PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
N° 2372
SII
Date ,/• •�% .+;.......................... .
Owner)W ................ Builder ...........................................
I '
Address .. {(. � ... 'd'L�?k. ' ,-4 • •-ff,-jAddress.........................................
LOCTI N OF BUILDING
I�
No....fa.. Street ... ........ ........................... Part of Lot
. .......................
Lot ......$t':�.. I: Block ..3 ............ Addition or Sub -Division We4 .p�.f.. ..........
iI a.
Corner Lot ........i.... Inside Lot ...W...... Setback .. ? ''�! �,rSideyard .�l�i .,ei�l�....r�.........
DESCRIPTION OF BUILDING
To be Used as: i!
Frontjp... Depth .aZ .. Height !.�'�... Sq. Ft. 7f'elf. Cu. Ft.........
.................. Front ........ Depth ........Height ......... Sq. F't......... Cu. Ft........ .
Type of Constructio# y 4A*" d Est. Cost ../�.�A ............ To be Completed ...................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the. description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
............
In consideratioz'.' of the payment of a fee of $..f:. , permit jh hereby granted to ... ..........
to construct the building or addition as described above. This p . t is granted upon
fexpWr'esss ondi 4 t 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 village limitsiIand this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit oes not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. a sure to see the Building Inspector, for separate permits for these Items.
III •
City of Fridley, Minn.
BUILDING PERMIT
Date: 41
Owner: _ �4 ,f,�t,suilaer .........
Address .... y, - , F w Address±.._._. __.._..._..._.._.._
LO 1 OF BUILDING
No. �.-%. Street _.,�:..�,��:-:�:,r..._....,E:_...._.....___._._..._..._ Part oR ut ......
_ __ :_
/�" +. •--........._......._....... Addition or Sub v ... � ... ' .. T
Lot ....... 4+'.:. r+...... Block .----_.;F -- ivisi n
Corner Lot...._. ..........._...._......_
Inside Lot ..... _.........---- ................: Setback
,�
►--.......----••------------- ......._......._-
Sewer Elevation _..._..._.._ .................. __.___......._..______...._......._..._.._._ Foundation evation
DESCRIPTION OF BUILDING
To beUqpd as;-' -- �y _ '� ,�
Depth,,:? d ...::.... Front _-••_-. Depth_., _ Height
�g
Sq. Ft..4i2-
........................
- Cu.
- ...........- ..-:.__....... ........... From. _.. Depth ....._.. eight s . Ft. ...................... Cu. Ft. ..
Type of Construction ""2'-.. Est. Cost ..:.......,._:.... To be Completed ............... _._.._..........................
C,SUTI N
THIS PERMIT DOES NOT AUTHORIZE VIOLAT•
ION D ni,1 pj ._
L'UILL;`-JNID COVENANTS AND
1; 'G ';EST1,1„ 'ONS.
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 $. e` .° "_i �.._...., permit Is hereby granted to ---- ------------- --------------
- _ ------ _ ..__ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon vition of- any of the provisions of said
ordinances. .11 A
Inspector
NOTICE:
This permit does not lover the construction, Installation for wiring, plumbing, 'gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
orI
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�2,-) /-/ 11-6-�
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name ilder .�
Address Address -
LOCATION OF BUILDING
No. /Z Street % Part of Lot
Lot Block Addition or Sub.Div.�_+,�,
Corner Lot Inside Lot_,_„ Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUIMING
To be used as:
4 ont Depth zHeight ,i/6
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Construction 2.64 .) Estimated Cost
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE����_ SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
., . . .0 • r
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CL
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
Bbllh Wash Floor Auto.
�.�:..
Urinal Tufa Shower 'Srhk : Tray011r1t;..;. Drain �6>I11n' Washer
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
New Fixtures
$7. 00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Slow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
W Sump/Receiving Tank
$ 7.OD
Water Treating Appliance
$10.00
rr Water Heater -Electric
'�
87.00
Water Heater — Gas**
$10.00
>_ Gas Range**
$10.00
Gas Dryer"*
$10.00
Back Flow Preventer Required ( )Yes
() No
Type
$15.00
Reinspection Fee $42,00/Hr
v
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
t�v
TOTAL. FEE
$ .50
Effective On March 1, 1996
Gas Mtwater Heater
> Gas Elec
JOB ADDRESS JW'/ ,2
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 c rect.
�
Owner IT� /- C®JPlo f✓ -.6e
72 -ogcaq
Building Used As
Estimated Cost ..� �✓ `` -
PERM11' NO.
PLUMBING M
SIGNED BY TEL�NO.4A
Approved By �C(� Rough -In Date Final Date
$ ®� s6 MINIMUM r•tt HUft ANY PLUMBINCaI
PLUS THE .5o STATE SURCHARGE
*"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 80 INCHES.
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F-
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 30.00 $
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $10.00 $
Gas Dryer $10.00 $
*Air Conditioning — All Sizes $ 25.00 $�
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work $
Commercial/industrial
1.25% of Value of Appliance or Work $
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING1COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS 125.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On March 1, 1996
JOB ADDRESS 561A E4k) 5+ • Or
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 orrect.
�i� _ 1996
OWNER F04h CV®sser
BUILDING USED AS 41J)P.I J 1 W
C J nn
ESTIMATED COST �� o PERMIT NO. `Z2/c)
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEA ING COMPANY BLAINE HTQ. Aic
ANOKA. MN A5y Q N.E.
Si ed 8f -A A Tel No.
15-?—(a�
Approved By
FILL OUT BACK SIDE FOR
REPLACEMENT FURNACE
Rough—In Date
STACK VERIFICATION ON
Final Date
t"�
y
CHEMMY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
Yes ()
No (
)
2. Is free from Hist 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's connected
Yes ()
No (
)
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
Yes ()
No (
)
8. Has combustion air been provided for water heater
Yes ()
No (
)
Remarks:
List ALTERATIONS Being Done:
H,
77
,.'
i�ZLa
HEATING CO:
Signed By:
a
Date:
SUBJECT
P•E"RIfi-E?�
City of Fridley
Q
2 5 5 0 8J
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
�
r 1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/16/97
JOB ADDRESS 5612 5 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9,10
3
Hamilton's Addn To Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Faith Crosser 5612 5 Street NE
586-0854
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Windgate Inc 3810 Rum River Dr, Anoka MN 55303
4229592 1389
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
B DESCRIBE WORK
Reside House (Vinyl)
9 CHANGE OF USE FROM TO
STIPULATIONS Install building wrap and have inspection of same unless
manufacturer's specifications state it is not required.
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
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
$7,000
$3'50
WITH WHETH SPECIFIED HEREIN R NOT. THE GRANTING OF A PERMIT
DOES NOT SOME TO GIVE ORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI S F ANY OTHER TE OFYLOCAL LAW REGULATING CON-
$124.75
Fire SC $7.00
STRUC I OR THE PERFO NCE O CONSTRUCTION.
IF XPLAN
CHECK FEE
TOTA KEE
oe
Lice C $5.
$140.25
N ONTRACTOR O AU A AGE T (DATE)
E PROP VALIDA
8 G )NSP
D HIS IS Yoj IM PERM T
qA E
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATEi
NEW [ J Effective 1/1/97
ADDN [ J CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY. AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION(
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Address: 44904�,
Tel. #
MN LICENSE # 1389
i7
Tel. #9a
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: o/a&j t�i9yl�� /�lyg Estimated Cost: $
r
(Fee S e/dule.on Back)
Driveway Curb Cut ,Width Needed: Ft. + 6 Ft $
DATE: !I( - APPLICANT:
CITY USE ONLY
Permit Fee $ : f S Fee Schedule on Reverse Side
Fire Surcharge $ ,L'C.� .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $950 per SAC Unit
License Surcharge $ �, �` L,' $5.00 (State Licensed Residential Contractors)
3riveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ -$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessaryf ] Not Necessary [ J
TOTAL $ / �_/e,
iTIPULATJOi\'S:
SUBJECT
PER
City of Fridley
T764 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
1 L• _ COMMUNITY DEVELOPMENT DIV.
v
PROTECTIVE INSPECTION SEC.
,
NUMBER
REV
DATE
PAGE OF
APPROVED 8V
_
CITY HALL FRIDLEY 55432
612-571-3450
910415
9/9
/9 / 98
10B ADDRESS
5612 5th St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
9-10(N3/4
3
Hamiltons
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Faith Crosser 5612 5th St NE
55432 586-0854
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Four Seasons Roofing & Rem d 7930 UniversityE Fridley55434
795-941020138780
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house & ara 20S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$1, 714.00
$.86
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
PR ISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$56.75
Fire SC $1.71
STRU ����THF vFRFnRMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FE /
Licen S
$5.0$
:32
SIGNATUAEOF-MTRA(CXORAUA40RIZEDAGENT IDATEI
N P OPLIDATED
S IS Y PERMIT
Ur
BL INSP
•//�r
GATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
[ ] Effective 1/1%98
CITY OF FRIDLEY
SINGL` E FAMILY AND DUPLEXES R-1 AND R-2 47
BUILDING PERMIT APPLICATION
,. -: LructionAddress:
IIS—•
Description;:
Name 'r Address: ,raA'{A S�; e'— _5& 1 a 56h S+ N e_ Tel.
_ f r:, �LS1 [ .c C: MN LICENSE
�_ ss:�^�i �l�tUP•t3[�ii_ �U�. /l!� Frtc!(�_ Tel.# Ig l�iy
�a
Attach`'"to this 'application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
AZ�EA: Length _-'Width Height Sq. Ft.
AREA: Length Width Height Sq. Ft.
v CK' AREA: Length w Width Hgt/Ground Sq. F,t.
HER:
e $
....�:ru�tioci Type: ��-t.'.¢� " Estimated Cost:
(Fee Schedule on Back). t
ray Curb Cut Width'Needed a, ' Ft:
ZAPPLICANT:��-'.-'. Tel. #
f
CITY USE (,ONLY
_ ...... $
Fee Schedule on Reverse Side
hee
of Permit Valuation (1/10th%)
:star Surcharge . $ $.501$1;000 Valuation {
SAC Chargeer SAC Unit } ;
Li-: cnse Surcharge $5.00 (State Licensed Residential Contractors) tF ,
!, :: Y c W ay Escrow $ - =Alt. A or' Alt. B Above r
h , r
u�iun Control $ ` 1$450.00 Conservation Plan Review a`
`Fee Determined by Engineering
Main Charge , ' $ w x 4 " ; Agreement Necessary [ ]. Not Necessary
a
TOTAL
h °,n
S` fPULATIONS:
I b�
op
4 Al
�
fi�51
.:
mss/zs laglk�
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (7 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:J (n -
Legal Description:
Owner Name & Address: Tk%� �- 1 /1 �D 5S 61 a, Tel. #–,f
Contractor: MN LICENSE # (jo
Address: S61'l(,Djji( t� J JJ-nMj i , e 564X Tel. # Cf62--g'7— I Lo 13
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
oq.. 6y
Construction Type: � Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 4 to APPLICANT: Tel. # 45Z '6%'] I c0
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
$TIATIONS.
c