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PRE 2010 DOCS• City of Fridley, Minn. BUIILDING PERMIT N° 3 614 Date: ../...... ....... .... ...... Owner ....................................... Builder ..... ........... Address ...................................... Address ............................................. LOCATION �jOFF BUILDING No. Street... �.�.�...'.`.s:'.-�....... Part of Lot ... ................ Lot !...l� .. �. Block .. l........... Addition or Sub -Div � �.. (� ................ Corner Lot ............ Inside Lot A ........ Setback �.1........ Sideyard . l ........................ DESCRIPTION OF BUILDING To be Used as: ..... Front !. "Depth .�. . 0' Height l ...... c Sq. Ft. kr. Cu. Ft. .................... Front ........ Depth .... ... Height ........ Sq. Ft. .. Cu. Ft. ........ Type of Construction ................. . r '=. 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 compliancewith all provisions of ordinances of the city of Fridley. .zC:. C.,. o... .. :fiLc°:1. .......... 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. �,...,� .. Building NOTICE: This permit does not cover the construction, Installation or alteration for wiring, pho fing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. 1% Application for Power Plants and Hearin Cooling, Ventilation Refrigeration and�� APP g. g• 9 Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 GRAVITY WARM AIR: RATE TOTAL Lmmmn (� ® Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 840 sq. ft. IDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. IDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS URRNER. (up to 400,000 BTU) ....................... 5.00 $ z.a[i, o .o ra 006 GAS PIPING (g to f. 3 Fixtures) .......................... 1.50 $ (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS $ See Fee Schedule TOTAL FEE $�/�_ City of Fridley: 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 representations stated in this application are true and correct. f,. Fridley, Affina •195_ Owner t e°v p 195— Kind of Building 195— Used as To be completed about 2- m c �-1 Estimated Cost, $- Old—$e:, Building Permit No. ' DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No 1 Capacity Sq. Ft. E.D.R ,Eek BTU H.P. Total Connected Load � �� � � Kind of U-1 n�ff=� BURNER — Trade Name �` Size No - Cap i o Capacity Sq. Ft. E.D.R BTU H.P. REMARKS: Signed �_._ I c r - P` 11 POST 1 M-8-58 Business Phone No ` Windows and Doors—Crackage and Area i f :)i. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack Be. ft. Width Height No. of Lineal f . Area No./ of pane of pane lights of crack sq. ft. Area sq. ft. ir� Agy" OP Infiltration Glass Coef. Btu Infiltration Coef.1 Btu Infiltration HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS a= MINNEAPOLIS. MIMV. Weatherstrips A.S.H. .E.11 9 Construction No. �° g Insulation Exp. wallaz!� Guide Floor Net exp. wall WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19— Ceiling F1.1 _.7' >: Roofs I Length j Width , -e Heiaht V• II #Fl.l F_n� Room I Length m VA Width a, Height ,v Windows and Doors—Crackage and Area i f :)i. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack Be. ft. Width Height No. of Lineal f . Area No./ of pane of pane lights of crack sq. ft. Area sq. ft. ir� Agy" OP Infiltration Glass Coef. Btu Infiltration Coef.1 Btu Infiltration Exp. wall a= 'M ;Ir Glass 9 Int. wall �° g Ceiling Exp. wallaz!� ®"" �"" Floor Net exp. wall Int. wall Ceiling e Floor Total Btu. 7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 -t E ANom I Length 7-1 Width ei Heittht Windows and Doors—Crackage and Area i f :)i. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack Be. ft. Width Height No. of Lineal ft. No. of Dane of pane lights of crack Area sq. ft. Coef. Btu Infiltration Glass Coef. Btu Infiltration Net exp. wall Int. wall Glass Infiltrations Glass Exp. wall Exp. wall a= Net exp. wall Int. wall Net exp. wall 42f; 9 Int. wall Ceiling Floor ®"" �"" Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader J r j' _ Room J Length �,3 Wid1 Windows and Doors—trackage and Area Width Height No. of Lineal tt. Arl, No. of Dane of pane lights of crack sq. Btu Infiltration I r. Glass d- a Exp. wall,•. ry Net exp. wall Li I Int. wall Floor Tstal Btu.,° Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and rs--Crackage ani ea Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. No. of Dane of pane lights of crack Area sq. ft. Coef. Btu Infiltration Glass A Exp. wall^ Net exp. wall Int. wall Coef. Btu Infiltrations Glass Exp. wall !• , 77 Floor a= Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area . FU .-, I Room I Leneh Width �. Height , ; Windows an Duero—Crackage and ea Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. P' Coef. Btu Infiltration Glass A Exp. wall^ Net exp. wall Int. wall Ceiling !• , 77 Floor Total Btu. Required sq. ft. ED.R. or sq. ins. WA. Leader area Fl.J ' •2:1 Room I Length Width Height Windows Ad Doors—Crackage incl Area Coef. Btu Infiltration 4:2 Glass Exp. wall p Net exp. wall Int. wall Q1 yu Ceiling Floor" t: Total Btu. i Required sq. ft. ED.R. or sq. ins. W.A. Leader area °-� 52 -e4 -S915.51 City of Fridley Application for Plumbing and Comas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK 6044 N E 4th St Number, Kind and Location of Fixtures Lova C _ 12 s ' F ZZ '� �8Zai p'�' d Z Ute' W • s WATER HTR. GAS ELEC. O Base 1st 1 2nd 3rd 4th • Future Connection Openings Connected with I Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ..... ................. ... Water Heater (Up to 200,000 BTL) ...... New Ground Run Old Bldg. ............ NO. RATE TOTAL — x $1.50 $ _ x 1.20 $ — x 1.00 $ — x 3.25 $ — x 2.00 $ — x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. 1 x 2.00 $ 2.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 10"3-66 19— Owner T Truehal Kind of Building frame Used as res To be completed about 10-8-66 Estimated Cost, $ 10.00 Old—New. Building Permit No Permit No. ROUGH FINAL d2 Si . L Business Phone G • City of Fridley, Minn. BUILDING PERMIT owner; Theodore R. Truehl Address —_ _ th Builder Same Address Same LOCATION OF BUILDING No. 6044 —. Street 4+'h St- I _ F _ ---- Part of Lot Lot ._ _ 7 & 0 Block Addition or Sub -Division .__.._fie Park Corner Lot — Inside Lot — Setback --- Sideyard -- Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING �T° 9693 -- -/7,- -'/i !P'9s— To be Used as: Front 241 Depth 22' Height ID_!_ Sq. Ft. 928 Cu. Ft. 5280 _ Front .— Depth _ Height ._ Sq. Ft. __ _ Cu. Ft. Type of Construction Wood_ Est. Cost To be Completed 1968 SURVEY LOCATED ON PERMIT #3614 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 - 8.OQ_I permit is hereby granted to_.,' ' .1aodd r..? Tsiphl 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 upon violatio the provisions of said ordinances. / / �d n r NOTICE: Tide permit does not cover the construction, Installation for wiring, Plumbing, gas hosting, sewer or water. Be sure to see the Building inspector for separate permits for these Moms. Front _Aepth _ _Height Square feet Cubic Feet _€s2_ 5 2-g 6Type of Construction P%`�` Estimated Cost ��,a®!� yy 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,,_— igz� SIGNATURE _ (Schedule of Fee Costs can be found on the Reverse Side). APPLICATION FOR BUILDING PERMIT' � CITY OF FRIDLEY,.$UMSOTA OWNER'S N� �. ., �'� r .�_.^�BU3�LU:: ADDitits E� S r� _ _ ....1Db1 S � LOCATION OF BUILDING NO STREET, 6�1y LOT., E ADIixti N`' SUBDIVISION l COR1kR LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOa',�I,�� Applicant ,attach to this form T ic6i .ficates of. SVF.veyx. of Lot and •proposed building locatioq drawn on thade= Chi t3ihc e6. DESCRIPTION OF BUILDING To Be Used As: e� Front /`�-Dept , Height _ Square feet Cubic Feet Front _Aepth _ _Height Square feet Cubic Feet _€s2_ 5 2-g 6Type of Construction P%`�` Estimated Cost ��,a®!� yy 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,,_— igz� SIGNATURE _ (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Applicaffm for Pkmbbe and Gas q Pemdt spit. of Bldga. Phone 50 -MM m�DESCRIPTION OF WORE /� d els/ _ ,�� Nuber, Kind and Location of ctures r �••�' 2 I I Base 1st 2nd 3rd PARTIAL RATE SCHEDULE wAM "ft. City of Fridley: D I : GAS ILW- Sower 0 cosePow 171 PLUMBING FIXTURE RATES. NO. RATE TO®J►b Number Fixtures ............... . z $200 $ �C" � Future Fixture Opening ....:...... x $1.50 $ New Fixture Olaf Opening .......... x $1.50 i Catch Basica . e e . e ............... x $3.25 = Water Beater (Up to 99,000 BTU) .... x $3.00 $ New Ground Bun Old Bldg..... a ... x $3.25 $ Electric Water Heater .............. a $2.00 $ GAS FITTING FEES,. NO. RATE TOTAL lot 3 Fixtures ............... • • x $200 $ Additional Fixtums ............... x $ .Tb $ Gas Range to 190,000 BTU ..,......... x $5.00 $ State Surcharge $ .50 REPAIRS fr ALTERATIONB- Astor to Cc& _ Description ..... • . . e . ... . . ... .... . . . ..... • .... ...... . TOTAL FF.E The undersigned hereby makes application for a permit for the work herein specified. agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings6 and hereby declares that all the fact and representations stated In this application are true and correct Fridley. Mina Kind of Building Used as To be completed about Estimated Cost, $ Old New. Building Permit No. Permit Signed By Business Phune No ROUGH FINAL -01 SUBJECT City of Fridley =52' ® AT THE TOP OF THE TWINS BUILDING PERMIT' r • COMMUNITY DEVELOPMENT DIV. w�_��_. r � PROTECTIVE INSPECTION SEC. ! ! i NUMBER REV DATE PAGE OF APPROVED BY j �"'1 CITY HALL FRIDLEY 55432 �'""'� I.J 612-571-3450 910-F15 6/20/97 JOB ADDRESS 6044 4 Street NE 1 LEGAL LOT NO.BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7,8 4 I Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE T. R. Truehl 6044 4 Street NE 571-3529 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 Cj 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 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 1 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 $1,815 $.91 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- $59.50 Fire C $1.82 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL EE $t2. 23 �SIGNATUOFCONTRACTORORAUTHORIZEDAGENT IDATEI PR PERL IDATED I$ I$ VQ R PERMIT 'BLDG $P GATE OF OW NER OF OWNER BU4 DERI IDATEI -01 NEW [ ] Effective 1/l/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2�/ BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: _l G'7" q� L Owner Name & Address: l�i� % ci Tel. # Contractor: Address: 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 Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: ,?'.A 'C tL .. Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Construction Type:_ Ppn_ Estimated Cost: $ /'Il/S (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: !Y-- Permit Fee $ Fire Surcharge State Surcharge $ C� SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Tel. #�7/ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$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 [ ] Fr— SUBJECT P City of Fridley 2674 4 AT THE TOP OF THE TWINS BUILDING PERMIT IPT NO. i COMMUNITY DEVELOPMENT DIV. /�/ _ PROTECTIVE INSPECTION SEC. �, y/ F NUMBER REV DATE PAGE OF APPROVED BY � CITY HALL FRIDLEY 55432 612-571-3450 910415 7/22/98 JOB ADDRESS 6044 4th St NE I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17,8 4 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Theodore R. Truehl 571-3528 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. T.R. Truehl 6044 44th St NE OwnerS71-3929 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 and garage 22 S Second Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. 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. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1378 69 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $45.75 $1.38 PLAN CHECK FEE TOTAL FEE SIGNATURE OF CONTRACTOR AUTM I D AGENT (DATEI WHEN PROPERLY ALIDATED THIS IS YOUR P/EER.M�I�ITT�j BL IN p F)A TE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddre, Legal Description: Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Owner Name & Address. % A�,A�h L /P Tel. # Contractor: 2�2/— MN LICENSE # Address:��1� Attach to this application, a • Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF MPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE •AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 0 Construction Type: Estimated Cost: $ 70 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE:�� �� s..�,�� L Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control S� S 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 [ ] s cInroF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 BUILDING PERMIT APPLICANT: HOMEOWNER I understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. By signing this document, I attest to the fact that I am building or improving this house myself. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building on speculation or for resale and that the house for which I am applying for this permit, located at ggn!i�/ �/ - S� Z/E . is the first residential structure I have built or improved in the past twenty four (24) months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund'' in the event that any contractors I hire are unlicensed. Signature of Homeowner Date ' Licensed residential building contractors and remodelers are covered by the recovery fund. Licensed residential roofers and manufactured home Installers are not covered by the recovery fund but are required to hold a surety bond. To determine whether a particular contractor is required to be licensed, or to check on the licensing status of individual contractors, please call the Minnesota Department of Commerce, Enforcement Division, at (612) 296-2594, or toll-free at 1-800-657-3602. SUBJECT City of Fridley C 27407 AT THE TOP OF THE TWINS BUILDING PERMIT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �r r NUMBER REV GATE PAGE OF APPROVED BY CITY HALL FRIDLEY $$432 1 612-571-3450 910-F15 18/26/98 JOB ADDRESS 6044 4th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 a 8 4 H de Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE T. R. Truehl571-1529 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Elk River Exteriors 82441-7940 4457 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 Replace siding on south and west side of house and garage 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 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 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 500 .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $21.00 Fire SC .50 PLAN CHECK FEE TOTAL FEE LIcen $5.0027. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI aat4� �,GNAT.REOF EN ROPE B G INSP IDATED IS YOUR P MIT nA OWNER OF OWNER BUILDERI IDATEI NEW [ ]" Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �Q ConstructionAddress: �/� %� � — 10� Legal Description: 2D ,� d� Ad n Owner Name & Address: sr -/yr Tel. # �52 / Contractor: Z-Z�i 72 ,,i h c 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 IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Sq. Ft. Sq. Ft. Sq. Ft. Construction Type:k16M.C� S/P1N� so�7h GrJ0sTEstimated Cost: $ If a-` makA � � ` (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ S DATE: e— -6 5;:'y APPLICANT:9E�7 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 $✓ G� 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 [ ]