PRE 2010 DOCSCity ®f Fridley, Minn.
LOCAT ON BUILDING
No. 2Street _ _ Part Qf Lot
Lot _ lt� _ Block_ Addition or Sub -Division .
Corner Lot _ :Inside Lot Setback 9 ` Sideyard _ y
Sewer Elevation�---------...... Foundation Elevation - a .
DESCRIPTION OF BUILDING
ToUsed a
Front ! Depth Height. Sq. Ft. f =� i Cu. Ft. - a
Fro t Depth s! Height Sq. Ft. Cu. Ft.
Type of Construction, Est. C& To be Completed
0
In consideration of the issuance to me of a permit to construct the buil cribed above I agree to do
the proposed work in accordance with the description above o and in pliance with a'll provisions of
ordinances of the city of Fridley.
In consideration of the 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 condition that the person to whom it is granted and his agents, employees and workmen, in all work.
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
limits within the city ana dthis permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _._ � — _
Building Inspector
NOTICE:
Als peredi does not ewer the eonstruetion, ientalldlon for vrirhM plumbing, gas hooting, sewer or water. Be son to sae
the Building Inspeetar for seperae permhs for these Rams.
01m, I.T. I S
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS ADDRESS
LOCATION OF BUILDING
No. Street Part of Lot
Loty Block $_Addition or Subdivisions
9 v '
Corner Lot Inside Lot Setback ;`i SideYArd S
SEWER ELEVATION 5'_2 < F MATZON ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Lbusedd ass
Front Depth Height
Sq. Ft. Z Cu. Ft.,� �.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cos>F�
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 / / -9 `
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley, Kinn_ 1083
6431 University Ave. N. E., Minneapolis, Minn. 55432
Date: - July 9. 1971
Owner: - David ?snnoxBuilder .Same
Address - 7397-iAvnte Address Same
LOCATION OF BUILDING
No. _ 7.397....____ Street _ IInivP_rs I ty Avg N F Part of Lot
Lot . L ___ Block _ _ _ ._S _. _ _ Addition or Sub -Division Mn -1 a d Man=
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation
-Garage Front _ 18' Depth 28 _ _ Height 12 ' — Sq. Ft..5 04____ Cu. Ft. 6LO48.,
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost ..–_$2711 52 To be Completed Oct - 1 1971
Provide Hard surface drive.
Maintain existing grade in rear yard so as to prevent any new surface drainage on to
abutting properties.
Grade of garage to be minimum 18" above centedr line of University Ave. Service Rd.
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 a'll provisions of
Ordinances of the city of Fridley. t -Z t _ . /J s
In consideration of the 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 condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of
Fridley, Minnesota regarding location, 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.
Building Inspector
HANK MUNICH
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Bo sure to see
the Building Inspector for separate permits for these items.
V
`' v
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME : A I'll 10 L c t__i BUILDER: L z-:
ADDRESS :U LDD t�"►1 a9�
R ` V � ADDRESS : ��.� � Ep,, ,sx uj �az_Ro
NO:. -T.7? �STREET : �J tom( k U �{ Z S 1 T ,
LOT: BLOCK: C_� ADDITION: E\_� t)'Jk PSS'Ac'
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:.
DESCRIPTION OF BUILDING
Front • 1 FT Depth • ` FT Height • F-
Square Feet: S (:� q Cubic Feet: (c, C:� A S
Front: Depth: Height:
Square Feet; Cubic Feet.-
Type
eet:Type of Construction: Estimated Cost:_$
To Be Completed: \ t
The undersigned hereby makes application for a 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.
DATE f T' --I SIGNATURE: a -It Vvu
(See Reverse Side For Additional Information.)
/® �-
Y
li THE IT. 0. WDONOUGH CO. FIC
1953 UNIVERSITY AVE.. SAINT PAUL 4 TELEPHONES MI. 5
6:6 t
606ie
it SCALE: I INCH— FEET 814 NATIONAL BUILDING, MINNEAPOLIS 2 MO. 9.60 2
PLAT Oj 6URIVEY
11
;1 OF PROPERTY OF
DESCRIBED AS
P,9
CERTIFICATE OF LOCATION OF
BUILDIN6, CERTIFICATE OF SURVEY.
I hereby certify that on 19 I hereby certify that on 19
I made a survey of the location of the bi2ilding(s) on the I surveyed the property described above and that the above
above described property and that the location W said
buildingO is correctly shorn p above plat. plat is a correct representation of said survey.
above
a
E. B. Mc UGH, REGISTERED SURVEYOR, No. 1990
PAUL. K ENE, No. 4449
JOHN RYAN. No. 4489
i No, -V3 IM VvCiain Hedman sebuldt Co.
r
�. L l
liv
TiIAJ
/®0
City of Fridley
Application for Plumbing and Gas ihttiing Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
eat
m
NO. RATE TOTAL.
Number Fixtures .............
x $1.50
$ ' 0 10
Future Fixture Opening ................
�Q{ Z
24
8Z
LL�
a
U
��
<
a'�
�•d
z
(�9'
UN'
w
�O
!
F
r
N
WATER HTR.
GAS
ELEC
Base
pox-
ist
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL.
Number Fixtures .............
x $1.50
$ ' 0 10
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
-2— x 2.00
$
New Ground Run Old Bldg . ............
x 3.25
$
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn 19_
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No �J ® Permit No.-
Signed
o.Signe
By
Business Phon �/ D d
ROUGH �/—
GAS FITTING FEES: NO. RATE TOTAL FINAL
1st 3 Fixtures ..........................$3.50
Additional Fixtures x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description .............................................. $
TOTAL FEE $ , V�� 4z
CITY OF FRIDLEY
APP CATION FOR PLUMBING AND GAS FITTING PERMIT
LI
o x v Water Job Address
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
Ur
TOTAL
Nu=ber Fixtures
.i
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
A
Catch Basin
x
$5.00
$
y
q
$5.00
�
Q, w
e
$10.00
Heater
Water Softener
u
14
9
N
x
e.
.ca
•rl b
x 11
$4
0
W
N
C
m $4
� N
w
Q
t�
Q'•
1st 3 fixtures
x
M
$4
0
U
iC
L.
.0
C
••1
N
�C
.0
C C
3
g
.0
4Jj •N
4J N
N N
W
.0
y
0
3,
'j
N
•.�
m
State Surcharge
x
$
ro (4
o m
rt -+
rt
+'
lec
v�
U
a
m
cn
3
U W
RC 3
c7 X
U
O
as
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Nu=ber Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Ran Old Building
x
$5.00
$
Electric tdater Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$1:0.00 '
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$
��.50
S
TOTAL FEE
$ -Oa
REINSPECTION FEE
($10.00)
Department of Buildings
City of Fridley
Tel. #571-3450
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
Fridley, Mn. =i , 199to
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT <) �� - 7
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO. to V
Company o� _
Signed By MING GASH
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT `p - fes• Y� ( SK
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
.JS -A" .�..`
s ' CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
each ad::. 53,000 BTU
4.00
$
^�
7.00
AIR
CONDITIONING SYSTEMS
AND DEVICES
PARTIAL RATE SCHEDULE
Re_airs & Alterations each add. $500.00
4.00
$
STi a,t OR IDT WaTi:R SYS T 0? :
7397 4 d � e�
GRAVITY WARM AIR:
RATE
TOTAL
Job Address
rsrnace Shell & Duct Work
$12.00
$
$
Re=laca.:.e nt of = urr.ace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
Tel. (k571-3450
MECHANICAL WARM AIR:
Flarnace Shell & Duct Work to 100,000 BTL'
$12.00
$-
each ad::. 53,000 BTU
4.00
$
enlacement of Furnace
7.00
$_
Repairs & Alterations -up to $500.00
7.00
$
Re_airs & Alterations each add. $500.00
4.00
$
STi a,t OR IDT WaTi:R SYS T 0? :
Boiler & L nes up to 100,000 BTU
$12.00
$
each adds. 50,000 BTL
4.00
$
Boiler only up to 100,000 BTU
7.00
$
each addn. 50,000 BTU
6.00
$
OIL BURNER- to 3 gal. per hour
$10.00
$ °
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
®®
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
AIR CONDITIONING
FAX HEATING SYSTEMS$
See Fee Schedule
VENTILATING S:•STENIS
$
ALTERATIONS & REPAIRS-
$
State Surcharge
$ .50
TOTAL FEE
$30 -so
ROUGH INSP.
FINAL INSP.
REINSPECTION FEE
Date (.$10.00)
Late
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
OWNER
Fridley, Minn. Z6-3 ,19%46
�a
KIND OF BUILDING
USED AS
Cj
TO BE COMPLETED ABOUT -C--)
ESTIMATED COST �®� ��
O D NEW BUILDING PERMIT NO. PERMIT NO. "Z
DESCRIPTION OF FURNACE/BURNER
(:ETI�NG)r POWER PLANTS, Steam, Hot Water, arm Air- NO. �?
Trade Name �P?/L® AyZ:a/V Size No. �E� J -
Capacity Sq. Ft. EE'D�R BTU gXCMm HP
Total Connected Load okC ) Kind of Fuel �a5
BURNER - Trade Name �/� `��'R Size No. k
Capacity Sq. Ft. EDR BTU ® HP
Company
Signed By
• Tel. No.W Z ?
n
va'd;�r.y,r a •a.'r,.: ..l' :• yy"t`1'�ta€'t .: <� `"' _.
.
I
DSA tNW.
OR BUILDINGS-- .� NN.'
' '1A►
TYP! O1� CONSTRUCTION `:
INRtILA"I'ION
! '} .,-
t Dai
n
Cwt. 4A1a11
10. won'
Glyn
Roe►fboor .
nom Cwili _
W4
4`►•- !, at
Room Long#b '�Vidfh M�IgM'
Ci�EtK "And; A1tEA
WINDOWS and DOORS-- CRIICKA►6E and AREA
No; at,o oa rf q a. o. tree • k.
'
zio,
.► ► 4
`
Caof. Btu.
Btn.
_•
L.-"7,-
It+Altratioa
s M
�
ssl.p
Twp. Wi�Q
Nat'- . wax INC
-
16+ Well-
efi h
ng or floor
: .
-T'r ia1 Bfu.
'ft ° " M !!. ; fiq. SSV. A. l redec area
Itsquired :q. ft ED. R. or sq. ir►s. W. A, Lsador. area
y 'Vi�fitdth
..: 1•Iri gM
VL Rim• LrA 9R+: Width . Hrlgbt
1 ilNll+tQW's and D iO , ClW6$ aad 'skREA'
WINDOWS and DOORS --. GRACKA E aae1:AREA
sd .qe a iu. of A:
No. of peu . f paasf o .: of dra Ar"
Coof. Btu:
Cosf. Bta.
+
ad*"
ladiihretioa Coors
wall
Wap
q r "Wall
NO Wall
W
Int Wall
or Floor
Criaaq or floor
T Sfu.
Total Bfu.
'Asquirod sq. ft. E. D. R. at sq. ins. W. A. Leader arra
Required sq. ft E. D. R. or . ins. W.A. Leader area
Fk' Room`I Length: Width
Height
FL Room Length Width Height
,'1lriINGOWS and DOORS — CRACKAGE and AREA
WINDOWS and DOORS -- CRACKAGE and AREA
WidthHeight ' No. Linea Area
149. of o of pee tt his of eradl . ft.
Width Haight, o. o anal ft. Area'
No. of pane of pane 11 hts of 4raek sq. ft.
ry ,
Coef.
Bfu.
Coef. Btu.
'Modors ,
�� itiaut.: ,
Infiltration Wladows
r
6910. well
6�a
r , WsS
Net . Well
..
Int. wam
a as4Coilloo
or hoer
Total Btu.
tq, -ff: E,.D' R.. or W.'A. Leader arse
a irod11q. ft E. D. R. or sq. ins. W. A.. Lsoder area
85
i .
GRAND TOTAI.e
CITY OF FRIDLEY
• APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Flrnace Shell & Duct Work
$12.00
$
Raolacenent of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
MECHANICAL ,ARNI AIR:
rzrnace Shell & Duct Work to 100,000 BTL'
$12.00
$
each add. 53,300 BTU
4.00
$
Reps aC2^a.^.t of Furnace
7.00
$— LAD
Re:airs & Alterations -up to $500.00
7'00
$
Re_airs & alterations each add. $500.00
4.00
$
STEA I OR HOT WATER SYST01: -
Boiler o Lines up to 100,030 BTU
$12.00
$
each.ddn. 50,003 BTU
4.00
$
Boiler onlyup to 100,000 BTU
7.00
$
each adorn. 50,000 BTU
6.00
$
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- frcm 100,000 BTU to 199,999 BTU
$10.00
$za.eo
(over 199,994; BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
Additional Fixtures x
Gas Range to 199,000 BTU x
AIR CONDITIJNING N�
FAN HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS 1
aLTE1-kTIONS $ REPAIRS
� P.OUGH INSF.
ua L.c
FINAL INSP.
Date
APPROVAL FOR PE&%IIT
$ 3.00
$ 1.00 $
$10.00 S
State Surcharge
TOTAL FEE
REINSPECTION FEE
(.$10.00)
. INLMUM FEE FOR ANY HEATING PER'.IT IS $7.50
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
OWNER
KININ 0
Fridley, Minn. Z ® a -3 119-26
USED AS
TO BE COMPLETED ABOUT I I
ESTIMATED COST
//'OLD'- NEW BUILDING PERMIT NO. PERMIT NO. ! _
DESCRIPTION OF FURNACE/BUIUNER
,I --HEATING o POWER PLANTS, Steam, Hot Water, Warm Air- No. ) _
Trade Name . Size No.� A
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel cL
BURNER - Trade Name /) .F, _ nr Size No:
Capacity Sq. Ft. EDR �BTU pQs�oBn HP
a. Company cvP2
i Signed By
Tel.
y = a:, �":',' � � z rpt �a u '�,h'�°' a �.. ` " q � ,„,., .� �, <•
��+ r <`#�¢ ;'; tat ",k. s :� ,sem✓'^ ,L<', wih:; g •:tww, s.'
r .+. r{ � a it
e-fr,e_ {
_�
rOU00CONMUC'ttON
ih151iLA?IdN
-1nt.lNei s Cit r ltoef Fkor ... Kin
�T!�+.n�.
cailmm, Vyaq
.
�"F��.I. .T� *��I� _ -•3TC
_
' 1 . .' ?� Rohm= Laaytb W1dtG
.; . H>li9Ai"•, :
R. Reofa Length, Width Hei�M
V, i I�ilt�i --B end EA ,
WiNDQW and' p00-,;CRACKAE'►@
o
pnd A
he i Des . it.
etq 0
� of eI
�M9. "
4.
r •S5
x,
QOef. Btu.
d°
Btu.
t
Infiltretionndowi
�
rr
'Wad
4
sug. Wail
&P. Wall
wall,14
Id. Wali
-
`
or door
` Bfn: _:,
Total 8tw
° : ft. E.IR R..or :Ris. W. /h Leader arae :
�'
Rs aired fA E. p. R. or sq. im. W. A: Leader eras
f1. teem 'i uigNt. Widtfi
Haigh#<
FL, f Room:. • Length Width HeigCit
" i00RrAKACE NDOW$sad and AAM
I
WINDOWS and DOORS— CRACKIN and AREA
Ha e. a
` t~a
Ne. of tinea of Rase 11" . of a +rq.
Ne. ' � e o
. of ne of
Meal", Area I
0 creek sq. ft.
fiisR;
! Wsll Net 4p, Wali
4d. Wall Int. Wall
or Floor Ceiling or Floor
TOM Btw Total ON.
Isquirod sq. f f. E. D. R. or sq. ins. W. A. Leaden area Required sq, ff. E. D. R. or sq. ins. W.A. leader area
F Room Length Width Height Fl. Room I length Width Height
WINDOWS 'and DOORS C,RACKAGE avid AREA WINDOWS and DOORS — CRACKAGE and AREA
Width Height No. of Linea ft: Area Width Hdght. o. of Lineal ft. Area
Nei of pane of` enc N hts oicr;ck . ft. No. of ne of as It hb of crack sq. ff..
COO Btu. Coef. Btu.
inittafioa Infiltration adowsDom —
SflfedlEw Wall
14t` well
it. wag
41409 or Floor
oral Btu.
equirod sq. ft. L D. R. or sq. Ins. W. A. leadar area
BRAND TOM
SUBJECT._-P£�i�MI
N@==
City of Fridley2
�y
8 6 8 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
..
-!
--
P
.10572-3Q �
�CEIPT NO.
1. ______ MtlNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
�1
�/ %63j
r 1
tttddd
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
=
1 "'1 CITY HALL FRIDLEY 55432
J, 612-571-3450
910415
12
1 98
JOB ADDRESS 7397-99 Universit Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
D
1
5
I Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeff Haris
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
New Haven Const. Co. 4208 83rd Ave N Brooklyn Pk 55443
566-5fi225 20077950
4 ARCHITECT OR DESIGNER MAIC. 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 :Ek REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (32 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OFCONST.
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 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 OWLG. 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
2742
$1.37
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 PERFO MANCE OF CONSTRUCTION
$74.75
Fire SC $2.74
_
PLAN CHECK FEE
TOTAL FEE
$83.86
SIGNATURE OF ' RACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERVIVALIDAVE
Bl0 INS
D THIS IS YOUR PERMIT
BATE
S.GNATURE OF OWNER of OWNER SUILOERI IDAiEI
4 a
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ��
d�3
ConstructionAddress: % 3 � 7Z-2`3 e+ ' -j -
Legal Description: ,a E--
Owner Name & Address:, j��'��� -S Tel. #
Contractor: /�� (�--' �' d —' MN LICENSE
Address: e% G' � �d �z > A/- i<' 1. # 5 - s
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width
GARAGE AREA: Length Width
DECK AREA: Length Width
OTHER: 66�-9-oo'c ,
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft. _
� s'� ✓ l!
_ Estimated Cost: $ p2 2��
(Fee Schedule on Back)
Ft x $ = $
DATE:, - / _ APPLICANT:�G�
C ` - %�� Tel. C,--,55
CITY USE ONLY
Permit Fee
$ S�
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 3
$.50/$1,000 Valuation
SAC Charge
$
$1000 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:
J
SUBJECT
IT NO: --
city of Fridley
33277
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
R CEIPT NO.�
r PROTECTIVE
1 � �
NUMBER
REVOATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910415
1 _A11/26/02
JOB ADDRESS 7397-7399 University Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
5
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vitaly Chernikh 7397 University Avenue NE
763-227-8237
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Double Bungalow
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Interior alteration to add basement bedroom
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
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.
SEPARATEpERMffS
REQuIRED 0
WIN HE
�sANDtiift
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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
2
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
$1,000
$ •50
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•
Fire SC $1.00
STRUCTION OR E PERFORMANCE OF CONSTRUCTION
$38.75
PLAN CHECK FEE
TOTAL FEE
$40.25
SIATURE OF CON -RACTOR OR AUTHORIZED AGENT iD4TEi
MEN PROPERLY VALIDATED THIS IS OUR PE MIT.e-�`
EILID& INSP
T� qAf
41 S4NATURE OF OWNERaF OWNER BUILDERS I IDAT i
J
NOU 25 2002 10:38 FR BEST BUY -COM 6129964830 TO 97635711287 P.02/04
NEW [ J CITY OF FRIDLEY Effective 1112002
AODN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572.3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION h
Construction Address: 9 �-199� ✓ r 11a
.!/T�7 � vP.7 Al- ,�..�,e......
Legal Description:
Owner Name & Address: V�•� Tel. #'�
Contractor: kit A)1 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 HeightSq. Ft
GARAGE AREA: Length _ Width Height Sq. Ft.
DECK AREA: Length Width HgWround Sq. Ft.
OTHER: Wsuk+ �-o &KX ig-oa,r-6S w'l r4O s e.fie �n� f�rr►S
Construction Type: Estimated Cost: $ A COf7
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ = $
DATE-. % � 20 ?.- APPLICANT: CAzf— ikl-L Tel.iM 3'Z `�-
Call (763) 572-3604 for Permit Fees If malitng In application or Fax to 763571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fre Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Paris Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
`-1J Fee Schedule on Reverse Side
$ . c .001 of Permit Valuation (1/10th%)
L ^ $.50/$1,000 Valuation
$ $1200 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 `� STIPULATIONS:
NOU 25 2002 10:38 FR BEST BUY -COM 6129964830 TO 97635711287 P.04f04
r
** TOTAL PAGE.04 **
m
MEN
m
momommmmmmmmoms
M
mi
ommol
millmommim
ilimim
EMEMENEMEM
No
ai'eo�
x�.w_......iOEM
NIEMEN
EMMEMMEMENiii
i
llommommoommaj
NMENME�l7�ofa
woommud
61
a
MINE
IN
Elm
** TOTAL PAGE.04 **
3uilding
$ FS 3• S�
BUILDING
Permit No.:
inspections
$ I .
RESIDENTIAL APPLICATION
Received By:
763-5,72-3604
$
CITY OF FRIDLEY
nate Rec'd:
)ATE
YOUR E-MAIL ADDRESS
Erosion Control
;ITE ADDRESS
Park Fee
$
Sewer Main Charge
$
Total Due
"M APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: `` GaG�4-tl v+ aft
ADDRESS: J 91 CITY
STA _ IP 5
TENANT
PHONE: SZ 3
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
®'TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ®'ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
UNEW ❑ ADDITION
❑ MAIlVTENANC&?"AM ❑ REMODELING
DESCRIBE WORK BEING DONE: 'Z At LO -1c, C H Co"
cost-KeC (±Cc- a
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ OUSE ONLY
NUMBER OF SQUARES 7—:1_
IS HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
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
I. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WIIVDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ -2 / 2 q 9 I OCCUPANCY TYPE
Permit Fee
$ FS 3• S�
Plan Review
$
Fire Surcharge
$ I .
Surcharge
$
License Surcharge
$
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
lations
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 re es review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME V 11 C(. Z-': �° DATE I o 66
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3454 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
r
understand that the State of Minnesota
requires that ifi residential building contractors, remodelers and roofers obtain a state
license unlesd they qualify for a specific exemption from the licensing requirements. As
the owner of the property at �'+ 311 ,„��� r'�ri�, �q,,,®z, , Fridley,
am exempt from the state licensing requiremeni only if I am not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because 1 do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under_ Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and 1 understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property. _I ---
Date
Date 'l fu 0&
From: 651 554 9970 Page: 2/3 Date: 9/22/2009 8:59:43 AM
oup e I UW Vb:zup KworoKer 763.416.0701
PA
Building
Permit Fee
BUILDING
2 9 . S`D
Permit No
Inspections
S
R.ESID t'NTUL "PLICATION
65% of Building Permit Fee
Received By:
'763-572-3604
CITY OF FR.IDLEY
Surcharge
Date R CD <. � 2 �
763-502-4977 FAX
.0005 x Permit Valuation Atinimurn $.50
License Surcharge
$
S'
$5.0C (State Licensed Residential Contractors)
EFFECT1VEg-1909
$
DA'I'S
YOUR E-MAIL ADbRESS �!b
$
SITE ADDRESS V7
A+ 6 fl= ft x S22 @ S
ErosionCtmtrol
Tt;tS APFLtCANTIS:
C O VUNER R
$4SO Conservation Plar. Review
PROPERTY OWNER/
NAhdE: s(C
TENANT
ADDRESS: ✓r CITY
SLPSTATE
-�r�--
PNONE: ��✓' 47�t; � C����
-�sa�-----
CONTRACTOR
NAS; ., 4 1 L 4
Make checks payable to: City of Fridley Attach Stipulations
SUBMIT A COPY OF
YOUR STATE LICW.SE
STATE LICENSE # LAS .7 ;L—EXP DATE
ANDCERMFICATE OF
Rg
ADDRESS: /0-415tL{9iu �P li -c—
Crrv- U'1 SF Aa,& STATE44A- .lp 3'�/!SE
INSURANCE -PHONE
c, - 7 / tao FAX 65Y -3 5 C4
PROPERTY TYPE
d Swam FAMp ymw CONSTRumic N SIZE
DTWO FAMILYMEW CONSTRUCTION STORIES
PERMIT TYPE
C ADDITION D GARAGEMED EMFINDOWS
G BASDAETTFINISH 0 ROOF O DRAIV TILE
Q DECK C SIDING O OTHER
0 SWUC NG PDOL
TYPE OP wCIRK:
O NEW' HOME CONSTRUCTION 13 ADDITION
C A1AMMANCIVASPAIR t] REMODELING
DESCRIBE WORK SMNG DONE: /. -V1 no.-Ow"
E OF IMMOVD4ENT
LENGTH /'ems WIDTH
HEIGHT SQ FT
0 HOUSE ONLY
RMODELING SUBMIT: I
N•JMBER QF 5QUAtSES
Z314OUSE & GARAGE
1&SP+G:NT'
I. Existing Floor Plan
e3AI A
Q ATTACHED GARAGE
2. ProFosgd Coar plan
PROPOSED SIZE:
13 DETACHED GARAGE
3, Uslofswwwrai membersto be used
PROPOSED HMONT.
pN
ICOR NEW CONSTRUCTION MCLUDING DECKS.
0 Vinyl
13sont
ADDITIONS_ & PORCHES SUBMIT:
la Aluminum
O Trim
1. Site Plan/Sunmy showing the exlningstructures
O Other
O Fascia
and proposed pmj=
2. Two sets of conswetion plass
WlIYD01-�
IN EXISTING OPEI RKM 12-6//
OX,
3. Energy Calculations
1 LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE UNALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WIN60W.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OP WINDOWS
ALL Jeers Ala RA5F„D U14 VALUATION, INCLUTHE COST OF LABOR AND MATERIALS:
(USING THR �,9 7 U.&C FEE SCHEDULE)
TOTAL JOB VALUATIONS �o �(�` I-- OCCUPANCY TYPE
Permit Fee
$
2 9 . S`D
See Back Page for Fee Schedule
Plan Review
S
65% of Building Permit Fee
Fire Surcharge
S
.001 times the total job valuation
Surcharge
S
.0005 x Permit Valuation Atinimurn $.50
License Surcharge
$
S'
$5.0C (State Licensed Residential Contractors)
SAC Charge
$
52000 per SAC Unit (Plans to MWCC for determination)
Curb Cut I %row
$
A+ 6 fl= ft x S22 @ S
ErosionCtmtrol
$
$4SO Conservation Plar. Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Totaal Due
$
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPUCATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate•, that the work will be in
cotlfortuance with the ordlaanc= and codes of the City of Fridley and with the Minnesota Construetion 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 itc; that the work will be in accordance with the
approvcd plan in the case ofallw k which re �l)trfe; >�S yieww and approval of plans. ^� t Y7
SiGNATUREOFAPPLICANT N�^_•--e L� / v PRINTNAMEt�h111 cr— �'Int��•.- nATF "I nt - 2
11