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PRE 2010 DOCS0 Village of Mdleyq Minn. BUILDING PF tD= N° 795 Ofce of INSPECTOR OF BUILDINGS f � � Architect Fridley, Minn., Builder LOCATION OF BUILDING No.��4 Stre1 ) Part of Lot Lot° Block Addition or Sub -Division DESCRIPTION OF BUILDING dd ge Front Depth C" height Stories Manner of Constructiop To be used as auk .� �lF. �►+ ? To be completed-" } Estimated Cost eoa rp aell Permit is hereby granted to E ^ -, I to the building C-' 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, around 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. � rsF A -- 2Z -L_ Jv'1 . inspector of Buildings. AGREEMENT AND SWORN In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, this day Of`v''W'''`"°'It�kcu:L'�?�"'{�..,• li .D. 19: 9 0 *City oFridley, F , inn. 0 BUIMING PERMIT N® 4397 /..............._/..�_...... _..�.� l _....__....---•--._.------ Date: ....1.... 6 Owner: ..... .......... .. �.. ....:......_,-- Builder .-----...--- 4'_ 12 Address..._........................ ..................... ...................... _..._.---- _..-._............... Address ........ ............................. _............. _...................... _...... _................................... _._ °� O ON OF BUILDING 1Vo..._/.......jStreet _..._...1 r�•'s�•=--------.._.••.<_.••.•.._.......... Part of Lot ....._..._........_.... _._..._..... .......... ..__.._ Lot ....G�!'.../...�....... Block....................7 ............. ......... Addition or Sub -Division ..../-.. .... .......... ......::_.........._..... CornerLot .................................... Inside Lot....ic......................r..,. Setback ............................----............. S ey_............. _........................................... _.._... _.. Sewer Elevation .................................................. _............................ --..................... Foundation Elevation ................................... - DESCRIPTION OF BUILDING To be Used as: 41'_r y —^- Q �� L�G7.....o�.... .. .. :� Front _._..r-�....'�depth �..�'..._0 Height .0 —A0. Sq. Ft. ...fk..6 Cu. Ft....:��_.. ....................................... Front Depth... .. Height ...................... Sq. Ft. ............. Cu. Ft........................ y p c Type of Construction .._.._._....................................... Est.Co Qom' 0..«-.... ...... ........... To be Completed -..._ .............._............._.......-----.... E, A 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. 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. FM City of Fridley, Minn. BUILDING PERMIT N° so85 Date: '"'r t Owner: Builder Address Address d L C BUILDING No. ftstreet Part of Lot/ Block /Addition or Sub-' ____ Corner Lot Inside Lot dam" Aback Sideyard Sewer Elevation Flo,dation Elevation DESCRIPTION OF BUILDING Toas: Frontal-- Depth Height Sq. Ft. cu. Ft Depth alt H bt "' = To be Completed Cu. Ft Type of Constructer Est. l �Z� :r 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 ail 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 anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regardin; location, construction, alteration, maintenance, repair and moving of buildings within the city limits and thus permit may be revoked at any time upon violation of any of the provisions of said ordinances. -00'l �.A _.—lll Building Inspector NOTICE: ihia penult don not eorer the construction, hutaMen for whb& plumbing, on hesthtg, sewr or wbr. Be sure to see the Building Inspector for separate permits for the:. ttenm 52-84-5915.51 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK 4?32 N E 3 add St Number, Kind and Location of Fixtures I'O�hOn PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... ............... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ..... ..................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ GAS FITTING FEES: x $1.50 $ x 1.20 $ X 1.00 $ x 3.25 H ZZ y�^ 8Z Pi x 3.25 w �U' Z Z �U' • 0 N WATER HTR. GAS ELEC. GQZ O U of < 3 C�9 °1 Su O rn Base Ir6t G 1st 2nd 3rd 4th • Future Connection Openings Connected with Sewer I e New Fixture, Old Openings Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... ............... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ..... ..................... Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ GAS FITTING FEES: x $1.50 $ x 1.20 $ X 1.00 $ x 3.25 $ x 2.00 $ x 3.25 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Gas Dryer 1 2.00 REPAIRS & ALTERATIONS—Refer to Code 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 all the fact and representations stated in this application are true and correct. Fridley, Minn.— 2-3-679 19— Owner Joe Wadnizak Kind of Building frame Used as MR To be completed about 2-8-67 Estimated Cost, $ 10.00 Old—New. Building Permit No Pe o. S• a • By Business Phone No FINAL kn – / T – [®I Description................................................$ TOTAL FEE $ 2.00 48 53-84—S-915.51 City of Fridley Apocaffm for Pkmbbg wd Gm Dart- d Sidra. Pham 90-M ozacalmou or ATO& Numb=. KMd aod tmealfes of rtxtue a J] ( Is III 'Ie os cis f�K. PARTIAL RATE SCHEDULE rLusawro nxTum Al Tw-. OO► RATK TOTAL ttt r MXbou ................ ® _ Fuumm sty ... a ...... �t► it� . Ord.......... : suer CMW% ............. o ...... _ i ire Water Boob r'Up to illi S9rU1.... ::'dSp i New Gnmmd Run Old Stdg:......... a Mobl<gratan .............. _ x S'100 i com IM RATE TOTAL s..ss=L 4732 N. E. 3rd, Street Cid of 1> ow. The undersigned her4ft mages appHisation for a permit for the w wta heed nweffled. agreeing to do an work In strict accordeum with the C!a OnWaner r- and ruUog of the Departmod of Buiidium sad hereby dedares that ail the tad. and eegresentatioau elated in this appHaMm are but and correct F"dIly. an••e 10-K-73 ®I$ -- PARTIAL - Oeaer Joseph Be Wadnizak Kind of BufldiaR Frame Used as lies • , To be completed about 10-12-73 Estimated Cost oid-%W�Wjouitding Pov mf N pwmit id.. ce. - M GAS"C Budd eas FOAM x� LE 3 Phtures .............. -ZSM AdMftood »es ............... sin e am Rno to M00 FM ..s........ ! 5.00 State Surcharge $ SO :/'AM f iLTF�ll1OA--mer 1a Cn/e Toren. M S -� 0 rjM wlA® Surcharge .5..00 PARTIAL RATE SCHEDULE F1XTU,'E RATES: N0. RATE TOTAL NurT•ber Fixtures ...............'. .`•�•- X-- CRY Of F -10.11Y ' S , -•-- %,ew Fixture Old Oppning. •,• • • •'• • • • ------ Applicca-sian for Plu�ri • x . _-.. Cate±► IIasin .................... ---- Dopa. of Bldgs. Phone SM -34W ' �• • Water Heater 11.'0 to 93.000 BTU) • • • • _--a DEscRlPTIO11 0: VIOIIi: • New Ground Run Old Bldg....:.... .... Lo,.ntioa • 1732 •3 Strout, M? S_------ NumSar, KLtd Lnd• Locr:loa of Flxtures S "r AS FITTING FLES: NO. RI+h:. TOTAL S - • 1st3Fixtures •••••••••••••'•••• ---'x52.00 City of Fridley: x S .75 S ' Cu Razz -+e to 193.000 BTU ........... ------ � -,1. �'I R • 5 7 o e r N wAfr• "Til. CA% MC. ' 'Me undersigned hereby makes applkation for a permit for t!:e• aorls h; CIt7 O:dsr.: 1 �. a, s . C. o w 3 t u v . �u $ specified. a� eeing to do all work in strict acco: Ca"ce with the the to i i i and ruling of the Deps:trreat of IIuily.lnr:. and hereby declares that a:t Es:r • , and representations stated to L':is application are true ar.d eone`"t' , . 6-17-76 1• r ridley. Liana Josoph Wadnizak �- Owner 3.d �•1""3i11^ Kind of Building Sly • FL `s Ge:: ut.;.a Cf?;,clr.;s vrith ucaor Used as i Naw Fl_turs. Old C-,,Szirss cczapool D 6-23-76 _...—_ To be completed about PARTIAL RATE SCHEDULE F1XTU,'E RATES: N0. RATE TOTAL NurT•ber Fixtures ...............'. .`•�•- X-- rvture Fixture Opening ... • • • • • • • • --- x $1.50 S , -•-- %,ew Fixture Old Oppning. •,• • • •'• • • • ------ x 51.50 i_-.»-- x . _-.. Cate±► IIasin .................... ---- Water Heater 11.'0 to 93.000 BTU) • • • • _--a x $3.00 S • New Ground Run Old Bldg....:.... .... x ;1.25 S_------ Eirctew water Puatar. . S3•CA S "r AS FITTING FLES: NO. RI+h:. TOTAL S - • 1st3Fixtures •••••••••••••'•••• ---'x52.00 AdMznal Fixtures ..:............ ---- x S .75 S ' Cu Razz -+e to 193.000 BTU ........... ------ x $5.00 5 ------- Estimated Cost. $ P•s�9t lva.�� Old—New. Building Permit No. - Sizrc By Busin= Phone No ROUGH FINAI.-Q� 50 State Surcha 9e P�?1:a3 k ALTERATIONS--Ref-Or 10 Cods • .jk=rijtion • .......... r .. r i ........ r........r r ... r • TOTAL ym . City of Fridley SUBJECT P = 6559 AT THE TOP OF THE TWINS BUILDING PERMIT rp RECEIPT NO L'----__ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � `t i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ----� �r---,,, j 612-571-3450 910-F15 5/6/82 JOB ADDRESS 4732 - 3rd Street N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9,10 7 Plymouth Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Joseph Wadnizak 4732 - 3rd Street N.E. 572-8862 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 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14' x 14' Two Story Addition to Rear of Dwelling 9 CHANGE QF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING. HEATING. PLUMBING AND SIGNS. 1% 1 FMG Before digging call local UZiil,iC TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Flame 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 196 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 $15,650 $7.83 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- $116.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 29.13 $153.46 SIG t A UREOFCONTRACTORORAU HORIZEDAGENT (DATE) WHEN PROPER VALIDATED THIS IS YOUR PERMIT a qq d—' BLDG )NSP ATE SIG URE OF WNER OF OWNER BUILDER) IDATLAi ,j CITY OF FRIDLEY Effective Aug. 1, 1961 APPLICATIM FOR RESIDENTIAL BUILDI IG PERtiITS (New, Alterations, Additions, or Repairs) ONINERBUILDER: ADDRESr % - �. ADDRESS: TEL NO: �L- TEL NO: Construction Location - STREET NO: LOT: 9- (d BLOCK:_ ADDITION: Corner Lot: Insiiie Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and ^proposed building location drawn on certificates to scale. l�J .\\ DESCRIPTION OF CONSTRUCTION u�►J �D Z W &'S '�T&.-( 7— Front: tf Depth: / Height: ®' Square Feet_: Cubic Feet: Front: Depth: 1 Height: , "Square- Feet: Cubic Feet: _ Type of Construction: WC -).D L i-) (Yt Estimated Cost: $ To Be Obripleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ 4vs e ty. SEE REVERSE SIDE OF SHEET . Mie undersigned hereby makes application for a permit for the t:.,ork' herein specified, agreeing to cb ,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. DATE: � SIGNATURE: Sti ulations: I P TY 9.93 `5 3. y` City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT PE MIT N _ 17994 • _ ___ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEY 55432 1'j 612-571-3450 NUMBER 910-F15 REV. DATE 5/21/85 PAGE OF APPROVED BY JOB ADDRESS 4732 - 3rd Street N.E. I LEGAL DESCR. LOT NO. 9110 BLOCK 7 TRACTOR ADDITION Plymouth. Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph Wadnizak 4732 - 3rd Street N.E. 572-8862 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 ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Enlarge living room window 9 CHANGE OF USE FROM TO STIPULATIONS 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $7QQ SURTAX $. 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. $15' OCL PLCHECK FEE TOTAL FEE (N $15.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY VjkkDATED THIS IS YOUR PERMIT XQQ BLDG )NSP f1AT SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI m 01 HEW [ ] City of Fridley Effective 4/1/84 ADDN. 1 2-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address:_ / Legal Description: A- Owner Name i Address: , � 3 A� — ?el. • ` o - to Contractor: ?el. d Ad dress • 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 Vidth Height Sq. Ft. GARAGE AREA: Length Vidth Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Z, Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ DO, ® o Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation p DATE: �- �- 0 S APPLICANT: Tel. I 0' �- Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ = 010 Fee Schedule on Reverse Side = 25% of Building Permit.Fee _ b =.50/=1,000 Valuation _ $425 per SAC Unit $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDEUiTL9L ` RATE Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 Gas Piping $ -10.00 (piping needed with new furnace) Gas Range $ 10.00 Gas Dryer $ 10.00 * Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit l Ai MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission frac adjoining neighbor. TOTAL '7 of Job Address Y ,3 2- 3 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER Fridley, Minn; 04b KIND OF BUILDING USED AS TO BE COMPLETED ABOUT V G G / 7 0 60 ESTIMATED COST 219<" - OLD - NEW BUILDING PERMIT NO. PERMIT NO. O "[3 DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. (,J('Kq Trade Name AeiAfke Size No. n%4000 �TcJ Capacity Sq. Ft. EDR BTU HP Total Connected Load BURNER - Trade Name Capacity Kind of Fuel Size No. Sq. Ft. EDR BTU HP Signed By ® s^(�/ �/✓�1`L� Tell No. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (;� No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes (� No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes (✓S No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s `' / I j/ I i CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3bU4 YAX: (7631571-1257 PERMIT.:2004-00781 DATE ISSUED: 05/26/2004 ADDRESS : 4732 3RD ST NE PIN : 263024320096 LEGAL DESC : UNAVAILABLE LICENSE SURCHARGE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 2,084.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF 1/2 HOUSE AND GARAGE (18 SQ) TEAR -OFF STATE LICENSED CONTRACTOR 1 APPLICANT KNUTSON ROOFING & SIDING (2501) 9307 HILLSIDE DR CHAMPLIN, MN 55316 OWNER WADNIZAK IONE B 4732 3RD 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 worl 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 a I3e -state or local law regulating cons ti mance of construction. Applicant nate_Z 9 Bldg BUILDING PERMIT FEE 83.25 FIRE SURCHARGE 2.08 STATE SURCHARGE, VALUE 1.04 LICENSE SURCHARGE 5.00 TOTAL 91.37 PAID WITH CHECK # 14556 ePneu errP nFuUrrre 1D1P7nTTTDPn Pnu AUnuu nTT=P TUAW rnPcruruFrn ARnVF e 44.,;2ql p NEW [) CITY OF FRIDLEY Effective 4/12004 ADDIS! [ ] 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: Legal Description: Owner Name & Address: r� lmyie- Tel. # Contractor. vt 5 l 0 MN LICENSE # Orlrlrpcc J �1 — �lZiG_7 ��itlsiG't 19/- Tel. # LIVINGAREA: GARAGE AREA: DECK AREA. OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT 2-e emit -A -z«u ,-)-. Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: GG�i Estimated Cost: $_�i®�Lf Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: 61,11V APPLICANT: ��hei�S�:� �c'c�, a1 C h t Tel. # 3 23 -yZ 3< 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. CITY USE ONLY - Permit Fee $ �� Plan Review $ Fire Surcharge $ State Surcharge SAC Charge $ License Surcharge $ , 0 0 Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ q ,p 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 [ ] STIPULATIONS: Building PLUMBING Permit No.: S Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date RREfdD M A 4 DATE'2 YOUR E -M . ADDRESS SITE ADDRESS � 7 f'� 17 E y i"� ,?� THIS APPLICANT IS: DOWNER OCONTRACTOR PROPERTY NAME: W&II W aj 1 -2 1 z 3 �� %� STATE dZIPS.S-'� � ADDRESS: Z T CITY i� TENANT PHONE: 74 _3 -'S7 Z- CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE SINGLE FAMILY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: O NEW M REPLACEMENT DET ED DESCRIPTION OF WORK 4, /r "1- y e+ --e /" PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = " FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER _WATER PIPING _ _FLOOR _ GAS PIPING (vEw c,rrucEwE) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER KITCHEN SINK CLOSET _ BA FLOW PREV. ($15) _ _ —WATER DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) R IRRIGATION _ _ WATER METER _ OTHER Z +��ii, Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ 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 applicati fora permit and work is not to start without a permit; tha the work will be in accordance with the approved plan in the case of rk ich r uire evie and approval of pl SIGNATURE OF APPLICANT PRINT NAME ATENO I'm City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 107 Building A/jLi CHANICAL ' Permit No.: 260 f -0, 1v Inspections RESIDENTIAL, APPLICATI®N Received By: AkOt 763-572-3604 CITY OF FRIDLEY Date 763-502-4977 FAX EFFECTIVE 2-19-09 S" 0 DATE YOUR E-MAIL ADDRESS SITE ADDRESS �%34AI vie: THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: m r1a, (,..i6 d h t 2.A <<- OWNER/ ADDRESS: W730. 3,tv- Si E CITY PYL to I t STATE" W ZIP 3T QI TENANT c PHONE;') 6 & - S :2 a-- rO ``,- CONTRACTOR COMPANY NAME: IQA V o✓ C ( I t- SUBMIT A COPY OF CONTACT PERSON: t -P le YOUR STATE STATE LICENSE #, EXP DATE LICENSE WITH ADDRESS: Y- tp t) .-t �- N CITY FOL 160 t t STATEn— ZIPS�M%3-- APPLICATION PHONE '7 6 *S 7 S,%4 o 1 9 j' FAX PERMIT TYPE -fiarSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK' 13 NEW >REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF W1 ORK 4'tj Sa- QC A t e- 0� 14 n—Ne FEES ARE BASED ON $10.00 PER -FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed u R MFG: C 64t ff- t 4-+L. MODEL: SIM j L 06%- SIZE/BTU igO o a At, MFG: C v'0_ U.,.,, • MODEL: a yA A 3 o slwnsrO QTO � MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 t-. �`4l• wt r, Sv�ti � k-✓ �� ° ,, �f �� tW� � > i THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building perr,�t,,and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances.,..a 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 which requires review and approval of plans. p SIGNATURE OF CL tli J �-�O�Q PRINTNAME rW W—t'I? to DATE APPLICANT 1014 T � 1:P , s 2I31?ERi�tiTS ARI : 13I2 CJ {City of Fr~dley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 E n Builciing Permrl NO. Inspections SIDE1 L% P1'1)LjC.A-?'j()jN Received By 763-572-33604� �-, � �.�'z:�Of 763-502-40,777 Fri '-�, I Date Rec` � _40, EFFECTIVE 1-i 78 G DATE O °7- ® 7YOURL MAIL ADDRESS should reflect only the cost of labor ) SITE ADDRESS 14,74W 3 Al j THIS APPLICANT IS: ❑ OWNER RCONTRACTOR I PROPERTY NAME: Z 0,^ a. W" n I,%- A WATERPIPING E� NT ra ADDRESS: LO S _1 ✓LOe S� tjC CIT" STATE S-1AI ZIP S s��-1 _ BACKFLOW ?REV. ($15) PHONE: S-13- 8 �'6 3. FOR IRRIGATION CONTRACTOR NAME: CV % ✓�- SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE _ LICENSE, BOND AND STATE BOND 4 0<P DATE CERTIFICATE OF ADDRESS: rcK tz. w S� tic- CITY FK t a( STATET$"J ZIP SX`VII.- INSURANCE. PHONE 7 d 3 _ 7 Fq2,1 ti i FAX PEP.5m TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 113 NEW 72KOMLACMAENT N DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement„ installation or replacement of a residential fixture, excluding the Extiues. '(This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X,05 = plus SO surcharge OR FOR PROJECTS WHERE LABOREXCEEDS 5.500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WMM NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEES 1550. _BATH SINIVLAV )FLOORDRAINS SHOWER WATERPIPING —BATHTUB _ GAS PIPING (NEED QTY LIC) _ SWIMMING POOL _WATER SOFTNER (S35) _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW ?REV. ($15) DISHWASHER _ LAUNDRY TRAY JWATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00 = $ 26 - State Surcharge = $ .50 (MINIMUM $15.50) (MINIMUM 515.50) Total = $ -1$ -S'% THIS IS AN APPLICATION FORA PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 accordance I .vith the approved plan in the case of all work which requires evietiv and approval of plans./n_- y SIGNATURE OF APPLICANT C �"`� PRINTNAME. �� V Ec DATE ,FPROVED BY BATT? i `3EPAE-.P rRMITS , RE'^'f✓t7UIRED FOR 311TLIDIN0'. EL 7RIC:1L. 1 NO t,1F 7T(7 L. %VORI �.t7r )f 7 ".' dlez,- , � i niverS17,, .i..venue . IE. ,5- 7-:__ n(i