PRE 2010 DOCSCity of Fridley, Minns,
BUILDING PERMIT
Date:
Owner: _ _ .. _
Address ..� �►
IN
N° 4'793
Builder—
Address
O T BUILDING
No..... . E._ Street _^ �............. _... ._._ Part of t
Lot ......_...... Block ...._.. ............._......._........ Addition or Sub -Division ....11deyard
ComerLot ............... ........... _........ Inside Lot ....._.1;.... ............ Setback .....; ...�........... ..._........._. .......... _............................
Sewer Elevation .... ....... _................ ..... _..____.__............. ----_-__----.._.. Foundation Elevation
DESCRIPTION OF BUILDING
To Used
I *� �a
Front ._. -- Depth --.. Q Height � Sq. Ft./V � Cu. Ft. tZ 4;, F. e
..........-------------...... ................... ont . Depth ...... _.........
.++ Height Sq. Ft......_....... ........ Cu. F't......_.............-
of Construction ._.'"'".......... Est. Cost.../',
Type '�,�"` � .rt' ,.�-���^ ....._........ To be Completed ............... ...................................
r , �
CAUTt®N
V101 -AT -
THIS PERMIT D07S NOT TS AND
p,UTHORI7_E
ION OF ANY Ni;i A`3D COVENAN
BUILDING RLS -MICTION
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 $...may_-.. ..... .' ...., 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 _pRon violation of -any of the provisions of said
ordinances. ' ` z a,
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 PEMM
CITY OF FRIDLEY, MINNESOTA
Owners Name - Builder
Address , / iQ A,o Address ---
LOCATION OF BUILDING
,
No. t, CI Street 11 kr _ � ,P4rt of Lot
Lot - S WZ Y Block Addition or Sub.Div.
Corner Lot Inside Lot Set Back ateSide-Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Construction Estimated Costti
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in striet 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 SIGNATU4�E
(A Schedule of Fee costs can be found on the Reverse Side.)
Application for Power Plants and. Heating. Coding, Ventilotion..Refrigerafion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL.
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. 60,000 BTU .... . .................. 2.00 $
Replacement of Furnace §.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. EDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
frAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
r
Additional Fixtures .................
x .50
$
. Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
ROUGH
FINAL
Dept. of Bldgs. Phone SII. 4-74700
01
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.
Owner
Kind of
Used as
To be c
Estimai
1 �
Old New 3uilding Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Ste Hot Wa ,Warm Ai //o
Trade Name -Q Size No
Capacity Sq. FLt.,EM.R BTU H.P.
Total Connected Load�Kind of Fuel
BURNER — Trade Name Size No
a
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
PAY N. WELTER HEATIN13 CL7v
Sign1063 7 CHIC
e
MIN{gfAP13LIS 7. MINNESOT-A
aZ zM 7.59 Business Phone No-
F1.1 Room I Length Width Height, II J FI_I Rnnm I Length Width Height -
Windows and Doors—Crackage and Area
�o4Li
.X6 -
DT6 t:.42
i
I 6A
Coef. Btu
HEAT LOSS CALCULATIONS
DEPARTMENT OF BUILDINGS
FRIDLEY, MINN.
Weatherstrips
A.S.H.V.E.
Guide
f,
Construction No.
Insulation
Windows
I DoorsReference
Net exp, wall
Out. Wall
Int. Wall Ceiling Roof Floor
Kind How Applied
Yes—No
-Yes No
19—
Int. wall
Int. wall
F1.1 Room I Length Width Height, II J FI_I Rnnm I Length Width Height -
Windows and Doors—Crackage and Area
Width HeightNo. of Lineal ft. Area
No* of pane of pane llghte of crack sq. ft.
Width Height No. of Lineal f . Area
No. of Dane of pane lights of crack sq. ft.
Y JI
i
Coef. Btu
Coef. Btu
ICoef.1
Btu
Infiltration
Glass
f,
a
Glass
Int. wall
Net exp, wall
Exp. wall
M`
Int. wall
Net exp. wall
Net exp. wall
Ceiling
Int. wall
Int. wall
_
Ceiling,
Ceiling
Floor
Floor
Floor
1 otal btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 -" Room I Length Width Height .
Windows and Doors—Crackage and Area
Width HeightNo. of Lineal ft. Area
No* of pane of pane llghte of crack sq. ft.
No. of Lineal ft. Area
lights of crack sq. ft.
': �: .�: •'`'.ate`
i
Coef. Btu
Coef. Btu
Infiltration
Infiltration
y .
Glass
Coef. Btu
Glass
Exp. wall
Int. wall
Net exp, wall
M`
Int. wall
Net exp. wall
Ceiling
Int. wall
Floor
_
I otal titu. '
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Room I Lenath..At.- Width Height .�
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
No. of Lineal ft. Area
lights of crack sq. ft.
': �: .�: •'`'.ate`
.e� ;
Coef. Btu
Infiltration
Coef. Btu
Infiltration
y .
.
Coef. Btu
Glass
Exp, wall
Int. wall
Exp. wall
M`
Int. wall
Net exp. wall
Ceiling
Int. wall
Floor
Ceiling,
Floor
1 btal 15tu. r
P Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height
No. of pane of pane
No. of Lineal ft. Area
lights of crack sq. ft.
': �: .�: •'`'.ate`
.e� ;
Coef. Btu
Infiltration
Infiltration
�.
y .
.
Coef. Btu
hlfiltration
Exp, wall
Int. wall
Glass
M`
Int. wall
Exp. wall
Ceiling
Net exp. wall
Floor
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F7 I Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
n.p
Coef. Btu
Infiltration
Infiltration
Glass
Exp. wall
Net exp. waU
Exp, wall
Int. wall
Ceiling
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Roam I Length Width
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp, wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
sq. ft. E.D.R. or sq. ins. WA. Leader area
E—
City of Fridley, Minn. 0 10 8 29
BUILDING PERMIT
Date: September 15, 1970
Owner: Mr. -'M. J. Ziouda Builder Same
Address �6051-4th Street N.E. Address i am .
LOCATION OF BUILDING
No. - 6051 Street — 4th 1K Street N _E _ Part of Lot
Lot KJ24,25 __ Block 3 Addition or Sub -Division _ Hyder park
Corner Lot w_ Inside Lot Setback _ - Sideyard
Sewer Elevation ___ ____ _.._ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 31.61 Depth _271 Height _101 Sq. Ft. cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Fst. Cost—._..y$1,390-OI — To be completed Rept 15, 1971
Provide Hardsurface3d Driveway
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 $— 23-00 , permit is hereby granted tom
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
AL 1`l.
NOTICE:
Me permit does not cover the construction, installation for wiring, plumbing, gas heating, rower or water. Be ams to sea
the Building inspector for separate permits for these iteam
Ll
Pi
B. H. BRADLEY
CIVIL ENGINEER AND SURVEYOR
8829 -24TH AVENUE SOUTH
MRONEtAPCL S. M111INE'6QPA 33008
724-2189
,Survry for 'like zlnudcl5'J 4 thf'
I hereby eerl.lfy Mcd this Is a corrcc� ofol.-ulveey of
fh lyortb y2 of tot 24 ars e1 a// of! c Z7 e'look- 3, 1 y de Rof t linok-Crfy;
Minn, IndLrdii?9 fl?e W%{ �7g Of VOCCIledO/%y 012CI.Wbjed fO 0 V illli�ts
6'afcMeOl OVO- Ale Wil %2 01', v1d VaWkd alleys as jwrveyecl b me
-I/e 91.0 day ofAugurl /x'70,
i11vey,or
I
4
i
I
I
APLICATION FOR RESIDENTIAL, ALTERATION, i
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: M - �� 7^ u a BUILDER:
ADDRESS:—(D. S I � �_k II ADDRESS
NO:. STREET : _ 4 -Z:?(, �L�!
LOT:1 ' LOCK: ADDITION:
CORNER LOT: INSIDE LOT: L/ SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As: 6/
j
Front: ,9®a Depth : 0 ` Height • l
Square Feet:-- , Cubic Feet: ,? S 3d,
,
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: i C� Estimated Cost:_$ ® C�
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� SIGNATURE:
(See Reverse Side For Additional Information.)
0
S ,33 9 3
City of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: Sep_teinber 1x_1971
Owner: _._ bike Zmuda Builder Same
Address __051 -4th s timet. N .F _ Address GamQ
LOCATION OF BUILDING
6051 4th Street N.E.
No. _ .__...___ Street _._. _ Part of Lot
Lot 4_24,25..._ Block Addition or Sub -Division —Hyfie .Bark
Corner Lot _.__._.__.__ Inside Lot _ _ Setback Sideyard
Sewer Elevation Foundation Elevation _..__.
DESCRIPTION OF BUILDING
To be Used as:
Garage _ _ Front 31'-6' Depth 271 Height 6' Sq. Ft. 850' Cu. Ft. 5103'
_F=c _ _..__ Front —aL— _ Depth 71 Height 0Sq. Ft. ___ 56, _ Cu. Ft. ___5601
Type of Construction — Est. Cost $._. 999 _ RO To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree tp do
the proposed work in accordance with the description above set forth and r' compliance with all provisions of
ordinances of the city of Fridley. I , �, .a� </
Inconsideration of the payment of a fee of $ 11100 , permit is hereby granted to Mike Zmuda
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
ivithin n� city limits and this permit may be revoked at any time upon violation of any of the pordinrovisions of said
a
Pspect.
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: 4a / 11,F 714# ,BUILDER :
ADDRESS :kas:/ 41 /" S %� ADDRESS • r
NO:. IA c I STREET: -'/
LOT: BLOCK : —3 ADDITION: T/i Ir to A&j
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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:
V, f AAaE Front: wt /®9i Depth: 2:) s Height:
Square Feet: Cubic Feet: �'� c?
aife Front: Depth: '7 Height:
-r
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:'$
To Be Completed: -_
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in edict accordance with tate City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: — SIGNATURE:
(See Reverse Side For Additional Information.) _f
I / . 0
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
November 9, 1977
Lke Zmuda
- 4th Street NE
:y, PMT 55432
Zr. Zmuda:
TELEPHONE ( 812)571-3450
T: INCOMPLETE GARAGE CONSTRUCTION AT 6051 - 4TH STREETNE
This letter is to confirm the conversation we had Monday after-
noon regarding your incomplete garage. I have checked the city
records and have determined that some items should be campleted
within 30 days:
1. Obtain a valid building permit to cmplete the siding
and any additional work. (Your second permit for this
structure expired on September 1, 1972.)
2. Include with your building permit application, a
letter assuring the city that the upper garage area
will not be used as a dwelling unit (see enclosed
letter dated August 10, 1971).
3. Cover the inompleted siding areas to make them secure
from weather and littering by December 8, 1977.
4. Provide this office with your plans for a schedule of
canpleting the siding along with your permit applica-
tion.
A re -inspection will be made on December 12, 1977, to check for
compliance. If you have any questions, please contact me at
571-3450, Ext. 166.
Sincerely,
CITY OF FRIDLEY
'��? z�-z
Ron Holden
Building Inspector
RH/grs
Enclosure
4�-T j'
a
B �
June 6, 1978
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Mike Zmuda
6051 - 4th Street N.E.
Fridley, MN 55432
TELEPHONE ( 612)571-3450
Registered Mail #495535
Re: Status of Work Without Permits - Dangerous Habitation '
Dear Mr. Zmuda:
During our inspection of your residence for rehabilitation grant funds
today, we noted some items which.must be taken care of immediately. The
items are as follows:
1. Obtain a plumbing permit and expose all work for a rough -in
inspection and air test by June 26, 1978. Failure to do so
will constitute a misdemeanor.
2. Renew the building permit for construction of the garage and
complete the exterior work by June 26, 1978. Failure to do
so will constitute a misdemeanor.
3. Immediately discontinue use of the garage attic area for
sleeping or any other human habitation (e..g. playroom,
sunroom, etc.)
4. Provide and maintain sufficient 30 gallon galvanized garbage
receptacles by June 26, 1978. Failure to do so will constitute
a misdemeanor.
If you have any questions on the above items, please contact me at
571-3450.
Sincerely,
Building Inspector
�I
74- CT
Pdit
0
C )%, 1 q7�?
u�--
}
/� ,� U
all
IME
suelEcr
PERMI
City of Fridley
4955
AT THE TOP OF THE TWINS
BUILDING
PERMIT
t �
R
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
t , ,
CITY HALL FRIDLEY 55432
REV.
DATE
PAGE OF
APPROVED BY
L•--- • •-J 612-560-3450
INUMBERI
910-F15
I 10/11/78
I
JOB ADDRESS 6051 - 4th Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
24,25
3
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mike Zmuda 6051 - 4th Street N.E.
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 [j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Side garage
9 CHANGE OF USE FROM TO
STIPULATIONS
.� -7 �rJYd�lsQC �il-�fi i�E
-rte
/�1�� l "�f6
� 9
G40 i— coyfele
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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR 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,
$$`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 ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$750
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHE FEE
TOTALFEE
$8.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED A NT (DATE)
W Fy P RLY VALIDATED THIS IS YOUR PERMIT
�6�,
BLDG )NSP
Q
DATE
SIGNATUREO WNERI)VNER BUILDER) (DATE)
IME
CITY OF FRIllLEY ,
APPLICATION FOR RESMENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
�/
OWNER:'/,
�e� Z�%l./�� � I3UILUER:
Address: 4`h �%� . Address:
Tel. No.:
No. .- Street: `i` S7'
LOT: BLOCY.: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
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. See reverse side for additional information.
DATE: �!� SIGNATURE:
Stipulations: U
7� v
. Sum
OC)
DESCRIPTION
OF BUILDING
To Be Used As:
Front:
Depth:
Height:
Square Feet:
Cubic Feet:
Front:
Depth:
Height:
'
Square Feet:
Cubic Feet:
Type of Construction:
Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Prdposed Driveway Width If New Opening
Is Desired
$ $
(SEE
REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: �!� SIGNATURE:
Stipulations: U
7� v
. Sum
OC)
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PEFMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
h'umber Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Stater Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each add. $100.00 or fraction
I
NO.
RATE
TOTAL
X
$3.00
$ �SC�
x
$2.00
. `-x
$2.00
S
x
$5.00
$
x
$5.00
$
X
$10.00
$
---x
$7.00
_
$
[a
$5.00
o
q
ro ►+
a
w
rWater
Heate
A3.00
$
$1.00
$
w
$
'�
$
State Surcharge
$ .50
w
$ /L2)
a
8
o
i
to
01
°
a
i
g
v o
w
v
as
cy'
1st
2nd
3rd
4 th
(R) - Future Connection Opening
Connected with Sewer
(•) - New Fixture, old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
h'umber Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Stater Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each add. $100.00 or fraction
I
NO.
RATE
TOTAL
X
$3.00
$ �SC�
x
$2.00
. `-x
$2.00
S
x
$5.00
$
x
$5.00
$
X
$10.00
$
---x
$7.00
_
$
=x
$5.00
$
"a
$5.00
$
x
A3.00
$
$1.00
$
$5.00
$
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ /L2)
REINSPECTION FEE
(510.00)
Job Address _ (11
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this appl cation are true and correct
Fridley, Mn. , 19�
OWNER U1 itE 1441y 46/4A)!Z) W /n u4od
KIND OF BUILDING H6 U►�
USED AS
TO BE COMPLETED ABOUT %a - 7
.ESTIMATED COST��� ,
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company ° ' t i r► ASSJ 0 tik [I w Jf . n j +
Signed By
Tel. No.
ROUGH INSP.
Date
e'
f'P
FINAL INSP.
Date
APPROVAL -FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.SO PLUS $.So STATE SORCBA M
SUBJECT
MIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
/1-1
CEIPT NO
• COMMUNITY DEVELOPMENT DIV.��
INSPECTION
r � PROTECTIVE SEC. ,
1 �
� /"'1 CITY HALL FRIDLEY 55432
IL
NUMBER
REV. DATE
PAGE OF
APPROVED BY
L"" A., -'j 612-560-3450
910-F15
10/25/78
JOB ADDRESS 6051 - 4th Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
24,25
3
Hyde Park SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Mike Zmuda 6051- 4th Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Decor Builders Inc. 2455 Bunker Lake Blvd, 757-1341
-'7ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
—T -CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�
8 DESCRIBE WORK
Finish basement
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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 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
$5,000
$3.00
xgxx
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-
$30.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
xqg-d�d//
$33.00
IGNATURE OF CCUACTOR OR AUTHVfIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
FZBLDG INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
• i . 9.=��rrmn�.
• CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PE11141TS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: i ll I ICC 4WD 40j4u.4
Z rn q ®4
BUILDER:
,c �t+
Address: � �� �
(Q ,
J4 T �• F�
Address:
-R1q55 BkVileft
Tel. No.:
--'7 51 - l 34 / _
No. ;
Street:
LOT: V 1, a 5
BLOCK: �_
ADDITION:
14' '0
CORNER LOT:
INSIDE LOT:
SETBACK: SIDEYARDS:
Applicant attach 'to this form Tvvo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
E//vo�H�� l�/ff>PE�%Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: �/'� ®/��L/A1� Estimated Cost: $
To Be Completed: / / - 7 Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. 'See reverse side for additional information.
e
DATE: SIGNATURE:
Stipulations:
3o, o o �K
� 3ud
11
97'8? -879001 ItFPLI�itT10Pl FOR PWIiDINka All Ens FITTING Pt:I r
11.3 t e r
11catar
eC
Job Address 6051 NE 4 Street
Dtpartmrnt c -f b-.1.12:1ij,r
Ci Ly c.t I'rldI.y
Tel. 1571-1450
Tl,a undnrnlgll, ,i h:lety r. akca a(Fll:at:a- r
e %:rn.iL t.:t Lt.: work I,etc11,
epnclfled oglcclny LQ d;: e:1 work in stria tL1 City C.Cca
I and rulin•1s cf the Dc!;arurcnr of eai:dir.
JS. -ete[r . c.:lactr LIAL al!
i{ rho faclil o.rd ra r,s,., taltoni ec�tuS
• •.•.:cart:,. :ra tlyo
6-26-80
1,
1 I••t•Ite C..nnc,;LIQrJ G ;:ntr. I
b C:..:.m.Led -.S,Lt1 Stsrer
I r -c- t latute, CLS Ol:cr.:,.� Hatar I
rl -.. !•I1: JhL k-TL.z
11..,: n 1 twl..Cet1
»e• I,.t.Ite, ";Id opc%1:.a
�It.i. aasln
Ialtt 'IcaLut - l0 Si.C;10 bits
11-0.000 tall LO 1y ;L3 b16
LLar a.,fLenac
lew C -9 --and R -in Old b.6/1.11r.1
lc�La►� watcc llaaiac
I-III11;G tM;
lal I eawLaleti •
,.LtatIwa&l 11ALuttu
-Ia 1..• -Ie La Is(A.G0a bIU
I'Aln-1 6 A1,Ti1L.T1u;15
it.at )IOU.04
ta.1. •s1. 11:,.,.o0 r fra.ual,
tiu. RATE TOTIAL
x
a•
;
,.
$2.00
ice_
—^
x
; 2.00
S
IX
;5. c0
;
ni
i
IY ,
LA
t 11 J
ii � .&
;5. 00
� (.J S i
...__
$ 5.00
;
x
;3.00
;
R
$1.00
g �—
x
$10.00
s �_
11.3 t e r
11catar
eC
Job Address 6051 NE 4 Street
Dtpartmrnt c -f b-.1.12:1ij,r
Ci Ly c.t I'rldI.y
Tel. 1571-1450
Tl,a undnrnlgll, ,i h:lety r. akca a(Fll:at:a- r
e %:rn.iL t.:t Lt.: work I,etc11,
epnclfled oglcclny LQ d;: e:1 work in stria tL1 City C.Cca
I and rulin•1s cf the Dc!;arurcnr of eai:dir.
JS. -ete[r . c.:lactr LIAL al!
i{ rho faclil o.rd ra r,s,., taltoni ec�tuS
• •.•.:cart:,. :ra tlyo
6-26-80
1,
1 I••t•Ite C..nnc,;LIQrJ G ;:ntr. I
b C:..:.m.Led -.S,Lt1 Stsrer
I r -c- t latute, CLS Ol:cr.:,.� Hatar I
rl -.. !•I1: JhL k-TL.z
11..,: n 1 twl..Cet1
»e• I,.t.Ite, ";Id opc%1:.a
�It.i. aasln
Ialtt 'IcaLut - l0 Si.C;10 bits
11-0.000 tall LO 1y ;L3 b16
LLar a.,fLenac
lew C -9 --and R -in Old b.6/1.11r.1
lc�La►� watcc llaaiac
I-III11;G tM;
lal I eawLaleti •
,.LtatIwa&l 11ALuttu
-Ia 1..• -Ie La Is(A.G0a bIU
I'Aln-1 6 A1,Ti1L.T1u;15
it.at )IOU.04
ta.1. •s1. 11:,.,.o0 r fra.ual,
tiu. RATE TOTIAL
x
$3.00
;
x
$2.00
ice_
—^
x
; 2.00
S
x
;5. c0
;
;10.00
i
x
47.00
x
;5. 00
...__
$ 5.00
;
x
;3.00
;
R
$1.00
g �—
x
$10.00
s �_
SS.00 , g
S2.GJ S
Sola S.rcr.atga S
.-,,.L — L r 10.50
MINER DOUG'S TV.
KIND OF ItUIL;,I;.,! Rframe
USED AS r2s .
TO BE C011I•U U5 Is,.Lr 7-3-90
ESTINATLD COST 50,00
OLD - t1Clt NZ. fr.�
s►yne.1 Ey
ROUGH I rISN .
Da La
rIlmL I,hp. _(I, —Y--kp
Oct.
AI.1•RUVAL t (,h 1•L11r1I 1-
NIUIMUtI t•CI,.Ir Ii S%.:J FLUS S.:D ::t•.TC 6UkMLA.11LC
J
SUBJECT
PE2
City of Fridley
218 0
AT THE TOP OF THE TWINS
BUILDING
PERMIT
t
_ COMMUNITY DEVELOPMENT DIV.
fr
PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
11L"""
j4., �'i 612-571-3450
910-F15
10/14/93
JOB ADDRESS 60.51 4th Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
pt 24, 25
3
H de Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Joanne Zmuda 6051 4th Street NE
571-2241
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (Tear-off) 15 Squares
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the
State Building Code. Provide adequate
attic ventilation. Provide smoke detectors
as per UBC 1210 adjacent to all sleeping
areas and in basement.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED 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 80 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
SURTAXC1. 00
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2,000
Fir SC$2 . 0
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-
$45.00
N/A
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
N/A
$48.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI]
WHW OPERL LIDATED THIS IS YOURPERMIT
LL
OG QL
DATE
i N TUBE OF OWNER OF OWNER BDERI IDATEI
J
NEW [ I
ADDN [] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Addres
Legal Description:
Effective 5126/93
Owner Name & Address: gP, Tel. # Vr) I
Contractor: MN LICENSE #
v
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �.�-c-ivz� 1 �,,� - e�%✓�, %
Corner Lot [ l Inside Lot [y" Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Side Yard Setbacks
Estimated Cost: $ ` )- 0—
(Cost on Back)
Ft x $ - $
DATE: v 4 _ 3 APPLICANT: Tel. # S�- 7
Permit Fee $ C D
Fire Surcharge
$ - 00
State Surcharge
$ / C
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )
STIPULATIONS:
SUBJECT
City of Fridley
(
16703
AT THE TOP OF THE TWINS
BUILDING PERMIf
2
r
COMMUNITY DEVELOPMENT DIV.
t✓ PROTECTIVE INSPECTION SEC.
�� ��
NUMBER
REV
DATE
PAGE OFAPPROVED
BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/16/98
JOB ADDRESS
6051 4th St NE
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt. 24 al 25 3
Hyde Park -SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert & Joanne Zmuda
571-2241
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Twin City Exteriors Co 9060 Zachary LN N429-4737
2999
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 2] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Storm Damage Repair
9 CHANGE OF USE FROM
TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
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
License SC 5.00
27.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHEN PROPE RLVFJPALI DATED THIS IS YOUR PERMIT
BLDC4 INSF' MATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ 1 Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 63
ConstructionAddress:_�/
Legal Description:
Owner Name & Address:
Contract
Address:
Tel. # , e5_17/ — R.0g1
ENSE #
Tel.#
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF ZWROVEMENT
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: 5j;,;" `4 f}�G4k&_stima�tw Cost: $ 6�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x' $ _ $
DATE: 7=/4 -9 EL APPLICANT: Tel. # ,5--
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $950 per SAC Unit
License Surcharge $ _ _ J? $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
•$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
-
SUBJECT
NO.
City of Fridley
2 7 4 3 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
R O.
_ COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L •/� 612-571-3450
910415
8/27/98
JOB ADDRESS
I LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
`411
ift.
SHEET
2 PROPERTY OWNER MAIL ADDRESS
Joanne �_Iudq
ZIP
PHONE
571-22141
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
-
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 (31 SO Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Contractor has no State license to do residential work.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2585.40
$1.29
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.
$74.75
Fire SC $2.59
PLAN CHECK FEE
TOTAL FEE
A ?X7'CLq
WT.9"I.F�.TRMORIZEDAGENT
Licen -1,91$5.00
83.6
(OATEI
R PERLY
BLDG P
ATED T S V PER
r
MATE
SIGNATURE OF OWNER I IF OWNER BUILDER) MATE)
J
NEW_ 1. ]
ADDN e' ]
ALTER [ ]
ConstructionAddress :
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
\-I J3 -
Effective 1/1/98
Owner Name & Address: Tel. #
Contractor: `7(ajon MN LICENSE #
-01
Address: Apar it'd ��-5�1 '_ �Sv , � ���1��- Tel. # -'?gam-Ua(o$
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E%1PROVEM ENT
LIVING AREA:
Length Width
Height
Sq. Ft.
GARAGE AREA:
Length Width
Height
Sq. Ft.
DECK AREA:
Length Width
Hgt/Ground
Sq. Ft.
OTHER:
ve
Construction Tyrer
4 Gnj rq� r�r
Estimated Cost: $
(Fee Schedule on
Back)
Driveway Curb Cut Width Needed:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Ft. + 6 Ft = Ft x $
CITY USE ONLY
$ -74/.75" Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ Z cJ $.50/$1,000 Valuation
$ $1000 per SAC Unit
i
$ 00 $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )