PRE 2010 DOCSC
0 �/ 1f
Village of Fridley, Minn.
;I UHMING PERMIT
Office of INSPECTOR OF BUMI)INGS
Fridley, Minn., °��° �'�• ,;ter"- 19
LOCATION OF BUILDING
No. " " Street ='�- Part of Lot
6, f
Lot ;°� n 2L.i Block Addition or Sub -Division 7 W, w
it
DESCRIPTION OF BUILDING
FrontDep* ,Height Stories - Manner of Construction
r
To be used as i ;:- To be completed It - Estimated Cost-1L-
Permit
ost1
Permit is hereby granted to
the building n• described in the above statement. This permit is granted
upon the express condition that the person to whom it is granted, 'and his agents, employees and workmen, in all
the work done in, artound and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., 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.
In considerate
the above permit,
above set forth al
sworn, I hereby sl
true as therein st-
of Buildings.
AGREEMENT AND SWORN STATEMENT
of the issue and delivery to me by the Inspector of Buildings of Fridley of
hereby agree to do the proposed work in accordance with the description
according to the provisions of the ordinances of Fridley, and, being first duly
e and say that the facts stated by me and contained in the above permit are
Subscribed andejworn to before me at Fridley, Minnesota, this
��A.D. 19 '
day of �*. A
City of Fridley, Minn.
BUILDING PERMIT N? 5 s
Date: .'"�` ,,� _
Owner: auder
Address _ "��" Address w —
L , T®F BUILDING
Part
Lotw Block Z __...___ _Additionor Subs- on .. —� —"—
Corner Lot ___ Inside Lot _��..ick S1 yard
Sewer Elevation _ _ r Ftmdation Elevation
DESCRIPTION Of BUILDING
T
A -fir Front Depth i J- Height Sq. Ft. 2off Cu. Ft W
+ o _ Depth _ Height Sq. Ft. -- Cu. Ft. . .
Type of ConstructiEst. 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 fn 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, . to the ordinances of
Fridley, Mumesota regarding location, construction, alteration, maintenance, pair d moving of buildings
within the city limits and this permit may be revoked at any on of . of the provisions of said
ordinances.
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 hens.
o4W4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
14Owner's,Name Builder
Address
Address
LOCATION OF BUILDING
No�7�l .�
Street � � ST: 6ZE Part of Lot$
Lp
Lot Block Addition or Subdivision
Corner Lot Inside Lot--I—Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
Front DepthgHeight �p/
Sq. Ft. 6 1
Cu. Ft. X/ 4
Front Depth Height
Sq. Ft, Cu., Ft.
Type of Construction 12 Estimated Cost 5Z,5-
r
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. f f1
DATE - c� SIGNATURE �t
(Schedule of Fee Costs can be found on the Reverse Side).
.4 - "
",..
SUBJECT
City of Fridley2702.4
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
-RECO-PT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
�p
1 i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
�
,`j CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
8/6/98
JOB ADDRESS 4851 2 1/2 St N
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
24,25
2
1 Plymouth
SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP
PHONE
Jackson
572-8893
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Viking Home Improv 4832 2 1/2 St M is 55421 572-1820 4772
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 XX REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (21 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
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
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
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
$1751.40
$.88
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.
$56.75
Fire Sc $1.75
PLAN CHECK FEE
TOTAL FEE
A �
�
�
I
License SC 5.00
$64.38
SIGNATUF CONTRACTOR OR AUTHORIZED AGENT (DATE)
HEN PROPERLY ^MATE9
THIS IS YOUR PERMIT
§LDG SP
DATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ )
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: gl/e.rl --?%- ,s7-, ,V. z'.
Legal Description:
Effective 1/1/98
Owner Name & Address: The—<S AJ Tel. # X72- - 517 1-3
Contractor: 0-r/(MN LICENSE # V Yot 2 -
Address: t1R,3 ,,2 Tel. # -4-7 -2 a o
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:
Construction Type:
Estimated Cost: $ %v�
(Fee Schedule, on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:
�- Tel. # �7z- l2t7
CITY USE ONLY
ar -1,
Permit Fee
$ 7
Fee Schedule on Reverse Side
Fire Surcharge
$ %
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ S
$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:
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 YAX: (763) 571-1287
ADDRESS : 48512 1/2 ST NE
PIN : 263024320025
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01842 � q'
DATE ISSUED: 10/27/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPAIR METER SOCKET.
1;1
APPLICANT
AID ELECTRIC CORPORATION
1622 93 LN NE
BLAINE, MN 55449 -
OWNER
JACKSON VERNON G & JEAN A
48512 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 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 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
ELEC AMP SERVICE FEE 30.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 30.50
PAID WITH CHECK # 43465
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Building
Inspections
763-572-3604
DATE k2 —
SITE ADDRESS I
THIS APPLICANT IS:
PLUMBING I Permit No.
REReceived By:
SIDENTIAL APPLICATION Dat �,
CITY OF FR DLEY
YOUR E-MAIL ADDRESS
❑ OWNER CONTRACTOR
PROPERTY NAME: CITY �,—:
STATIN ZIP :' �`1
OWNER/ ADDRESS:
TENANT PHONE: ��
CONTRACTOR NAME:
EXP DATE
STATE LICENSE IF
SUBMIT A COPY OF -CITY STATE ZIP
ADDRESS: 3678 pod Rd #100
YOUR STATE Eagan, MN 55123-1339 FAX
LICENSE WITH PHONE
APPLICATION
SINGLE FAMILY
O TWO FAMILY ❑TOWNHOUSE
PERMIT TYPE
El NEW tXEPLACEMENT
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK IF LQ
, for the
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% oftotal e fixtures.
so (niisshouuld reflect only whichever r there cost of labor )
improvement, installation or replacement of a residential fixture, excluding
x.05=
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor __—____ 1CATE TOTAL
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FD�T �� P IN
NUMBER OF EACH BELOW) FLOOR DRAINS _SHOWER WATER SOFTNER ($35)
BATH SDMLAV — _ SWIMNIING POOL —
GAS PIPING (nom G7YIJCFld� _BACKFLOW PREV. ($15)
— BATH
BATHTUB — KITCHEN SINK WATER CLOSET FOR IRRIGATION
CLOTHES WASHER LAUNDRY TRAY WATER HEATER ($35) OTHER
— DISHWASHER — WATER METER —
`"a-ZE-M
_ Number of fixtures @ $10.00 x $10.00 – $
Permit Fee 00 Number of fixtures @ $15.00 x $15.00 =
Surchar a .50
$ Number of fixtures @ $35.00
TOTAL DUE State Surcharge = $�
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
the work I hereby apply for a building permit an be in
d I acknowledge that the information above is complete and accurate; that
that I understand lthis is
conformance with the ordinances and ocoadesof thea C work of is not o startridley and �withouth the Minnesota perrn; tha the �v°rk g'''Construction al be in accordance with the
not a permit but only an application permit
approved plan in the case of all work which requires review and approval of plans.
�. ` ;. PRINTN
SIGNATURE OF APPLICANT
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977