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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PEIiWr O N Office of INSPECTOR OF BUILDINGS 7;5� /J,, Fridley, Minn., - d-z-fe; ��// 19 LOCATION OF BUILD G No. Street Part of Lot Lot Block Addition or Sub -Division DESCRIPTION OF BUILDING, Front Depth Xeight ' . Stories er of Construction To used as To be completed Estimated C Ate_ . Permit, is 'hereby k the building , described in the above statement. This permit is grant ed upon the express condition thift 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, !Mregarding the construction, alteration,. maintenance, repair and moving of buildings within the city um�to, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances, rnspector of Buildings. In consider the above perm above set forty sworn, I hereb, true as therein Subscribed day AGREEMENT AND SWORN STATEMENT tion of the issue and delivery to me by the Inspector of Buildings of Fridley of t, I'• hereby agree to do the proposed work in accordance with the description and according to the provisions of the ordinances of Fridley, and, being first duly state and any that the facts statpa by me and contained in the above permit are is�vorn to before me at Fridley, A.D. 191 C� 0 • City of Fridley, Minn. MU DING PERMIT Date: June 21, 1965 Owner: Robert Witzig Builder R. P. Wilson and Asso. Address 5980 lith Street N. E. Address 3101 93rd Ave. NO LOCATION OF BUILDING No. 5980 Street 4th Street N. E. Part of Lot Lot 1 & 2 Block 13 Addition or sub -Division Hyde Park Corner Lot , Inside Lot Setback —_ Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING N° '7976 Front Depth Height Sq. Ft. Cu. Ft Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost $5s7OOsOO _ To be Completed Storm damage repair 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 21 provisions of ardinaacs�s oY the city of Fridley. In consideration of the payment of a fee of $ 10.00----.--., permit is hereby granted toCharles A.i lson to construct the building or addition as described above. This permit is granted upon the expV tion that done inand uponFridley,ta regardwithinmits and th�i s ordinanoea Allen Jensen BuildingInspector NOTICE: 7bb pwmlt dos not carer the cendnmfl n, haftildlen fm wkbg, phrmbing, gas hearing, aww or water. Be wre to no the BoBding hnpeator for apwate pwmift for thea Bmns. r APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, mINNESOTA OWNER'S NAME BUILDER ��eSS- 7 ADDRESS_,� /Y ADDRESS : LOCATION OF BUILDING Street Part of Lot ..LOT�� CK_ ADDITION OR SUBDIVISIONS C� Corner Lot Inside LOT Setback Side -Yard SL6JER EL.EVATiON FOUNDATION ELEVATION. Applicant attach io this form x'06 Certificates of Survey of Lot and proposed building location dratin on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth, Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost-F'�'—,7 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. (Schedule of Fee Costs can be found on the Reverse Side). C) SUBJECT PERMIT NO. City of Fridley 1746 4 AT THE TOP OF THE TWINS BUILDING PERMIT r `L ------ COMMUNITY DEVELOPMENT DIV. RE{`[�1� r � � PROTECTIVE INSPECTION SEC. SQL) CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ----� �r---,'� 612-571-3450 910-F15 4/17/84 JOB ADDRESS 5980 - 4th. Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Winters 5980 - 4th Street N.E. 574-9471 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK � El11NEW ADDITION ❑% ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install wood stove 9 CHANGE OF USE FROM TO STIPULATIONS MV1 AS 034tno38 ,J)3 Sbg - 31813373 - EPERATE PERMITS saris/►ln leao alp REQUIRED I lira �ui��ip F OR t+VlRrry ajo p31 aao�a� EATING. Pl�1MRINoS AND SI�GNSa 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 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 STALLS I 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 $400 $� rJ� 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- $15.00 ' STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 IDATEI WHEN PROPERLY A ATED THIS IS YOUR PE MIT 1,xg(GTuREOFCONTRACTORORAUTHORIZEDAGENT 17 �� BLDG INSP SATE NATURE OF OW ERIIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: ) 7 g® � NC, C Legal Description: Property `nen/Addr.5s� V� �� Tel. # y- qy� / Contractor: Tel. # Address: 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: W 60 9 46y e- - - Corner Lot [] Inside Lot n[ ] Ft. Yd. Setback Side Yard Setback Type of Construction: � 001 Estimated Cost: $ DOpOO Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: N' 1-7 ` ,r APPLICANT: L Tel. # y/ 2c/' CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ ® 25% of Building Permit Fee State Surcharge $ ,�� $.50/$1,000 Valuation SAC Charge $ ""-® $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS• 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 RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work,e9— 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 18 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit 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 from adjoining neighbor. $ $ $ .50 S Job Address 5-55") Y/ 51 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. y4 Fridley, Minn. , 19/ OWNER KIND OF BUILDING n A. USED AS L9E�� P TO BE COMPLETED ABOUT ESTIMATED COST A OLD - NEW BUILDING PERMIT NO. PERMIT NO.l4 Q DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water armAir- No. Trade Name ���1�y� Size No.Q Capacity / Sq. Ft. EDR BTU HP s Total Connected Load�� 7B 1` Kind of Fuel � BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP ROYALTON HEATING & COOLING Company A 4120 - 85th Avenue N. Brooklyn Park, MN 5544 Signed By /A Tel. No. Fill out back side for stack verification on replacement furnaces I CHIM14EY 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 ( No ( ) 6. Has Total heating BTU's of / 0 All other BTU's t�U TOTAL Rema rk s 6 6 k f ,v Company ° Signed By IV Date _� CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS �� 8 0 �h S4- N RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ �O •OD that all the facts and representations stated in this ap kation are 3pii b� � " 1 ,1991 Gas Piping (Needed with new furnace) $10.00 $ / 0 O XS6yN OWNER I Gas Range $10.00 $ BUILDING USED AS DU) 15L1_4 A) 6 - Gas Dryer $ 10.00 $ ESTIMATED COST 1A00-0 70 PERMIT NO. �� S 'Air Conditioning - All Sizes $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) Value Appliance or Work $ No. of Heating Units_ Circle One (Steam) (Hot Water) arm Air 1 % of of Trade Name L� M P I AO' Size No. 14 -3T Commercial/Industrial BTU 35,cQ-0 HP EDR 1 % of Value of Appliance or Work $ Fuel -r Total Connected Load s � , � State Surcharge $ .50_ Burner Trade Name Size No. BTU HP EDR TOTAL FEE $ �%• °� BLAINE HTG, A/C $ ELECT. INC. 13562 CENTRAL AVE. N.E. HEATING COMPANY ANnI(A. 14W 55304 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION , REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE r/ Approved By Rough Date Final Date REINSPECTION FEE $30.00 -In 'Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE SUBJECT PERMI :--s-o City of Fridley 2 0 9 4 2 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � i CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/17/91 JOB ADDRESS 5980 - 4th. Street NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 & 1 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave/Loretta Larson 5980 --4th. Street NE 571-5860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Handyman Helpers. Plus Inc. 1821 EXXX Glenwood 521-0658 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 O NEW ❑ ADDITION ❑ ALTERATION C2 REPAIR ❑ MOVE ❑ REMOVE S DESC IBE WORK Rep ace 13 windows 9 CHANGEOFUSEFROM TO STIPULATIONS One window in each.bedroom must meet. State Egress Code requirements. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4,835 $2,42 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PR SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS ANY OTHER. STATE OR LOCAL LAW REGULATING CON- $72.00 Fire SC $4.83 STRUCTIO R THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $7925 SIGNATURE OF CONTRACTOR OR AUTHO ZED AGENT IDATEI WHEN PROPE LY VALIDATED THIS IS YOUR PERMIT 1 L SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP BATE N [ ] Effective 1/1/91 ADEN [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Mnstructicn Address: s7'g'6 — � S�-/v'-g-7 regal Description: Lcrs �� � 3, L� Owner name & Add,.: Tel. oontractar: l�y�-v�y�.�✓ Wl. # Address: /9Y-' Attach to this application, a Certificate of Survey of the lot, with the proposed oars xu tion drawn on it to scale. loom IP!'IDrT OF ROVEMENT LTVn G AM: Length Width Height Sq. Ft. GRrd= AREA: Length Width Height Sq. Ft. DBCR AREA: length Width Hgt/Ground Sq. Ft. oma: Corner rot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of fiction: Ji�/fNdvui J,,c Cost: $ gag <, Approx. Ocupletion Date: Com✓® o J ,� // C6y�,,2 Proposed Driveway Width If New Opening Is Desired: Ft. $. $ Width + 6' See Back Page DATE: APPISCM: \%f1 It ��� Tel. # moi/ - 10•6 SS Permit Fee Fire Surge State Surcharge $ SAC Qzarge $ Driveway Escrow $ Park Fee $ Sewer Main Qkarge $ �7IN1I10 t;V-V- k, k-: k CITY BBEY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Emjiroer *+g Agreement Necessary [ ] Not Necessary [ ] I'LR 1, SUBJECT PE City of Fridley- `AT THE TOP OF THE TWINS BUILDING PERMIT f 822575 t COMMUNITY DEVELOPMENT DIV. v _ PROTECTIVE INSPECTION SEC. ^ ���J/ .1 CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE Of APPROVED BY 612-571-3450 910_F15 611194 JOB ADDRESS 5980 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 13 Hyde Pak SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David/Loretta Larson 5980 4 Street NE571-5860 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 ❑x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (12 Squares) Tear-off 9 CHANGEOFUSEFROM 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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,200 $.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29.00 Fire SC $1.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $30.80 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI yy RLY ALIDATED THIS IS YOUR PERMIT BLDG )NS i'), SiGNATURE OF OWNER 0F OWNER BUILDER) IDATEI I'LR 1, NEW j Effective 1/ 1/94 ADDN CITY OF FRIDLEY �� � / 3 ALTER (j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 oto Building Permit Application Construction Address: _ _ J / J© �/ 571 • ✓). C Er, d Legal Description: -IL&, r p p Owner Name &, Address: 00„,,, (14 4 LG r Tel. # _j'/ S0'fvd Contractor: Address C MN LICENSE # 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 GARAGE AREA: Length DECK AREA: OTHER: Jt ?ceGK — -7 w A 2 y r Width Width Width Height Height Hgt/Ground Tel. # Sq. Ft. Sq. Ft. Sq. Ft. 5 Corner Lot [ ] Inside Lot ��jj ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ oo Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + fi Ft = Ft x $ _ $ DATE: C APPLICANT: Tel. # 5 2Z-5L3(,rO CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ STIPULATIONS: J4 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 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 SUBJECT City of Fridley ? 5 `� 4 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. i COMMUNITY DEVELOPMENT DIV r � PROTECTIVE INSPECTION SEC NUMBER REV DATER AGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/25/97 JOB ADDRESS 5980 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave/Loretta Larson 5980 4 Street NE 572-8591 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Accent Home & Kitchen Center Inc 701 W Main St, Anoka, MN 55303 427-1200 6773 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 8 DESCRIBE WORK Kitchen Remodel 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 11 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 $500 $'50 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 JNY OTHER STATE OR LO L LAW REGULATING CON- $21.00 Fire SC $.50 STRUCTI R E ERFORMANCE C TRUCTION PLAN CHECK FEE TOTALFEE �- �v "MATE, $22.00 NT SIGNATURE OFC R CTOR O R AU THORIIEDAGEN T WHEN PROPERLYAL1 ATED THIS IS Y UR PERMIT BLD INSP )ATE SIGNATURE OF OWNER,IF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/97 ADDN I I CITY OF FRIDLEY ALTER l�'�— SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: c R) A% Z/ ' Legal Description: Owner Name & Address: y- Tel. #. 5-7Z X S � / Contractor: MN LICENSE # C,o 77-3 Address: % / �, y�� ,'k s� lt��l� Tel. # -c/ 7- 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq.. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: 'S Estimated j,,��� Estimated Cost: $ 50-,-r (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ J / DATE: (o APPLICANT: Tel. # !K? % /Z -0y Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $_ 22V Gv CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $950 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 [ ] AtCENDATE'1' ._ .. . r . MGR CK CREDIT 'mak 701 WEST MAIN ANOKA, _ MN, 42`7 , .. , - ' ' -SALES ID I -©moo z =1200 .JOB 4 ' 110 CONTRACTOR CUSTOMER.. ADDRESS NEW ADDRESS CITY/ST/ZIP` CITY/ST/ZIP PHONE. HOME PHONE �. CONTACT WORK PHONE LEAD SOURCE -- OLD ADDRESS SALES REP �•� REQ CABINET DEL ' NEW / REMODEL CABINET INSTALLATION_ye" no SOFFITS REQ COUNTERTOP DEL KEY/LOCKBOX COUNTERTOP ,INSTALLATION.__(D.no ' DIRECTIONS TO JOBSITE: CABINET LINE• Drawer T .......... YPe Drawer' Edge „r .-.Drawer Design`- r, _ DRWR#1 ,DRWR#2 ..._ r. . DRWR#3 Hinge Type Door Edge Door Design DOOR#1 J) 9741-5 5 �•�, DOOR#2 DOOR#3 PULL#1G PULL#3 PULL#5 PULL#2i „moo PULL#4 PULL#6 DOOR PULL LOC, Z _ DRILL?e no STAIN COLOR DRWR PULL LOC. G� DRILL? � no FINISH TYPE &fiJ WOOD SPECIES _ 2� &Z CORNERS FINISH TOPS? yes no REMIGERATOR SIZE RANGE/COOKTOP BTZE RANGEHOOD CUTOUT WALL OVEN CUTOUT MICROWAVE • S= . DISHWASHER SIZE TRASH COMPACTOR SIZE ,CENT HOME & KITCHEN CENTER 701 W. Main AN01(A; MINNESOTA 55303 (612) 427-1200 JOB SHEET NO. OF CALCULATED BY DATE CHECKED BY DATE susJEcr _ FERMI 1 ` City of Fridley � � 7 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir? • COMMUNITY DEVELOPMENT DIV. a r � PROTECTIVE INSPECTION SEC. � NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 555432 612-571-3450 910415 7/2/97 JOB ADDRESS 5980 4 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1,2 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Larson 5980 4 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Affordable Custom Finishes 3MEM 680 63 Avenue NE, Fridley, MN 55432 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 574-0728 20055319 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION X7 ALTERATION O REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Install egress window 9 CHANGE OF USE FROM TO STIPULATIONS Window must meet the State Egress Code. III 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 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 $675 $.50 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 OTHE ATE OR LOCAL LAW REGULATING CON- $26.50 Fire SC $.68 STRUCT51pqR THE PERF MA CE OF CONSTRUCTION, PLAN CHECK FEE TOTAL FEE License SC $5.00 $32.68 SIGN ATUREO O OR OR AUTHORIZED AGENT tbATEI it WHEN PROPERLY V ATED THIS IS YOUR PERMIT BLDG INSP J— O / Lri MATE _ SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ) Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: %Z Legal Description: Owner Name & Address: Tel. # Contractor: ��� —�3+�31 s MN LICENSE # -2co5s3/-7 Address: ZjjA r--;PsJ,4AZI Tel. # -4q2;1-C7' 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: � �s� �,te.�c /��✓,b�� Construction Type: Estimated Cost: $ � 25,- ax�;' (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ - $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY 4 y `(� I! -a, Fee Schedule on Reverse Side $ y .001 of Permit Valuation (1/10th%) ,&Ivu� $ $.50/$1,000 Valuation r. $ $950 per SAC Unit $---:), e6 $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 [ ] G CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADD r The undersigned hereby makes application for a perm it 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. 1997 Owner c Building Used As_�-�cw�-�' Estimated Cost PERMIT NO. PLUMBING COMPANY SIGNED BY JA��\ TEL N0.�2 2 %O Approved By J<n=j— Rough–In Date 50 MINIMUM FEE F R ANY PLUMBING/ $_ PLUS THE $.50 STATE SURCHARGE Final Date MY IQ @nn nn **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6–A. MINIMUM SIZE 9 SQ INCHES. NO. \ 1 SUBJECT P IT City of Fridley 2 5 17 6 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. �• COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/7/97 JOB ADDRESS 5980 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1, 2 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave/Loretta Larson 5980 4 Street NE 571-5860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Legvold Construction 374 E Belmont In, Maplewood, MN 55117 774-9422 3650 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 O NEW ❑ ADDITION ALTERATION ❑ REPAIR O MOVE O REMOVE B DESCRIBE WORK Install shower enclosure, tile floor, medicine cabinet 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 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 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 $5,400 $2.70 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- $PLAN Fire STRUCTION OR TH7PERF RMANC F CONSTRUCTION. /SC CHECK FEE TOS 20E35 `Y SIGNAT� OFA NTRACTORO HORIZED AGENT (DATEI // EN OPE ALIDAT BLO )NSP D HSS IS YOUR F771T /O )ATE SIGNATURE OF OWNEROF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/97 ADDN [ CITY OF FRIDLEY ALTER ( ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 h BUILDING c ~-PERMIT APPLICATION � 6 ��%�,ConstructionAddress: Legal Description: Owner Name & Address: p# C 4� Co y' [ y Tel. # 6-`7 %-- 5'9'6 d Contractor: Z- 1�:" -S Ver 4, Z,? C ® S 7— MN LICENSE # 04!S- 0 Address: z A c6 . Tel. #2 711— 9 y 2 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: Construction Type: Estimated Cost: $ 6/-/C)0 (Fee Schedule on Back) Driveway Curb Cut Width Needed 'FL-+-6-Ft= Ft x DATE: 14_ 7"c7 APPLICANT: f � Tel. # -z - APPLICANT: TOTAL $ /p��' -3c- S'1'II'U1,A'1'I0NS: USE ONLY i Permit Fee $ / Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ Ld $.50/$1,000 Valuation SAC Charge $ $950 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 $ /p��' -3c- S'1'II'U1,A'1'I0NS: SuBjECT City of Fridley 28=402 -TAU THE TWINS BUILDING PERMIT . ,57% _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC r PROTECTIVE 1 CITY HALL FRIDLEY 55432 NUMBERREV DATE PAGE OF APPROVED BY L J� 612-571-3450 910-Fl5 110/23/98 JOB ADDRESS 5980 4th Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 2 13 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David & Loretta Larson 572-5860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Giertsen Co. 860 Decatur Ave N Golden Vly 55427 546-1300 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 O ADDITION O ALTERATION 50c REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (20 S) tear -off; Reside house and garage 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for buildng wrap inspection before covering. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 7314 $3.66 DOES NOT PRESUME TqeGIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION F ANY THER STATE OR LOCAL LAW REGULATING CON• STRUCTI O TH ERFORMANCE OF CONSTRUCTION $137.25 Fire SC 17.31 PLAN CHECK FEE TOTAL FEE (/F✓J/ ` License SC $5.00 1$153.22 SIGNATURE OF CONTRACTOR OR AUT.IORIZED AGENT IDATEI WHEN PROPERLY BLDG -NSP VALIDATED THIS IS YOUR PERMIT T1ATE S-GNATURE OF OWNERoF OWNERBUILOER- IDATEI w NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �/P, f o Legal Description: Owner Name & Address: �� �✓�� fi��w _ Tel. # Contractor: MN LICENSE # Address: 6-4-19:—_ /a, Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length _ Width Hgt/Ground Sq. Ft. OTHER: !' J, -/-1 -2j—' Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $_ ;� f Y, 4? -10 (Fee Schedule on Back) Ft x $ = $ DATE: APPLICANT: Tel. #, Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: 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 [ ] CITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLFr) ON FACH FI OOR Effective On Jan 1, 2000 ® R j" ® n ySR ® 7 . � � R 4 , •'• w ' `f� � � �R iW�[ 1� ! �® PLUMBING FIXTURE RATES: NO. RATE 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 TOTAL JOB ADDRESS f-MOC tS 6WL31ff _ 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. LARSON, DAVID to 7- 2001 5980 4TH STREET NORTHEAST FRIDLEY, MN 55432 Owner_ (763) 571-5860 Building Used As��`�>�AY cam, Estimated Cost PERMIT NO. PLUMBING COMPANY O&C'MPLO NdAJtJ SIGNED BY TEL NO.�Z Approved ByRough-In Date Final Date .50 MINIMUM FEE -40R A PLUMBINGIGAS PERMIT IS S20,00 $M- PL S THE 9.51f STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 O 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 existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When Installina a new venting system, 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 [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. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input at- Fan Assisted or Nat - Appliance #2 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : In 3Uilding See Back Page for Fee Schedule BUILDING Permit No.: -nspections /-'s i RESIDENTIAL APPLICATION $ Received By:, 763-572-3604 $ -5.6 y Dat=:AUG 14 200 $ CITY OF FRIDLEY $ -)ATE 6/13(69 YOURE-MAIL ADDRESS Yocl��cflc�d�ra o/ys. cuM iTE ADDRESS 61180 — $450 Conservation Plan Review $ Fee Determined by Engineering _ rIIS APPLICANT IS: O OWNER ;KCONTRACTOR Agreement necessary ( ) Non Necessary ( ) :'ROPERTY OWNER/ NAME: o u f Lar O Make checks savable to: City of Fridley Attach TENANT ADDRESS: $ R b O 4 � A S tvf CITY Fr I el l f(t STATE—ZIP S S y 3 of PHONE: Z G 31 -571 - 5e & o CONTRACTOR NAME:_ The Home Depot A.H.S. Inc. Io ch 6) J°ilt S SUBMIT A COPY OF STATE Llc 3200 Cobb Galleria Pkwy. q 5;1 13US - L e 4? YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHONE 763-542-8826 T�oGFA License #20268257 .DRIES PROPERTY TYPE0 PERMIT TYPE QADDITION 0 GARAGE/SHED WINDOWS 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: 0 NEW rt?14LL 0 ADDITION MAINTENANCENEPAIR 0 REMODELING ,ESCRIBE WORK BEING DONE: W i D d o la Pt o/ A U M/ n s/ v TZE OF RAPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. _ OOFIING 0 HOUSE ONLY gUMBER OF SQUARES O HOUSE & GARAGE BASEMENT REMODELING SUBMIT: :ARAGES O ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan ROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used ROPOSED HEIGHT: IDING FOR NEW CONSTRUCTION INCLUDING DECKS, I vinyl OSoffit ADDITIONS & PORCHES SUBMIT: Aluminum 0 Trim 1. Site Plan/Survey showing the existing structures Other 0 Fascia and proposed project 2. Two sets of construction plans WINDOWS _; EXISTING OPENINGS ,kes ONo LOCATION �DOWS 3. Energy Calculations R FOR NEW OPENINGS -DESCRIBE SIZE OFf PENING CHANGES & YPE OF WINDOW TO BE INSTALLED da►bit A ujvS NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ P Z 33 OCCUPANCY TYPE -rmit Fee !an Review urcharge ire Surcharge icense Surcharge AC Charge rb Cut Escrow -osion Control ark Fee swer Main Charge otal Due $ 3 • P2 5 See Back Page for Fee Schedule $ 65% of Building Permit Fee $ /-'s i (.0005) times the total job valuation — Minimum $.50 $ 2.13 .001 x Permit Valuation (1/10%) $ -5.6 y $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Q 2. `3 Make checks savable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED ulations hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in mformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a -rmit 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 .an in the case of all work which re . es r 'e and approval of plans. �- % % GNATURE OF APPLICANT PRINT NAME ll m �C�f�� DATE �[ t3/ bb Building PLUMBING Permit No. ` ' Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604CITY OF FRIDLEY 763-502-497TEA EFFECTIVE 1-1-N DATE, I 0 YOURE-MAIL ADDRESS �N� v� o r F ee �,ow� e[� l,.o-(tea ; I .c�c� q SITE ADDRESS THIS APPLICANT IS: ❑OWNER CONTRACTOR PROPERTY NAME: pa v i d. 1 t r e - 44-y— LA,<.pin OWNER/ ADDRESS: S`1 RO '-I h 4' w Crry STATE ZIP TENANT PHONE:�p3 CONTRACTOR NAME: OI SUBMIT A COPY OF YOUR STATE STATE LICENSE # iyo /Dl to 7��1 "� EXP DATE 3 I -6 LICENSE, BOND AND STATE BOND # EXP DATE - 3 / -6 $ CERTIFICATE OF ADDRESS:�/ CITY /t 7� STATE i , ZIP .S INSURANCE PHONE ( -a7'7 - 0 t 1 S_ FAX 57 -a--77 '-6 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW jo(REPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK l( 7th [ e T PER MS 168.665 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= plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL ILTNMER OF EACH BELOW). MINIMUM FEE $15.50. IfBATH SINJUJ AV FLOOR DRAINS _ SHOWER WATER PIPING _ fBATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMNG POOL —WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK _LWATER.CLOSET _ BACKFLOW PREV. ($15) —DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ .6u Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ :7,® State Surcharge = $ .50 $15.50 $15.50 Total = $ THIS IS AN APPLICATION FOR A 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 odes 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 with the approved plan in the case of all work 'ch re *res review and approval of plans. -� SIGNATURE OF APPLICANT 1 PRINT NAME_&I'l % �L c /GC l - �e S DATE APPROVED BY DATE I` i PLEASE NOTE: SEP�4RATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK q e City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 0013 763-572-3604 FAX: 763-5024977 wilding Permit Fee BUILDING Permit Ivo.: Inspections. $ RESIDENTIAL APPLICATION Received By: 763-572-3604 "00 .001 times the total job valuation CITY OF FRIDLEY a DV 07 08 763-502-4977 FAX License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge EFFECTIVE 1-1-08 $1825 per SAC Unit (Plans to MWCC for determination) �® $ ft + 6 ft = ft x $21 = $ DATE YOUR E-MAIL ADDRESS $450 Conservation Plan Review SITE ADDRESS $ Fee Determined by Engineering THIS APPLICANT IS: ❑ OWNER -KONTRACTOR $ PROPERTY OWNER/ NAME: $ TENANT ¢h F—` � THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED ITY ADDRESS: CC STA ri ZIP pp-- PHONE: l— 55- NAME: t1t2MC9 ADDRESS: r 1 11V1Q ClTy STA fn ZIP (, CONTRACTOR SUBMIT A COPY OF -7 PHONE /6 3– �5&7– q7,41 FAX YOUR STATE LICENSE STAT # 20 f L4'7 &0 EXP DATE " 02 LICENSE PROPERTY TYPE KSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMIN rOOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION� ADDITION MAINTENANCE/REPAIR ❑REEMODELING p DESCRIBE WORK BEING DONE: Gl � OCC i/iC V4SaTfaArd SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. &PORCHES SUBMIT: ❑ Vinyl []Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: loU ING THE 1997 UBC FEE SCHEDULE) ����++t P TOTAL JOB VALUATION $ Z dOCCUPANCI' r e, 1 YPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ "00 .001 times the total job valuation Surcharge $ CP CL)'_ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks a able to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the informatiogAboye is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the es Construct' n s; t 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 m ac with th prov d the case of all work which �,reeview a idd as pr val of p SIGNATURE OF APPLICAN L PRINT NAMF[1✓VL cJe DATE APPROVED BY DATE i G�� S�1'W i' ,�' ....... --- Must be done with every full bath remodel and every job containing any of the following: doored whirlpool, floor, demolition, sub -floor repair, relocation of plumbing or wiring. Use solid lines to indicate the current location of items. Make sure to include measurements. Use doffed lines to indicate the new location of items (if different from current). IF THIS IS NOT DONE WE WILL ASSUME THAT THE CURRENT AND NEW LOCATION IS ONE IN THE SAME. MUse shaded areas to indicate where repair is needed. Ha279(02&07) DISTRIBUTION: White—Office Copy Yellow/Pink—Customer Copies PageB REVIEWED� OR CODE PLIANCE Ell L I llsp Ci r�lfck l aJ 5;26k �� Qh PC