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 6y ^/I r I PROTECTIVE NUMBED DATE PAGE OF A�vnOVED BY CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15=10/28/99 JOB ADDRESS 4869 Main Street NE 1 LEGAL LOT N027 2$ I BLOCK TRACTOR ADDITION SEE ATTACHED DESCR.`/ 1 I Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cheryl Olson & Mike Zerwas 574-7501 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION A REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (24 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 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 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 $2098 $1.05 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- Fire STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83..25 C $2.10 PLAN CHECK FEE TOTAL $8 .40 SIGNAIOF CON7R T AUT OR4Ep AGENT iDa TES ENP OP LIOAT IS IS YOUR P MIT BLOO iNSv 5. aTUF+E OF WN oXZW1�*A-WC0Epi iDATEi NEVI [ ] . Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATIONQ ®�b 0 Construction Address: Legal Description: Owner Name & Address: Contractor: �i Tel. # 41W ./ MN LICENSE # Address: $ State Surcharge Tel. # SAC Charge Attach to this application, a Certificate of Survey of the $ Driveway Escrow lot, with the proposed construction drawn on it to scale. Erosion Control $ Park Fee DESCRIPTION OF EIAPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Lens Width Hgt/Ground Sq. Ft. OTHER: 1��1 A" -r 4X4"/-( - hrZ� 7-'If G Construction Type: Driveway Curb Cut Width Needed: DATE: AlAr Estimated Cost: $ I C1110 Ft. + 6 Ft = Ft x $ APPLICANT: Tel. # Permit Fee $ (93- '-)S— Fire Surcharge $ State Surcharge $ l� SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ - V6 STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ]