PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N® 473
Date:
Owner: rrAz�
+wlderr
'Y _ ..
alwhAddress ._ . _ .. �# - r "�.'• r . ®.7 r ,dress . `" �""' It _.._..._------ _---------------------
fp ,e'O ------
I?N OF BUILDING
iY ,^. Street _'t�L�s•-� ` 10", t+ C ....._..........__...... _ Part of Lot _.__.._._.._. No.
Lot ...._ ..1.7-.......... Block , - ...:.:...... Addition or Sub -Division . ..........
... ....
Corner Lot .......................... _... - Inside Lot .._.....,1�.............. _........ Setback ....�,4..: ..........._........ Sideyard....._/40........................ ...........................
Sewer Elevation
Foundation Elevation
.DESCRIPTION OF BUILDING
T �e Us
a* �%
._� .... Front .. Depth :.:.:...._.. Height Sq. Ft. d�+_ Cu. Ft...i1
..... _............ ..................................... Front ...................... Depth .... /Height ........... Sq. Ft. ................. ..... Cu. Ft.
Type of Construction _ger. Est. Cost..:�r:..---._------_... To be Completed ....._............._--_.
. CA UTION
THIS PERMIT DUES NOT AUTHORIZE VIOLAT-
ION Or ANY PRWATE LAND COVENANTS AND
BUILDING RESTRICTIONS.
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 violationf any of the provisions of said
ordinances. "e"
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.
APPLICATION FOR BUILDING ..PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder --
Address J. Address
,Q
LOCATION OF BUILDING
No. U Street 41 S �` � G Part of Lot
Lot �'� Block ' Addition or . Sub. Div.
Corner Lot Inside Lot Set Back_ `j ,^� Side -Yazd /5 ' ` -k- .ti`s I/V
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION' OF BUILDING
C �°�
To be used as:
. •�{ �f f .
ECRL Front Depth HeightT
Sq. Ft. -� Cu. Ft'.
Front. Depth Height
Sq. Ft. Cu. Ft. .
Type of Construction Estimated Cost 1�
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions"stated in this application are..true and correct.
DATE-�' 3 SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
�r City of Fridley, Minn.
MOL XPERMIT04831
Date: ---_... 'off
Owner:
AddressAddress ............ ..._._.._..,._... _..___.. _ _.._.._.._ _...:__.___...__......._..__.
Street, L TION OF BUILDING
.._.,M. .
_. _.__..... Part of Lot ..........AP
Lot....-/''� ....._........ Block -----__.......__............._. Addition or Sub -Division .
- ... _.
CornerLot .......... ............. ..._........ Inside Lot .....__ *" ................. Setback ....ji5_ ............. Sideyard ....._. ,✓ ..................................................
Sewer Elevation ._.__.--------_--------_--
To be Used as:
... _............ ......................... _..._..... Front
...-.............._......----...--..--.--............. Front
Type of Construction ....................
Foundation Elevation
DESCRIPTION OF BUILDING
Depth ...................... Height
Depth ..............- Height
Est. Cost ...................................
Sq. Fi......_...___._._. Cu. Ft.
Sq. F`t ....._......_....._.. Cu. Ft.
To be Completed ........................
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. Id
In consideration of the payment of a fee of $.rF.!_..."`"":'_'.'..'., 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. '1_11--.111171
Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas hosting, sower or water. Be sure to see
the Building Inspector for separate permits for these Items.
4
APPLICATION FOR MOVING PERMIT
No
Fridley, Minn. 19-
Inspector of Buildings,
6431 Univ. Ave. N.E.
The undersigned hereby makes application for permit to move building as herein specified, agreeing to do all
work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby de-
clares that all the facts and representations stated in this application are true and correct.
Lot Block Addition
PresentLocation:cation :
s\1 [. L41 `jam I ' /pry,
To be moved to:
Routing:
Distance moved ft.To be completed abou 19e�51
Taxes paid? Estimated cost $ a Foundation and alteration permit numbers
Certification as to cost:
I hereby certify that the above designated building is worth at least sixty (60) per cent of the cost of a simi-
lar new building.
�'Al_�
Signe
Owaer or Ageni
Approved by:
�_ater& Sewer Department
(00"U" City Engineer
Utilities Notified:
(Title)
(Title)
Gas Co. (date) a
orthern States Power Co. (date) - /k-
orthwestern Bell Telephone Co. (date) ' -If- l"
Signed
W 0 (See reverse side for instructions)
Mover
In the event that the moving permit is to be applied for by the owner or by any other person than the licensed
Mover, the following letter must be completed and signed by said mover:
Inspector of Buildings,
6431 University Ave. N.E.
Fridley, Minnesota
Please issue the bearer of this application, Mr.
-
a permit to move building from:
Date 19—
to: to which I hereby authorize him to sign my name.
Signed
Licensed Mover
GENERAL INSTRUCTIONS
The following must be secured before moving permit will be issued:.
1. A building permit for new location of building to be moved. To obtain this building permit, the following is
required:
(a) The building to be moved must be inspected for structural soundness by the building inspector. Phone this
office for inspection. SUnset 4-7470.
(b) A survey of lot to which building is to be moved. This survey must be made by a licensed surveyor.
(c) The building and moving permit must be obtained at the same time.
2. Tax receipt showing that all real estate taxes due have been paid. Duplicate receipts may be obtained at Anoka
County Auditor.
& Approval from, the Fridley Water and Sewer Department showing that bills chargeable against the property to
be moved have been paid and water connections have been discontinued at the curb line or at the main. (See
reverse side of form.)
4. Approval from Fridley Director of Public Works office approving routing.
5. Notification to, and signature of utility companies. (See reverse side of form.)
(a) Minneapolis Gas Co:; 739 Marquette Ave., Engineering Department, Fourth Floor.
(b) Northern States Power Co., 15 South 5th Street, Application and Extension Department.
(c) Northwestern Bell Telephone Co., 224 South 5th Street, Business Office, First Floor.
ii 2s0-8-58 •
•
•
"City of Fridley, Minn.
BURDING PERMIT N? 6456
owner -6L&" 1� Builder
Address Addre-a
�� BUILDING
No. Street f - - - -�' _ Part of Lot
Lot Block Addition or Sub -Division .
Corner Lot _ Inside Lot _ Setback —._ Sideyard
Sewer Elevation -- Foundation Elevation
DESCRIPTION OF BUILDING
be Used &'qet
Depth _ Z40 Height .AQ
Sq. Ft. CU. Ft
Type of Constructio
Deptheight
Est .�..a�
®� Sq. Ft Cu. Ft
__ . � To be Completed
In consideration of the issuance to me of a permit to construct the buildin described above, I agree to do
the proposed work In accordance with the description above set forth and 01 pliance with all provisions of
ordinances of the city of Fridley. n I
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, construct►on, alteration, maintenance, repair and moving of buildings
within the city limits and this permit maybe revoked at any time upon violation of any of the provisions of said
ordinances. 0"% _ A ----%
Building Inspector
NOTICE
" permit does net serer the constrectionr Installation for whthm plumbing, gas hosting, sewer or water. an sure to ass
the Building Inspector for separate permits for than hems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER ° S NAME 7h& ln as X &yc d ' r BUILDER //r/ 1'e iP C r °T % S R GZcAS
ADDRESS,, _f C�� ADDRESS 3Z
e/ LOCATION OF BUILDING
No. �j �y- `9 �� Street
Lot Block _Addition or Subdivis
Corner Lot Inside Lot Setback Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Part of Lot
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
1�ec� 1F0 0'V_'g Front eZ Depth ID Height
Sq. Ft. a f 0 Cu. Ft. D__ 0 30
Front Depth Height,
Sq. Ft. -Cu. Ft.
Type of Construction Estimated Cost Id ® 0
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 a m .SIGNATIME .4t'
777
(Schedule of Fee Costs can be found on the Reverse Side).
-4®®XV-
City of Fridley, Minn. N° 8337
BURRING PERMIT
i
Date: August 10, 1965
0
0
Owner: THCKAS M. A..NNETT Builder LYNDAIE BUILDERS CO.
Address 5Wn 4th St. N. E. Address 7437 Tyndale Ave. So.
Fridley, Minnesota Minneapolis, Minnesota
LOCATION OF BUILDING
No. 5910 Street 4TH STREET N. E. Part of Lot
Lot 17 _ Block 2 Addition or Sub -Division Bennett—Palmer Addition
Corner Lot — Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
To be Used as:
Front
Front
Type of Construction
DESCRIPTION OF BUILDING
Depth Height Sq. Ft. Cu. Ft.
Depth Height Sq. Ft. Cu. Ft.
— Est. Cost_' 17 000.00 To be Completed
Rebuild - Due to storm damage.
B --L/ Ve a -a-&
In consideration of the Issuance to me of a permit to construct the building described above I agree to do
theproposed work fn accordance with the description above t forth and In com ce with ill provisions of
ordinances of the city of Fridley. � %�
LYNDALE
In camcideration of the payment of a fee of $ 10.00 , permit is hereby granted to MRS.
to construct the building or addition as described above. Thist is granted upon
the express condition that the person to whom it is granted and his agents, employees an workmen, fn all work
done in, around and upon said building, or any part thereof~ shall conform in all respects to the ordinancesof
Fridley,
MR—ees is iregarding ts and tion, cronstruction, alteration, maintenance repair moving
of buildings
ui f said
within permit may be revoked at any time upon violation of the
ordinances.
ALIEN G. JENSEN Building Inspector
NCMCEe
TM@ pwadt don not eowr the eonstrastfoe, hwalhM en for Y Mh& phmbbie, en heathm www or wdw. Be sore to ae
the WMIng Wgmbr far separate pwmih for thea ham&
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME Thomas M. Annett BUILDER Lyndale Builders Co.
ADDRESS 5910 4th St. N.E. ADDRESS 7437 Lyndale Avenue S.
LOCATION OF BUILDING
NO, 5949 XMU= STREET 4th St. N.E. _PART OF LOT
LOT 17 BLOCK 2 ADDITION OR SUBDIVISION Bennett -Palmer Addition
CORNER LOT INSIDE LOT x SETBACK 30 SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
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: Rebuild: Storm destrpyed frame completely
dwelling Front 32 Depth 24 Height 13'
Sq. Ft. Cu. Ft.
'Front Depth Height
Sq. Ft.
Cu. Ft.
Type of Construction Frame Estimated Cost $17.000
To be completed_ November 1, 1965
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.
'lders Co.
DATE_ 8/6/65 SIGNATURE b
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley, Minn.. 1-134'
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: Aiigunt 12, 1971 .
Oma• _ Thomas AnnAtt Builder Same
Address - 59 49-4t:b Street --N A - Address Same
N LOCATION OF BUILDING
No .5949 Street — 4th Street-N.E. Part of Lot
Lot 17 Block - 2- Addition or Sub -Division Rpnnpt Palmer Additinr
Corner Lot Inside Lot X Setback Sideyard 7.7
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Second Garage Front 131 Depth 22t Height 10 t Sq. Ft. __286' Cu. Ft, 2,8601
Front Depth Height Sq. Ft. _ Cu. Ft.
Type of Construction Frame Est. Cost „_,MAQ__ To be Completed _. _ __ 90 days
($12252.68)
Stipulations: Subject to maintaining sod in side yard to accessory building in
rear in lieu of hard surface drive as per City Engineer May 24, 1971
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.
.62 State Surzehevge
In consideration of the payment of a fee of $�� , permit is hereby granted to Thomas Annett
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildingo
n the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
,�C�,(' � - • ��_-��:,in;nb mor
�a
- T ARENCE BET TSL E
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no
the Building Inspector for separate permits for these items.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: A Ny ey- BUILDER:-
ADDRESS
UILDER:_
ADDRESS •_ J� 9 yM S% ADDRESS:
NO: �' _ STREET /-/ TO :57- N t ,
LOT: BLOCK: Z ADDITION: 13 e,tjv
e
CORNER LOT: INSIDE LOT: SETBACK:-/-' SIDEYARD: 7 9
Applicant attach to this form Tao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
L74v17'-P"&1 Vffifle Front: 3 Depth: -2- 2- Height:
Square Feet: -2- 8 Cubic Feet: L _U
Front: Depth: Height: 'T
Square Feet; Cubic Feet:
o®
Type of Construction: /LQ A4 Estimated Cost: _$ g®
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: I -L SIGNATURE:
(See Reverse Side For Additional Information.)
7-7- 6 /C /'C/ 7`4 /-,viy
fid 14e s
♦ Jl / b
2
� Sr
v
r
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
F & t2,
Effective On March 1, 1996
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT yt, 0 r di y
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS U
�
1.5% of Value of Fixture or Appliance
Cg
State Surcharge $ .50
TOTAL FEE
JOB ADDRESS,
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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
-�/
1996
Owneryy o 1A (Zs %/ '7"2
Building Used As_.
Estimated Cost_ PERMIT NO.__ 1 y�
PLUMBING COMPANY
SIGNED BY
Approved By
Rough—In Date Final Date
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
A * e
01
SUBJECT
ofE R M I T NO.
City of Fridley2
6 2 21
AT THE TOP OF THE TWINS
BUILDING
PERMIT
' ,
R NO.
COMMUNITY DEVELOPMENT DIV.
_
v PROTECTIVE INSPECTION SEC.
r
I
NUMBER
REV
DATE
PAGE Of
APPROVED BY
i �/'�';.� CITY HALL FRIDLEY 55432
--_•�
l 612-571-3450
910415
6/12/98
JOB ADDRESS 5949 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17
2
Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Susan/Jerry Early 5949 4 Street NE
571-7764
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Jamey Viger 2955 Bunker Lake Blvd NE,
Ham Lake, MN
55304 755-9526 CITY
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 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
1
ISTALLS 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
$.92
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,834
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-
Fire SC $1.83
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$59.50
PLAN CHECK FEE
TOTALFEE
License SC
N/A
$62.25
NATURE OF IGTRACTOR ORY91IRiZED AGENT IOATEI
HEN PROPERLY V DATED THIS IS YOUR PERMIT
' BLOG I SP
pq
FATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
01
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ./ 419 -VI/i ST -
Legal Description:
Owner Name & Address: SGfS�9� ��.Q,� �i9�,c Tel. #
Contractor: MN LICENSE #
Address: ps�/ 61lykf4 4,4:r-, ;?4 c,Tel. #2:5715- -<95•2�4-e
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: 49,& �` 7` 9/1'Q / -
aZ2 s �
Construction Type: Estimated Cost: $ lC 7
(Fee Schedule on Back)/
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #-7 9r j9
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ l .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 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 $
STIPULATIONS:
SUBJECT
PT"N'B^-�
City of Fridley
29644
AT THE TOP OF THE TWINS
BUILDING
PERMIT
EC
COMMUNITY DEVELOPMENT DIV.
SEC.
r � � PROTECTIVE INSPECTION
OY
1 �
=
1 ----1 CITY HALL FRIDLEY 55432
�'�
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
16/8/99
JOB ADDRESS 5949 4th Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
]]
2
1 Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jerome & Susan Earley
571-7764
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 ®C REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house and garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
1 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
$14,000
$7.00
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 PERFORMANC OF CONSTRUCTION
$209.25
j
Fir Ci 14.00
PLAN CHECK FEE
TOT L F E
.25
SIGNATURE OF CONTRACTOR OR AUTHO� GENT IDATEI
ENROPE ALIDAT HIS I$ Y R PE T
BL �NSO
r
r,A TE
SIGNATURE OF OW NER,iF OWNER BUIL DERI IDATEI
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �V
BUILDING PERMIT APPLICATION
Construction Address: 5?Yq �� -10E
Legal Description:
Owner Name &Address: �rQ gTel. # 571-77(0
Contract
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EM PROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: /iI
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
'ENSE #
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost:
Ft x $ = $
DATE: - APPLICANT: Tel. # 6--71-7
CITY USE ONLY
Permit Fee
,� z r
$ 2 /,
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
V, .,j- . L.— i IvN LAV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
L.II9;:k.,Irvc vI, J a I I i..UUJ
PLUMBING FIXTURE RATES:
NO. RATE TOTAL JOB ADDRESS�'d `i2 — Q jr _
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas"
Gas Range"
Gas Dryer"
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
The undersigned hereby makes application for a permit for the work herein
CV ob specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
2003
$ .50
Owner
Building Used Asos�_
Estimated Cost a� PERMIT NO.
293(o-
PLUMBIN
SIGNED
Approved By
_ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
I
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
r.nMMnN `/FNT- VFNIT r.QNN CTQR AND CQMR1 ISTIQKI AIR VFRIFICATIM
When renlarinp an xis ing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes ( ) No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No ( )
The Px*.cWnn _nmh ,stinn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new comhus ion air, it will be sized and installed
to meet the current codes and manufacturers specifications. Yes () No ( )
When onstallann a n _w venting nyc+em, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category l Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Typp
Yes( )No( )
Si7P/Common Vent and Vent CQnnartnr Information
Apulian and
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #2 Type
BTU Input Fan Assisted or Nat
Appliance #3 Type
BTU Input Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height
ft Length ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length ft Diameter in Type
HEATING CO:
Signed By: Date :
L
a
SUBJECT
RMIT NO.
City of Fridley
34040
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
A
r PROTECTIVE INSPECTION SEC.
REV
DATE
PAGE OF
A PROV O BY
i "'1;•� CITY HALL FRIDLEY 55432 1NUMBEA
___•�;
L 763-571-3450
910-F15
12/1/03
JOB ADDRESS 5949 4 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17
2
1 Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Jerry Earley 5949 4 Street NE
763-571-7764
J CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
AJF Contracting 10638 Thomas Ave S, Bloomington, MN 55431 612-685-1206 20365377
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 O ADDITION �I ALTERATION O REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Remodel kitchen
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REOUIgED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
1
ISTALLS
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
$19,600
$9.80
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-
S RUCTION OR THE PERFORMANCE OF CONSTRUCTION
$321.25
Fire SC $19.60
�� /�®
Aezo
PLAN CHECK FEE
TOTALFEE
$5.00
$355.65
SIGNATURE OF CON'RAC OR AUTHORIZED AGENT iDATE,
PERLY VALIDATED THIS IS YOUR PER IT
=IGI
FIATS
SIGNATURE OF OWNER.IF OWNER BUILDERI IDATEI
L
a
NEW [ ]
ADDN [ ]
ALTER [ ]
Construction Address: r 01 q
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
U NG PERMIT APPLICATION
Ll
e 1/1/2003
(763) 572-3604 Bldg In�,6
(763) 5714287 Fa
4)w
B ILDI
4 Ii E_
Legal Description:
Owner Name & Address: 6A 2i -r -q �5AAA=) Tel. # 6ts3) 57' - -1 -1
Contractor. A , E Cent_ 64 MN LICENSE # 90 3 C-� 3 "2 i
Address: ioL3,4 iWMO+S AVE 5 R ivalini -L4 0 s1 5593/ Tel. #(u'/Z)
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: (I,6Mo6 - P-fmovjAlr, 6EAI�P_iA-L< WACC XDnYAl1� 2
Construction Type: RcevLoo P C_ i Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: /1-v?L% -63 APPLICANT:�� Tel. # �'o/Z BS-� o
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
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 3I -�5
$ I
$ 9 L )o
TOTAL $ 355.
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]