PRE 2010 DOCSSUBJECTPE
N0.
City of Fridley
? 14331
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
812-560-3450
910-F15
8/29/77
JOB ADDRESS 6181 Starlite Boulevard N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
20
2
Sylvan Hills Plat 2 SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Archie L. Lindgren 6181 Starlite Boulevard N.E. 571-4624
3 CONTRACTOR, MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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
Construct 12' x 14' Utility Shed
9- CHANGE OF USE FROM TO
STIPULATIONS
Keep building at least 5 feet off rear lot line.
SEPERATE PERMITS REQUIRED FOR WIRING,
'HEATING, PLU.WING AND SIGNS
A I NG
Before digging call local utilities
TELEPHONE - ELECTRIC - GAS Etc.
'REQUIRED BY LAIN
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. T.
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.
$475.00
$.50
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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
ti
$8.00
SIGNATURE OF CONTRACTORORAUTHORIZEDF, ENT (DATE)
WHEN PROPERLY. VALIDATED THIS IS YOUR PERMIT
•
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BLDG INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER:
BUILDER:
Address : 4/ft/
.V l- /
�� � 8f V
J
Address: .
Tel. No.: -r71 ` q e' LZ
No. Street:
Street:
LOT: L BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
a
'9�- ront: Depth: ! _ Height: %
Square Feet: 1CP� Cubic Feet: fG T
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: Estimated Cost: $ ®®
To Be Completed: 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 Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE- � SIGNATURE:
Stipul tions:
q d —j 1z 0 0rF
-
mw, r, f)
BUILDING PER141T FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or for any addition to any existing building or structure,
or for any alteration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $15.40
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In -no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
use or occupancy of any structure for which a building permit has been issuec
said structure shall not be used or occupied until a Certificate of Occupanc3
been issued. .
10
AGREEMENT
owner of the property
located at ,lao XEa have no objection to the
City allowing the construction of of c l° / .o be
located atwithout the required
certificate of survey that the City ordinarily requires for all new
construction.
Witness
t
�j
Signature
Address
/s=
Date a
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
Rate TOTAL
$ 20.00
$
$ 10.00
$
.00
$
$ 10.00
$
$ 10.00
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work
Commercial/industrial
1 % of Value of Appliance or Work
State Surcharge
TOTAL FEE
JOB ADDRESS ;tel e�Z �; 2'"
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 ruling of the Building Division, and hereby declares
that all the facts and representations stated in this application are
true and correct. ,1991
OWNER0?6110E,
BUILDING USED AS -- il�e!5-
ESTIMATED COST 0 000a—'PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units Circle One (Steam (Hot Water) (Warm Air)
Trade Name eD e4 M6 N o.
BTU -6 e �C)C HP EDR
$ Fuel-"= Total Connected Load
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPA
Signed By Tel No.
Approved By _ (� Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes ( )
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5. Meets all current Code requirements for
size and total BTU's connected Yes ( ) No ( )
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks X/, , ` rl.,
v
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
SUBJECT
P
City ®f Fridley
?7669
AT THE TOP OF THE TWINS
BUILDING PERMIT
i �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r t L PROTECTIVE INSPECTION SEC.
672
t �
t � �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
1', 812-571-3450
910415
9/10/98
JOB ADDRESS 6181 Starlite Blvd
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
$ lvan Rlkiibm Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Sylvia Lindgren
3 CONTRACTOR MAIL ADDRESS ZIP PHONE
LICENSE NO.
New Haven*r Construction Co 4208 83rd -Ave N Brookhm Rark 95443 566-
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 0 NEW 0 ADDITION 0 ALTERATION LJ REPAIR O MOVE 0 REMOVE
6 DESCRIBE WORK
Reroof house & garage 20S Tear -off
CHANGE OF USE FROM TO
STIPULATION S
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
$1714.00
�y`"Z
86
$
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
PROVIS OF ANY OTHER STATE LO LAW REGULATING CON-
$ 56.75
Fire
SC $1.71
STRU ION R THE PER RMANC C RUCTION.
PLAN CHECK FEE
TOT FEE
Lice e $5.0
$64.32
ATURE OF CO RA TOR OR AUTHORIZED AGENT IDATEI
EN ROP VALID T HISUR M I
;FUR
SIGNATURE OF OWNER (IF OWNER BUILDERI IDATEI
INSP
OATS
If
Shp OS S8 06:22a Kerri 566-7183 p.2
[ I Effective 1/1/98
AWN [
CITY OF FRI DLEY
AL'TER [ l SINGLE FANCY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION A
ConstructionAddress•
Legal Description:
Owner Name & Address: ��'f'�' Z''"-) r' 6, Aj Tel. # S -J !'r- C/&';� C/
Contractor: /L/C- C --j �� veo-) C g n S MN LICENSE #
Address: � o� �-�` ' � � e /� , Tel. # � 2- 2_
Attach tofthis application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGR "AREA:
DECK AREA:
J :i
DESCRIPTION OF IMPROVEMM
Length Width Height Sq. Ft.
Length Width height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type. "/� " a � r ,ec. re C, v - Estimated Cost: $ ®S q c- L, ► e l / `L/
'(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
DATE: APPLICANT
Ft. + 6 Ft = Ft x $ = $
Tet. #
CITY [TSR ®T�LY
Permit Fee $ qS Fee Schedule on Reverse Side
Fire Surcharge $ % i .001 of Permit Valuation (1/10th%)
State Surcharge $� $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determines) by ]Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary
TOTAL $ ( STIPULATIONS—
vv4W4 Lot V.
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories (1 11 Urinal
Basement
Floor 1
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
Effective On May 10, 1999
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARKNUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
i
Wash
. FI
OOr
Shower `: > .11.1.
.:..... Tra :�t��ti�l�<;<::;:; Dram
Auto.Gas -::
��' :>
�.:•<.::.�. Water Heater
Washer ":`"r<
Range
.
}"` Gas Elec
NO. RATE TOTAL JOB ADDRESS_ IOU �5
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance C50 Ferner) �-
Water Heater -Electric
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes {) No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$z0___50
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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
--z=0 (
z 2% .
LINDGREN, ARCHIE
Owner_ 6181 STARLITE BOULEVARD N.E.
FRIDLEY, MN 55432
;763) 571-4624
Building
r� 00Estimated Cost PERMIT NO.
PLUMBING COMPANY FZ_010&1AJC,
SIGNED BY TEL NO.(61 lJZ7- gO33
Approved By Rough -In Date Final Date-la?_Q
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.