PRE 2010 DOCSDate .+� : .... .
Owner+'°', • Builder .............................................
Address .%t - Address .......... ........... ...........
LOCATION OF BUILDING
JAI �
No. Street , ' 6,;u a .. Part of Lot ........... ... .
Lot ...... .. Block ......... ""'... Addition or Sub -Division .................... .
Corner Lot Inside Lot ..... Setback ............ Sideyard ..................... ...
DESCRIPTION OF BUILDING
To be Used as:
�..Front Depth .. Height Sq.
Ft....... , , Cu. Ft. ........
. Front ........ Depth ........ Height ...... Sq. Ft.. .... Cu. Ft, ........
Type of Construct!, n - Est Cost ...... ............ To be Completed
In consideratio of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work accordance with the description above set forth and in compliance with all provisions of
ordinances of the v age of Fridley. ,°
J� A
�
cansideratio 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
t e express conditi that the person to whom .it is granted and his agents, employees and workmen, in all work
done in, around anc upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota egarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. .e?
6 16-4 Building Inspector
NOTICE: .
This permit does not cover the construction, installation or alteration for Wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building, Inspector for separate permits for these Items.
��'
City of Fridley, YHnn.
BUILDING PERMIT N° Q5 33
Date: Owner:
AddressAddress L-- ---
WCATION OfSJBUILDING
No. Street ' `' ._ Part of Lotir _
Lot _ _ _ .__ Block Addition or Sub-Divis:$n'
Corner Lot . _ Inside Lot _ ._ –qWtbaer �y_:.d,-.,,--XWSideyard ......_---
Sewer Elevation on Elevation _ — ---
DESCRIPTION OF BUILDING
T *Used _s:711,
YJ
7Y4 A,
.�
Front Depth . Height 412-412—Sq. Ft..r Cu. Ft.;,y,�=�.
From, Depth Sq. Ft. Cu. Ft.
Type of Constructionv __To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
A,
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
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 violation of any of the provisions of said
ordinances. ..
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, 'plumbing, gas heating, sower or water. Be sure to we
the Building Inspector for separate permits for these Items.
4
P
SUBJECT
P
City of Fridley
717 8
AT THE TOP OF THE 'TWINS
BUILDING
PERMIT
r
RECEIPT NO.
`
• COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
I �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
8/13/98
JOB ADDRESS
140 Sylvan Ln
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
2
Plat 3
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Bill Reshiler
574-9433
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Tabor & Sons 3716 St Francis Blvd Anoka 55303
789-1902 20014248
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 XX REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
-Reroof house and garage 28 S Tear-off
8 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with 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
MOT.
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
I 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
1.16
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.
2,33
PLAN CHECK FEE
TOTAL F E
8 24
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
P OPER IDAT S IS YOUR PERMIT
BLO INSP
a �
MATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
P
'NEW" [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: �� _
Legal Description:
Owner Name & Address: %��/� _���� Tel. #
Contractor: Jc.�� y� o MN LICENSE #
Address: Tel. #
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 Hgt/Ground Sq. Ft.
OTHER: zz; �r r` 6" al—pe —0
Construction Type:
Estimated Cost: $ _91� _33S
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: CP- J3
APPLICANT:
Tel. # 29 2-49a,2
CITY USE ONLY
Permit Fee
$' %�
Fee Schedule on Reverse Side
Fire Surcharge
$
3
.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 Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
$ `� 3
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 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 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 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.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
S Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range**
IZ16)1111111111111111:70tI 0i1rMI
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
y�
$ C,o
JOB ADDRESS I S V1% Vl '' (,,.V1
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.
DATE: ,20 O�
OWNER \Xf I I � ('A VVI F)f SkR_-tZi
BUILDING USED AS i.5 (de- VTl.q I
ESTIMATED COST 4 200• 00 PERMIT NO
PLUMBING COMPANY b P
SIGNED BY TEL N0. 754
Approved By Rough -In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF CO
$ 7_-� P 5 (R) OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
� COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
0
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :