PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Mi.
N° 2373
Minn.N?
Date ........~df !................
t�
Owner.. l .r�,�?`1,�,.,11�i-iI�F":3;.�!'� ...... Builder-�C'!`+~ ✓ .......................
Address ..t .�.. X ��++y...10711C... Address .......................
LOtAT ON OF BUILDING
No. ...� I. Street ... ..................... Part of Lot .......................
Lot ... Block ... ........ Addition or Sub -Division . �� �.diGf�q .. d.....
Corner Lot ....... .... Inside Lot .. 4........ Setback �►i 4`+,f.# . Sideyard ..........................
11
DESCRIPTION OF BUILDING
To be Used as:
o.Of
. .. Front P3110.... Depth . S�r� �. Height �. � � ... Sq. Ft......... Cu. Ft........ .
............... z .. al . Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft........ .
Type of Construction,x94- 4.".. Est Cost .'42,00-0 .,........ To be Completed e..
l
I'
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 village of Fridley.
il
In consideration!of the payment of a fee of $.I.+tow .. , PermJ is hereby granted to ..... ............ .
�,�f,Il,►��I Q,!... to construct the building or addition as described above. This p t is granted upon
the express c ditiar# that the person to whom it is granted and his agents, employees an 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 village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances, r. ...
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
•
0
L J
City of Fridley, Minn.
BUILDING PERMIT
Dates — Nov. 7, 1967
Owner: _ Terry Ferrard Builder Inter City_Blders
Address 5608 5th St. N. E. Address 35 Hwy 10
�Io o 7,3
No 9544
LOCATION OF BUILDING
No. 5608 Street ____ 5th S t . N. E. Part of Lot
Lot 10,11,12_ Block 3 _ Addition or Sub -Division __ Hamiltons Addn. to Mechanicsville
Corner Lot ---- Inside Lot .... Setback
Sewer Elevation
Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 20' Depth _ 22' Height — 10, Sq. Ft. 440 Cu, Ft. 4+00
Front Depth _ _ Height _ __ Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost — --- To be Completed
$1550.00
In consideration of the issuance to me of a permit to construct theding described above, I agree to do
the proposed work in accordance with the description above set forth and mpliance with all provisions of
ordinances of the city of Fridley. 4
In consideration of the payment of a fee of $----L. 00 , permit is hereby granted to— Inter City Blders
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 buildiags
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE
Building Inspector
NOTICE:
Uls permit doss not cover the construction, installation for whine, plumbing, gas heating, sower or water. Be sure to see
the Building hrspeetor for separate permits for these Meme.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIULEY, MINNESOTA
OWNER'S NAME BUILDER .. .T fLC�G/�ts
ADDRESS �� a ,� .
116.4-409 S'T'REET �1 ART ' bF Or
� to ii iz
LOTADDITION OR SUBDIVISION�h,�Ill-I'l-Lo USA4-4, To
C0 NEk'LO1k------ �IRSIDEI LOT _SE'MACR
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Cestifices o
stA•Survey,of Lpt and,pra�aped
.building'..Ideation diaiwc!dn these Ce ti°fidgtee '
Front. L� neptb._ Height
Ft. Cu. Ft. �00
.Aeptt ,,r...: .Hecht
Y
Sq. Ft.
Type of Constructiraii' 1 A EstimateCost00
To Be Completed p. - G .
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 truce and correct.
DATF-
(Schedule of Fee Costs can be found on thever a Side).
let
z;1
SUBJECT
P
City of Fridley
5
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV
16
PROTECTIVE INSPECTION SEC
1
I
NUMBER
REV
DATE
PAGE OF
APPROVED By
1
1 CITY HALL FRIDLEY 55432
�.J
612-571-3450
910-F15
10/3/95
JOB ADDRESS 5608 5 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
11-12
3
Hamilton's Addn to Mechanicsville SHEET
I
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Jex 5608 5 Street NE
571-8288
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 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors as per UBC - adjacent to all sleeping areas
and in basement.
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 IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
I STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,500
$.75
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
$48.50
Fire SC 1.50
PLAN CHECK FEE
TOTAL FEE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPEPRY VALIDATED THIS IS YOUR PERMI
B G INSP
MATE
GNA- O NE OWNER BUILDERI IDATEI
NEW [ ] Effective 8/1/95
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: — h n
Legal Description:
Owner Name & Address: hx--nni n Tel. # 5-7 1— ov Zs�)'b
Contractor:
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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Grouund Sq. Ft.
OTHER: K) I K )JY)\ -k I QMV1 ACl--7Vt E --AI I C1 K 71-2 y S31q-�
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: _
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ 4 t`QjL1 r CIO
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ , 10 Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ , $.50/$1,000 Valuation
$ $850 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 [ l
a
SUBJECT
City of Fridley
7'489
AT THE TOP OF THE TWINS
BUILDING
PERMIT
I
RECEIPT NO.
Ir
�
• _ COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC
r
NUMBER
REV
DATE
PAGE OF
_
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/19/96
JOB ADDRESS 5608 5 Street NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
10-12
3
Hamilton's
Addition to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Jex 5608 5 Street NE
571-8288
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 19'6" x 12' Deck
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
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
@
$1,889
$.94
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
$62.33
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHENPER V�ED THIS IS YOUR PERMIT
I/
tel! �V • �Y/ fY — �� f
W
BLGt INSP
—
BATE
SIGNATURE OF OW R IIF OWNER BUILDERI IDATEI
a
NEW j ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 5�� -- 7'� 1 �}
Legal Description:
Owner Name & Address: Tel. #
Contractor: MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEAHM
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width 12-' HgtlGround ZO a Sq. Ft.
Comer Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date:
Ft. Yd Setback
Driveway Curb Cut Width Needed:
DATE: APPLICANT:
Side Yard Setbacks
Estimated Cost: $
(Cost on Back)
Ft. + 6 Ft = Ft x $
Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$,j ()
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ m
$.50/$1,000 Valuation
SAC Charge
$
$900 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
$ �2. �3
STIPULATIONS:
BOW
No---]
)IN
Ap�
- MbL "Ma
loop "A
WHO
WS!
%'1
f
■■
■
9
SUBJECT
P
City of Fridley
2 8 5 39
AT THE TOP OF THE TWINS
BUILDING
PERMIT
%572 NC
O
_ _ MMUNITY DEVELOPMENT DIV.
r L PROTECTIVE INSPECTION SEC
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
111/5/98
JOB ADDRESS
5608 5th Street NE
1LEGAL
LOT NQt • 10
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11,12
3
Hamiltons Addition to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Jex
571-8288
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION f;k REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace windows and sheet rock
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install smoke detectors to meet the State Building Code -
in each sleeping
room and on each level of house.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
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
$625
$.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
$26.50
Fire SC $.62
PLAN CHECK FEE
TOT/ F E
$ .62
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATE,
E P
H�
V L1D T D HIS IS PERMI
V 1 / ! IT
i1
S-GNATURE OF OWNERSIF OWNE BUILDERi 1DATEi
BAG INSD
gAtE
9
NEW
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
.azo v 5 s -Tr., 5- - Y1,
Effective 1/1/98
< Mki -3�s13Z
Owner Name & Address: S Tel. # S---� - 8�
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
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
W I NDbLQS StUAtJ�
Construction Type: 1��) stimated Cost: $ Cp Z5
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: P - -5�" � y
APPLICANT: �� Tel. #
Permit Fee
$
Fire Surcharge
$ ,
State Surcharge
$
• tjy
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 [ ]
SUBJECT
P MIT NO.
City of Fridley
30285
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
T ,
'RECIEIM—NO.
COMMUNITY DEVELOPMENT DIV.
,
j PROTECTIVE INSPECTION SEC,
1
1/C,Jt�/
067
1
NUMBER
REV
DATE ,23/9
TE
PAGE Of
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 5608 5th Street 1VE
1 LEGAL
LOT NOp t 10,
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
.
11.12
3
Addition tcl Mechanicsville
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kelly Jex
-
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Midwest Roofing & Siding 18979 Gladstone
-
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
O NEW 0 ADDITION 0 ALTERATION x® REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Re -roof house and garageTeggr-off
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
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
'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
$1923
.96
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
69.25
Fine SC $1.92
PLAN CHECK FEE
FEE
Licens 5 00/
1;7
7. 13
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI
NEN ROP VALID D THIS 1R PERMI
/ IO
S-GNATURE OF OWNEAoF OWNER BUILDER, IOATEi
BL IN$ r AiE
NEWT ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FA 13LY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
b� Oo
Construction Address:
-th S -L 0& J n
Legal Description: 911 - I lt)�
Owner Name & Address: E V S & D �? S+-'? 51d Tel. # S71— 2
Contractor:M-Awezi( 1 MN LICENSE #0001 W-7 �
Address:bjn(-f'EJMJ[ Tel. #
Attach to this application, a Certificate of Survey of --- n
lot, with the proposed construction drawn on it to scale.
DESCRLPTI TON OF IPORROVE,�NT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground S . Ft.
OTHER: 2 aC
- baL4Q �UCLQ'a--Construction Type: %timated Cost: $ 1/
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:Tj!�APPLICANT:(JM AWTel. # ill&
CITY USE ONLY
Permit Fee $ Z-�Fee Schedule on Reverse Side
Fire Surcharge $ q9- .001 of Permit Valuation (1/10th%)
State Surcharge $ o ' (p $.50/$1,000 Valuation
SAC Charge $ $1050 per SAC Unit
License Surcharge $ 5.00 $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS: /�
SUBJECT
P
City of Fridley
3033 1
AT THE TOP OF THE TWINS
?
BUILDING
PERMIT
r
:
RVUEFOTT NO.
1.0
COMMUNITY DEVELOPMENT DIV.
tr ______
d � PROTECTIVE INSPECTION SEC
I "'S CITY HALL FRIDLEY 55432
NUMBED
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
9�o-F15
10/1/99
10B ADDRESS 5608 5th Street NE
I LEGALLOT
NO.pt . 10
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11-12
1 3
Hamiltons Addition to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dennis Jex
5-71-8288
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Owner
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION MR REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK
Window replacement
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the house.
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 1 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
$1000
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$38.75
F SC 1.00
PLAN CHECK F
FEE
;TrAL
40.25
,SIGN ynnATURE OF CON 7RACTORORAUTHORIZED AGENT � iDATEi �
Jr
HE P
Y VAU
THISIS YOUR PER1T
SGN4 TUBE O� OW NE A.1 OWNER BUILDER. iDATEi
SLAG INS
QA I
NEW[ Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY ®#'
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 r j
BUELDING PERMIT APPLICATION
Construction Address: 5 (6,C'B — �s� Z
Legal Description:
Owner Name & Address: IJP) S Tel. #
Contractor: IvlX MN LICENSE # -
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
.�Construction Type:1 t�� (0 N W(ALWE&Pstimated Cost: $ 1 DODO .
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: G l APPLICANT: Tel. Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
E5
S�
Sewer Main Charge $
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
"'Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
Building PLUMBING Permit NoMJUL720(9
Inspections RESIDENTIAL APPLICATION Received
763-572-3604 CITY OF FRIDLEY Date% ' �
763-502-4977 FAX EFFECTIVE 2-19-09
FDAT0723/09YOURS-MAILADDRESS wnelson�larsonplumbing.com
DRESS 5608 5th St NE
THIS APPLICANT IS: 0 OWNER 09CONTRACTOR
PROPERTY NAME: Dennis Jex
OWNER/ ADDRESS. -_5608 5th St NE
TENANTCITY Fridley STATE NZIP 5
PHONE: 763-205-4270
CONTRACTOR NAME: Larson Plumbin Inc
SUBMIT A COPY OF
YOUR STATE STATE LICENSE * 58757 ( 3341) EXP DATE
LICENSE, BOND AND STATE BOND # EXPDATE
CERTIFICATE OF ADDRESS: 3095162nd Lane NW CITY Andover STATE MN ZIP 55304
INSURANCE PHONE 768-427-7680 FAX 763-427-9448
PERMIT TYPE IN SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE
TYPE OF WORK: 0 NEW 19 REPLACEMENT
DETAILED DESCRIPTION OF WORK Replace Water Heater
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER: OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING
_—BATHTUB _GAS PIPING (NEED CITY LIC) —SWIMMING POOL _ WATER SOFTNER($
_CLOTHES WASHER _KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. $I )
DISHWASHER_LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER _OTHER
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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 codes 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 ' the case of4H-work which requires review and approval of plans.. n
SIGNATURE OF APPLICAN PRINT NAME M LC� a -e ( 9' nV OL (t Y-tJ L6ATE 07/23/09
�• } ?O E i `l~ ' l l S. A �1 . YJ t ir31 Z"91`UY%,D NGs:Ei,EC TC L A �C t` '• � r 1 �Nv
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, DAN 55432
763-572-3604
FAX: 763-502-4977