PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT NN®f 4 7 5 0
Date: +-
Yr
Owner: leBuilder _ .-.__...._..._.. ._.._.._._._...__._
Address .... _.._ `._.m �;_..... Address ............ ._. .z'........_..._.._ ................_.
_.._....
CATION OF BUILDING
" Part of Lot
Street
.�.........-........._ 7 ....
Lot ---. F Block Addition or Sub Division ...
Corner Lot .......... ...... Inside Lot ...... '`: "' ......... Setback: , ... Si /y '
4�pr b.,y. _...._.._. yard ....._..i°.-.._ ... .....................................
.._...
Sewer Elevation------............._.....------...__.....-----............._......._................---_..._... ,Foundation Elevation ........ ...................... - ..... -
DESCRIPTION OF BUILDING
To bey�Used as•
. ..� .... _t. w .. Front .. ....... Depth ...+.. ;._.. Height ..r.- ... Sq. Ft.+.. _ e Cu. Ft.„t._. -
.----...._............. ......... :............. Front, -......._.. Depth . Height q. Ft . Cu. Ft.
a...€+ Est. cost....... r+* 3+.. To be Completed _.--. ............._.............-
Type of Construction -;�:��--......: �.. �.`-,...,,..,,-W
CAUTION
THIS PERi,11T t.JE: (155 AUTHORIZE VIOLA'.
ION or A(JY P';A 1 LAND (;OVENANTS ANO
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 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 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 " I
Building Inspector
NOTICE:
This permit .does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
.OW4
R-. _v .21
Owners Name r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY$ NiDOMOTA
F
Builder ,_:E____�.
Address 15 2 1A, Address .�
LOCATION OF BUILDING
No. Street ��% Part of Lot..,�.:�_,,,.,,,.
Lot., Block . `L4 Addition or Sub.Div.
Corner Lot Inside Lot Set Back L.Side-Yard
SEWER ELEVATION --1; 1V 6. OUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
t
Front � - ._Depth
Sq. Ft. ,1 Cu. Ft.. N_ 7 f"b e
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost /J11
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 representa-
tions stated in this application are true and correct.
DATE 1j_t_1A..�JIGWMM
1l !/
(A Schedule of Fee costs can be found on the Reverse Side.
City of Fridley
Application for Plumbing and Cas Fitting Permit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures I'°cati°n
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ....... ..............
� x $1.50
o
$�
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
�= Z
o�
Catch Basin ...... .....................
x 3.25
?
Water Heater (Up to 200,000 BTU) ......
+
WATER HTR.
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
m
Jx $1.50
It f . !�—v
1st 3 Fixtures ..........................
pp
x .50
$
`aa
0°d
�Z
c�4c
�a
too
R
N
GAS
ELEC.
Base
1st
2nd
_
3rd
_
4th
• Future Connection Openings
Connected with Sewer
New Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ....... ..............
� x $1.50
o
$�
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) ......
x 2.00
$�Z.
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
Jx $1.50
It f . !�—v
1st 3 Fixtures ..........................
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS --Refer to Code
Description ................................................$
TOTAL FEE $ Z 70
City of Fridley:
2 i
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 true and correct.
Fridley, Minn �� 19
Owner
Kind of Building
Used as
To be completed about
�_ r ��• dry
Estimated Cost, $
Old—ew'BBuilding Permit
ROUGH 0 - "� 6
FINAL
d 2 2M 7-59
By L `C_ -I
Business Phone
City of Fridley, Minn.
BUILDING PERMIT
Date:
Owner: `" - Builder "
Address
LQ► 4TI ASUDING
N4- Street Part of Lot
Lot _-a Block _ Vis$_. Addition or Sub-
Corner Lot _._4.�.._ Inside Lot wetback Sideyard
Sewer Elevation F dation Elevation
DESCRIPTION OF BUILDING
Tolle;
Front Depth - Height Sq. Ft. Cu. Ft. '
Depth AHeight Sq. Ft. Cu. Ft. _
Type of Constructio st. GdV _ __ __ To be Completed
0, /1--cl
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 city of Fridley.
T
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 pon viol of any of the provisions of said
prdinanc�s. �
NEW
Building Inspector
NbTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
;thea Building inspector for separate permits for the items.
Owners
Address
No. `5�% - -3
LOCATION OFeBUIp INN
of Lot
Lot Block_. Addition or Sub.Div.
Corner LotInside Lot Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION,
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used a - ,v
Front Depth Height 1'
q. Ft. 's� d Cu. Ft,
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Construction I IEstimated 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 representa-
tions stated in.this application are true and correct.
� s
DATE`-1�G.- �' SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley, .
N°(:5:9:45
Address
.,IOCAT�ION OF BUILDING
No. Street , �s�` of Part of Lot
Lot _ Block Addition or Sub'D on
Corner Lot _ _ Inside Lot _Lw�,' tbadk Sideyard
Sewer Elevation _ _ Fo6dation Elevation
DESCRIPTION OF BUILDING
T e as:
# Front Depth Height _ Sq. Ft. Cu. Ft.
]Front Depth rHeight Sq. Ft. Cu. Ft.
Type of Construction 090 _ Fust. 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 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 Bart 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 violatip of any of the provisions of said
ordinances. .+ a
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for there items.
Inspector of Buildings,
6431 Univ. Ave. N.E.
APPLICATION FOR MOVING PERMIT
No
Fridley, Minn., '�" -5— y 9 .�L -_;' —
The undersigned hereby makes application for permit to move building as herein specified, agreeing to do all
work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby de-
clares that. all the facts and representations stated in this application are true and correct.
Lot Block
Present Location :
!�/z 4z �z Zf 7
To be moved to:
y j
I
Routing:
Addition
— 7L ' T�--z
Distance moved To be completed aboutrl
Taxes paid? Estimated cost Foundation and alteration permit numbers
Certification as to cost:
I hereby certify that the above designated building is worth at least sixty (60) per cent of the cost of a simi-
lar new building.
Approved by:
Utilities Notified:
Owner or Agent
Water & Sewer Department
(Title) —Minneapolis Gas Co. (date)
Northern States Power Co. (date)
(Title)
Northwestern Bell Telephone Co. (date)
(Title)
Signed Z�
Licensed Mover
(See reverse side for instructions)
Engineer
In the event that the moving permit is to be applied for by the owner or by any other person than the licensed
Mover, the following letter must be completed and signed by said mover:
Inspector of Buildings,
6431 University Ave. N.E.
Fridley, Minnesota
Please issue the bearer of this application, Mr.
a permit to move building from:
Data , 19—
M
to: to which I hereby authorize him to sign my name.
Signed
Licensed Mover
GENERAL INSTRUCTIONS
The following must be secured before moving permit will be issued:
1. A building permttt for new location of building to be moved. To obtain this building permit, the following is
required:
(a) The building to be moved must be inspected for structural soundness by the building inspector. Phone this
office for inspection. SUnset 4-7470.
(b) A survey of lot to which building is to be moved. This survey must be made by a licensed surveyor.
(c) The building and moving permit must be obtained at the same time.
2. Tax receipt showing that all real estate taxes due have been paid. Duplicate receipts may be obtained at Anoka
County Auditor.
3. Approval from, the Fridley Water and Sewer Department showing that bills chargeable against the property to
be moved have been paid and water connections have been discontinued at the curb line or at the main. (See
reverse side of form.)
4. Approval from Fridley Director of Public Works office approving routing.
5. Notification to, and signature of utility companies. (See reverse side of form.)
(a) Minneapolis Gas Co., 739 Marquette Ave., Engineering Department, Fourth Floor.
(b) Northern States Power Co., 15 South 5th Street, Application and Extension Department.
(c) Northwestern Bell Telephone Co., 224 South 5th Street, Business Office, First Floor.
11 250-8-5a _
w , . W
SUBJECT
M
City of Fridley
17 0.5
AT THE TOP OF THE TWINS
BUILDING P E R M IT
r
RE
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
®®�
t �
NUMBER
REV.
DATE
PAGE OF
APPROVED By
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/14/83
JOB ADDRESS 5923 - 2nd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
22,Pt.23
10
Hyde Park SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Wayne Siegfried 5923 - 2nd Street N.E. 571-3254
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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW El ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 12' Deck
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
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
$.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1100
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE.OF CONSTRUCTION.
$19.00
PLAN CHECK FEE
TOTALFEE
$19.55
SIGNATURE OF CONI RAC TO 7 OR7AUTLIZED AGENT (DATE)
PROPERLY VALIDATED THIS IS YOUR PERMIT
��WHEN
(NSP rA E
SIGNAT EOF OW NER IIF OW R ILDERI (DATE)
(DATE)DG
CITY OF FRIDLEY
APPLICATIM FOR RESIDENTINL BUILDING PEW41TS
(New, Alterations, Additions, or Repairs)
1 p l
01111ER: r
ADDRESS "6f ' o
TEL NO:
• STREST NO: STREET:
LOT: e
BUILDER:
ADDRESS:
TEL NO:
Construction Location
BLOCK: ADDITION:
Effective Aug. 1, 1981
Corner Lot: Inside Lot: Setback.: Sideyards:
Ap,plicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: _ Depth: Height:
Square Feet.:_1 Cubic Feet:
Front:
Square -Feet:
Type of Construction:
Zb Be Completed:
Depth: Height:
Cubic Feet:
I ),C)
Estimated Cost: $ �v
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE F.EVERSE SIDE OF SHEET
Mie undersigned hereby makes application for a permit for the uork 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 corre t.
D.',TE: ,�, � p� � SIGNATUF.t^� :
Stipulations:
1q o 00
15;, ?o oq
I 1 DC)
t-sz .�-
C
t'"-�1
G11T OF MI)LEY
97 -8b -h, 6051 APPLICATION FOR PWMBING AND GAS FITTING PCAMIT
PARTIAL RATE SCHEDULE
PLUINMING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
AJ
$2.00
$
Water
x
$2.00
�-51
Catch Basin
A
$5.00
N
IXC
m
$5.00
$
100,000 BTU to 199,000 BTU
a
w
$
Water Softener
Heater
$7.00
$
c
x
$5.00
$
Electric Water Heater
x
$5.00
$
y
Id �
1st 3 fixtures
x
Additional Fixtures
x
o
u
+�
Gas Range to 199,000 BTU
x
►7
a
•.i
a w
0
8
aq a
0 .�0
$5.00
$
o
to
$2.00
:IA
State Surcharge
ai
4
TOTAL FEE
ai
w
u we
a 3
t�
as
lec
1st
it
2n3'
3rd
4 th
(R) Future Connection Opening
Connected with Sewer
I•) s New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUINMING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
•
$
stater 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 Pun Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$30.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
tiEItl�!'E:^1'1,,1 F'LE
Job Address 5923- 2 Street NE
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the Werk 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. 6-23-78 , 19
OWNER Siegfried
KIND OF BUILDING frame
USED AS res,
TO BE COMPLETED ABOUT 6-30-78
ESTIMATED COST 20.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. I r
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE- --
Fridley, MN 55432 APPLICATION FOR POWER PLANTS ARID if EATING, COOLING, VENTILATION,
763-572-3604 REFRIGERATION ANQ AIR CONDIT
E SO E®ULE
I State Surcharge 5 �0
TOfAP_ FEE $ _
LL MINIMUM FEE FOR ANY HEATINC4/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
j ,, EP THE 150 STATE SURCHARGE
REiNSPECTION FEE $47,LO/Hr
'Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
i
s
Effective On January 1, 2001
IAIVIAIG SYSTUNAN EVICES
JOB ADDRESS S 5 V,3 Z 1-7d�
OWNER__ ,n -
��
BUILDING USED AS 1
ESTIMATED COST CQ ` PERMIT No----_i`-7_s�
DUO OF gRNACE A_RNER
No. Cd Pleating UI " _ — Circle One (Stearn) (Iiot Water��'WarmAir),,
Trade �9arne—'�-�L y� �® _ Size No.� Z5 �m
BTUA9. Fie. w _ EDR_
Ful� Total Connected Load
Burr*r Trane 14arne3 — _ Size
BTd1_--
The undersigned hereby makes application for a permit for the work herein
specified agreeing to ria all work in strict accordarrce with the City Godes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application am true and correct.
DATE
HEATIRG CC) _ - ,
Signed— TEL 4i1�/"�/�
Approved By Rough -In Date -- Final Date _ 1�U1
D COMBU'RTION AIR VERIFICATION
Residential
Rate
TO'fAL
L;
Furnace Shell and Duct Work., Burner -
ZD
Also Replacement Furnace
$ 30,00
(Side Vent • Fill Out Back)
Gas Piping (Needed with new furnace,
$10.00
$ _
but not replacement)
Gas Range
$ 10.00
$_
Gas Dryer
$ 10.00
"Air Conditiornirg - All Sizes
$ 25.00
$ i�
All Others./Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Mork
$
ti
Conwn a rc i a l l i n d us tri a l
A
1.25% of Value of Appliance (:�r Work
�
LL
I State Surcharge 5 �0
TOfAP_ FEE $ _
LL MINIMUM FEE FOR ANY HEATINC4/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
j ,, EP THE 150 STATE SURCHARGE
REiNSPECTION FEE $47,LO/Hr
'Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
i
s
Effective On January 1, 2001
IAIVIAIG SYSTUNAN EVICES
JOB ADDRESS S 5 V,3 Z 1-7d�
OWNER__ ,n -
��
BUILDING USED AS 1
ESTIMATED COST CQ ` PERMIT No----_i`-7_s�
DUO OF gRNACE A_RNER
No. Cd Pleating UI " _ — Circle One (Stearn) (Iiot Water��'WarmAir),,
Trade �9arne—'�-�L y� �® _ Size No.� Z5 �m
BTUA9. Fie. w _ EDR_
Ful� Total Connected Load
Burr*r Trane 14arne3 — _ Size
BTd1_--
The undersigned hereby makes application for a permit for the work herein
specified agreeing to ria all work in strict accordarrce with the City Godes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application am true and correct.
DATE
HEATIRG CC) _ - ,
Signed— TEL 4i1�/"�/�
Approved By Rough -In Date -- Final Date _ 1�U1
D COMBU'RTION AIR VERIFICATION
SUBJECT
IT NO.
City of Fridley
31940
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPTNO..
�• COMMUNITY DEVELOPMENT DIV.
v ------�
r PROTECTIVE INSPECTION SEC.
572®36®4
CA /
E �
E
NUMBER
REV
DATE
PAGE OF
APPROVED BY
{
E --1 CITY HALL FRIDLEY 55432
I.J
612-571-3450
910-F15
6/27/01
JOB ADDRESS 5923 2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
22,23
10
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Susan Elmer 5923 2 Street NE
763-502-9578
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
a 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 O ADDITION ❑ ALTERATION] REPAIR ❑ MOVE - ❑ REMOVE
8 DESCRIBE WORK
Reroof Garage ( 5 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED 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 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
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 SE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$511
$ .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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$26.55
Fire SC $ .51
PLAN CHECK FEE
TOTAL FEE
1.11 , /
1 $ .56
5"GNATUR OFCON'RACTO UTNORIZEDAGENT iDATE"
HE
HIS IS Yy1UR PERMIT1,
oo*�OFO.NEAacOWNERBUiIDER" �PR04PEALIOATED
DATE,
g "NgAtE
NEW [ ] Effective 1/1/2001
ADDN (] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: C- Tel. # 2P
Contractor.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE!_ #
Tel. #
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.
v
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: '" l APPLICANT: Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $� -_ Fee Schedule on Reverse Side
Fire Surcharge $ e / .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1150 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 $ C�• 41-s��'-
STIPULATIONS:
U
011
SUBJECT
City of Fridley
3355
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RE
�4 COMMUNITY DEVELOPMENT DIV.
r`L ------
PROTECTIVE INSPECTION SEC.
/0/-3
r � �
1 �
NUMBER
REV
D1/03
F�PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
763-571-3450
910-F15
10B ADDRESS 5923 2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
22,23
10
1 Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Marlene Coffland 5923 2 Street NE
763-571-8778
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Custom Remodelers Inc 474 Apollo Dr, Lino
Lakes, MN 55014 651-784-2646 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 O ADDITION O ALTERATION) REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace 8 windows within existing openings
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. Caulk and flash all
exterior openings.
r n inspechon Cards
111 Be Malled
16 Hamenw, er To PosM
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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$8,360
$4.18
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 $8.36
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$167.25
PLAN CHECK FEE
TOTALFEE
'cense SC $5.00
$184.79
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi�AL
EN PROPERLY VALIDATED THIS IS YOUR PERMIT
G
R -:
\Ve
INSP T1A E
S4NATURE OF OWNERoF OWNER SURDERi 1DATE,
U
011
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 1
Legal Description:
Owner Name & Address. `'o q a r Tel. # 3 �� j - 17q
Contractor: MN LICENSE
Address: `i JAOA 11M�� 6 0[L4Tel. # 6 h 1 I q 6 qb
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF LIAPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width, Height Sq. Ft.
DECK AREA: Length - Width Hgt/Ground Sq. Ft.
OTHER:
Construction TypeAL&U%U4W l)4 Estimated Cost: $ ® �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ _ $
DATE: �--d05 APPLICANT: Tel. #6 5l' 7 94 " A L4 b
CITY USE ONLY
Permit Fee
$ 1
Fee 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`s p 0
$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: C
l�
SuBJECT
P �L
City of Fridley
3734422
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
REC NO.
COMMUNITY DEVELOPMENT DIV.
______
r PROTECTIVE INSPECTION SEC.ra
'
1 I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
9t0-Ft5
4/11/03
JOB ADDRESS 5923 2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
22, 23
10
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Marlene Coffland 5923 2 Street NE
763-571-8778
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
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION ❑ REPAIR
X
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside detached garage
9 CHANGE OF USE FROM
TO
STIPULATIONS
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
1
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
$1,800
@
$•90
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
$63.15
Fire SC $1.80
PLAN CHECK FEE
OTALFEE
/$65.85
SIGNATURE fiCONTACT OR AUTHORIM AGENT iOATE,
H N P RLY VAL
ATED THIS IS YO R PERMIT
ZI
LOG iN
�'d-
qA TE
GNATURE OF OW E iF VUN LDER� iDATEi
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 R4 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: �7 U' k7l 6/� —
Legal Description:
Owner Name &Address: / f ro a 1�Z Tel.#�
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: Lepgth. WidthHgt/Ground Sq. Ft.
OTHER: i r r r"jID Pa rE_GI ��'
Construction Type: IV Estimated Cost: $ �✓
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ v = $
DATE: ' ® APPLICANT: Tel.
Call (763) 572-3604 for Permit Fees if mailing in appli ation. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
TOTAL $ ��
Fee Schedule on Reverse Side
001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 INSPECTION DIViSION
Effective On January 1, 2002
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING
SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
OWNER Mc& LL-u C_Z"
Residential Rate
Furnace Shell and Duct Work, BurnerBUILDING
TOTAL
USED AS
Also Replacement Furnace $ 30.00
(Side Vent - Fill Out Back)
$
ESTIMATED COST`2�1 • � PERMIT NO.
Gas Piping (Needed with new furnace, $ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Gas Dryer $ 10.00
$
Trade Name Size No.
*Air Conditioning - All Sizes $ 25.00
$
BTU HP EDR
Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No.
1% of Value of Appliance or Work
$
BTU HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work
$
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 an
State Surcharge
$ 50
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE
$ Jrt
DATE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
HEATING CO ROYAJON HEAIING_&C®®LING
4120.85th AVENUE NORTH
Signed Bp2Oi46-YN PARK.MNT664Q
FAX # 763-424-6333
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved By Rough -In Date
written permission from adjoining property owner.
'JA
Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VENT VENT CQNNFCTQR AND COMMISTION AIR VFRIFI ATIM
When _ra In acing an existing furanca, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes( ) No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes( ) No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The avec ing cnmh nctinn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to install a new cnmh ,conn air. it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When installing a new v _ntingsyStem,, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes( ) No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
HEATING CO:
Signed By: Date:
Building
Inspections
763-572-3604
763-502-4977/FAX
DATE ;?•l! • ID
SITE ADDRESS _,_,
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBmrr A COPY OF
YOUR STATF LICENSE
BUILDING
RESIDENTIAL APPLICATION.
STATE LICENSE
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
FAX
PROPERTY TYPE JeftgLE FAMlt Y g�
❑ TWO FA*N YiNEW CONSTRUCTION STOR7F_S
PERAW
Permit No.:
Received By:
Date Mt
DATE - 9
Cl BASEMENT FINISH ❑ ROOF _ .,......,. u
❑ DECK .WSMING ❑ DRAINTII L
13 OTHER
❑ SWR&Awn pint.
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
.01GIAIlV'TEDTANCE!REPAIR ❑ REA0E
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT (iTH WII
00 G ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE
GARAGES ❑ ATTACHED GARAGE
PROPOSED SIZE: ❑ DETACHED GARAGE
PROPOSED HEIGHT:
❑ Aluminum
❑ Other
MANDOWS
IN EXISTING OPENINGS ❑Yes Mo
OR FOR NEW OPENINGS-DESCRIEE SIZE OF
OPENING CHANGES &
COTAL JOB VALL
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
— IuOtrr SQ FT
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
.2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑Soft ADDITIONS &MTT-
❑ Trim I. Site Plan/Survey showing the wasting structures
E3 Fascia and proposed project. •
2. Two sets of construction plans
LOCATION OF WINDOWS 3. Energy Calcolations
TNG THE 1997 UBC FEE SCHEDULE)
v"' nrfn
$ /
k % a-� See Back Page for Fee Schedule
$
65% of Building Permit Fee
$
.001 times the total job valuation
$
4t,50 .0005 x Permit Valuation Minimum $SO
$
.6 , •$5.00 (State Licensed Residential Contractors)
$
$1825 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 payableto: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the info on above Is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley the Conshuction Codes; I undersmnd this is not a permit but only an app]icatio for a permit and work is not to start without a
permit on site; that the =work be in ce wi& the in the a of all work which review d gfplana.
SIG'NATUE 01� PRINT NAME � //DATP� •Q I • D
APPROVED BY DATE