PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No5 0 4 s
Date:
Owner:` ` Binder`
Address _ ____ _ _ _ _ Address ---.------- ----- —
I >d
LYIOI\I- 0:; BUILDING
04fNO. Street_. _..._..__ _ _ . Part Lot
vQaw
Lot _ _ .__ Block ____ __9 _ - _ Addition or Sub,r iva on . .
corner Lot Inside Lot ^back Sideyard
ww
Sewer Elevation w _ _ _ Fo' trdation Elevation ----
DESCRIPTION OF BUILDING
To ,' a Used as:/�
{' Front Depth Heigham Sq. Ft. Cu. Ft.
Front Depth l;Iei ht Sq. Ft. cu. Ft.
Type of Constructio Est. 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 fProvisions and in compliance with all provcions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ S ! 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. , _ A ,w
Building Inspector
NOTICE:
This permit does not. cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no
the Building Inspector for separate permits for these ,items.
4
Owner's
Address
APPLICATION FOR BUILDING PFRNIIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OFyB,UILDING
No. / l� Street )! . cq Part of Lot
Lot_ Block Addition or Subdivision
Corner Lot Inside Lot Setback .-Z1 Side -Yard`
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and � prgpospd buildings-�`
location.
A n , �.-� ,lk q -DESCRIPTION OF BUILDING , 4
To be used as:
'9 eq
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representations
stated in this application are true and correct. _
DATE �.Lc� - _� � SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
oa
one
SuBjECT
PERMIT
City of Fridley
24656
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE C IPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
e
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/11/9
JOB ADDRESS 4716 2 Street NE
1 LEGAL
LOT NO.
TRACTOR ADDITION
SEE ATTACHED
DESCR.
10,11,12
JBLOCK
5
Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mary Ann Cook 4716 2 Street
572-8959
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Custom Remodelers Inc 8729 Central Ave NE Blaine 55434 784-2646 1748
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
X
8 DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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
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
$4.89
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$9,776
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-
SC $9.78
STRUCTION OR THE PERFORMANeliOF CONSTRUCTION
$162.25
Fire
PLAN CHECK FEE
FEE
//
��'%%"� b
Licen Sc
.00
ZTAL
$181.92
SIGNATURE OF CONTRACTOR OR AUTHORI2 AGE IDATEI
P
LY V LI OtTED THIS ISYOUR FERJAIT
OG IN Wr
DATE
S.GNATURE OF OWNER OF OWNER BUILDER; IDATEI
one
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application Ava)
ConstructionAddress: G J
a
Legal Description:
Owner Name & Address: f%./ ,�J (�° a� -216 �L4Tel. # �� Z
Contractor:Sr►, MN LICENSE # I i
Address: Z 9�.✓� /�!� �'.!. Tel. #
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:
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbac
Type of Construction:�sf'd d—p- Estimated Com: $ /, v
Approx. Completion Date: /d —lz — 9
(Cost on Back)
Driveway Curb Cut Width Needed: F + 6 Ft = Ft x $ _ $
DATE: _16-11 -9 G APPLICANT: "�;Tel. # -A
Permit Fee
$
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
$ 6)d
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $—i 11
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 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 [ ]
CITY OF FRIDLEY PERMIT NO.: 2004-01500
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004
572-3604 FAX: (763)571-1287
ADDRESS : 4716 2 ST NE
PIN : 263024320065
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114 -
OWNER
COOK MARYANN M
4716 2ND ST NE
FRIDLEY, MN 55421
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 wort
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 construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 117431
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE . 4 . /
SITE ADDRESS `f
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERIVIIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING DOI
SIZE OF IMPROVEMENT
IBUMDING
RESIDENTIAL APPLICATION.
CITY OF FRIDLEY
YOURE-MAIL
`Y)
PHONE_L(c \ /I •L i5
STATE LICENSE #___Z2
P5SIN0CE FAM Y
0 TWO FAMILY/NEW CONSTRUCTION
0 ADDITION ❑ GARAG
0 EASEMENT FINISH O ROOF
0 DECK 0 SIDING
0 SWIM
C1 NEW HOME CONSTRUCTION
g� MAINTENANCEIREPATR
h .
/7,
�b
Permit No. • DO (6 6W,0
Received By: - t
Date AP 2 10
ZEWii2►`1 WRIM
EXP DATE_ Z/
SIZE
STORIES
VSHED W§
0 DRAIN TILE
0 OTHER
NO POOL
0 ADDITION
0 REMODELING
ROOFING 0 HOUSE ONLY
NUMBER OF SQUARES 0 HOUSE & GARAGE
GARAGU E3 ATTACHED GARAGE
PROPOSED SIZE: 0 DETACHED GARAGE
PROPOSED HEIGHT:
SIDING
0 Vinyl
0 Aluminum
0 Other
WINDOWS
IN EXISTING OPENINGSAYes ONo
OR FOR NEW OPENING DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTAT T Rn
WAL JOB VAIA
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
ON
OSofffit
0 Trim
0 Fascia
LOCATION
NUMBER OF WINDOWS d
"ON, INCLUDING TSE COST OF
THE 1997 UBC FEE SCHEDULE)
' 2-
crnrurtir _ SQ FT
BASF IBM
REMODELING M1T
1.
Existing Floor Plan
.2.
Proposed floor plan
3.
List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DEM,
ADDITIONS
& PORCHES CTIBMIT
I.
Site Plan/Survey showing the existing structures
and proposed project.
2.
Two sets of construction plans
3.
Energy Calculations
See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ c9, • DD .001 times the total job valuation
$ DD .0005 x Permit Valuation Mmimam $SO
$ . D D •$5.00 (State Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft- tx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ % make checks payable.to• City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmoWIedge that the inti
of the City of Fridley and with the Wanesota Construction Codes;
permit on site; that the work will bre in sc Ic a with the annrovet
SIGNATURE
APPROVED BY
ion above is complete and accurate; that the work will be in conformance with the ordinances and codas
I understand this is not a permit but only an applit�tio for a permit and work is not to start without a
K7of ail work which 771d o plans.
PRIIVTNAlVIE (M DATE- •`d
DATE