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PRE 2010 DOCS0 0 City of Fridley, Minn. BUILDING PERMIT N°• Date: X///41 ....................... Owner ....................................... Budder Address ...................................... Address . �l ../.... ...1.�1 3274 / w� �SS�/f ��jj % LOCATION OF BUILDING No. .'�.`.`.!`. f.. Street .`.""::. ....................... Part oft . ..... .............. Lot ..... A!� .. Block .....1�............ Addition or Sub -Division � : � .... ................. . Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING s e� % 2 �j { 7 q ........�% .. Front �+-� . !�. �'rDepth Height .. � .L .�. Sq. Ft. 4.0 Cu. F't. �! 'y � W"be .. ................. nt ........ Depth ....... Height ..... Sq. Ft. ........ 9L Ft. ........ Type of Construction ..... ........... lit. Cost... ��� �.� ...... To be Completed ..... ...:... . c V ' In consideration of ffie issuance to me of a permit to construct the building desribed 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 $.-fl .... ..., permit is hereby granted to 0 T ................. ......................... 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, employed 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 with - In the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 'c �': >� • •�� .. �.. Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building. Inspector for separate permits for these Items. CITY OF FRIDLEY 97-84-116051 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL N`.fm' er Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water a +� .Oi 100.1000 BTU to 199,000 BTU a $10.00 H •.[+ a y�� $7.00 y ro W poi, �" g Electric Water Heater Heater -.1 o h r lst 3 fixtures �C( a+ Cl $ .0 G Ca 0 $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS G ALTERATIONS 0 O + First $100.00 N ,of( C. N •.1 a pN O tOi N State Surcharge tf $ .50 6�1 ui V a m y 3 o y w v m a 3 8 v a lec uo, p as 13t reTiace 6 ra e 2nd 3rd 4 th (R) m Future Connection Opening Connected with Sewer !*) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL N`.fm' er Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 HTO x $5.00 $ 100.1000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Pun Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: lst 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS G ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 11 5.50 Job Address 4921 3 Street NE Department of Buildings 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 Fridley, Mn. 5-12-78 19 OWNER ELM .UTST KIND OF BUILDING brick USED AS apts TO BE COMPLETED ABOUT 5-19-78 ESTIMATED COST 70_00 ea - OLD OLD - NEW BUILDING PERMIT NO PERMIT N0. -D�J Company SCO Signed By GA Tel. No. ROUGH INSP. Date FINAL INSP. /® - /.5 -- Date 5 --Date APPROVAL FOR PERMIT < MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.S0 STATE SURCHAj= City of Fridley SUBJECT P P 71 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECE . `L ...... COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5-11-82 JOB ADDRESS 4921 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4,5 4 1 Carl son's Summit Manor South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Arnie Elmquist 1420 North County Road J Shoreview 784-4861 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L.Johnson Co. 2533 Central Avenue N.E. 781-9548 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 C7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK flat roof repair 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 OF WORK WILL BE 19200,00 WITH WHETHER SPECIFIED H REINIOR NP T. THE GRANTING OF AOPERMIT .60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTH STATE OR LOCAL LAW REGULATING CON- 20.50 ST UCTION OR THE PERF R A E OF CON RUCTION. DSIGNATUFiE!OVCONfTRACWR-AUTHORIZED PLAN CHECK FEE TOft b AGENT IDATEI HEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP GATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI �' CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATI94 FOR RESIDENTIAL BUILDING PER14ITS (flew. Alterations, Additions, or Repairs) OWNER: �i Q` � �/S v BUILDER: � L 1-0 �./Ym s ADDRESS: 2A%� ' (iT, AD' TEL NO: TEL NO: Irl —9',S- - � Construction - STREET NO: STREET: tioi V LOT: =f BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square. Feet: Cubic Feet: Type of Construction: 0 A aS�l2 210 Be Completed: �u Estimated Cost: $ Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVER: E SIDE OF SHEET . Tile undersigned hereby makes application for a permit for the cork- herein specified, agreeing to do,all work in strict accordance with the City of rridley Ordinances and rulings of the Department. of Buildings, and hereby declares that all the facts and representations stated in this application are true and c re DATE: � � �y SIGNATURE: Stipulations: 4-i7 SUBJECT PERMIT NO. City of Fridley 2 3 7 1 1 AT THE TOP OF THE TWINS BUILDING PERMIT RENO. Ir • COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC I 1 , NUMBER REV DATE PAGE OF ROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 4921 3rd ST NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. t of 4 pt f 5 bl 4 Carlsons Summit Manor South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE NICK ELMQUIST 4921 3rd ST NE FRIDLEY MN 55432 574-7212 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 - APARTMENTS 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION §X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK REROOF - RUBBER BALAST 9 CHANGE OF USE FROM TO STIPULATIONS INSULATION MUST MEET STATE BULDING CODE. ALSO FOLLOW MANUFACTURER'S RECOMMENDATIONS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING MOT. 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 I 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 4,500.00 2.25 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- 99.75 FIRE SC 4.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 106.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IRATE, 97-C1�a WHEN PROPERLY VAI Gt/7 THIS IS YOUR PERMIT 000 SIGNATURE OF OWNER IIF OWNER BUILDE I IDATEI BLDG NSP GATE Prepaid Plan C hack $ -timated Cost $ Receipt # 9'515 - MY OF FRUX" R-3, CJOMMMIAL & MUSIRiAL Effective 8/1/95 Construction Address 4? 21 – - G? - JJ Zoning TYPE OF WORK [] New [] Addition [] motion AB, o c) 7- 3 3 � trs , o L - P 7:� )! I -- Applicant Signature d , u`t-Tel # W6 / 7Z�� Date 9— amannaG Length % Width 3-7 Height s r Sg. Ft. / %00 # of Stories • �G� 7c�c�S�i �GLt-c•.¢-5 � 61��D" 55__T • �j i OFC. AREA: Length Width Height Sq. Ft. 4C j WHSE AREA: Length Width Height Sq. Ft. an m AREA: Length �irl I�EaJTIA 3 Width 37— Height /5 Sq. Ft. ?? Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) 00 Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building use aPT • Constructien Type Occupancy Croup Air Conditioning KYes []No Fire Protection Provided p.Yes []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee $ c1q,/ Plan Check $ Fire St -charge State Surcharge $ L SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ T07AL $� See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Scled. for > $1 Million) $850 per SAC Unit ( Plans to N WOC for determination) $450.00 Conservation Plan Review Fee Determined By Rxjireering Agreement Necessary [] Not Necessary [] feet x $13.50/foot +1 W J -a(3 '-LS PA% M17-4, ©� a1 �,) ,►tip P , -�, --r -LS 04- 45"9,71 b vH ✓��cp 5 b- -51- S,.A 1 C JV ?(L