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PERM N
City of Fridle
!MIT
19 6IT
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
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R IP
• ___ COMMUNITY DEVELOPMENT DIV.��
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PROTECTIVE INSPECTION SEC.
1 �
= CITY HALL FRIDLEY 55432
NUMBER
REV-
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/16/87
JOB ADDRESS 6133 Woody Lane N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
3
Moore Take Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Isabelle H. Jordal 6133 Woody Lane N..E.
571--8064
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Quality Builders
784-18244
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
B DESCRIBE WORK
Construct a 241 x 13141° Addition to top of existing garage
9 CHANGE OF USE FROM TO
STIPULATIONS Variance approved from 351 to. 251 front yard on 9/1/87. See notations
on plans.
SEPARATE PERMITS REQUIRED FOR
WIRING, HEATING, PLUMBING AND SIGNS
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
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
$2.23
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,450
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-
$50.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
AN CHECK FEE
TOTAL FEE
$12.63
$65.36
SIGNATOR F TRACT RORAU ORIZED EN (DATEI . ,
WHEN PROPERLY LI DATED THIS IS YOUR PERMIT
>1
Si A R OF OWNER (IF OWNER DER) (DATEI
Vo
BLDG INSP
j
np�
I
NEW [ ]
ADDN. [ ]
ALTER. [ ]
City of Fridley
�R-1 AND R-2
Building Permit Application
Construction Address:��J���d
Effective4/1/86
Legal Description: -�"
Owner Name & Address :�L IJO��/ % l ���z �®/� �% Tel.
Contractor • f� & rla�91 " I —LA- Tel. #
Address:���MT�p%f%�,�
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 IMPROVEMENT
r
Length � Width Q. --�, Height S -
Sq. Ft. PE - -
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft. ("
40
Corner Lot, Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
100—:1,Type of Construction: IsiJae3 l%01 a Estimated Cost: $ r D
Approx. Completion Date: !
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
G104U 0
STIPULATIONS:
Fee Schedule on Reverse Side
25$ of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
}
i
SUBJECT
P
City of Fridley
30009
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
l
1 T
NUMBER
AEv
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/5/99
JOB ADDRESS 6133 Woody Lane NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR.
2
3
1 Moore Lake Hills
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dan Gergen
572-2329
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Midwest Roofing 18979 Gladstone Blvd. Maple Grove 55311 416-4804 20010277
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 ❑ ADDITION O ALTERATION ®x REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2010
$1.01
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-
T UCTION OR THE PERFORMANCE OF CONSTRUCTION
$83.25
Fire SC $2.01
PLAN CHECK FEE
E
TOTV.2
Lice C$5.
$
SIGNATURE OFCONTRACTOR OAAUTHORi2EDAGENr
ENP OP
LI ATE IS IS YQµ@ PERMIT
Nrv7.Nsp
OATE
S,GNATURE OF OWNER OF OWNER BUILDEAI iDATE,
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION b\`
Construction Address: (I3 3
Legal Description:
Owner Name & Address: Tel. Tel. # 6 7,1 -23.2c7
Contractor: J'/!- MN LICENSE # obQ 16,2
Address: Tel. # Y/6 5'
Attach to this application; -a Certificate of Survey of the S�®�
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:
l.d r
Construction Type: 4-c A-5-? -7 :-C� z% 7':?) Estimated Cost: $
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE -J -s- 9 � APPLIC C: -
Tel. # 3-`' c,7-/ 3,Yk
TOTAL
STIPULATIONS:
S
CITY USE ONLY
Permit Fee
$
83-
Fee Schedule on Reverse Side
Fire Surcharge
$a
U r
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.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
STIPULATIONS:
S
Building
Inspections
763-572-3604
DATE (f/ iI
SITE ADDRESS _,,
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATI®N
CITY OF FRIDLEY
e YOUR E-MAIL ADDRESS
L OWNER I�ONTRACTOR
NAME: o -e
ADDRESS: CITY
PHONE: b 3 — ;tiel'—
COMPANYNAME: E214ar fjbs shca' s 4A.
CONTACT PERSON: 8290 Main St W@ -E, Ss
Permit No.:
Received By: /L
DateRec'd: L, "D
STATE LICENSE # Q"
ADDRESS: - Cff STATE ZIP,
PHONE FAX
IiGLE FAMILY O TWO FAMILY 0 TOWNHOUSE
0 NEW PqtgPLACEMENT 0 ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK V A—&
0
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor x .05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)G MODEL ®' ��� X12 SIZE/BTU X�n/
Equipment Installed MFG: SIZEIBTU
WG: MODEL:
MFG: MODEL: SIZE/BTU
GAS RANGE/OVEN $10.00
A/C $25.00 ,_FIREPLACE (GAS) $15.00. _
—_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GR1LL $10.00
BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00
_CHIMNEY LINER $10.00 GAS DRYER $10.00 —POOL DATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00
1:d4 ..rLu __rFvi.'Ss . WAP"a.... - s....,a ,.,..,, .........
..,
Permit Fee $ �90 Number of fixtures @ $10.00 x $10.00 =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ sy Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans. /! /90b
SIGNATURE OF APPLICANT �.C/� PRINT NAME [� DATE L/�.L
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with N N Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
S. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
I
SU11(1111a
�
Pe=A No:
Ins ertions
RESIDEjNT , APPLICATION
Received 3v:
763-57 -'604
CITY 'Y OF F LEY
'
:'�14�
EFFECTIVE 1-148
DATE �LZ 1?q YOURE-MAILADDRESS I
`n o
SITEADDRESS
THIS APPLICANT 1S: ❑ OWNER ONTRACTOR i
I
PROPERTY
NAME: QA �
ONVNER/
� t-
ADDRESS: ( p (U l: CITY i' STATE ZIP
TENANT
PHONE:3
CONTRACTOR
NAME: PINS 46idd,
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE, BOND AND
STATE BOND EXP DATE
CERTIFICATE OF
ADDRESS: 57 -IV ie�I S1�� #3j CITY ftrille44 STATE�ZIP S� ✓��
INSURANCE
PHONE �W�1"�' 'J.I� FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
❑ NEW $REPLACEMENT
DETAILED DESCRIPTION OF WORK r111.6Aj(9jn y�il, LC&&417 WkJ"UJ h:C i
PER. MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement,, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = plus SO surcharge
OR
FOR PROJECTS WHERE LABOREXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FI)CTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE 51550.
_BATHSINK2AV _FLOORDRAINS SHOWER _WATERPIPING
—BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35)
_ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15)
_
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER.
C''��. r.��"�,�?'� „�'��.. _t�`„� �e'��.',�,.:N.:A
Permit Fee $
Number of fixtures @ $10.00 x$10.00=$
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
OR Number of fixtures @ $35.00 1 x $35.00 = $ 3"sD'
TOTAL DUE $
State Surcharge = $ .50
(MINIMUM $15.50)
(MINIMUM S15.50) Total = $ T_ -3P
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 j
ifwith the approved plan in the case of all woric which requires review and approval of plans.
SIGNATURE (JF :1PPLI .1I �`� PRINT NAME. ClG'D�P.i� DATE �Z 1
,wPRaVED f31'
�ATr'
N0 :SEP!�%K=PERNUTS._ RE*REOI IRED FOR 3.1-fTEDINC:..Ei. rCTRIC.AL. _kf�D: titEC,—TAf IC:iL. NORK
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