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PRE 2010 DOCS
NEW [ ] Effective 1/ 1/95 ADDN {. ] CITY- OF. FRIDLEY ALTER [ ] SINGLE FAMILY -AND -.DUPLEXES R -4 -AND R-2 Building Permit Application ConAruc-tionAddress: 5b.�{Ila. � (��. FP 6.1; . fA .:65+3;, Legal Description: : -Owner Name &.Address: '. P� �LC��f�1P� Tel. # ' S��-q35� , .. j 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 DECK AREA: Length.. Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) (Driveway Curb Cut Width Needed: io Ft. + 6 Ft = Ao Ft x $ _ $ DATE: S APPLICANT: Tel. # 57 y+ q i57 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit a License Surcharge $ $5.00 (State Licensed Residential Contractors) r 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: !�07 s� Q11 _ APPapvEo er OF 'Fri �a1e� pilot / is WOOS p��E C,ty � Q OF tHE Sv MENT O\V• per 8126199 AtTAGHEO AT THE N\tY OEVf-E tyON SEG N�M�Ep SHEEt GOMtE�tiVE yNSP Y 5592 g��.f15 1,0010 RO G \OLE PHONE AI 36 O HALE fR 13450 ZyP 502 L\GENSEN 1 , ,.•`,-, C\TY 61`5, ��eet CT OR p°�,Tazk Aadi�io� PH566�522 LycENSENO 4 2 1�2 S TRA 89de Y z\P 55443 PHONE o1�950 0 593 g1 OCK �� zk � 20 ENSE N Joe poORESs T No Mp1\. AOORES`L Std eet, oo1c1Y� Y a �yP E ��c LO 2 1� $T PHON y oES�R TYoWwN£R a ek 58MA,`Ap�os$ 83 pve �' ZyP 2 PROpflpRaz 51 OnStxuct Mp�AOORESS aEMQVE NTRACTO yeTL C MOv� 4 9 CO 11 1�ROES\GNER 0p11.AOORESS Pp1F1 O 4 ARCH\tECt O ON � RE ENG\NEER P S SE of BU\l0\NG ��a'1 O 0►0o1.�1pN e Ugesiae'n' NEW ASS OF WORK D �eaz,Ott LMt cl WORK se X11 SO ldiTl� Code • oo am to GAW $ oESCR\aoothe f 8o uage $ui da9 9 St i DECD ?.P -lc w��h �,ijzu Fz FROM ollmcomP1Yonda9 CHANGE OF USE ent �u5z to 9 •00 p1U� COy s NS UudeztiaYx° S • � ,op am Sunday S11Po��'�10 woRK gp 'go wpzk RUo�Zp� a'�uzda9 Driveway C ooS`S on S 9.00 4"m DAM G OCCUPpNCY`OA OCCUPANCY GROUP GU pS OF CONgt G pamft Fee SO FT pT\NG TYPE pFfStREET P pAG S Fire P-UMB\NG•HE Ct\ON .15% ON \NG GA Stale .Sic £o FOR E�ECTR�C oRK oR EONS a Jp S A O OW`G UN�tS ST A��S SURS 5© £ .SACC ARE REOUtR \NG \f W OR \F y2p D N 1 • G �t PERM\TS CONov000NO VO\O 1 OAY PER\Do Of Spr SC' •96 i Shaw SEP ARATS NG eECOMESMMENCEAN % ED FORA 15 APp\,\GA AWS ilk- 1% � N EE VENT PERM\T \S VA CEO OR AMMEN EO. AM\NEO 0.i\S\O"S OMP0 X96 FEE tOT •21 Dri"�sy co AUtHOR�KE\5 SUSP`ENNpRK % CO fkeAO ANO SGT p�LK WNL 6pfGp PERMNE P£RM�t 15 P + Cp]�Ql aNWOME AfTER Y THAT \ HTRUEpNOTOP BOTH OG pT£ OP` C SN%NG�CON-3aGHECKf o0 A tN\S \4 rdvasa+�+ RT\f TO BE G THIS NOT V\OLA REGVLA 5 • Vpy10 PmtkF� •\HERKNOW1HESSGOVERNHER£\NTNOR\TY G Lp ON L E PR /,�, O C .SewrMau►Qwve pN0 OBOE -T EPESPEc\fTO G\VESTATE F CO \D VJHOT P ESUA V OtHORM NC O ®+optE+ et G wsv . 'i(]T pF10V Sl % OES N S OR Of Tµ PERF R O PG"I TOTAL �a SiFUGT\ .PAClOP IlulHO ZE ,� +p►yE+ - }� �•� G' CON STnnjL (} 3O�� S+GNpTUp _ ,c O,,NEP B,,,Or. - SUBJECT - ER . City of Fridley 3 1127 AT THE TOP OF THE TWINS BUILDING PERMIT t L -®y o � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 . � NUMQER - REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 IL ---- 11.� �'' 612-571-3450 910-F15 8/26/99 JOB ADDRESS 5834 2 1/2 Street NE 1 LEGAL LOT NO. BLOCKTRACT OR ADDITION SEE ATTACHED DESCR. 23 7 Hyde Park Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Pat Myslajek 5834 2 1/2 Street NE 502-0736 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Construction 4208 83 Ave N, Brooklyn Park, MN 55443 566-5225 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20077950 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (11 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 $961 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO S OF ANY OTHER STATEAR LOC L LAW REGULATING CON- $38.. 75 Fir SC $.96 CoSTRUCTI OR THE PERFORM NC OF TRUCT"0N P AN CHECK &K TOT L EE ®2j -��j S 5.00 .21 SiGNATURI OF CONTRACTOR OR AUTHO IED AGENT (DATE, EFPR BLIG INSP o. VALIDA THIS I DOR M 00 F1ATE S-GNATURE OF OWNER SIF OWNER BUILOERI IDATEI 41 k hFkY-16-1999 18:06 F" CITY IF FRIDLEY TO 6125567183 Effective 5114/9'9 nVf1 [ l CM OF FRMM ADDN E 1 MLLE F"My AND DVS R-1 AM R-2 ALTM I l BMDrK0 PEWT APFLICAT M Cowcuction Ate: 14dDe%xipdM Owner Name & Address: Conftaetor: LJMGAREA: GARAGE AREA: DLCO AREA: i A? -, -() -/-r- P.81/@2 Tel. # 7 MN LICEMg ZC-0 -7 7 Tel. ! Amh to this Wl M a Certificate of Survey of the K with time construction drawn on it to sca1g. DESCRIPTION OF WROVEMENT Vd&Height r Sq. Ft. ---- Le � _--- width__-�__- W - Sq. Ft. --- jgyC4Vgnd sq. Ft. �--- Width OTs: CoasduuW= TYi e: Ft. # A3 Ft 7C $ Driveway► Curb cut Width 13 _ V � DAM, F _ z7_%j APPLICANT: permitFie Fire Stuc" Swe Sw $ $ s--50 �_ � -'�S" 6� 6 SAC Cbuge SucberV $ S - �'o Driveway Emrow $ Control $. Park Fess $ Sewer Main $ TOTAL STUniLATIONS: Fee Sclmdule on Reverse Sick .001 of permit Valuation (1110th'9 ) $.s!$1 ,000 ValtWoa $1050 per SAC UWt $5.00 (State Unsed RaWeDfid CONUSM s) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Deter by FmgiWw* Wit] Not N [l vA A SUBJECT MIT NO City of Fridley 32656 AT THE TOP OF THE TWINS BUILDING PERM r � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. F , i A � CITY HALL FRIDLEY '51432 NUM13EP REV DATE PAGE OF APPROVED BY ......I -•-- L J` 612-571-3450 910 -Fl! 6/4/02 10B ADDRESS 5834 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 23 7 Hyde Park Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Debra Gabrialson 5834 2 1/2 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing Siding Windows 7385 Mark St, Greenfield, MN 55357 763-416-4804 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20010277 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House 9 CHANGE OF USE FROM TO STIPULATIONS 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. Caulk and flash all exterior openings. 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 SQ. 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 1 1STALLS 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 $5,500 $2.75 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- $5.50 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION $125.25 Fire SC PLAN CHECK FEE TOTAL FEE License $5.00 .138.50 SIG UON-RRE OF CRAUTHORIZEDAGE-NT IDATEi N ROPE ALIDATE HIS ISOUR PERMJITj BLO 5- gAiE S-GNATURE OF OVVNER.IF OWNER BUILDER, (DATE, vA A NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ILA Legal Description: Owner Name & Address: iy6m ,u ��yy\ Tel. # Contractor. PA , MN LICENSE # 5ZOl Q-7-7 Address: -)-MS /l%,Ylc Sfi '� �� SS35rl Tel.# 96-LIl&-L1&6V 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: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: �')CA,�' Estimated Cost: $ 5, '�Oo Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # 3- LI 1 b -&t 1O L- / Call (763) 572-3604 for Permit Fees if mailing in application or 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 Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ S3 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Resideritial Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: -W - Building $ BUILDING Permit No. c0 Enspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572=3604 Surcharge CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 SATE' "! YOUR E-MAIL ADDRESS L a�S f ! 4 6.1-, 3M ADDRESS S'S 3 `Y p %. 7- rHIS APPLICANT IS: ❑ OWNER ICdITRACTOR PROPERTY OWNER/ NAME:��I'Zt, ( L, v ivy 5"--1 TENANT ADDRESS: 5-8 3"t— CITY �2 i STATIC, -ZIP $ PHONE: 7'G 7J 6-69 1- 9 -7 �— CONTRACTOR NAME: dk Ctt M 9 n C','e44 STATE LICENSE # 6 6 2 6 3 / 'g EXP DATE L a66 --V SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: �� t1 }y�b�=� • cs� S CSTAQ�11IP J S 1'S WITH APPLICATION PHQNE el 7q FAX PROPERTY TYPE PSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERAM TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING G ,ETHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW❑ TTION 13MAINTENANCE/REPAIRMATENANCE/REPAIR CQ-TtEMODOZNG DESCRIBE WORK BEING DONE: � U1 -j --J `,- SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SEZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WIlVDOR'S 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: JOB VALUATION OCCUPANCY Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 17 0 .0005 x Permit Valuation Minimum $.50 License Surcharge $$ , CrD $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ 1170, b'5- 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 n for a permit and work is not to start without a permit; that the work will be in accordance with the approved p c es review and approval of plans. plan m the case of 1 work w ---- - a-- SIGNATURE OF APPLIC 3-RINT V t f __PATE