PRE 2010 DOCSVillage of Fridley, Minn.
WELDING PFS
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269 ®Vice of INSPECTOR OF BUILDINGS
Owner
Architect Fridley,
Builder
Y 4a�A
BUILDING
10 -71
'rQN OF BTJYLD z
No.j Street Part of Lot
Front , ' _, ' De
To be used as`�`��`
Block Addition or Sub -Division
R x
A_%71nRESCRIPT1011T OF BUILDING
Height—L.7Stories Manner of Construction
Estimated nnat
q To be com
R P
Permit is he granted to.°•,r=: �"'°r', to,
kk q s
the building ks' .9 . ' described in the above < statement. This permit i8 granted
upon the express c'gndition that tp rson to whom it is granted, and his agents, employees and workmen, in all
the work done in,' around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley,i, I inn., 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. Ji
�. _,_Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consider Alon of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth''and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I'herebyij state and say that the facts stated by me and contained in the above permit are
true as therein stated.
Subscribed and sworn to before me at Fridley, Minnesota,, fbis l- '4"; P _
day of A.D. 19 �� � �� 4 L4'�
C
BUILDING PERMIT
Village of Fridley, Minn. N° 2522
Date.... ...t ...::. .
Owner {, Builder ... .1-Al
Addressa
Address
LOCATION OF BUILDING
No. .. :. 1. Street... , . y , .� ........ Part of Lot .......................
Lot ..............!i. Block ................ Addition or Sub -Division .......................................
Corner Lot Inside Lot ..... Setback .. Sideyard ..
DESCRIPTION OF BUILDING
To be Used as:
Front " . a"
• . Depth height Sq. Ft. «` Cu. Ft. ........
� , x Front .. if Depth ... ' Height ... Sq. Ft. mei Cu. Ft. ........
Type ofonstruion Cost ......?... ... To be Completed .. .
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 all provisions of
ordinances of the village of Fridley. �y y
In consideration f the payment of a fee of $. rrrt is hereby granted to cifa� 'A^
to construct the buil din or ad itio# as described above. This pernnt `is g �e upon
the eres� rnditign that the person to whom it is grant'and his agents, employees and workmen, in all work
done in, afind and: upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota liegarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances,
, Building Inspector
NOTICE: �.,
4011F Z_
This permitrydoes not cover the oonstruotion, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
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SUBJECT
PE O.
City of Fridley
®1412.2
AT THE TOP OF THE TWINS
PERMIT
' `
r
BUILDING
REC
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
KJ
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
-
--6/1/77
JOB ADDRESS 320 Osborne Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
�ParC
2649&
ftb&rme—NAuor North Half of Sec. 11 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Ezekiel Moreno Jr. 320 Osborne Road N.E. 784-5050
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW .0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a porch.addition and r:eroof dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
$efw dkft un low d t s
TELERIONE - ELECtRIC • GAS Etc.
REQUIRED BY LAW
SEPERATE PERMITS REQUIRED F'OR WIRING,
HEATM PLUMBING AND SIGNL
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
1 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
$2,000
$1.00
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-
$12.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$13.00
SIGNATURE OF CONTRAQORNORAUTHORIZ AGENT (DATEWHENP
PERLY VALIDATED THIS IS YOUR PERMIT
7SIGNA
BLDG. INSP IJATE
RE OF OW ER 11ER BUILDERI DATEI
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CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: �/ z e 2 k4 p v C k u �6 BUILDER:.
Address: a o 05 1�5' or w e Address: d-14 1s /y,6-2 e l
Tel. No. 7 S-6
No.: Street: Q o,
LOT: BLOCK: ADDITION:
CORNER LOT: , INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
2-0 t= Front: Depth: Height:
�)�& 10or Square Feet: Cubic Feet:
A t°t� '
e � dtiFron t : � Depth
�2
Height:
Square Feet: f 7 &v Cubic Feet:
Type of nstruction: N je� b 3(rt
,
To Be Completed:
/3®z. 9/a
Estimated Cost: $ 1097, ( 0
®Yv '7'.;t.
/Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE : ZI 1-2 ? SIGNATURE:
Stipulations:
, da
i,3.,
F. C . J, C ST. f
LAND SURVEYOR
REGISTERED UNF.-tii LAWS OF STATE Or
LICENSED BY OROINANCE OF CITY OF MINNLAPOLIS
3616 EAST 55TH 57REET t1A 4-1661
ribu n:l1�=ezlr, 5 - Crrti i ILA
—
-
On
I7
,
Foley,
I HEREBY CERTIFY THAT THF A60VE IS A TRUE AND CORRF-T PLAT Or A SUFz\'F-Y OF
-t
That -nLrt of the 1, 1 // 4 Or t 1 3 1 f S o,.- 0 1, 24
-
that is described as f oalo-""Z; -1,7 E�t a "."l -Z in 1:3 35-1'1- "'A -et f
-i e 1, 1-1 o t I i c., mea:- il r t r t r
the V est line of t! sald
n" tl--o -,fj,�CA�
.d1 t h said Vie,3t lizw and 7131; �fee-t, So,.i!;h frovi tho ',,',.c-ornax
-; 1 jf t-,�e
LA t"re
of t' -,,-
i n-,- 'lor-h
c a-0, nol'it I u r i (" -j P F_, (I
p a r I t o s E, I d ,--st, 1 -'Lr-,) to thf3 center line c.-" C, 3b o ,, n a H o! -, d t h e n c e n r -j c. i--� e -d f
NT -, r th e a s , e r 1. y a I o Tl f:.; su i d c n t,,� r I -' o ' or a d i s tn n c ,) -1 f �� 5 1, .- I t- i I. 11cl t o n i lit 6
thance -,,)iith pur!Aliel t'd ',,est 11ne to -,n intersection.
e -u 11 t, t -13 d �,-- S c, '1.:1.- J1 a o1 1 3 or_t3.r. Cent ter line of -aid
Osborne .--Wa-d fvcni po-1 - t c c fec,,t;anf' proc--iu7-J-,n:-
Sout'1 and to t�,P- .101- a e:listance, of
,S'ei�lv a-,,! 'n E, c�lr-2-t !-Irie
di
th-,nca -'rom sa-id int,ers,--4-.1on tD poInt ri, c h n t
t tc 3o.�.3-77 r-' - a. c)
3
e
60
I ®
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
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: -32-0 05loCwnr,
Legal Description:
Owner Name & Address:
Contractor.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
)er7e AI. # -fo3--7!`7- b43 2
MN LICENSE # 1051P
Tel. # 61152®gSl
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type:.LP .VVt —A4i✓L ' jistimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:450 � APPLICANT: Tel. # � 2—
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee Fee Schedule on Reverse Side
Fire Surcharge - .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1275 per SAC Unit
License Surcharge $ . b® $5.00 (State Licensed Residential Contractors)
Curb Cut 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 $
C1
Building
PLUMBING
Permit No.:,3007 -C?04-
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
20��
OF FRIDLEY
e
DATE:® y YOU�tE 1LADDRESS
SITE ADDRESS �� �Jt �.� �Vq
THIS APPLICANT IS: OWNER CONTRACTOR
PROPERTY
AFPrNPE 15OWN
ADDRESS: l �(1T aj ti.3CI STATE ZIP
TENANT
PHONE: L Z
CONTRACTOR
N
SUBMIT A COPY OF
STATE LICENSEE # E�,XryryP DATE t 5 � o
DS�bCii1 1
YOUR STATE
ADDRESS: J Q _�� Ivy CITY STATE ZIP
LICENSE WITH
PHONE " �(� '� Z FAX
A.PPr ICATION
PERMIT TYPE
`5 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
NEW -REPLACEMENT
DETAILED DESCRIPTION OF WORK aj&_-k-- 4j�CZ_t
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= M /-C-
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV DRAINS SHOWER _ WATER PIPING
_FLOOR
—BATHTUB GAS PIPING pvEED crrY=NsE) SWIMMING POOL _ WATER SOFTNER ($35)
_ _
_ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15)
LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
—DISHWASHER _
_ WATER METER ` _ OTHER'AAgC
,,, , ,, ,t FEE i�.Plt Kis, ,_ ' .
Permit Fee $
Number of fixtures @ $10.00 - x$10.00=$ --
$10.00=$Surchar
Surcharge
a .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
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 d work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all rk which r s review d approval of plans.
SIGNATURE OF APPLIC INT NAME ' C Lin ATE LC
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977