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PRE 2010 DOCSVillage of Fridley, Minn. BUH D NG PERXHr N° 854 Office of INSPECTOR OF BUILDINGS owner Architect Fridley, Minn., , 18 Builder LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Sub -Division DESCRIPTION OF BUILDING Front; Depth f�p Height Stories ' u z '4 .1Vlanner of Constructiont To be used as To be completed Estimated Cost ".,. Y 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. ' eh �s � " " -L—Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Ilnspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forthand according to the provisions of the ordinances of Fridley, and, being first duly 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, day of ,r 3k. A.D. 19-:_ l� \ Minnesota,.._this - 'q -/ a cp City ®* Fridley, . II PERMIT N® 7054 LOCATIONBUILDING La No. Street -� ZPart of Lot Lot _ Block Addition or Sub -Di on .� Corner Lot . _ Inside Lot setback Sideyard Sewer Elevation — Fo dation Elevation DESCRIPTION OF BUILDING To�Ua: Front Depth Height Sq. F't.Cu. Ft Front Depth Height _ _ Sq. Ft. Cu. Ft. Type of Construction _. _Est. Cost To be Completed In consideration of the issuance to me of a permit to construct the building des a e, I a do the proposed work in accordance with the description above set fo and in compli ce all o of ordinances of the city of Fridley. z�- 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 done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of te Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viol43ap of any of the provisions of said ordinances. Z-% _ / I NOTICE: 'this penult doer not corer the eonstrueHon, h ataMen for whkg, phnnhine, ®+r heating, wwor or water. Be ane to we the BWM Ing Inspeetar for separate pernifts for there hent. City of Fridley SUBJECT PERMIT AT THE TOP OF THE TWINS BUILDING PERMIT r • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. t S � CITY HALL FRIDLEY 55432 612-571-3450 CEIPT . '7 3 NUMBER 910-F15 REV. DATE 5/9/83 PAGE OF APPROVED BY JOB ADDRESS 6120 Sunrise Drive N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20- Z 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Mrs. Holm 6120 Sunrise Drive N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Richard Hastings 6331 Riverview Terrace N.E. 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. O:6 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.- 6USE OF BUILDING Plesidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. 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 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION NO. DWLG. UNITS 1 OFFSTREET PARKING 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1.000 $.50 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $17.50 PLAN CHECK FEE TOTAL FEE $18.00 bIGNATUREo CONTRACTOR OR AUTH VIED AGENT (DAE) WHEN PROPER VALIDATED THIS IS YOUR PERMIT ka BLDG INSP rl TE SIGNATURE OF OWNER (IF OWNER BUILDERI (DATEI • CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR RESIDENTIAL BUILDING PE-ra4JTS (New. Alterations. Additions. or Repairs) ONI1ER: 5. L.c/l BUILDER: _.L c A A e D s �t'-4-V � ADDRESS: � f Z e� _S� srr�,`s� (� Q2_ � ADDRESS: G.s"3 ) K a 1� di. ?-Li TEL 110: TEL NO: S?!( Construction Location • STR= NO: STJtEET: LOT: DL4XX: ADDITMW L v �, AA.' Corner Trot: Inside Lot: setback.: Sideyazds: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. OESCRIPTIOR OF CONSTRUCTION _ Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Neight: Square Feet: Cubic reet: Type of Construction: _ ��a F Estimated cost: �$ Zo 0 0 . 0-0 9b Be Completed: 5�.� V/ Alt. A Alt. 8 Proposed Drivmiay Width If New Opening Is Desired: $ _ SEE PZVERSE SIDE OF SHEET The undersigned here water application for • t'Y '' PP permit icz the Mork herein specified, agreeing to do ,all work bi strict accordance with the City of Fridley Ordi»ances tlzd rulings of the Delvirtment of Duildings, and hereby declares that all the facts and representations stated in this application are true and co--rect. MM � lye_ slcNnTv�: Stipulations: SUILDM PERMIT FEE SCHEDULE 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: TMAL VAIMATICe1 TE£s MOD to $SDD.00 $10.00 Minimum Fee S1S.00 plus surcharge $SOI to $2,000 $ID.00 for the first $S00 plus $1.50 for each additional $IOD or fraction thereof, to and Including $2,000 $2,001 to $25, 000 $32.50 for the first $2,000 plus $6. DD for each additional $1,000 or fraction thereof, to and Including $25,000 $25,001 to $50,000 $270.S0 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to - _....�, and including $50,000 $S0, 001 to $100,000 $283.00 for the first $5D, 000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,00D $100,001 and up $443.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof ALN CHECK: 25 percent of building permit fee DRIVEWAY DEPRESSION ESCROW: Concrete R:rb Streets Only Alternate 'A": Removial and replacement of curb and gutter only Driveway width plus 6 feet x $13.50 Alternate 08': Refloval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet a $15.75 VERIFICATION OF FOUNDATION perrits 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 r has been constructed will be required before proceeding with the framing. %J C� ` 0— 1_fat3 %(11 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATIOJA 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'(Ntteded with new furnace) Gas Range Gas Dryer "Air Conditio - izes 4_^ Rete TOTAL $ 20.00 $ 00 , $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ Lo 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 $ .50 TOTAL FEE $ J0, 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. 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. /- IF ,199 OWNER 6_ 7/ -a 2 36� BUILDING USED AS-- e� ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (S Trade Name � BTU HP Dam) (Hot Water) arm Air Size No.. - 7 EDR Fuel Qi2la Total Connected Load Burner Trade Name Size No BTU F,P EDR HEATING COMPANY H&WING & AIR enNOMCNI G CQ 8910 WENTWORTH 0E. S0. Signed By tiA1N 55420 1- 0 Approved By6-F-F Rough -In Date Final Date-) 40-9), 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 (K) No ( ) 4. Is securely supported Yes (I() No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes Q) No ( ) €. Has tctal heatin- BTU's of IS' aoP ef All other BTU's TOTAL BTU's DS Paz) Remarks List Alterations Being Done: a HEATING COMPANY S E ® WI C HEATING & AIR CONDITIONING CO. Signed By - 8910 WENTWORTH AVE. S0. e, C, MINNEAPOLIS, MN 55420 Date 881-9000 'SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO: q:33 15910 WENTWORTH AVENUE SOUTH - MINNEAPOLIS, MN 55420 - (612) 881-9000 TEST RECORD ADDRESS 6,/do So pi sq,NG6 c) OCCUPANT6-b� A b 146 m SOLD BY MAKE i OA SERIAL NO. THERMOSTATA-0-0 F_ Y l 7 VALVE (K 16 J!� R T 5 &A �Q 0 b e LIMIT hAl LIMIT SETTING../<ro FAN SETTING PILOT TYPE IGNITION MODEL RO APIAT 13 H AV7 13 P2 3� CITY OWNER INSTALLED BY W I Q MODEL INPUT 5 09to z-> dy VENT SIZE q TYPE OF LINERAOM — 51 N 6!k& W A, I- .,— Ie LINER SIZE a S P FILTERS: SIZEff9X' _Y NUMBER WIRING TEST TAG LIGHTING INST. PILOT TIMING) NIS TA- P 7' PATE TESTED mb 07 PRESSURE PERCENT CO, 44& INPUT CFH PERCENT 0, COMPANY TESTING A6— STACK TEMP. qvo PERCENT CO NAME OF TESTER FORM 235 (REV. 11/89) FORM DISTRIBUTION: VVHrrE COPY - JOB FILE YLLOW COPY - m7f- 11 a u_ 0 U 6431 University Ave NE Fridley. MN 56432 572-3604 Sto ri es Basement Floor 1 Floor 2 Floor 3 Floor 4 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Auto. Urinal '-<= - _ Shower-- -=3. --ti€..r:- ;�-. .,s::�-:: Tray _<. Grain Bas= Washer PLiJMBINGFIXTURE-RATES: NO. New f=ixtures O'd Opening, New Fixture Raer Dispenser 310-m Off Basin '_a:ch Basin Rain Water Leader Sum plReceiving Tank *Wa ,ur Treating Appliance 4aier Heater - Electric 'N- ter Heater:- Gas** Gat, Flange** 3a_ Dryer** Flown Preventer Required { )Yes No Type -____- - 2 RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 _ $ 7.00 $14.00 $10.00 $10.00 $15.00 dem-. pection Fee $42.001Hr ALL 0TH ERS ANDIOR REPAIRS AND ALTERATIONS o� • Q 1-5ero of Value of Fixture or Appliance State Surcharge TOTAL FEE .50 JOB ADDRESS 6_120 Effective On January 1. 1997 Gas =i1S4A�� Water Heater _ F sv#�T Range The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work In strict accordance with the city code's and rurtngs of the Building Division, and hereby declares that alithe facts and representations stated in this application are true and correct. 1997 Own er L- �� 1 0 Building Used As Estimated Cost: ?� � PERMIT NO. e� PLUMBING COMPANY e V. zr - SIGNED BY 4-= L, s TEL AiO. a Approved By Rough -In Date Final Date�� + MINIMUM FEE OR AN3 PLUMBING CTAS PERMIT IS PLUS THE $.fit! STATE SURCHARGE **COM BU STION AIR SHALL BE PRO VIDEO PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 80 1 NCI;ES. SUBJECT PE _ City of Fridley("_2 5 g 9 AT THE TOP OF THE TWINS BUILDING MIT t RECEIPT NO. COMMUNITY DEVELOPMENT DIV. _ _____ v r I ------ PROTECTIVE INSPECTION SEC. e , 1 . � NUMBER RE7 DATE PAGE OF APPROVED BY f 1 CITY HALL FRIDLEY 55432 1'' 612-571-3450 910-F15 10/13/97 JOB ADDRESS 6120 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 2 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Glad s Holms 6120 Sunrise Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Greg Wills Exteriors 4246 Royce St NE, Mpls., MN 55421 788-0529 20037840 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 Soffit/Fascia; Trim 9 CHANGE OF USE FROM TO STIPULATIONS Install ventilation in soffit to meet the State Building Code. 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 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 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 $1,080 $.54 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- $37.50 Fire SC $1.08 STRUCTION OR THE PERFORMANCE OF CONSTRU TION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $44.12 SIGNATOR FCONTRACTOR ORAUTHORIZEDA, ENT TqkTEI WHEN PROPERLYV IDATED THIS IS YOUR PERMIT s lz?�� kZ BLD& INSP ( GATE NA RE OF WNE I of OWNER BUILDER: NEW [ ] Effective 1/1/97 ADDN [ I CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION `6 l ConstructionAddress: S1441le- l S Legal Description: Owner Name & Address: CQ ® Tel. # Contractor: C jf l�;4 1A,/�' �) S' ?C. >2 ( s MN LICENSE # Address: XO V 5-45 S 7----V �� Tel. # -79o—e5,-A Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width H Ground Sq. OTHER: $ $950 per SAC Unit License Surcharge Construction Type: Estimated Cost: $ (Fee Schedule.on Back) Driveway Curb Cut Width Needed Ft.` + 6 'Ft Ft x DATE: 3 APPLICANT: Tel. # %?eP��a s"CII'ULA,nONS: CITY USE ONLY Permit Fee $ 39 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $S �� $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ - 06 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ •$450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL s"CII'ULA,nONS: BUILDING "I"RrMIT FEE SCHEDULH. The Chief Building Official 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 repair 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: TOTAL VALUE FEES $1 to $500 '1- $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 - $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including'$1Q0,000 $100,001 to $500,000 $887.25 for fust $100,000 plus $5.00 for each additional $1•,1100 or fraction thereof, . to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and .including $1,000;000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement -of curb and gutter only- Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION 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 l,;utiticate ot' Surrey Of the lot, showing the location of the foundation c+rlce it has it has been const. UM:::{ rctfuired hC1,0rc prc�.:c cdirl�� gill] tic 1r:1I11in,,. SUBJE& PER O. MqqCity of Fridley 8 099 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT_ • COMMUNITY DEVELOPMENT DIV. V-----_� r PROTECTIVE INSPECTION SEC. � 1 � NUMBER REV DATE PAGE OF APPROVED By = CITY HALL FRIDLEY 5$432 612-571-3450 910-F15 10/5/98 JOB ADDRESS 6120 Surise 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Gladys Holm 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contr. 6331 Rive574-9966 4mi 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 O NEW O ADDITION O ALTERATION xEj REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (23 S Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1971 $.98 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $62.25 Fire SC $1.97 PLAN CHECK FEE Licens 5.0 IOTA EE 0.20 S.GNATURE OF CON • RACTOR OR AU(kORIZED AGENT iDATEi N ROP 9t IN VALID T THIS IS YOUR PERMI OAYE SIGNATURE OF OwNEA,1F OWNER SUILOER1 iOATEI NEW [ f Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �� S�� ®` DR_ Legal Description: Owner Name & Address:G &A el 5- 4v � Tel. # Contractor: c i'��A• ` �j r.; 5 MN LICENSE # Address: 6 3, 1 ?'�- G �j T-,—= Tel. # Y -5'791C Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 5� n Construction Type: �� ` � PC Estimated Cost: $ /991 /4 tc 5-6 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 1 0 -- APPLICANT: Tel. #__ S 7 o f F 5;�4r Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] It BUILDING PERMIT FEE SCHEDULE The Chief Building Oficial 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 repair 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: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) . $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and includimg$1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue.iEty of Fr aneyd'530379 AT THE TOP OF THE TWINS ATTH BUILDING PERMIT ` RECEIPT. NO. COMMUNITY DEVELOPMENT DIV. 1,44/0 �® ______ r - PROTECTIVE INSPECTION SEC. 1 NUMBER REV GATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 ti""11•� �', 612-571-3450 910415 10/11/99 108 ADDRESS 6120 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 20 2 . Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Dillenburg j00¢/j$jgU "4000f 3 CONTRACTOR MAIL ADDRESS ZIP 'PHONE LICENSE NO Custom Color Painting & Rem. 2066 142nd in NW Andover 55757-0651 20139344 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 O ADDITION ❑ ALTERATION Xg REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside house and garage Shakes 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED 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 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 $2800 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1.40 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- $83.25 Fire SC $2.80 .STRUCPON OR THE PERFORM OF CONSTRUCTION PLAN CHECK FEE TOTA E License $5.00 IS9 .45 51GNATU E F O . A , Op OR uTN IZED AGENT IOATEI EN O EO LIDAT HIS IS YQQUUJ�R' PERMIT l/V SIGNATURE Of OWNEROF OWNER BUILOERI IDATEI BLOf INSP - QA1E NEW[ ] - Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Tel. # 0 Contractor: MN LICENSE # �O/ Address: QO4, �� /�� h �� lZ�A/ �e��('G'e/�� Tel. # �. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EM PROVEMENT LIVING AREA: Length -� Width Height Sq. Ft.�G7 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: od Construction Type: `�4e Estimated Cost: $ 6Ay Driveway Curb Cut Width Needed: R. + 6 Ft = Ft x $ _ $ DATE: C) ;/l 9APPLICANT: Tel. # 7-S-? Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 63.2s' $ 6?0?. qt 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 [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official 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 repair 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION 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 it has been constructed will be required before proceeding with the framing. Building PLUMBING Permit No.l®- W015 Inspections RESIDENTIAL APPLICATION Received Bye 763-572-3604 CITY OF FRIDLEY'A�l C� rig in 763-502-4977 FAX EFFECTIVE 1-1-2010 ( DATE YOU n iv_IAII� ADDRESS SITE ADDRESS �1 (ZCO Kl f Ab1 �tS� 16 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: L CA - ADDRESS: & t ? O 40U,4116"1847 `t� k -y CITY 1 �l IC _STATE "`iIP OWNER/ TENANT PHONE: CONTRACTOR NAME: Lf"C Ilnyn f v/l //� C (D STATE LICENSE # �O Z Z% P I'" t SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND HEXPDATE STATE BOND # % Z-2-7 ( ki-1 P DATE CERTIFICATE OF ADDRESS: Z��tZ i`IOVid �� CITY .p �STATE zip 5S4�'i INSURANCE (763-1 75_:� - 3 9G Lt FAX 6 7J - 30' 7 PHONE PERMIT TYPE SINGLE FAMILY ' ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: W o REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER _ WATER PIPING _ _ PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB WASHER —GAS _ KITCHEN SINK —WATER CLOSET _ BACKFLOW PREY. ($15) —CLOTHES DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER ��fT ,'Lf S 3 ^X�' ➢ A � i } � � � R - � ''. s �.,�; ,�1 ,.fit k � �-'""'ie+Tw _ 5 "?. F 3� `ih ✓" ty �,^%.'. YS' i' - t'-�.� X �'. � -..3 K " THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 OF APPLICANT in the case all w r w 'ch requires review and approvo ofplans PRINT NAME �CJ lry DATE SIGNATURE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 S>1