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PRE 2010 DOCS• City of Fridley, Minn. 0 BUR DING PERMIT N® 3607 Date: . .................................... �(...... �f- Owner ....................................... Builder .................. Address ...................................... Address ...... ..................................... ��.CA'�[ON OF BUILDING e�% No. ..... Street ... �/...... .......:...!,:........... Part of t ........ .................... . Lot aa[.:.... Block .. ......... Addition or Sub -Division -.............. deyard . �v...® Corner Lot ............ Inside Lot .�......... Setback J ................. DESCRIPTION OF BUILDING To Used as:� -. �r •r n ... ... .... Front:: C) Dept e ' (� Height l !.cc :a Sq. Ft/0'1/9. Cu. Ft. / v Vo �_ .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... Bet. Cost../R.i17 F'Q—"e. .. To be Completed ................... In consideration of the 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 $�.., 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. A ---- �. .... 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. 53-84-s-915.51 Bax tit PARTIAL RATE SCHEDULE II Ce MUM RATM M& RA= Tor" INMwhw rixb ................ .... i ...... p rvi 6 New Od.......... = O.w • ............. ® ...... Rater nester 'Up to MAW .... a M.OiD New Ground MM told aids ........ r $.n Electdawatwunur .............• s an $, G" rtrMM rts: M M&TZ TM, 1d 3 sutures .................. —as= y AddRload lb*w s .............. • s 6.75 s Qct Rmw is llim vru ........... —z"M i State surdiagp $ .50 xxvam f —Ndsr As am" ....... �Install.GaswGill .w ...... �.��.�nn T TALM S 5.50 OaSs "'N' Surchu b.. . CRY of Fridler. The undermsmed herd noes appUemion for a pea®it for the- warh hemi :, verified, acmedaa to do an wwk h9 daiet with the Cita r- and nihns of the Deparunmi of BuddfivAM and hamby deciarn that &M Ow bd.- WW d.and Mpresentatiam dated to t#ia appOcedge we trove asd correct 6-8-73 i n -- Owner Albert Campbell Kind of Rvfdtn Frame . , Dsd as Res. To be COUW eted shout 6-15-73 m iss s _e 3 — d l`70' AL ZATZ 'ZCOH '.IDU 2' MA17177 WARN AM: RAT9 TMAL MOB A Duct'77v is X10.09 I% Replacement of DIUMBee (3.00 Rppairs & Aherations^--k?.r lui, 60 --. — RepeiTz & Alwrauons 301D r— — - 7vrnace Shell & Duct Work to n20,8M BTUg— each ffickL 00,M MV ......... .... Replacement of Furnace 1.00 A-lra--' Repairs & Alterations --up to SM.00 3.00 $ Repairs & Alterations each add. $3M.00 3.09 $ 1' f2ijM or HOT VAT= MTM 17�,rnace Shell & bines—to 400 A. ft. FDR Steam $10.00 $—. ,I - Purnace .Purnace Shell & Line --to 640 sq. 4t. EDR Hot Water 10.00 $_ Each add. 300 aq. ft. EDR Steam 3.00 $... - _ _ -- Each add. 320 sq. ft. EDR Hot Water 3.00 $�_ OIL DDR —to 3 gal. per hour over 3 gal. per hour—See Fee Schedule GAS S (up to M,000 ) LOO s a over 199:000 vM S" Fee Mdodule OAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures X$ 200 $ Additional Pixturea x .79 ; Gas Range to 190.004 Z$ QLOD >j AIR CONDITIONIlIG FAN HEATING STSTZM See Fee Sabodobr TEXT 3 ATIING SYSTEM �— ALTERATIONS & REPAIRS TOTAL Ivao Iovn r/o-3It-i. City of Ridley: The undersigned hereby mattes applicataon FSS a pemit ffos one work here specified, agreeing to do all work in strict accordance with %xe L -My acrd ruling of the Department of Buildings, ammd hereby dc-lWrez thgZ all tE and representations stated in this application are tree and cs ozcL Kind of Building Used as i / -- To be completed about __%� e.) 7 Estimated Cost, Building Z?tinwdt No Psrreit No. z3 O EMATING or team, _Iwa, WarmAir No Trade N //e Capacity.(QZ,52c,L-v sq. Ft. E.D R A° S BTU MP Total Connected Load `7 0� � of BURNER — Trade Name Size Nb Capacity ft FfL ZM A- BTU Ha. (a.�.,►:�s-owl APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA VWNER' S NAME: BUILDER ADDRESS: �g �% CL�S 74- /'' ADDRES S: 0 6 Y/ V NO • . S- a L(U STREET • 3 -1JQ LOT: BLOCK: 02.9-- ADDITION CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form .Two Certificates of Survey of Lot and propos.c building location drawn on these Certificates. DESCRIPTION OF BUILDING To B Used As: r T Front• 4 Depth: Height: Square Feet: 1-41-C) Cubic Feet: Front: Depth: Height: / V 1 SquarVFe t;Cubic Feet: r--- Type of Construction: Estimated Cost: $ J LTCcJ 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. DATE: '` SIGNATURE : (See Reverse Side For Additional Information.) SUBJECT PERMIT NO. City of Fridley 13059 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE r INSPECTION SEC. 1 � CO a C� ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910415 -3 -75 JOB ADDRESS. -PENr St. ' dle 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 & 6 22 HYDE PARK SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. MILES GARAGE 4500 LYNDALE AVENUE NORTH, MINWSOTA 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENC E 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK CONSTRUCT MRAGE -7-0 x 22, x 12 9 CHANGE OF USE FROM TO STIPULATIONS WAN11111 PROVIDE HARD SURFACED DRIVEWAY, Before digging cr!' TRUNK smols My f)Nf8jgn1d '9NIIM WkRNMG VW MIf1Mm q l 4"11714 31 v � 3.. Before diOng CA'local uet ft i� TELEPHONE - EIECTR1C BY LAW TYPE OF CONST. OCC OUP 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 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 R-1 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 $3,256 $1.63 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOC L LAW REGULATING CON- STRUCTION OR THE PERFORMA E OF CO TRUCTION. $ .5O PLAN CHECK FEE TOTAL FEE -?,07 1; $10.13 SIGNAT REOFCONTRACTORORAUTH IZEDAG NT (DATE) 114WHEN PROPERLY)PALIDATED THIS IS YOUR PERMIT BLDG WSP e�(`m JUNE 30, 1975 DATE.., - SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) •APPLICATION FOR RESI'DENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: j�* , C14 M 13 BUILDER : ADDRESS: S 8 y O 3"Z�5' tXli r ADDRESS: ?-(S'60 A X ry jDA A L' IVO NO:. S ® STREET • LOT:- BLOCK: Z ADDITION:. ffy0 r CORNER LOT: INSIDE LOT: Ci SETBACK: SIDE -YARD: Applicant attach to this form Two Certificates .�f Surve .of Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front : ® Depth • ° Height: - Square Feet: 01q0 Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: 4Estimated Cost: $ 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. D&TE: � ~ �S SIGNATURE• !i! (See reverse Side For Additional Information.)' Dtvurk J 13UjA✓z /�� S CITY OF FRIDLEY APPLICATION FOR PLUMBING AND 'GAS FITTING PEWIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE N *:umber Fixtures x v $ ti d $2.00 Water c m m c Catch Basin x ►bi c a m c 0 w w e $10.00 Heater v L -1 $ N x E -1 M k m 0 k tL X C G m U D G N 0 W W W U M Q 3 U e C7 O a3 leC is= ! 2 .d 3rd I 4 t'i (?) = Future Connection Opening Connected with Sewer {*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL *:umber 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 BTU x $5.00 $ 100,000 BTU to 199,000 BTU� :Mater Softener :2x $10.00 $ $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $3.00 $ x $1.00 $ X $10.00 $ State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) $5.00 $ $2.00 $ $ .50 S F, ©O Job Address 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 reprosentations stated in this afpvPlication�are true and correct Fridley, Mn. OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO.' PERMIT NO. (-1-:7 9 Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT -, - O M=IMUM FEE FOR ANY PLUMBING PERMIT I0,47.50 PLUS $.50 STATE SURCHARGE 97-8)1-879001 CITY OF FRIDLEY , • APPLIcATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE a Number Fixtures X $3.00 u" Future Fixture Opening x e $ Water x $2,00 M b C 4 a. $5.00 $ u fu a w b' 9 100,000 BTU to 199,000 BTU Heater Le Le vy ' Water Softener x $7.00 $ New Ground Run Old Building x $5.00 11 J2 C x � . d , 0 �C N uLd c� g U *� a as lee uJ' .3 me 3 c�7 p lid • ra e 2nd 3ra , 4t (R) - Future Connection Opening Connected with Sewer (•) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE TOTAL Number 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 BTI) x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ ' Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ `- REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 REINSPECTION FEE Job Address 5840 NE 3 Street ' ,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. 11-13-78 19 OWNER GAMPBELL KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 11 20-78 ESTIMATED COST p 1� OLD - NEW BUILDING PERMIT NO. PT i1� r/�`® • Company MINNEGASCO Signed By . Tel. No. ROUGH INSP, Date FINAL INSP. Date APPROVAL FOR PERMIT . MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7,50 PLUS $.50 STATE SMXMARr,.E a SUBJECT PERM City of Fridley 6 7 5 9 AT THE TOP OF THE TWINS BUILDING PERMIT r R ` _-___ COMMUNITY DEVELOPMENT DIV. fr 1 PROTECTIVE INSPECTION SEC. r I , LT' �, 1 i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/9/82 JOB ADDRESS 5840 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5, 6 22 Hyde Park SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Albert Campbell 5840 - 3rd Street N.E. 571-7665 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 1670 Camelot Lane N.E. 574-1398 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof & Reside dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd layer of roofing. Install ridged galvanized valleys. 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 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. DV/LG. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,976 $2.99 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- STRUCTS OR THE PERFORMANCE OF CONSTRUCTION. $56.50 PLAN CHECK FEE TOTAL FEE $59.49 SI ATUREOFCONTR OH O'A AUTHORIZED AGENT IDATEI WHEN PRQ�OPERL V�ApLI DATED THIS IS YOUR PERMIT BLDG INSP �GAT� SIGNATUREOF OWNER IIF OWNER BUILDER) IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM F04 RESIDENTIAL BUILDING PERMITS (New. Alterations, Additions', or Repairs) OHJNER:9j6rt%'-t ADDRESS: _��{D �°� si-/-, TEL NO: � §7/- % ADDRESS: Z670 O'�Vmewr LAV' TEL 140: �LA / 3 �:�� Construction Location • STREET NO: STREET: S 9d S7,- LOT: TLOT: BLOCK: ;1592 ADDITION: / ye 0Wk Corner Lot: Inside Lot: X Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. Front: DESCRIPTION OF CONSTRUCTION Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: ��yM. leice(, Me Estimated Cost: $ CS/c/776, NO Rb Be Cbrapleted: sept 1M f ^d' Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ ' $ SEE REVERSE SIDE OF SHEET . Me 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 Delwirtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: !'q_l?Z S104ATUM: Stipulations: M SUBJECT IT NO. City of Fridley 26 829' AT THE TOP OF THE TWINS BUILDING PERM I r O COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r —116o-3 NUMBER REV DATE PAGE OF APPROVED BY I CITY HALL FRIDLEY 55432 L „ 612-571-3460 910-F15 7/27/98 JOB ADDRESS 5840 3rd St 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 01 5 & a 1 of 6 22 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tian Yu 586-0258 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Remodelers 474 Apollo Dr Lino Lakes 55014 784-2646 1748 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 M REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Residing door and window trim 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 6880 $3.44 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 PER MANCE OF CONSTRUCTION. $124.75 Fir SC $6.88 PLAN CHECK FEE TOT L FEE ce 40.07 iGNATUREOFCONTRACTOR ORAUTHORIZED AGENT (DATEi EN ROP BLQA INS P VALIDATE THIS ISX,:Tne), DATE 9 '745 SIGNATURE OF OWNER OF OWNER BUILDER I IDATEi NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Ohl BUILDING PERMIT APPLICATION o ConstructionAddress: 3-Y � 0 Y r"d Legal Description: LV S;o(,'^ cp Owner Name & Address: � u 5-F q0 Mrd q -f- '� �-- Tel. # 5;� S-8 Contractor: (I _US MN LICENSE # Address: k fro LL ® 1, C 1, c% o 1 -kfS ON SS'o H Tel. # �2 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: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: — �-7 "'cC APPLICANT : Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 0, oq CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] P NO. SUBJECT City of Fridley 2943 4 AT THE TOP OF THE TWINS BUILDING PERMIT f EIPT NO. COMMUNITY DEVELOPMENT DIV. SEC r PROTECTIVE INSPECTION 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By ' 612-571-3450 910415 x/10/99 JOB ADDRESS 5840 3rd Street NE 1 LEGAL LOT NO O BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. all 6 22 Hyde Park SHEET , 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tian Wei Yu 586-0258 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 PSX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (22 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlavment must comply with theState Building Code. SEPARATE PERMITS ARE REOUIREO 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 A7 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 188.x7 $.94 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 66.20 Fire SC $1.88 PLAN CHECK FEE TOTAL FEE — 69.02 RACTOR OR AUTHORIZED AGENT IOATE, WHEN PROPER VALIDATED THIS IS YOUR PERMIT �WE"O".C.VVNER ' s,iF O U4DERi �DATE, BLE7 TNS MATE P NO. NEW[ l Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMH..Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 7LO , Construction Address: --Pe' o ' Sy Legal Description: Owner Name & Address: " ( htj 1 J r- [ YyA Tel. # sW o z M Contractor: abykz/e _ 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 EMPROVEMENT LIVING AREA: Length Width Height' Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: SX sJ %,OLID t'c -2-2- zw �m Construction Type: Estimated Cost: _ $ I00S� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: S -1 o - g APPLICANT: MTel. #� b - o Z CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ vp .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $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 $ Oc2 STIPULATIONS: