PRE 2010 DOCSaN
Y.
it
BUILDING PERMIT
'S\No
Village of Fridley, Minn.
to.. .............................
Owner 71.
Address .......
............................
2218
Builder
..........................
Address.........................................
LOCATION
ATION OF BUILDING
No. .... Street
-,* ..... Part of Lot .....................
-ow A�
Lot ......... Block ...... ........ Addition or Sub -Division ..........................
Comer Lot ...... ..... Inside Lot ............ Setback Sideyard '1......
To be Used as:
" 0
Type of
DESCRIPTION OF BUILDING
Front Depth .,444... Height AR Sq. Ft.........
Cu. Ft. ........
Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft... .. .
Est. Cost ...... To be Completed 7
In consideratio of the issuance to me of apermit to construct the building described above, I agree to do
the proposed work yin accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
.................... .............. 4.7 ..... ........
In consideratim L of the Payment of a fee off, $., . /i/,.!n—permit is hereby granted to ..
e_19114-,0414. - - to construct the building or addition as described above. This permit •is granted upon
the express conditic n 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 respLacts to the ordinances of
Fridley, Minnesota regarding 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_qf any, of the provisions of said
ordinances.
LAuilding 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.
l
Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ...............,..........$10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6,00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq, ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam . .................. 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal, per hour 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) ....................... 500
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 2.00
Additional Fixtures ................. x .75 $
Gas Range to 199,000 ........... x$ 500 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
$
TOTAL FEE $� � �"
Dept. of Bldgs. Phone 560-3450
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir.
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application,are�true and correct.
Owner ® twig 'J—oi
Kind of Building
Used as i4®� —__
To be completed about
Estimated Cost, $_ -- '/2'0'y --
%
Old New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No.
19 6,,Z
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuer
BURNER — Trade Nam Size No -6e— ���
Capacity M%rz9!!0 661# .
(REMARKS -OVER)
c � �
SUBJECT
PER 0.
City of Fridley
00680
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
�
COMMUNITY DEVELOPMENT DIV.����
PROTECTIVE INSPECTION
r SEC.
1 �
;
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
I
7-8-75
JOB ADDRESS
6421 TAYLOR ST. N.E., FRIDLEY, MINNESOTA
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
]
]
MOORE LAKE HIGHLANDS, 2ND ADDITION SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
WARREN HESSELROTH 6421 TAYLOR ST. N.E. FRIDLEY MINNESOTA
3 CONTRACTOR MAIL ADDRESS ZIP ` PHONE LICENSE NO.
RICHARD HASTINGS CO. 6331 RIVER'VIEW TERRACE N.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION XXI REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
RESIDE & TRIM
9 CHANGE QF USE FROM TO
STIPULATIONS
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 AR
1 R-1
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,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
gxmm $1, 900
.95
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 P FORM NCE QF CONSTRUCTION.
$11.00
PLAN CHECK FEE
TOTALFEE
$11.95
NATURE OF CONT ACTOR OR KTHORIrENT (DATE)"WHEN
PROP1ERLY VALIDATED THIS IS YOUR PERMIT
w✓� l MMY 8, 975
BLDG. INSP T DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
c � �
•APPLICATION FOR RESI'DENTIAL., ALTERATION,
OR ADDITION•BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAriE:���4J z BUILDER:t
ADDRESS • 7 < ADDRESS:
STREET:
LOT:� BLOCK: / ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach . to this form Tsao Certificates if Survey .of' Lot and .proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth: Height:
• Square Feet: Cubic.Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type1of Construction. j r)vvc- Estimated Cost. $ J �
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: �" ZZ SIGNATURE: ! 2
(See Reverse Side For Additiondl Information.)'
d //,
BU1LL)IN i r-LI(Mi 1 rL'L' 0w11:1uui.1:!
SECTION 2. The Inspector of Buildings shall, bei•.ore 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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet; or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
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 are -
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 averager.
'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 $5.00.
VERIFICATION OF -FOUNDATION
n
'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 Certified 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
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued..
HOU E TING TEST RECORD
ADDRESS APT. FLOOR CITY SUBURB
OCCUPANT OWNER
HEAT LOSS DATE HTG. NST.
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA PA -1—,"0' HW` STEAM SPACE HTR.
GAS DESIGN
MAKE 71'MAKE OF BURNER _
Model Model
Serial r� Max. BTU Rating —
INPUT —,Z y MAKE OF FURNACE
Model.
UNIT HTR. OTHER
CONVERSION
CONTROLS P/
THERMOSTAT 14-6Plug Vent Size
Valve KIND OF LINER SIZE NONE
Limit Draft Hood 13 Regulator
Limit Settings+�®� Filters Size Number
Fan Setting �� LI Chimney Location Inside Outside
Pilot Type ` _ — Chimney Construction
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing Draft Test Tag L�
L.W. Cut Off Door Pressure Lighting Inst.
Pressure �s-S -------'-PercentCO2,Date Tested
Input CFH Percent 02 Company Testing
Staek Temp. Percent co Name of Tester
Form 235
CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
$
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE'
$
$10.00
$
10.00
$
16
GRAVITY 1ti:iR>1 AIR:
P.ATL'
TOTAL
Job P.ddress Ce d
r^urnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Re --airs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add.. $500.00
Tel. 11571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
$1
-
specified agreeing to do all work in strict accordance with the City Codes
Furnace Shell & Duct Work to 100,000 BTL'
each add. 50,000 BTU
Y•0
and rulings of the Department of Buildings, and hereby declares that all the
7.00
$
facts and representations stated in this application are true and correct.
Replacement of Fu=nate
RapairS & Alterations -up to $500.00
7.00
$
1927
Repairs & Alterations each ado. $500.00
4.00
$
Fridley, Minn.
ss s --1 6 e n
STEX,1 OR HOT 1, .XTER SYSTEM:
Boiler & Lines up to 100,000 BTU
each addn. 50,C00 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTL'
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
$1.2.00
$
4.00.
$
7.00
$
6.00
$
$10.00
$
10.00
$
$10.00
GAS FITTING FEES:
1st 3 Fixtures x $ 3.00
Additional Fixtures x $ 1.00
Gas range to 199,000 BTU x $10.00
AIR CONDITIONING
FAN HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS & REPAIRS
- State Surcharge:
� ROUGH INSP.
Date
FINAL INSP. 9 -/ q - 7 /
Date
APPROVAL FOR PER!.! --,T y
TOTAL FEE
REINSPECTION FEE
(.$10.00)
MINII:UM FEE FOR ANY HEATING PERMIT IS $7.50
OWNER
KIND OF BUILDING v
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST 4wc---" 6.
LD - BUILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
?EATING or POWEP PLANTS, Steam, Hot Water Warm Ai No. O
Trade Name 9 6 Size: No. a- eO
Capacity So. Ft. EDP . BTU HP
Total Connected Load Kind of Fuel B
BURNER - Trade Name s _ Size No. "4e 1/`� !Q -
Capacity Sq. Ft. EDR,/452A TU a� HP
Compan
RAY N. WELTER HEATING CO. Signed By
A637 Chicago Ave.
Tei. No.
Minneapolis, Minnesota 55497
4ey�e�0�1
.el
HOU E TING TEST
ADDRESS APT. —
OCCUPANT OWNER.
HEAT LOSS DATE HTG. NST.
RECORD
_FLOOR CITY SUBURB
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA'' FA A'00'HW STEAM SPACE HTR.
GAS DESIGN
MAKEMAKE OF BURNER
Model _7 Model
Serial Max. BTU Rating
INPUTT ® MAKE OF FURNACE —
Model
CONTROLS
!'j
UNIT HTR. OTHER
CONVERSION
THERMOSTAT
Heat Plug
Vent Size %�e
Valve
KIND OF LINER
SIZE NONE
Limit
Draft Hood
Regularor
Limit Setting
T�_®�
Filters Size
Number
Fan Setting
�e
Chimney Location
Inside 0 side
Pilot Type
Chimney Construction
Pilot Make
Pilot Model
Smoke Bomb
Wiring
Pilot Timing
Draft
Test Tag f�
L.W. Cut Off
Door 'Pressure
Lighting Inst. ei
Pressure _S F
Percent CO.
Date Tested
Input CFHPercent
02=
Company Testing
Staek Temp.
Percent
Name of Tester
Form 235
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY N_\R.11 AIR:
Furnace Shell & Duct Work
ceniaca e of Furnace
Repairs & Alterations -up to $500.00
Renalrs & Alterations each add. $500.00
MECHANICAL WARN AIR:
Furnace Shell & Duct Work to 100,000 BTL'
each add. 50,000 BTU
R eolacem.e nt of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STE.a:,f OR HOT NATiR SYSTEM:
Boiler & Lines up to 100,000 BTU
each add-: 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BUP..\ER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BURNER- from 100,000 ETU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
RATE TOTAL
$12.00
$
7.00
$
7.00
$
4.00
$
$10.00
$
10.00
$
7.00
s_ t
�3
7.00
$
4.00
$
$12.00
$
4.00.
$
7.00
$
6.00
$10.00
$
10.00
$
$10.00
GAS FITTING FEES:
1st 3 Fixtures x $ 3.00
Additional Fixtures x $ 1.00
Gas Range to 199,000 BTU x $10.00
AIR CONDITIONING
FAN HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS
- � State surcharge
I ROUGH INSP.
FINAL INSP.
Date
APPROVAL FOR PERMIT
TOTAL FEE
REINSPECTION FEE
(.$10. UO)
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
Job
Department of Buildings
City of Fridley
Tel. '1571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
(9—.BUILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
??EATING or POWE$ PLANTS, Steam, Hot Water
Warm Ai No.
Trade Name /' C � Size No. 4zlelle:W
Capacity Sq. Ft. ED -y BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Namc- L=_!� —. Size No.'1 ?% 4y')
Capacity Sq. Ft. EDR/_ 5V'TU IiP
Conpany
RAY K WELTER HEATING CO. Signed By
4637 Chicago Ave. Tel. No.�`�
Minneapolis, Minnesota 55407
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
N
NO.
RATE
>4
m
x
r0
$
ca
x
$2.00
a
New Fixture, Old Opening
Water
$2.00
m
N
x
$5.00
$
N
C I
N
Q
100,000 BTU to 199,000 BTU
+-3 -
ri
Q
W
�
x
Heater
v
41
r -I
$5.00
U]
Electric Water Heater
H
bm
$
GAS FITTING FEES:
r:
0
N
pa
q',
1st 3 fixtures
r
}�
$
.,q
S4 0
0
$
G
-H
N
$10.00
11
z
N
3
S4
O
.0
Ei
0 4
First $100.00
U
$5.00
N
each add. $100.00 or fraction
74
O N
G
•rf
.4'
-P
N
#
N
•ri 9
O
O
ly N
41 UI
N
N
W
4
U
�
M
P2
t
3
Q w°
m
w
U w
a 3
0
X
(D
O
as
lec
is t
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU`
x
$5.00
$ !� S
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
X
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
r
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTION FEE
($10.00)
Job Address � ! � �� � � �' /14 <Xr
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work her
specified agreeing to do all work in strict accordance with the City Co
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and co
Fridley, Mn. 19 "7
OWNER (✓�1�� L�Oy� T! s�" �] o�Ca`7�
KIND OF BUILDING �ri ®�'r°,-e
USED AS ��� e� 1 F
TO BE COMPLETED ABOUT
ESTIMATED COST 4�9'
OLD,71 NEW BUILDI14G PERMIT NO. PERMIT NO. 0�/
<7
Company
Signed By�
Tel. No. J-3 7 -J Z) _
ROUGH INSP.
Date
FINAL INSP. a -.S-- / 7
Date
APPROVAL FOR PERMIT
)ta
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
0
AYABLE 19X7
Pew Plat
iv.sion
Combination
Add as Omitted
LUate of Transfer ��
Special Assessment Funds
Paperwork Proofed►' -
Contract for De 'h
Warranty Deed
Quit Claim De
Request
Other, specify ---
I I
pecify
L! I I I I I I I I I I I I I I I I 1 I L 1 1 1 1 1 1 1 1 1 1 I I I I I 1 t I I
Plat Name: 1 I 1 1 1 1 1 1 1 1 fill -III I 1 1 1 1 1 1 1 1 1 t
The following Parcels are now out:
PIN (s}
L3 -a I oz 7
t I l I W W I I I 10QV
I I I I I I I I I I L I I I I I I I
I 1 1 1 I_ I I— I I I I I I I I I
I i l I I IBJ I_L I 1 1 1 1 1
The new Parcels are:
I 1? 15 3 -Lc -)j ^
-4 3z Do_q4
I I I 1 I I V I I I 11 1 I I I I
I I I I I I I I I i I I I I I I I I
1 1 1 1 W W W I I I I I 1 1 1 1 I I
FC to Assessor , , , ,, p,� FC from Assessor
Date Completed 010O.v Date to Auditor
To Assessor 7 � g D Values Entered 1 1 1 1
Deleted by
Date
Added by Date
1 11 1 I ! I I 1
I I
I C
1 0
I r l I I
I I I 1
1
E
�1
f
'IN..; 93J
i/._ /
7
A
00/7/L TITAX DESCRIPTION PAY 19 Paperwork Proofed Pag 1
Division, Combi tion ❑ *Jew Description Proofed
ACRES t I I I I I I B ATE 6el CRT DATE I 11W
7 1 I I I I I I I I
I I I I I I I I I I I I I I I I I I I
9 1 1 1 1 1 I I I I
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13
15 I I I I I I I I I
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6
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R13 30 24 32 0007
LOC 06421 TAYLOR NE
----m9 I L ING ADDRESS -------
SHIMMEL GEORGE K j & B J
24iTnSCHILDS
E� EARN 7TH PLACE 0200
07 PAUL. MN 5E101
----LEIAL
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LOC 06421 TAYLOR NE
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LOC
----MAILING ADDRESS-------
SHIMMEL GEORGE K JR & B J
%ROTHSCHILDS
85 EAST 7TH PLACE #200
ST PAUL MN 55101
0000
----LEBAL DESCRIPTION ----
#PK 461725 508150
THE S 30 FT OF LOT 13 AUD
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SALE 00/00 PRICE
LAST ACTIVITY 06/24/88
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SUBJECT
P O.
City of Fridley
29732
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
�
RECEIPT NO.
• ______ COMMUNITY DEVELOPMENT DIV.�Cs
r PROTECTIVE INSPECTION SEC
1 e �
REYDATE
PAGE Of
AVPROYEO BY
---,.j CITY HALL FRIDLEY 55432
�
---- A',.
612-571-3450
nq�10-Fl5
6/21/99
/
!OB ADDRESS 6421 Taylor Street NE
1 LEGAL
LOT NO.S . 701
BLOCK
TRACT OR ADDITION
SEE ATTACHED
oescR.
of Lot 1
_
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP
PHONE
Moon Chong
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
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION X® REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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 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
$3000
1,50
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
$87.75
SIGNATURE OF CONTRACT A OR AUTHORIZED AGENT (DATE.
WHEN PROPERLY LIDA ED THIS IS YOUR PERMIT
io�p
SSG TUAE OFakABUILOER- iDATE�
BLD NSP
GATE
t L.-Ol - . . -
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
1�67
Legal Description:
Owner Name & Address: / o� ��o�g �l y�� ` /bP Tel. htg1a�3,9S.3a 6
Contractor: MN LICENSE # W/lA
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
Tel. #
LIVING AREA: Length Width Height ' Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: r:2 Estimated Cost: $ 4&0&'
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: �' APPLICANT: Tel. #6/-)- 36 906
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 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 $ F7 -
STIPULATIONS:
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.