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
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.D.`19-4.
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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: