PRE 2010 DOCSSUBJECT
-ow--AT-14 0.
City of Fridley
28304
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
-W NO.
------COMMUNITY DEVELOPMENT DIV.®�
INSPECTION SEC.
r PROTECTIVE
1
NUMBER
HEV DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/19198
JOB ADDRESS
4632 2 1/2 Street NE
1 LEGAL
BLOCK
ACT OR ADDITION
rFl
SEE ATTACHED
DESCR.7
ILOTNO.
8
11
Outh
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeff Towberman
3 CONTRACTOR MAIL ADDRESS.
ZIP PHONE LICENSE NO
Viking Home Improv. Co. 4832 2 1/2 St NE MUls 55421 572-IR20
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
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (14 S Tear-off; Reside house
and garage; Soffit and
fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Call for building wrap inspection before covering.
Install soffit ventillation to meet the State Building Code.
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
1 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
$5199
$2.60
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE7
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRU OR THE PER MANCE OF CONSTRUCTION
$112.25
Fire SC $5.20
PLAN CHECK FEE
TOTAL FEE
1IG+NATUOFQ6N/RACTORORAUTHORIZEDAGENT
License SC
5.00
125.05
IO E,
HEN PROPERLY V DATED THIS IS YOUR PERMIT
SLOC/-NSP77
8
QAIE
S.GNATURE OF OWNER IIF OWNER BUILDER, [DATE- -
NEW' I ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATIONS g
ConstructionAddress: L4(03 2, 2 Y Z /-). e.
Legal Description:
Owner Name & Address: O -rb woFie to.4-,V Tel. # 57!j y7 Zi/
Contractor: MN LICENSE #'�
Address:W 2- Z V2 -54, 1/, , Tel. # 57 Z 1&7--0
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
D 5.O'
rr-17
Construction Type. (� Q� ��t su�rrtso
�'����-� rO�SlR�stimated Cost: $ cv0 ' ° + 104®= j 24do�"
(Fee Schedule on Back) 7/71
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ -.519L
DATE: 10/lc(/15 APPLICANT: Tel. # ��-d
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 1 C2. 02'5�
$ 'S-10
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
Effective
i
CITY OF FRMLEY MOVING [ ] WRECKING PERMIT APPLI
6431 University Ave NE
Fridley MN 55432
(763) 572-3604 FAX (763) 571-1287 �{ 1 �^ ,C
Job Address: ?- C'pJp� a S feIV-
lt_i !- •, PR I -Pte`, // /ii,
Legal Description:
Owner & Address:
Contractor: (rj
Address: S 1 State License #
DESCRIPTION OF BUILDING
HOUSE: Length Width Height Sq. Ft.
GARAGE:Length Width Height Sq. Ft.
OTHER: Length Width Height Sq. Ft.
Estimated Cost $ Cj�Q Off— Approx. Completion Date
N
l
Tel. # 7 'oZ0 "4%73
0 . K/-3�S-?3
Cu. Ft.
Cu. Ft.
Cu. Ft.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL
UTILITIES FOR DISCONNECTS BEFORE WRECKING MOVING STRUCTURE.
Water Bill Paid: Yes [ ] or Collect [$
Moving Route:
] Signature
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing
to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the property to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated in this application are true and correct. ALL
Date
Moving Wrecking
Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25
Accessory building into Fridley ... $ 42.00 For structures which would be impractical to
Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost
Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00
or fraction.
PERMIT FEE: r-20, 0() MINIMUM $20.00 STIPULATIONS:
/^ P /I')_.. n - �?;4 5- - 17--3 --� 9
Building
BUILDING �.���
ermit
InspectionsRESIDENTIAL
APPLICATI N
Received By:
763-572-3604
CITY OF FRIDLEY
Date Recd:
DATE — ('' S
YOUR+ E-MAIL ADDRESS
SITE ADDRESSo1-
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: Ali
TENANT
r
ADDRESS: 4 Gs Sal l — Q yi S !'. A) F. CITY I� L �
STATS 7y�
IP S�Na'v
PHONE: �D �' ®Zi!, 173
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
INGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITIONGARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAINTILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:W
El ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: r4
SIZE OF IMPROVEMENT c2 ,30 (7 LENGTH Q o; + WIDTH 3 ®'
HEIGHT $ Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGESr
x30
❑ ATTACHED GARAGE
Az
1.
2•
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:�a/
PROPOSED HEIGHT: !3.
❑ DETACHED GARAGE
6000 k �� �.�i�0 ��
List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
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:
(USING1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ ��S�� OCCUPANCY 1-1( TYPE
Permit Fee $ See Back Page for Fee Schedule
PIan Review $ ,;� 65% of Building Permit Fee
Surcharge $ /, i71) (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $ /0. C .001 x Permit Valuation (1/10%)
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks payable to: City of Fridley Attach Stipulations
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 w 'ch requires peview and approval of plansSIGNATURE OF APPLICANT PRINT NAME �k) VW DATE
• C:.�
Certificate of Survey for
�7-
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D
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Id
1 7 - 1
y AAe 4Z44I
Ale
ON
5 1 ot
77—
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I hereby certify that this is a true and correct representation of,* survey of the boundaries of the above–
,described land, and a ' f the location of W4 buildinglPt,,theroln, and all visible encroachments, if tiny; from or an
said land. As surveyed by me this JZ"fdoy of A&*.jP D. 19 Z
Stk#GURBAN. ONOME-SONG, INC.
L Engineers 5 r e.yors
by;,e�wa
OtOu wi AII'k4hts Reserved
' X9.:3`1_:^!,:
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ok
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
//
ISSUED:06292006
(763)572-3604FAX: (763)502-4977
Permit #2006-01206
4632 2 1/2 ST NE
ADDRESS:
PIN:263024330036
LEGAL DESC:UNAVAILABLE
:LOT O BLOCK O
PERMIT TYPE:ELECTRICAL
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:ELEC CIRCUITS
NOTE: CALL FOR ROUGH IN AND FINAL INSPECTION
H.O. PHONE #
TWO CIRCUITS, NEW DETACHED GARAGE.
STATE SURCHARGE, ELEC FLAT0.50
APPLICANT
ELECTRICAL PERMIT FEE40.00
KEVIN & JULIE LARSON
ELECTRIC FORM FEE1.00
4632 2 1/2 ST NE
TOTAL 41.50
FRIDLEY, MN 55421
Payment(s)
CHECK61792101041.50
OWNER
LARSON, KEVIN P
4632 2 1/2 ST NE
FRIDLEY, MN 55421-
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 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 work 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 ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:06/29/2006
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2006-01206
4632 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330036KEVIN & JULIE LARSON
LEGAL DESC:UNAVAILABLE4632 2 1/2 ST NE
:LOT O BLOCK OFRIDLEY, MN 55421
PERMIT TYPE:ELECTRICAL
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:ELEC CIRCUITS
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
ELECTRICAL FINAL06/29/07PBOBC
ELECTRICAL ROUGH-IN07/14/06PBOBC
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.