PRE 2010 DOCSBUILDING PERMIT
F
Village of
Date ....... .. .......... .
Owner
Address�,'t • "t ..,�,�f—°e°'.. , i
Fridley, Minn N? 2440
Builder...........................................
Address................................
LOCATION OF BUILDING
No. Street .. .. ........ Part of Lot .......................
Lot ...... Block ... Addition or Sub -Division a- .. ...... .......
Corner Lot ..... Inside Lot ..,F 6 ...... Setback Sideyard,tP' fe.................. .
DESCRIPTION OF BUILDING
To be Used as:
Front . j,/ f 1)epth Z_jf4Ae1ght Sg. Ft.. la r Cu. Ft.fP .......
.... .. Front ......... Depth ... Height ......... Sq. Ft... .... Cu. Ft......... .
Type of Construct] n �� .. Est. Cos f
�.�� ��. �> pIeted v .. .
In consideratic a 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 Nillage of Fridley.
In consideratioi of the payment of a fee of$.. 0 , permit is hereby granted to "'*
. , .: .... to construct the building'�o�' addition as described above. This permit ins 0 ted upon
express conditli n that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around ant. upon said building, or any part thereof, shall conform in all respects to the ordinances of
Pridley, Minnesota regarding ' -location, construction, alteration, maintenance, _repair and moving of buildings with -
In the village Ihnits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ,
a:.? 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 1Fridley,Minn.
BURDING PERMIT
Date: June 10, 1965
s
oar: Gerald Sundboom Builder Carlson and QarlAm Cs truetion CO.
Address 6$15 Washington Street N. E. Address 4416 3rd Street N. E.
LOCATION OF BUILDING
No. 6S� r _ _ street Washington Street N. E. Part of Lo't
Lot 17 _ Block 1 Addition or Sub.Division Rice Creek Terrace, Plat 4
Corner Lot Inside Lot
Sewer Elevation
To be Used as:
Setback Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft.
Type of Construction Est. Cost kdQQ _ To be Completed
Stout damage repair
Cu. Ft.
Cu. Ft.
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 com an th ail visions of
ordiaanc:es of the city of Fridley.
In consideration of the payment of a fee of $ , permit is hereby granted to Carl man & Car3 son
Constr. Co. 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.
NOTICE
" permit doss not cover the construction, huftildlen for rrhb& plumbing, gn healing, sower or wder. Be arca io see
the Building ingm for for separate pwmft for these items.
1 u
APPLICATION FOR BUILDING PERMIT
CITY -OF FRIDLEYO MINNESOTA
OWNER S
ADDRESS
LOCATION OF BUILDING
No. Street Part of Lot
LOT f BLOCK ADDITION OR SUBDIVISIO /�-
Corner'Vot Inside LOT' Setback Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
ESCRIPTTON "ILDING e&,j
To be used as: t7 U
Front —DepthHeight,
Sq. Ft. Cu. Ft,
Front Depth Height
Sq, Ft. Cu. Ft.
Type of Construction �- Estimated Cost
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.
DATI
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley, Minn. No 9440
BUILDING PERMIT
Date: Sept. 7, 1967
Owner; Donald L. Fag+erhaug Bid. Bussey Co.
Address 6815 Washinhton St, N. E. Address 1850_Cma Ave -
LOCATION OF BUILDING
No. 6815 Street Washington St. N. E. Part of Lot
Lot 17 _ Block 1 Addition or Sub -Division ..RLi~jp� Cr .k._ Terrace
Corner Lot _ Inside Lot x Setback _____ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24' Depth 22' Height 101 Sq. Ft 5 8 Cu. Ft 5280
Front Depth Height Sq. Ft. Cu. Ft
Type of Construction Frame Est. Cost _ 1600.00__ To be Completed
In consideration of the issuance to me of a permit to Dnstr ct 7br1;PPsVbed ve, I agreeto do
work in accordance with the description above set orinnce with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to Sussel Co.
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 ordir►ances of
Fridley, Minnesota reg ung location, construction, alteration, maintenance, repair and movhzg of buildings
wI thin the dty limits and thea permit may be revoked at any time upon violation of any of the Provisions of said
ordinances.
CLAUNCE BELISLE Big Inspector
NOTICE:
'This permit doss not cover the construction, butallation Ter wiring, plumbing, gas boating, sower or water. Be curs to ass
the Building Inspector for saparsts permits for those hams.
4
mi?'L:£Cmarx.i +: a MILDING TETE: � i.T
C.i`ti`t OF ilt�.J ,E i, MINNESOTA
7
OWNER'S NAME T—
ADDRESS
ADDRESS
LOCATION OF BUILDING
NO.- STREET d /� PART. 0F LOT
LOT BLOCK ADDITION OR SUBDIVISION�o
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
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 Ad:
Front Depth Height
r �
S'. Ft. —CU. Ft.—
Front
t.
Front Depth Height
r .,
_. Sq. Ft. • Cu. Ft.
Type of Construction Estimated Cost / / (Y CJ
To Be Completed_ 6 U 1 A At -
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 Ordices
and. rulings of the Department of.Buildings, and hereby declares that all the.facts
and representations stated in this application ar true and correct.
(Schedule of Fee Costs can be found on the Reverse Side).
S60 - /p.7
%" I
I
Cc ayr
0
S o l'
NAME
SIZE
17
-2 -1 �C a
BLOCK
ADDRESS
VALUE/,+
ADD'N.
/tic
AREA
TYPE
FR Q
%" I
I
Cc ayr
0
S o l'
SUBJECT
PERM
City of Fridley
14991
AT THE TOP OF THE TWINS
BUILDING PERMIT �fs'
r
ECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION
�� 71?r
PROTECTIVE SEC.
1 i
;
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
110/26/78
JOB ADDRESS
6815 Washington Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
17
1
1,
Rice Creek Terrace Plat 4 SHEET
2 PROPERTYOWNER MAIL ADDRESS I ZIP PHONE
Roger Frants 6815 Washing -ton Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Leo O. Sanders 7813 Jackson Street N.E. 786-2860
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
X
8 DESCRIBE WORK
Install drain 1
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 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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,900
$.95
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION OF ANY OTHER STATE OR LOCA LAW REGULATING CON-
STRUCTIO R THE PER2ORNCEI F CO UCTION.
12.00
PLAN CHECK FEE
TOTAL FEE
$12.95
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
1 o /..)- (. I
BLDG. INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
t
CITY OF FRIDLEY
APPLICATIO11 FOR RESIDENTIAL BUILDING PEIMITS
(NEW, ALTL=RATIONsi ADDITIONS, OR REPAIRS)
OWNER: BUILDER:
Address:
Address : - �L- -z
Tel. No . ? 'G'• �'
No. �,o IL
LOT:
Street:
13LOCK:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form T<vo Certificates of 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:
Type of Construction: �'_r �_.%- e _ Estimated Cost: $� �
To Be Completed: Alt. A Alt. B
JPrdposed 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 representatigns stated in this application
are true and correct. See reverse side fg 'additional information.
DATE: SIGNATURE:
Stipulations:
CITY OF,rRIDLEY INSPECTION DIV. Effective On January 1, 1993
64.?1 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
512-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS �® 1� �f ®� A),
jATTi SCHEDQLE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Fumace Shell and Duct Work, Burner – ®� rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correc . el
Gas PIping (Needed with new furnace) $10.00 $
OWNER h 'J.0'W 1
Gas Range $10.00 $
BUILDING USED AS Ld�)u
Gas Dryer $10.00 $
a� ESTIMATED COST 3 y0-0 PERMIT NO.S-
*Air Conditioning – All Sizes $10.00 $ to
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Wa (Warm
Trade Name koisrIV A'-" Size No. 10
Commercial/Industrial BTU HP EDR
1% of Value of Appliance or Work $ Fuel AI Total Connected Load.
L �—
State Surcharge Burner Trade Name Size No.
BTU HP EDR
cl„) TOTAL FEE s 3 o
W Llan
HEATING COMPANY ROYALTON HEATING & COOUNG
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION 4120 - 85TH AVENUE N.
REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00 Signed By BROOKLYN PARK, JMW43
PLUS THE $.50 STATE SURCHARGE 4,/
HuNE 424403`333
REINSPECTION FEE $30.00 Approved B Rough–in Date Final Date
g 4-7
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
I.
Has been carefully examined
Yes
No
( i
2_.
Is free from rust or deterioration
Yes
No
( j
3.
Has no foreign objects lodged within
Yes
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 40 at)
TOTAL BTU's -10400
Remarks
List Alterations Being Done:
ROYALTON HEATING & COOLING
4120-3M AIGNUE N
BROOKLYN PARK, MN 55443
HEATING COMPANY
Signed By
Date
e,
'...�'�A.IAAiIAAA.tiAAAA.AA�YA1fA�.gA,
AI AAAAp�A�AIIpIlA�9e.l R�/AAOW�.AAA.
Width I Height No. of Lineal tL Area
No. of pane of pane lights of crack q. tL
HEAT LOSS CALL ATIONS
DEPARTMENT OF INSPECTION MINNEAPOUS. MM.
Weatherstrips
/7.r- /3-7
/ 'y e
Construction No.
Insulation
19 . r
Guice
Reference
Btu
Infiltration
Kind How Applied
Windows
I Doors
Out. Wall
Int. Wall Ceiling
Roof Floor
Yes—No
0
19_
�7 e)p0
/ FI.1 Room I Length Width
-",;r, Height t
Fl.1 Room I Length Width Height
Windows and Doors--Craekage and Area
'
Windows and Doors--Craekage and Area
%Vldth Height No. etLineal ft. Ana
Ne. of pane et pane lights of crack aq. tL
Net exp. wall
width Height No. at kcal IL Area
No. of tune of pane lights of crack p. IL
7
Int. wan
z SL 20 -7 9,4
ICOCCIBtu j
Coef.1 ?tu
Infiltration
Lafiltrahon
Glass
{
Glass
Exp. wall
.
Exp. wall
Net cap. wall
f
Net ezp. wall
Int. wan
vY
Iat. wan
Ceiling
Ceiling
Floor
Floor
Total Btu.
_ '
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area !
Required sq. ft. F.D.R. or sq. inn. WA. Leader area
Fl.1 Room I Length Width
Height
I
FU Room I Length Width Heiaht
Windows and Doofs--Craehage and Area
Width I Height No. of Lineal tL Area
No. of pane of pane lights of crack q. tL
Width Height No. of meal IL Area
No. of pane of pane llgkts of track so. tL
10.0
/7.r- /3-7
/ 'y e
Infiltration
2-1.0
19 . r
Coef. I
Btu
Infiltration
Int. wan
a -7a
=
-y�;
�y�pO
Glass
�7 e)p0
Exp. wan
Net exp. wall
Int. wan
Ceiling
/D vv
/O
/0 /a p
Floor
j
vY
Total Btu. cLy600 'i
I
Required sq. ft. E.D.R. or sq. ins. WA: Leader area
Fl_I Ream ILenath Width I-Iciaht
Windows and Doors--Crackage and Area
Width I Height No. of Lineal tL Area
No. of pane of pane lights of crack q. tL
Coef. Btu
Infiltration
Glass
Exp. wall
set esp. wan
Int. wall
Total Btu. I
Requircd sq. ft. E.D.R. or to. ins. WA. Leader area
Windows and Doors—Crackage and Area
Width Height • No. of Lineal IL Area
No. of pane of pane tighta at crack sq. tt
Btu
Infiltration
Glass
Exp. wall
Net exp. wan
Int. wan
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ii& WA. Leader area
F1.1 Room I Length Width
Windows and Doors--Craehan and Area
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Required sq. ft. EA.R. or so. ins. WA. Leader area I
Btu
J
SUBJECT
P
City ®f Fridley
4 70'
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
•COMMUNITY DEVELOPMENT DIV.
1 ______ ~ I PROTECTIVE INSPECTION SEC.
®0��
Ly/
r
)
NUMBER
REV
DATE
PAGE OF
APPROVED BY
_
CITY HALL FRIDLEY 55432
612-571-3450
910415
8/27/97
JOB ADDRESS 6815 Washington Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
17
1
Rice Creek Terrace Plat
4 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Renken 6815 Washington Street NE
574-9140
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Karl Kiphuth Construction 11227 Garnet Const, St Michael MN 55376 20065378
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
498-7980
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS Roofing can be the 2nd layer but not the
3rd.
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
MOT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEDi OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THATHAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO �E TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVE NING THIS TYPE OF WORK WILL BE COMPLIED
$1,629
$.81
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 Oh ANY OTHER STATE OR LOCAL LAW REGULATING CON-
ON-
$54.00
Fire Sc $1.63
STRUCT ON O HE PfeRF MAQICE OF CONSTRUCTION.
STRUCTION
1
PLAN CHECK FEE
TOT EE
X!(Jlq�"{Jj(�
C
$5.
$61.44
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
ENP OP
ALID THIS IS Y UR PERMIT
BLQ6 INSP
GATE
SIGNATURE OF OWNER)IF OWNER BUILDER) IDATEI 11
J
NEW [ ) Effective 1 / 1 /97
ADDN [ ) CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: (' Q K W 4 � w o Top, � Td ,-'P e I- n F,
Legal Description:
Owner Name & Address: ) H 1i R &_ P1 K Tel. # � 7 Y - 9 / 16
Contractor: N F) r^ L K,'e g H 7 /t MN LICENSE # 'z 04 6 `i 3 %
Address: [ (2 2 7 r -A d' P? e i" coliff 7-n & ft yieL Tel. # Y q 6-- % 9 F
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
He 145 e- Q -2 rip ez/Pr ^%,°
Driveway Curb Cut Width Needed:
DATE: ?
Permit Fee
$ S
Fire Surcharge
$
State Surcharge
$ 1
SAC Charge
$
License Surcharge
$ S C IO
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer. Main Charge $
TOTAL
STIPULATIONS:
Estimated Cost:
(Fee Schedule on Back)
Ft. + 6 Ft = : Ft x $ _ $
E
CITY USE ONLY
Fee Schedule on Reverse Side
Tel. # q 15 --?1 5d
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt_ "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ )
SUBJECT
_
City of Fridley
28088'
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
►COMMUNITY DEVELOPMENT DIV.
v______
f PROTECTIVE INSPECTION SEC
i
NUMBER
REv
DATE
PAGE OF
APPROVED BY
I = I CITY HALL FRIDLEY 55432
612-571-3450
910415
10/2/98
JOB ADDRESS
6815 Was hin t n
1 LEGAL
LOT NO. BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
17 1
I R - Plat 4
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Norlina Exteriors
-
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 2 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside and cover trim
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
Install soffit ventilation to meet the State B uilding 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 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6000
$3.00
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
$112.25
Fire SC $6.00
PLAN CHECK FEE
TOTAL FEE
cam-14i/0- a- Sr
License SC $5.00
$126.25
SIGNATURE OF CON'RACTOR Op AUTMORIZ AGENT IDATE,
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
S-GNATURE OF OWNEROF OWNER BWLDER�iDATEi
BL NSP
gAiE
NEW
ADDN [ ]
ALTER [ ]
ConstructionAddress
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
CAI h Ba / 0/ a'0 ST /V
Effective 1/1/98
Owner Name & Address: -S-q H,., e_ Tel. #
Contractor: K �� l o c_ MN LICENSE # 2- ®p
Address: �'� y ( a../ Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
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 e s[ �.f� Ca vc -�V%, �, Estimated Cost: $ g�y
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: /6 APPLICANT: Tel. # 7&q jpi 3,�
Permit Fee
$ �,mZ✓�
Fire Surcharge
$
State Surcharge
$ 3 ,
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 [ ]
-
SUBJECT
City of Fridley
30176
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
i+
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
B
r � �
NUMBE
RE
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/7/99
10B ADDRESS 6815 Washington Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
17
1
Rice Creek Terrace - Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Renken
574-9140
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
B F B Roofing Service 6760 Madison St Fridley 55432
571-0248 9042
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 )4N REPAIR D MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 26 S Tear -off
9 CHANGE OF USE FROM 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
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
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 THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2272
81.14
DO N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
P OVIS NS OF ANY 0 ER STAT OR LOCAL LAW REGULATING CON-
TRU ION OR THE FORMAN OF NSTRUCTION
$83.25
PLAN CHEC E
TO EE
1 `fi
Is
HE
THIS I Y R MIT
J
SIGN U OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
BL G iN SP
r
14I
nATE 17
S,GNATURE OF OWNER OF OWNER BUILDER. IDATE,
NEWS [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ®�
ConstructionAddress:
Legal Description: e _: ; /,t)
,,���., ��/��a�� Tel: #
Owner Name & Address:
Contractor: �� ��o������ MN LICENSE #��-
Address: 6 76Tel. # Z7 -/Z/ —,c� -7 W'
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA:
DECK AREA:
DESCRIPTION OF EVIPROVEMENT
Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ = $
DATE:JV� _ Z 9 APPLICANT: j ilew y � ��� Tel. # _ 71
Permit Fee
$
IF �!
Fire Surcharge
$
?
State Surcharge
$
SAC Charge
$
License Surcharge
$
-fi Go
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ C? l` G 4
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 [ ]