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
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•
F
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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 [ ]