PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
10TH 2452
g Y
Date .. .. ... .
Owner
Address I .... ........ .
j,
Lot ...... .
Corner Lot . . .
Builder . `.� .... ...............
Address .. .. ..... _ ... ,
LOCATION OF BUILDING
Street . ....`.
]?art of Lot ...... ..... ........
Ri
Block ..... ...... Addition or Sub -Division ..� . .. ... ....
inside Lot ............ Setback "+...� ! Sidgyard '.�•' ...........
DESCRIPTION OF BUILDING
Tie Used as:
�g
. !.�.M....... Front . ;tl"`:� .. Depth Height d�.'.... Sq. Ft. : Cu. Ft..... .. .
............... Front ........ Depth ....Height Si Ft......... Cu. Ft .... .
Type of
In consideratic
the proposed work
ordinances of the i
)n ......... Est. Cost ................ To be Completed Al .....10-8's
fi
n of the issuance to me of a -permit to construct the building described above, I agree to do
in accordance with the description above set forth and in compliance with all provisions of
illage of Fridley.
..................... ..
• cons do ati tithe 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 con dit n that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around an , 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 lima and this permit may be revoked at any time upon viol on of any of the provisions of said
ordinances."
a ... �. �Y'. Building Inspector
NOTICE:
This permit oes not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. a sure to see the Building Inspector for separate permits for these Items.
City ofFridley, mn6
B_ D ll'
Date: June 7s 1965
owner: Larxx $tickler Budder Wallace Be Johnson
Address N. E• Wasnton Street
Address Nine a Greek
LOCATION OF BUILDING
No. 6825 street Washington Street No Be Part of Lot
Lot 1$ _ Block l Addition or Sub -Division Rice Creek Terrace, Plat 4
Corner Lot Inside Lot Z Setback Sideyard
Sewer Elevation
To be Used as:
Type of Construction
Foundation Elevation
DESCRIPTION OF BUILDING
Front _,____r Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Gia. Ft.
Est. Cost—st9r�+W--QQ __ _._ To be Completed
Storm Damage repair
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 21 provisions of
ordinanc�a of the city of Fridley.
In consideration of the payment of a fee ofl$ C0� , permit is hereby granted t-WaUace E Johnson
to construct the building or addition as described above. This permit is granted upon
the expressgd
dition that the person to whom it is granted and his agents, employees and workmen, in all work.
done in, arand upon said building, or any Bart thereof, shall conform in all respects to the ordinances of
deY, 1lfiota regardi� location, construction, alteration, maintenaace, repair and moving of buildings
within the limits and this permit may be revoked at any time upon violation of aay of the Provisions oP said
ordinances.
Men JensenBuildingInspectcir
NOTICE:
W& permN does not corer the construction, lostaMon for winos, plumbing, ®as beating, sewer or water. Be sure to we
the sanding le""wer for Separate permhs for dtm Rama.
0
251
APPLICATION FOR'BUILDING-4E
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME Tarry ic_kler BUILDER Wallacl E. Jnhnaga
ADDRESS6825 ff, *- Washington rent ADDRESS 4708 Nine pile Creek Pkyr.
LOCATION"OF BUILDING
No. 6825 StreetX k. Ww hg�tog Part of Lot
LOT /+ {� ..BLOCK,. ADDITION OR.SUBDIVISION
Corner tot__,, Inside LOT Setback Side -,Yard
SEWER:ELEVATION FOUNDATION ELEAfATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buiiding.locetion-drawn on these•Certificates.
DESCRIPTION OF BUILDING
To be used as;
Front. Depth, Height,
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Cowtruction Wim_ Estimated Cost 621,000,
Ta be completed norms e3gte r 1x965_
The undersigned hereby"'tnakes application for a permit for the work herein specified,
agreeing.to.do•all work in 'strict accordance with the City of Fridley,Ordinances
an$ rulings of the Department of:Bu�.lding,..and hereby declares that all the facts
and representations stated in this application are true and correct.
(Schedule of Fee Costs can be found on the Reverse Sid ).
r3/eel
City of Fridley, Hinm N° 8532
EUDITG PERAUT
Date: OCTOBER 15, 1965
Owner: D. LARRY STICELER Builder _ _ SAME
,Address 6825 Washington St. N...' • Address
Fridley, Minnesota 55432
LOCATION OF BUILDING
No. 6825 Street Washington St, N. E. part of Lot
Lot ._ _ 18 -- Block I_ Addition or Sub -Division RICE CREEK TES., E,AT 4
Corner Lot , Inside Lot X Setback — Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
DET. GARAGE Front 20 Depth 22 Height 10 Sq. Ft. 440 Cu. Ft. 4400 --
Front Depth freight Sq. Ft. Cu. Ft.
Type of Construction Frame Est Cost _ $1,320 To be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above se forth and in compliance with afl provisions of
ordinances of the city of Fridley. `
In consideration of the payment of a fee of S 4.00 , permit is hereby granted to D- TARRY
STICHLER to construct the building or addition as described above. This permit is granted upon
the expressgta
dition that the person to whom it is granted and his agents, employees and workmen, ffi aII work.
done in, arand upon said building, or anyctippoaanrtt thereof, shall conform in all respects to the ordinancedi�ofe
Fridley, Mioa�etlardinng tau, revoxed� t e time uponla�tian of r heo Po
I
the limits and thin
ordinaaoa.
ALLEN G. JEN'SEN Building Spector
NOTICE:
M permit does not aver the construction, hoWla inn for wbtng, plumbing, on boating, sewer or water. Be sure to as
the Building b qm for for separate permits for thea Nems.
OWNER'S
ADDRESS
APPLICATION FOR BUILDING PERMIT
CITY OF F$IDLEY, MINNESOTA
LOCATION OF BUILDING
NO./01,2 S- STREET . �_ PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE YARD
SEWER ELEVATION FOUNDATICFN 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 'as;
Front Depth Height
Sq. Ft. C' Cu. Ft.��
Front' Depth Height
Sq: Ft. Cu. Ft.
Type of Constructn 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.
DATE_Z d 5 0 S SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side)..
SUBJECT
PERMIT N
City of Fridley
19583`
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
ECEIP
;,
___ COMMUNITY DEVELOPMENT DIV.
g
r � � PROTECTIVE INSPECTION SEC.
1 �
= CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
OF
APPROVED BY
612-571-3450
910-F15
7/7/88
F;PAGE
/
JOB ADDRESS 6825 Washington Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
18
1
Rice Creek Terrace 4th Addn, SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Stickler 6825 Washington Street N.E. 571-4963
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Home Improvement 7401 Central Avenue N.E., Fridley 784-7543
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
Reroof Dwelling (21 Squares)
9 CHANGE OF USE FROM; TO
STIPULATIONS
On all new roofs or tear -offs and replacement roofs,
State Code requires that 2 layers of 15 16. felt,
mopped together, be installed to a point 24 inches
UP from exterior wall line, or the use of other
approved underlayment membrane.
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.
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 GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
,ORDINANCES
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,050
$53
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.
$27.00
PLAN CHECK FEE
TOTALFEE
1 $27.53
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
HEN PROPERLY VA LI A ED THIS IS YOUR P RMI
/. e
I BLDG INSP A E
SIGNATURE OF OWNER(IF OWNER BUILDER) IDATEI
NEW City of Fridley EEfective 5/1/88
ADDN R-1 AND R-2
ALTER t/(j Building Permit Application
Construction Address: 665 lq-
5h;n� */u :5-�A16-
legal Description:.
Owner Name & Address:_ JW Tel.
Contractor: lno- ` at p ev a epAte'lt Tel. # -7gg5
Address: 0 -eelA AV e
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
LIVING AREA: Length Width Height Sg. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
ODrner Lot [ ] Inside Lot M Ft. Yd Setback Side Yard Setbacks
Type of Construction: _" S/N ,P -e 1 -'3'"�� q Estimated Cost:
Approx. Completion Date:�� 5�
Proposed Driveway Width If New Opening Is Desired: I $
Width + 6'
DATE: —7 _ T $ APPLICANT: aZw
Permit Flee $ `�, o
State Surcharge $ 153
STC Charge 5
Driveway Escrow $
Park Fee 5
Sewer Main Charge 5
TOTAL
STIPULATIONS:
CITY USE ONLY
Alt. A Alt. B
See Back Page
Tel. 5 7SY 75 -YS'
Fee Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
, 0
CITY OF FRIDLEY
Effective Date January 1, 1991
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL RATE TOTAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $ 20.00 $
Gas Piping $ 10.00 $
(piping needed with new furnace)
Gas Range $ 10.00 $
Gas Dryer S 10.00 $
' Air -Conditioning (all sizes) _ $ 10.00 $ W D D
All Others/Repairs and Alterations
1% of Value of Appliance or Work $
COMMERCIAL/INDUSTRIAL
li of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $
REINSPECTION FEE $30.00. $
Rough Insp. _
Date
Final Insp.
Date
J
Approval for Permit
MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT
IS $15.00 PLUS THE $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Job Address O "
Building Inspection Div. 6431 University Ave NE Fridley MN 55432
Tel. No. 572-3604
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.
g-a� ,19.91
OWNER
L S
KIND OF BUILDING
USED AS l�
TO BE COMPLETED ABOUT - a - 9 l
ESTIMATED COST a O .
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size No.
Capacity Sq. Ft. EDR BTU -75-,"1• HP
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company ym Me&ASW CONDMON NO
MGMMAVE
Signed By 9EIM PAM MN 55425
am 1214M myltr
Tel. No.
r5 Zt
Fill out back side for stack verification on replacement furnaces
E
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
I.
Has been carefully examined
Yes (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )E
No { )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes O.
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes (�'j.
No
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Com pa ny e R-e� �R .� '--
Signed By
Date
f HOUSE HEATING TEST RECORD
ADDRESS
�(_ It, L/ APT. FLOOR CITY SUBURB A, ® �
OCCUPANT OWNER
HEAT LOSS
D E HTG. INST.
04
SOLD BY
INSTALLED BY
\16 ' _ f t /
Electrical Work By
Gas Line By
a
TYPE OF HEAT
GA FA HW STEAM
SPACE HTR.
UNIT HTR. OTHER
GAS ESIGN
CONVERSION
MAKE
1w bL 0
MAKE OF BURNER
Model
—
Model
Serial
920
Max. BTU Rating
INPUT
MAKE OF FURNACE
Model
CONTROLS
I/
THERMOSTAT a
Y21 Heat Plug
Vent Size
Valve
)too
KIND OF LIN
SIZENO k
Limit
& 714Draft
Hood t
I ReguleTor i T
)
Limit Setting Lino 0
Filters Size
Number
Fan Setting
Chimney Location
Inside Outside
Pilot Type
Chimney Construction
(�� 66
Pilot Make
Juul
Pilot Model
Smoke Bomb
Wiring
Pilot Timing
� &
Draft
Test Tag
L.W. Cut Off
®
Door Pressure
Lighting Inst.
Pressure 3 e � Percent CO 2- Date Tested /o— - ql
Input CFH 7�Percent 02 Company Testing �.4 :77 Stack Temp. Percent CO .—a(,Name of Tester �$
Form 235
SUBJECT
City of Fridley
r'726
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r?
RECEIPT NO.
F r.
r • COMMUNITY DEVELOPMENT DIV.
_ __
PROTECTIVE INSPECTION SEC.
a ��
r
f1QJ
8 r r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
� CITY HALL FRIDLEY 544.32
L J\ 612-571-3450
910-F15
19/28/98
JOB ADDRESS 6825 Washington Street
I LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
18
1
Rice Creek Terrace 4
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Larry Stickler
571-4963
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
B & B Roofing Service 6760 Madison St Fridley
-
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 0 ADDITION 0 ALTERATION 2& REPAIR O MOVE - O REMOVE
8 DESCRIBE WORK
Reroof house and garage (22 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlaymen¢t must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPLOFCONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
WITHW ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1885
DOE OT RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RVISIO
UCTI N OR THE PERF RMANCEV CONSTRUCTION
$59.50
Fire SC $1.88
PLAN CHECK FEE
TOTA11FEE
Licen C
5. 001,f
$ 6 .32
SIGNATUR F CONTRACTOR OR AUTHORiZEO AGENT IDATFi
ENP OPE Y ALIDAT D HISUR P R
-
S-GNATURE OF OWNER OF OWNER BUILDER, iOWTE'
rNSo
gArt
NEW [ ]`
ADDN [ ] CITY OF F UDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
,14 71
Owner Name & Address: �/�%� % G�/G'L G'?L Tel. # ..3'7/-
Contractor: MN LICENSE #
Address: ��A4 /�ii/�--17/Y1 --s- / Tel. # ..S%'"d 9 yoi'
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Effective 1/1/98
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Construction Types;1 -;' / fW Ot5"—
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: APPLICANT:
APPLICANT:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost: $��
(Fee Schedule on Back)
Ft x $ = $
Tel.
P CITY USE ONLY
Permit Fee $ ` Fee Schedule on Reverse Side
Fire Surcharge $ 'd .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ �e `� $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:
`
SUBJECT
of Fridley
PCity
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RE .
• ______ COMMUNITY DEVELOPMENT DIV.
r v PROTECTIVE INSPECTION SEC.
512-3604
1-16�
1 , �'�•1 CITY HALL FRIDLEY 55432
°•j
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
7/12/01
JOB ADDRESS 6825 Washington Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
] $
1
Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Glenda Stickler 6825 Washington Street NE 763-571-4963
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Northern Crest Inc 7401 Central Ave NE, Fridley, MN 55432 763-792-9364
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
20098415
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION fel REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAO
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 OWLG. 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
$3,875 $1.94
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-
SC $3.87
STRUIC.LAN OR THE PERFORMANCE OF CONSTRUCTION
$97.25 Yire
PLAN CHECK FEE T AL FEE
Licens SC $5 0 $108.06
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
H PR 7, LY VALIOA D THIS IS YOUR PERMIT
664bG INSP - MATE
S.GNATURE OF OWNERIIF OWNER BUILDERt t ATEI
NEW [ ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg Insp
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 6825 washi naton St ATF
Legal Description:
Owner Name & Address: Glenda Stickler Tel. # 571-4963
Contractor: Northern Crest, Inc. MN LICENSE# 20098415
Address: 7401 Central Ave. NE Fridley, MN 55432 Tel.# 763-792-9364
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: re -side house ted' garage 18square
Construction Type: SFD - wood Estimated Cost: $ 3,875.00
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 7-12-01
APPLICANT: Bill Olson Tel.# 792-9364
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application
Permit Fee $ 97 Fee Schedule on Reverse Side
Fire Surcharge $ 3.9-0 .001 of Permit Valuation (1/10th%)
State Surcharge $ k 2 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ _ $1100 per SAC Unit
$ � - 00 $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 [ ]
$ / 0(s` C6::,
10
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: ld l w
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE -
// gg
L1 YOUR E-MAIL ADDRESS J /? Gl ` n
W
SITEADDRESS
G l/t /`/
THIS APPLICANT IS:
❑ OWNER KONTRACT
PROPERTY OWNER/
NAME: 1'•
TENANT
ADDRESS: . ) 1 1AVUIE CITY l
STATE"ZIP S 2K
PHONE:
CONTRACTOR
NAME: S
SUBMIT A COPY OF�i
YOUR STATE LICENSE
L
STATE LICENSE # ^�v �� EXP DATE
AND CERTIFICATE OF
ADDRESS: `� e0 h CITY _
/ J
STATF%UTA P
INSURANCE
PHONE 9S - Cf)—J-- FAX
PROPERTY TYPE
INGLE FAMILY/NEW CONSTRUCTION SIZE
TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED .'WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAINTILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
UMAINTENANCE/R(EPAIR gREMODELING
o1
DESCRIBE WORK BEING DONE: a ' A (J(,J� S .S 9 S i-• �C -
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
Q HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE 2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE 3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit ADDITIONS.
& PORCHES SUBMIT:
❑ Aluminum
❑ Trim 1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS- SCRIBE
SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
f (U$JN)G THE 1997 U.B.0 FEE SCHEDULE)
Permit Fee $* See Back Page for Fee Schedule
P
Plan Review $ >�65% of Building Permit Fee
Fire Surcharge $ 04f) .001 times the total job valuation
Surcharge $P l0 .0005 x Permit Valuation Minimum $.50
License Surcharge $ 00 $5.00 (State Licensed Residential Contractors)
SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = R x $24 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ 875 '�.� Make checks savable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building 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 in the case of I work which q res/review and approval of plans. /
SIGNATURE OF APPLICANT �/ PRINT NAME �/' //yy,� EY Ae/9 1i'k DATE d V -/ J"ll