PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date:-SEPTENIM..9,.._1.9_.?9_.._.__.._......................... _.
Owner:
Address
N° 4206
Builder UN.ION._.BUILDERS, INC.
...................
Address -_101/+ Plymouth Avenue North
Minneapolis., Minnesota
LOCATION OF BUILDING
No. ....... 5..01 ............. street ....................... 5th ._Street....N.,e..._Ee...................................... Part of Lot ....................... ... _... _.......................
__..._.._ _
.............. Addition or Sub -Division ...............Bennett...Palm.er........_.............-.....,.,.....-•
Lot ........9 ..............._.. • Block ..................._�............. ....
Corner Lot .................................... Inside Lot ................ ...._X............ Setback ..... _......... 351 .............. .. Sideyard................ .15. ..................................... _.......
Sewer Elevation ..... .............. -............._............._..................................................... Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Dwelling ......................... Front .....�i�_t....... Depth ...........26 t. Height ..1.9 t.......... Sq. Ft. l: 4. Cu. Ft. 1. _910
9-
.... . .............. -.................................. ... Front ........................ Depth .................... _.. Height ....................... Sq. Ft......................... Cu. Ft.........................
Type of Construction ........Freme z:.7-.2...._ .................. To be Completed .....DeCe?aber, 1959
Est. Cost .................. 9
In consideration of the issuance to me of a permit to constru the building described above, I agree to do
the proposed work in accordance with the description above set rth liance wi rovisions of
ordinances of the city of Fridley. /
In consideration of the payment of a fee of $._204 ............. permit is hereby granted to. ................... _.............. -.......................
...... _.......... _......... ........... ......_....................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance,, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of an provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see I
the Building Inspector for separate permits for these hems.
4 1 -a
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Stzlc- Builder
Address % G� Address
LOCATION OF BUILDING
No. �D / Street �` 6 m Part of Lot
Lot Block Addition or Sub..Div.�
Corner Lot Inside Lot t/ Set Back �`� Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant mach-_to*this form Certificate of Survey of Lot and proposed building
location,.
DESCRIPTION OF BUILDING
To be used as:
Frontes Depth height
Sq. Ft. A® Cu. Ft. /� Z 6 G
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost��' �� U
To be completed AL��zq,(l
.
The undersigned hereby makes application for a permit for the.work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling..of
the Department of Buildings; and hereby declares t all the facts and re$resenta-
tions stat d in this application are true and corr It.
DATE SIGNAT TM,
(A Schedule of,Fee.costs can be found on the Reverse Side.) �,.
A
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
c Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TO a
Furnace Shell & Duct Work .......................... 8.00 V
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 124,000 BTU ............ 8.00 $
each add. 60,000 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
NO RATE TOTAL
1st 3 Fixtures ......................
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 $
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
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
$
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
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_ItKue
�and correct.
Fridley, Mira- (// r / , 195</,-;—,
Owner 195—
Kind of Building r [ lf—"- 195—
Used as kwiLultr
To be completed about �l✓ ®'°
Estimated Cost, $ -15� p'
Old—New. Building Permit No.
DESCRIPTION OF WORK
HEATING or POWE#iTS Steam, Hot Water Warm aa—No
Trade NamePA,,e��
ize 11S
Capacity Sq. Ft. .D.R BTU H.P.
�' . p� . r
Total ted Loa �I /� Kind of Fu 64
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
-Q110011 POST 1M-12-58
Business Phone
Appticarion for Power Punts and Healing, Cooling. Ventilation, A Fiigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL,
4
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 $
Dept. of Bldgs. Phone SII. 4-7470
City of Fridley:
Y6_2_14,
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.
MECH. WARM AIR
NO RATE TOTAL
1st 3 Fixtures ......................
��
$
Additional Fixtures .................
x .50
Fridley, Minn 19�_0
Furnace Shell & Duct Work to 120,000 BTU ...........
8.00
$
each add. 80,000 HTU ........
2.00
$
Owner �a
Replacement of Furnace .............................
.§.00
$
Kind of Building
Repairs & Alterations—up to $500.00 ... ............
5.00
$
'0
Used as r�4 /)
Repairs & Alterations each add. $500.00 ....... :.......
2.50
$
To be completed about /
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam, ......
8.00
$
Estimated Cost, $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
�a 0 0 Permit 7
Old—New. Building Permit No. No.
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
DESCRIPTION OF WORE
OIL BURNER—to 3 gal. per hour ........................
5.00
$
HEATING or POWER PLANTS team, Hot Water, Warm Air—No
over 3 gal. per hour—See Fee Schedule
Trade Name Size No
GAS BURNER (up to 400,000 BTU) .......................
5.00
$
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
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
'0
ROUGH
FINAL
Capacity.
Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER —Trade Name . Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signed i .,.fir lee,
Y._ 4/ 4
City of Fridley
Application for Plumbing and Gas Fitting Pervnit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
�j
yQ N
H
eTi
w
�z
Z
•
•
WATER HTR.
GAS
ELM
3
��
3F
eGu
ec
t�
<3
t�'d
t9 Sc
(90
rill
Base
e
1st
/
t
t
2nd
_
3rd
4th
• Fuiure Coaneciioa Openings I
Connected with
Sewer
* New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................-7 x $1.50 $
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $—'�- ��
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $J�
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $
Dept. of Bldgs. Phone SII 4-7470
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.
Fridley, .Minn 11—'9 4 - .19S-7
Owner
Kind of Buildin�'g�%��
Used as mss^
To be completed about `,
Estimated Cost, $��
Old—New. Building Permit No Permit No. 6
Signe 41/ � v
By
Business Phone NodeL
ROUGH a
FINAL
42 2M 7-59
City of Fridley, Minn.
BUILDING PERMIT N° 4 s 11
Date:
Owner:
. ..____.�"� .�� -1._...... Builder ....._.... .. .-. _ _._..__._.. - -_•--..moi
Address Address _..___....._............ __
BUILDING
No.4.+_:/._. Street _ _--- __ L q•---._.._.._.._ Part of .. ........
-- . _..
Lot ..-.._-...�._...._._........ Block ................. Addition or Sub i n _... `� ...__� _.:........ +"-
Corner Lot ............... !!!! ..... Inside Lot ............ ............... ......... Setback ideyard . �F - ...............- ........ - -._..
Sewer Elevation-.-----...._...._......._..-___--.--.---_..._----_......._.......................... Foundation evation
DESCRIPTION OF BUILDING
To Used
_......._:. .... l r.._. Front _f._.._._.. Depth ....�"'.-.- Height .../to._.. Sq. Ft. ..f1 Cu. F`t. ��'
.......... ......_......_.............. Fro Depth..........._...._. eight .................... Sq. Ft. .............. ....... Cu. Ft. ...... ................
,,ma�yy
Type of Construction .. , i!! ....... Est. cost ?y V.... 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 city of Fridley. y
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,,.4vpair,' and moving of buildings
within thhee city limits and this permit may be revoked at any time ry�v�Qlation of apy of the pr7Wsions of said
ordinan
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.
y � 4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name b C k 1 ) u W! C 7 i' � �4
Builder
�d A
0 �
K.
Address 51 Ci XL -6 SL JL a_ _ _
Address
4` eO
L(A f/4j- t
)Y'
No.
s- Th
LOCATION OF BUILDING
of Lot
Lot Block � Addition or Sub.Div.�, A 4 M C2 A ED
cornerLot„A_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 BUILDING
To be used as: i
'T J?Front % Depth 2Height
Sq. Ft. C� Cu. Ft. V 3 R
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction F Rb MEstimated Cost # 10, r, C-)
To be
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 corr ,ct.
DATE jl SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
•
City of Fridley, Minn.
PiJ"ING PERMIT
Date: June S. 1965
N? 7774
Owner: Larry D. McCauley Builder Bureau of Home Insp.
Address 5801 5khe Street no E. Address 2714 So �ndale' Ave. �o.
LOCATION OF BUILDING
No. 5501 Street 5th Street N. E. Part of Lot
Lot 9 _ Block 6 Addition or Sub -Division Bemett Palmer Add.
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation _ Foundation Elevation
To be Used as:
Type of Construction
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft
Front Depth Height Sq. Ft
Est COst 59900 To be Completed
0 Storm damage repair
•
Cu. Ft.
Cu. Ft.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the work in accordance with the description abo�tformth and in ante with rovi ons oP
ordinances proposed of the city of Fridley.'z'�r`.
In consideration of the payment of a fee of $ 10a0 , permit is hereby granted +Zureau of Home M
to construct the building or addition as described above. This t is granted upon'
the express condition that the ZbuI
to whom it is grantedand his aL
, around and upon saiding, oany partthereof, shall coBliirmesota regards=g ln, contruction, alteration, mainthe citylimitsand thist may be revoked at any tiaae upon violation of any of the Provisions of said
ces.
Allen Jensen Building Inspector
NOTICE:
Uh permit don not Corer the construction, hidatlation for WkWg, plumbing, gn hading, swot w water. Be sora to ass
the Buliding l gmWor for sopwate pwmih for these U*mL
OWNER'S
ADDRESS
c
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
"2 S4 S- f
1/ o. 0-74
a.vvniava� yr uv.wuaaw
ko / Street r Part of Lot
LOT BLOCK ADDITION OR SUBDIVISION
Corner Lot Inside LOT Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Dept _Height
Sq. Ft. Cu. Ft.
Front Depth TlHeight
Sq. Ft. Cu. Ft.
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 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 trruue, and c ect.
� � Q
(Schedule of Fee Costs can be found on the Reverse Side).
t
PAYABLE 1991
DIVISION # 262
COVER SHEET
Division Type: DIVISION
Document Type: REQUEST
Date of Transfer: 05/09/90
City: CITY OF FRIDLEY
THE FOLLOWING PARCEL(S)
ARE NOW OUT:
PIN
KEY
R23-30-24=24=01.20�
491293
�
R23-30-24-24-0121
491300
R23-30-24-24-0122
491319
`�I ���--
1 1
Maps/mylars proofed q14
Generated on 01/10/91
Proofed by JMS on 11/02/90
Written by JR on 09/28/90
To Assessor 1 - ( 1 1�
Chained? _
Chained?
Chained?
DIANE'S
REQUEST FOR VALUES
Page 32
Div. # 1991- 262 Parcel A CITY OF FRIDLEY
23-30-24-24- o 1 a g LEVY: '� 3 O I Aj .I KEY // / I of %S -
PARENT KEYS: 491293 491300
Notes:
LEGAL: Subdivision 56308
Lot/Unit 6 Block/Tract 32 More HYDE PARK
LOTS 6 & 7 BLK 32 HYDE PARK, TOG/W 1/2 ADJ ACREAGE: 0.00
VAC ALLEY, SUBJ TO EASE OF REC
PCA: 2 1 O 3
STC: 3 (i
AREA: F R D
INC:
AgPres:
AgCred:
EXM:
LAND: 1 %4 1 D D
IMPR : 0-0-
TOTAL:
'TOTAL: ! %,
GREEN ACRE
LAND USE:
r'
DIANE'S Page 33
REQUEST FOR VALUES
Div. # 1991- 262 Parcel B CITY OF FRIDLEY
23-30-24-24- o aq LEVY: 930111 KEY
PARENT KEYS: 491319 491300
Notes:
LEGAL: Subdivision 56308
Lot/Unit 8 Block/Tract 32 More HYDE PARK
LOTS 8 & 9 BLK 32 HYDE PARK, TOG/W 1/2 ADJ ACREAGE: 0.00
VAC ALLEY, SUBJ TO EASE OF REC
PCA:
13
--9-03
STC :C
_ .3
AREA:
-F80
INC:
AgPres:
AgCred:
EXM:
LAND:
O O O
IMPR :
TOTAL:
% 0
GREEN ACRE
LAND USE:
SUBJECT
PERMIT NO.
City of Fridley
27457
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
�6
61
1
NUMBER
REV
ATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
�----J 612-571-3450
910-F15
T018/31/9R
JOB ADDRESS
58 h Street 4E
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
6
1 Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard Hubbard
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Partners
Roof Des
-20004817
4 ARCHITECT OR DESIGNER MAIL ADDRESS
PHONE
ZIP 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
Rer-oof house and garage (24 Sq) Tpar-aff
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
STALLS GARAGES
ANDKNO THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND OR IN CES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH W ETH R SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES OT P ESUME TO GIV IRITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS NS F ANY OTHER AT R LOCAL LAW REGULATING CON-
STRUC R THE NC F CONSTRUCTION.
aI
Fire 917 $2.00
3FOR
PLAN CHECK FEE
TOT L FEE
SIGI A U E OF CONTRACT R OR AUTHOIED AGENT IDATEI
E
VALID T15THIS IS UR PER IT
00i
7Y
G INS
MATE
SIGN URE OF OWNERIiFOWNER BUILOE I IDATEI
NEW_ [ ] Effective 1/1/98
CITY OF FRIDLEY
[ILY AND DUPLEXES R-1 AND R-2 / I
)ING PERMIT APPLICATION
Tel. #
r+ , MN LICENSE -7
Tel. #
?lication, a Certificate of Survey of the
)osed construction drawn on it to scale.
ofRFr lleeyPT
=ION OF IMPROVEMENT
Permit Fee
T
CUSOPER:
Fee Schedule on. Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
TURDK OC
DRAWER: 1
$.50/$1,000 Valuation
SAC Charge
$
DATE: 8/31/38 00
RECEIPT: 000,,617
Width Height
Sq. Ft.
DESCRIPTION QTY
PERMITS -BUILDING 1
AMOUNT TP
$74.75 BP
TM
CM
Width Height
g
S Ft.
q•
FIRE SURCHARGE F 1
SURTAX 1
$2.00 FS
$1.00 SU
GK
CK
Width Hgt/Ground
Sq. Ft.
LICENSE SURCHARG 1
$5.00 H2
CH
ROOF DESIGN PARTNERS LLC �C J L/Jo �U
BP #27457, 5801 5TH ST NE CCS Estimated Cost: $ 4.
TOTAL 10EGK:41 W.75 (Fee Schedule on Back)
+6Ft= Ft $ =$
DATE: APPLICANT: 1=k Tel. # o�
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on. Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ C41
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ �j ,
$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
N . ,
City of Fridley
28591
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
`
RECEIPT NO.
• _____ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
13�
r
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= 1 CITY HALL FRIDLEY 55432
'J 612-571-3450
910415
11/16/98
JOB ADDRESS 5801 5th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9
6
Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dick & Barb Hubbard
571-1063
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Renewal by Andersen 350 73rd Ave NE Fridley 55432 502-4777 20040630
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 t REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 4 windows in home
9 CHANGE OF USE FROM TO
STIPULATIONS
Install smoke detectors to meet the State Building Code
- in each sleeping
room and on each level of house.
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
4788
$2.39
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$99.75
ire 4.79
PLAN CHECK FEE
TOTAL F
Licens C
5.0
1 3
SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT ,DATE,
N PRWPEIDT6 I$ VpU PERM,
L// r00,
SIGNATURE OF OINNER,6 OWNER BUILDER, (DATE,
gLp I
gAiE
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [..]� SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ,' )X M
Effective 1/1/98
/0
Legal Description:
Owner Name & Address: -NIX � Mi k w d -'101 - `J�—' a nb Tel. # 5-11
Contractor: MN LICENSE # cZ)O i ob*io
Address: . �3 - Tel. # 5- aR-Ll117
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:�� l 1J LY1(� c_ X 11111 1 X)`%1.O Y1l L
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
` Qgsu. ag
DATE: APPLICANT: L411J Tel. # Stj
CITY USE ONLY
Permit Fee
$ �fi-- `j
Fee Schedule on Reverse Side
Fire Surcharge
$ t -j,'19
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 5-0 D
$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:
Elder -Jones
Building Permit Service, Inc.
1120 East 80th Street
Bloomington, MN 55420
Phone: (612) 854-2854
Fax: (612) 854-4909
To whom it may concern:
We at Elder -Jones Building Permit Service, Inc. are acting as an agent for Renewal by Andersen.
If there are any questions, or if the permit has to be picked up in person, please give us a call at
the number above. If the permit can be mailed back to us, we have enclosed a self-addressed
envelope for your convenience.
Thank you,
Tim Schenk ext. 140
Jolene Connors ext. 134
Holly Connolly ext. 158
Elder -Jones Building Permit Service, Inc.
1120 East 80th Street • Bloomington, Minnesota 55420-1498
612-8542854 FAX: 612-854-4909
s
Building
BUILDING
Permit No. ?oo oqq&
InspectionsRESIDENTIAL
APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Dat c .-20
763-502-4977 FAX
I EFFECTIVE 1-1-08
Q c�
DATE & • _ •
YOUR ADDRESS
-�E-MAIL
PC SITE ADDRESS d Q S .
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
Nom;
TENANT
ADDRESS: J' ?6 / _5e:0- `t7 f, CITY
STAT29i ZIP SG4 9 a
NAME:
CONTRACTOR
ADDRESS: q 7q C
STA4W) ZIPSSD
SUBMIT A COPY OF
PHONE S! —7,9v4— FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE .
`✓ / 0'1- 0 /!�
PROPERTY TYPE
AIJSINGLE FAMILY SIZE
❑ TWO FAma Y/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED"Mows
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑NEW HOME CONSTRUCTION ❑ ADDITION
gMAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes
❑No LOCATION OF WINDOWS
OR FOR NEW OF NINES -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
TOTAL JOB VALUATION $ ODOIN�THE 1997 UBC FEE SCHE OCCUPANCY TYPE
Permit Fee $ `. ' See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ P .001 times the total job valuation
Surcharge$ 7j , 543 .0005 x Permit Valuation Minimum $.50
License Surcharge $ �� , D -D $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21= $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks savable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMrr-NOT VALID UNTIL PROCESSED
I hereby apply for a build' t and I acknowledge that the infommtion ve is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and the Minnesota Construction Codes; that I derstand this is not a permit but only an application for permit and work is not to startwithout a
permit on ' e; that the wor be in acro with the appro ed p=the all work which requires ret`,e'w alnqapprov plans.
SIGNA AP LI ANT RINT NAME �-lL DATE D
1 A " .