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PRE 2010 DOCSa O 05 f, �& Village of Fridley, Mum BUILDING. PERMW N® 83 Office of INSPEOOR OF RIDINGS Owne Architect Fridley, Minn., 242L,— Builder LOCAON OF BUILDING 4111 k' ? 1 No.400 Street Lot loek Addition or Sub -Division DESCRIPTION OF BUU DING Front- Dep Height StorieManner of Construction p To be used as v .. To be completed Estimated Cosh f s ,4 I Permit is hereby granted A to @:.4*' ... : described in the above statement. This permit is granted the buildin" upon the eq114und n that the person to whom it is granted, and his agents, employees and workmen, in all the work and upon said building, .or any part thereat, shall conform in all rospects to the ordi- nances of , regarding the construction, alteration, maintenance, repair and moving of buildings within the city limit , and this permit may be revoked -at any time upon violation' of any of the provisions of said ordinances. q' %f 6 Iasnector of Buildings. AGREEMENT AND SWORN STATEMENT In considers 'on of the issue and delivery to me by the Inspector of Buildings of Fridley of the above perm I hereby agree, to do the proposed work in accordance with the description above set forth d according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby to and say that the facts stated by me and contained in the above permit are true as therein s ted. Subscribed an sworn to before nae at Fridley, Minnesota, thisC77 day o 7,4 ' a City of ]Fridley, Minn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 Mate: _ nrj-pber 26- 1971 Owner: -- KathleenLanger Builder Same - ,Address __ 4875 - 21 Street N.E. Address Same LOCATION OF BUILDING ZTa4875 Street 2i Street N.E. Part of Lot got _2&29 Block 2 Addition or Sub -Division Plymouth Addition Corner Lot Inside Lot X Setback ___ — Sideyard Sewer Elevation Foundation Elevation To be Used as: Basement Entry Front 4 Depth Height 10 1 Sq. Ft. _ _ Ca„ Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Mas n{y ry&Fr McEst. Cost $500,0Q To be completed 1 year 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 3orth and in compliance a all provision–a Of Ordinances of the city of Fridley. .In consideration of the payment of a fee of $_1.00 , permit is hereby granted to Kathleen Langer 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 . � city limits and this permit may be revoked at any time upon violation of any of the provisions of said dinanr LAREW E RELT T F NOTICE: This permit does not cover the construction, installation for wising, plumbing, gas heating, sewer or water. Be sum to sea the Building Inspector for separate permits for these Items. .9 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER ° S NAME : �j�//P of Z 1 n r e Y BUILDER: ADDRESS ® �%7 S SADDRESS: No: '7,5 STREET: LOT: BLOCK: ADDITION :M O h CORNER LOT: INSIDE LOT:�ETBACK: SIDEYARD: 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: J34R + V_F7:ont: Depth: L e-"Z:LL4z-wght: Square Feet: Cubic Feet: Fronts Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ 5"06 To Be Completed; The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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. DATE:' 71 SIGNATURE: (See Reverse Side For Additional Information.5 i • s . LY City of Fridley Dept. of Bldgs. Phone 960-3450 DESCRIPTION OF WORK Number, Iliad and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ � x$2.00 $ b ' 6 O Future Fixture Opening ............ x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 89,000 BTU) .... x $3.00 $ New Ground Run Old Bldg........ . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures . Additional Fixtures . , ............... . Gas Range to 198,000 BTU.. . ... . ­. .... REPAIRS & ALTERATIONS --Refer to Code x $3.25 $ $2.00 $ NO. RATE TOTAL x $2.00 $ x $ .75 $ x $5.00 $ Description ......... , .............. , ... , .............. ..$ TOTAL FEE 1�b (SURCHARGE City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that &R the fact and representations stated in this application are true and correct Fridley, Minn Owner Kind of Building Used as To be completed about Estimated Cost, $ Old ew. Building Permit No. Permit No. b�7 Signed By Business Phone No �' �� ,Z ROUGH �v FINAL /J Y �Z N i N WATER MTR. GAS ELEC. `gq F rA ; u. �i V < 3 (9 (�! I t� Base l 1st 2nd 3rd 4th ' -Future Coaaeella Openings Com with * Sewer New Fixture, Old Oponings Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ � x$2.00 $ b ' 6 O Future Fixture Opening ............ x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 89,000 BTU) .... x $3.00 $ New Ground Run Old Bldg........ . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures . Additional Fixtures . , ............... . Gas Range to 198,000 BTU.. . ... . ­. .... REPAIRS & ALTERATIONS --Refer to Code x $3.25 $ $2.00 $ NO. RATE TOTAL x $2.00 $ x $ .75 $ x $5.00 $ Description ......... , .............. , ... , .............. ..$ TOTAL FEE 1�b (SURCHARGE City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that &R the fact and representations stated in this application are true and correct Fridley, Minn Owner Kind of Building Used as To be completed about Estimated Cost, $ Old ew. Building Permit No. Permit No. b�7 Signed By Business Phone No �' �� ,Z ROUGH �v FINAL /J 'Lin SUBJECT PERM1 City of Fridley 17261 AT THE TOP OF THE TWINS BUIL DING PERMIT/1,00, _ r � RECEIPT NO. � •err----- _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. -"1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY .11. 612-571-3450 910-F15 9/23/83 JOB ADDRESS 4875 - 2� Street N. E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28,29 2 1 1 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathleen Langer 4875 - 2j Street N.E. 572-8880 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 13MM 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO S iPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Fiberglass 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 $800 $.50 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- $15,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIG ATU OFC NTRACTORORAU OR EDAGENT (DATE) WHEN PROPERLY A ID ATE THIS IS YOUR PERMIT 9 - 9 1 SIG TUREOFOWNER OW RBUIL (DATE) BLDG INSP DAT 'Lin CITY OF FRIDLEY . Effective Aug. 1, 1981 APPLICATIO'1 FOR RESIDENTIAL BUILDING PERMITS (Heir, Alterations, Additions, or Repairs) OWUER: l&e , L. nel f-1,0� ADDRESS:�7� ,,n - TEL TEL 110: J 7— geg n BUI LDER : E�-- ADDRESS: TEL 110: c~ Construction Location STRICT NO: 7 0 7 STREET: XQ 2 ; IDT: -- swrx: AmITION: Corner Lot: Inside Lot: Setback: Sideyards: Ap,plicant attach to this form two Certificates of Survey of lot and f proposed building location dras,?n on certificates to scale. DESCRIPTION OF COi;STF:UCTION �dC Front: Depth: Square Feet: Cubic Feet: Height: Front: Depth: Height: Square Fent: Cubic Feet: _ Type of Construction � Estimated Cost: S ZOO 7b Be Cbr-pleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PEVF.R.;-' SIDE OF SHEET . Mie undersigned hereby makes application for a permit fcr the %..ork herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Departmomt. of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. _-I? D.M.: — U. :3 SIGNATU -, : Stipulations: CITY OF FRIDLEY PERMtISSUEDt:4 00510 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE 2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 4875 2 1/2 ST NE PIN : 263024320027 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING VALUATION : $ 4,000.00 NOTE: PER SECTION 1402, 1997 UNIFORM BUILDING CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE. REPLACE SOFFIT & FASCIA. APPLICANT BUILDING PERMIT FEE 97.25 BULTENA SCOTT FIRE SURCHARGE 4.00 4875 2 1/2 ST NE STATE SURCHARGE, VALUE 2.00 FRIDLEY, MN 55421 TOTAL 103.25 OWNER BULTENA SCOTT 4875 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 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 c cel the provisions of any other state or local law regulating co truct' no e performance of construction. Applic s Date Bldg In Dat SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. e ao.,-9-o NEW [ ] CITY OF FRIDLEY Effective 411/2004 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: y 7S1� Legal Description: Owner Name & A gess: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. FL DECK AREA: Lengthy Width �/ Hgt/Ground Sq. Ft. Construction Type: - Estimated Cost: $�0�� o `� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: - l -o APPLICANT: S C o� -v`. \Azs � Tel. # 3 -S q -77S&/ Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ ®�-�� STIPULATIONS: Building $ BUILDING Plan Review Permit No.: 2 Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY License Surcharge M DateM: NOV 2 4 20011 763-502-p4977 FAX SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 1-1-08 Erosion Control $ DATE B ' e�- �. (26, YOUR E-MAIL ADDRESS Park Fee SITE ADDRESS Fee Determined by Engineering Sewer Main Charge THIS APPLICANT IS: ❑ OWNER .CONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME: -T TENANT ADDRESS: CITY (' . I V STATEN_ZIP PHONE: I 3 NAME: 9 ADDRESS: Lt Wq 01(f4 do l'_i(% CITY CR(d1n ()__STA% ZIP 316 CONTRACTOR SUBMIT A COPY OF PHONE 1 r,- 2-6 FAX �� YOUR STATE LICENSE STATE LICENSE # %} EXP DATE �Z ,a 4711 PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH )d ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR V REMODELING DESCRIBE WORK BEING DONE: 1 m d f SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used, PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. 13 Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 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: SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ( �(D OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ V :4 T) Make checks payable to: City of Fridley Attach Sti ulations 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 on site; that the work will be in acco0ance with the apgroved plan ip the case of all work which requires review and approval of plans. SIGNATURE WXR�NT „� PRINT NAME -Fr ac(Il' 60I�oe I I DATE 1 I APPROVED BY t 1WJrN DATE