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PRE 2010 DOCSVillage of Fridley, Minn. h BUILDING PERMT 48 Oiface of WSPECT01% OF BUMDINGS at Owner Architect Frid'_Vy, Builder LOCATION OF BUILDING No.Go otol Street Fart o rot - Lot � it lock m Addition or Sub -Division D. cs-scrnp nci �F BUILDING FrontDepth w height stories % Manner ,of Construction To be u � completed A Estimated Coat 0404 used as � To be Permit is hereby gmitpd {4, to toy _ the building described in the above statement. This permit is granted upon the express cond' that the; par on to whom it is, granted, and his agents, employees and workmen, in all the work done in, ar and and upon said building, or, any part, thereof, j shall conform In all respects to the ordi- nances of Fridley,Minn.,,regarding the 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. Inspector of Buildings. AGItEEMtNT AM SWORN STATEMENT In consideration: -of the issue and delivery to ane by the Inspector of Buildings of Fridley of the above permit, hereby, agree to .do the proposed work :in accordance with the, description above set forth an according to the provisions of the`ordinancen of Fridley, and, being first dilly sworn, I hereby st, Lte'and say, that "the facts stated'by Brie andcontai�el 1n the above p alit are true as therein sta ed. Subscribed and W07 to before me at Fridley, Minnewota, this day o '' ° .D.`19-4. I W I r u f 3 +r ._ �1gjpNgr yy9 r� N i y ( x I `• h _ I C2 (SyAd r h x �I 11 +rn 1Q� CD tl INA M. ID 143 W I 9 r u f 3 +r ._ �1gjpNgr yy9 r� N i y ( x I `• h _ I C2 (SyAd r h x �I 11 +rn 1Q� 9 uG N i y ( x `• C2 (SyAd r Ij M. b I f) z � fiel l i. I�fIfl�tI�.. Mw V i S �I Pn E.i 9 ® 7 i 4Ip,t h` i I I I - - - � I ; LJI —ryez` I I _ I 1 I i 64- � I i i I} 1 IlI I 1 I i i I I 07 I L_ i i e T- City of Fridley SUBJECT rO?-- 13396 AT THE TOP OF THE TWINS BUILDING PERMIT r RE COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION l •LGJ r SEC. 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 I 3/2/76 JOB ADDRESS 6069 Woody Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 Moore Lake Hills SHEET - 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Mr. & Mrs. R. Nash 6069 Woody Lane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Budget Builders 6912 Oakland Avenue South 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 J7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 14' Addition to dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Call for location inspection before starting construction. Call for verification of energy compliance. SEPERATE PERMITS REQUIRED FOR HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE, PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Fraine 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 196 1960 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. $6,500 $3.25 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. $22.00 STRUCTT OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE -'- $25.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) A W N PROPERLJ;, VA11.DAXEDTHIS IS YOUR RM IT 7RE BLDG INSP ✓ DA E SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) • ' •APPLICATION FOR RESIDENTIAL, ALTERA'T'ION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NME � Mk �BUILDER : V r ADDRESS : 1,r0.,�,�F_ ADDRESS: (_W/ ('ty) I rp lk�•l STREET: I.OT: 1L BLOCK: ADDITION: ''� p►° • t CORNER LOT: INSIDE LOT: -SETBACK:- SIDEYARD: .Applicant attach to this for_r. Two Certificates. 'If Survey .of Lot and .proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Qp `C .o Front• 1 ` Depth: �® Haight Square Feet: �� Cubic.Feet:C{. Front Depth: Height: Square Feet; Cubic Feet: Type of Estimated Cost: cnc. To -Be Completed: `2yvk(, ; The undersigned hereby makes application fora permit for the work herein specified, agreeing to do all work in sttict 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. f • • � • t— ! I.l a • TE: - 2 - (, SIGNATURE: I,1A `� (See reverse Side For Additional Information.)' J.� SUBJECT IT NO. City of Fridley 21350' �. 3 5 0 AT THE TOP OF THE TWINS BUILDING PERMIT r EIPT NO. _ COMMUNITY DEVELOPMENT DIV. ' rr PROTECTIVE INSPECTION SEC. '; yC)y3 r � NUMBER REV, DATE PAGE Of APPROVED BY � �•"S � CITY HALL FRIDLEY 55432 -'"'� �', 612-571-3450 910-F15 5/21/92 JOB ADDRESS 6069 Woody Lane NE 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 10 JBILO 4 Moore Lake Hills Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paul Agnew 6069 Woody Lane NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. House Calls Home Repair & Remodeling 1401 Brenner Ave, St Paul 6318511 6408 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 [� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (21 ScZuares) Tear--off 9 CHANGE OF USE FROM 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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,113 $.56 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29,00 Fire SC $1.11 TR CTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License Sc $5.00 $35.67 IGN URE OF CONT RACTOR ORAUTHORIZED AGENT -'IDATEI ' W PERLY VA ATED THIS IS YOUR%PERMIT BLDG )NSP DATE SiGNATURE OF OWNER 1iF OWNER BUILDER) (DATE) .8' N", NEW F I Effective 3/1/92 ADDN CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: L4:L 17 CL2C22:iLl (16 Legg Description: Owner Name & Address: SAA Tel. # Contractor: MN LICENSE # 1:5"9e `6</'0(5 Address: lqc)*I' /A U sf P Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF H"ROVEhMT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Gi OTHER: YI C75C Sq. Ft. Sq. Ft. Sq. Ft. 2, Comer Lot P Inside Lot I ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Two -v-­affi Estimated Cost: $ Approx. Completion Date: tm c -L -R-1 >-2-, c? c' (Cost on Back) Driveway Curb -cut Width Needed: Ft. + 6 Ft = Ft x $ $ e DATE: APPLICANT: r Tel. # 63/-3511 Permit Fee Fire Surcharge State Surcharge $ SAC Charge $ License Surcharge $ --- At Driveway Escrow $ --k Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: 040MIMAWOR Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $700 per SAC Unit 67 $5.00. (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary I I Not Necessary SUBJECT PER City ®f Fridley AT THE TOP OF THE TWINS lJ I L I PERMIT BUILDING J RECEIPT NO. I ` _ COMMUNITY DEVELOPMENT DIY. ~ r ; PROTECTIVE INSPECTION SEC. NUMBER REV GATE PAGE OF APPROVED BY 1 CITY HALL FRIDLEY 55432 �"" � �'� 612-571-3450 910-F15 6/14/93 JOB ADDRESS 6069 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 Moore Lake Hills Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paul Agnew 6069 Woody Lane NE 574-1249 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The Cities Home Improvement 6148 Olson Memorial Hwy, Gol Val. 55427 591^0332 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 Soffit/Fascia & Gutters 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors as per uac 1210 -adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2 X00 $l, OQ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ! PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $45,QO Fire SC $2.00 STRUCTION THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5,00 $53,00 SI NATURE F C15NTRAeOR6R AUTHORIZED AGENT (DATEI WH Y ROP Y VALIDATED THIS IS YOU PER IT BLDG INS TATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] Effective 5/26/93 ADDN [ j CITY OF FRIMEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: WO 4P01 `� 1&ozllf Lid V— Legal Description: Owner Name & Address: �,��,��� Tel. #� Contractor: A/6MN LICENSE #,_.3 Address: b ..✓ /4--g Tel_ # �f t 33L Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot. [ j Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ Z P`P-zp (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: C 9 APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ Fee Schedule on Reverse Side $ _ .001 of Permit Valuation (1/10th%) $ -- $.50/$1,000 Valuation $ $750 per SAC Unit $_ $5.00 (State licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ Conservation Plan Review $450.00 $ Fee Determined by Engineering $ Agreement Necessary [ 1 Not Necessary [ j TOTAL $�-�° STIPULATIONS: CITY OF FRIDLEY INSPECTION - 6431 University Ave NE 572•- _REF GERATION FAIR CONDMONiNGSYSTE IS Al EViCES- -.... -.... RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Blimer - Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) .. Cas Piping (Needed with new furnace) $10.00 $ Cas Dryer $10.00 $ HFR�E *Air Conditioning — All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) Irk of Value of Appliance or Work Cormnercial findustriall 1.25% of Valueof Appliance or Work State Surcharge TOTAL FEE REINSPECTION Ii *Air Conditioners can not be placed in a side Bard witho(A written permission from adjoining .property owner. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance vAth the City Codes and rulings of the Building DivisloR and hereby, declares that all the facts and represe ntations stated in this application are true and correct. BUILDING USED AS e ,'i �o ESTIMATED COST /,f90, O0 PERMIT N0. t _3 -)2 No. of Heating Units Circle One ,(Steam) (Not Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Signed Approved By Rough—in Date Final Date J FILL OUT BACK SID E FOR ST- :VERIFICATION ON '1040 I. REPLACEMENT .. y... J ' s , ii mrymy AND STACK VERIFICATION Th� undersigned hereby verifies that the existing chimney or stack: 1. Ha$ been carefully :examined Yes (} Yes ( No { ) 2. Is � ,ei from rust or deterioration Yes {) combustion air been provided for water heater No ( } No ( ) 3. i ITa ,uQ foreign objects lodged within Yes() No ( )< 4. Isarely supported Yes ( } No ( } 5.-- Meet$ all current Code requirements for size a�X total BTU's connected Yes () No ( ) I ,- i 4�4 6 Hto 1 heating BTU's of 1 Alther BTU's T TAL BTU's I 7. H26 a liner been provided for water heater Yes ( ) No ( ) 8. ' Has combustion air been provided for water heater Yes ( ) No ( ) i R marks: j' List ALTgRATIONS Being Done: CO: SuBjECT . City of Fridley r25r99 AT THE TOP OF THE TWINS BUILDING P E R MI I T RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � � PROTECTIVE NUMBER pEV DATE PAGE O: APPROVED By E i i"""1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/15/02 10B ADDRESS 6069 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 Moore Lake Hills Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Michael/Regina Quirimit 6069 Woody Lane NE 763-502-1563 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Improvement 8400 89 Ave N, Brooklyn Park, MN 55445 763-425-2227 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW O ADDITION 0 ALTERATION REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Install 1 bay window 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. "em" o 1'00 111 ops To foiled ®opo®o ger to Post . 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 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 @ $6,904 $3.45 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- $139.25 Fire SC $6.90 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Licenge73C $5.0 $154.60 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE, H PR Y VAL�1, ATED THIS IS YOUR PERMIT S,GNATURE OF OWNER. -F OWNER SUiLDERi iDATE, G INS - pArE JLI NEW [ ] C/o) ADDN [ ] CITY; OF FRIDLEY 51A - �� ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �P13aS 17C, Effective 1/1/99 a, I -F—t o Ll Legal Description: Owner Name & Address: Tel. # ZZs- 5'( -16-6,3 Contractor: (�J;n�l�ia �/p/�Q C�°l,J i/�i✓z5 MN LICENSE # Address: 1�lkj) 41)p �r� A�i�r, Jrk /)W # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF MPROVEMENT 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: Aau Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: 560 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th% ) $.501$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 [ ] 0 s SUBJECT PEEAAkT=iV�g`�-O_. City of Fridley AT THE TOP OF THE TWINS BUILDING PERM r ` RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. /YES /r/A 1 � � NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 L 763-571-3450 910-F15 12/12/03 JOB ADDRESS 6069 Woody Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 Moore Lake Hills Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Querimit 6069 Woody Lane NE 763-502-1563 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA. Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339 20268257 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8826 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace three windows within existing openings 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit 111soectioll M11 r To p To post 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 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1,868 $.93 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 $66.20 Fre SC $1.87 PLAN CHECK F E T TAL FEE Lice e C 0 $74.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE- P LY VALI ED THIS IS O R RMIT JKOG -NSP r -Ai S-GNATURE OF OWNER SIF OWNER BUILDER- (DATE- s NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRMLEY ALTER [ l SINGLE FANMY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: - "-, d Owner Name & Address: '(il'.0-e-\ (1 u `C l rM't �, "' �' --- Tel. # (o?, • �jp'a I cj(� Contractor:; RMA HOME SERVICES INC. MN LICENSE # Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. # Atlanta, GA 30339 A 763-542-8826 urvey. of the k BC -20268257 ,� iii -it to scale. • 02 -- r --r---- -_Y.�.._....� ....... DESCCR ON OI+ IW�R4VEN[ENT . . LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length. Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width' Hgt/Ground Sq. Ft. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: _ ak-r-0MQ:n APPLICANT: �� r�,c— Tel. CITY USE ONLY Permit Fee S Fce 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 $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 $ Agr em ary [ ] Not Necessary [ ] TOTAL 71, 00 STIPULATIONS: CITY OF FRIDLEY PERMIT NO.: 2004-02343 ? 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/29/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 6076 WOODY LN NE PIN 243024120076 LEGAL DESC : UNAVAILABLE LOT BLOCK PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 10,000.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. APPLICANT DACO INC. 14510 45TH ST NE ST MICHAEL, MN 55376 (612) 221-3900 OWNER LIND DONNA M 6076 WOODY LN NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating con uction or the performance of construction. Applicant Date Bldg Insp BUILDING PERMIT FEE 181.25 FIRE SURCHARGE 10.00 STATE SURCHARGE, VALUE 5.00 TOTAL 196.25 PAID WITH CHECK # VISA SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. IVCvv i 6431 University Ave NE, Fridley, ivuv �:-4— ADDN I SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax ALTER i l BUILDING PERMIT APPLICATION Construction Address: O Legal Description: Owner Name &Address: �o �Ci,�/cl "N n �� '-�r-'°I'�el. MN LICENSE # Contractor. Tel. # I i, -j- r L 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 th Width Height Sq. Ft. Len th Width _____ — Height _— Sq. Ft. GARAGE AREA: • 9 9 DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ,/� a�„ �,P�uQuitstimated Cost: Construction Type: - � " Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ APPLICANT:4174V ;� C_ [/t ti Tel. # �� DATE ,� –U A PPZe ,� u ✓IJ C tll Ctl� Call ( 1763 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL J' Fee Schedule on Reverse Side $ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1350 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 [ ] $ !`, STIPULATIONS. as= 6 W NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Ldkq Legal Description: Owner Name & Address: Tel. # R Contractor 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: Construction Type:ke'6 Estimated Cost: $ a Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: QdM& Wdu2kKU- Tel. #2&&R��� Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ ; $ $ _ I $ 3 �� Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ 15 STIPULATIONS: aDo�-- o () rov r NEW [ ] CITY OF FRIDLEY ADDIS! [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 6[ I W e" CV1/ L i-aT-o t- S `5 4 3 Z Legal Description: Owner Name &Address: r-NaLLi.6" 15 Tel. # 397 -7 G 3 571( 0`/3et Contractor: 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: Construction Type: Estimated Cost: $ �a Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: 51—Z°t _ 0 1 APPLICANT:4 Tel. # % � 7 Call (763) 572-3604 for Permit Fees if mailing in application. Fax o 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ 47 • C1 1) Fee Schedule on Reverse Side $ 3 [ • ( 65% of Permit Fee $L • o� .001 of Permit Valuation (1/10th%) $ ► G of $.50/$1,000 Valuation $ $1450 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 [ ] $ 126,91 STIPULATIONS: