PRE 2010 DOCS9
SUBJECT
RMI
City of Fridley
16 5 8 0
AT THE TOP OF THE TWINS
BUILDING PERMIT
P
RECEIPT .
�L ....... COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
/
r i
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/12/82
JOB ADDRESS 5744 West MOore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
5
Donnay's Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
'timothy Ziegler 5744 West Moore Lake Drive N.E. 571-7619
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Ariel Remodeling 5744 West Moore Lake Drive N.E. Same
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
Construct a 16' x 18' Addition with basement to dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Variance approved by Appeals Commission on 5/11/82.. Provide products
of combustion alarm in bedroom area. Provide outside combustion air for
existing furnace.
...
C"11 local u iifie SEP RaI'E PERMITS REQUIRE® FOR t
�iru� di ��� f HEATING, PLUMBING AND SIGNS.
TEIE.KNE-
LAW
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
$12,550
$6.28
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-
$98.50
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
.$24.63
$129.41
SI AT.14-RE OF CONTRACT^ OR &LaHORIZEWGENT. (DATE)
w
�ItNATUREOF
WHEN PROPERLY VALIDATED THIS IS YOUR P RMIT
BLDG INSP HATE
ER IIF DO IN I E (DATE I
9
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OVINER: Jzm e4A,J
ADDRESS7 LN til, IrldoipE 4Ke. D'e,
TEL N0: 57/- 7(P lq
BUILDER: XI?IEI- R_F1n0Da1AA7
ADDRESS:
TEL NO:
Construction Location
STREST NO: / 1 STREET:
LOT: . BLOCK: S
�(J®p $: Z-19 e
ADDITION:-U�/��ys
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
3 DESCRIPTION OF CONSTRUCTION
®t Front: I� Depth: /6 Height:
Square Feet: Z Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
?VSR1 vc.?c,+'.3j qU I /2 530.00
® D
Type of Construction: ���/VL� Estimated Cost: $
To Be Cbmpleted: 710 _C>AaS
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ ' $
SEE REVERSE SIDE OF SHEET
Mie undersigned hereby makes application for a permit for the work -herein specified,
agreeing to cb ,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.
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DATE: S vvZ SIGNATURE:
i
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SUBJECT
P IT NO.
City of Fridley
2 9 7 7 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
� � COMMUNITY DEVELOPMENT DIV.
- PROTECTIVE INSPECTION SEC.
4003
f F �
CITY HALL FRIDLEY 55432
NUMBER
REv
DATE
PAGE OF
APPROVED BY
612-571-3450
91Q -F18
6/28/99
JOB ADDRESS rive
5744 West Moore LakeRkmixo
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
5
I-Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Tim & Mary Ziegler
571-9531
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Ken Ban sund Constr. 8805 Dave n Ave NE Mo295-5937
7408
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 O ADDITION O ALTERATION )(0 REPAIR O MOVE O 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.
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
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
$2272
$1.14
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 PERFORMANC OF CONSTRUCTION
PLAN CHECK F
TOTALFA
Li $5
9 66
SIGNATURE OFC TRACTOR OR AUTHORIZED AGENT (DATE,
HE P
A E IS 5U T
f
S.GNATURE OF OWNERoF OWNER BUILDER, IATE,
8 G,NSP
pAtE
F
011
NEW [ ] Effective 5/10/99 0
ADDN [ ] CITY OF FRIDLEY bp � 7q
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 n��1
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: /O"Y ?.-,- 1I d Tel. #
Contractor: K z N A a n q��" a k f/ P' G C�'* o� MN LICENSE #
Address: `� C) 5 �a r �v-r A . 74I
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF BIPROVEMENT
_Tel. #
C- r- l/ N
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type:-FeltV' ° f P d '41, v® o 9(
Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: Z S i APPLICANT: Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ }Z'
Fee Schedule on Reverse Side
Fire Surcharge
$ L29
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 1.141
$.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
$ /. t�r'
STIPULATIONS: