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Ocity oFridlf Y, Minn. 0 Fridley, BUILDING PERMIT K® 4357 Date: -----------_/ i 7- ...................... ....... Owner- ----- -------- ----------- -------------- ----------------------- -------------------- _------- _---- --------------------- Builder ...1 <f1 .-ii i....... ...._._._._.._ _. Address....._......................... _.......... ......... _... _...... _...._....... _._..... .................. Address LOCATION OF BUILDING No. _...11.9Ar Street ------------------------ Part of Lot ...... ............. ............. Lot ....._._.........-.. _........_. Block ............. ...................--------- Addition or Sub -Division -. ................. a •7 Corner Lot ................ ............... Inside Lot .A ....... _...._.......... Setback ._3�'�............. Sideyard ....AL ._. 7 ......�4_............-..............._........... Sewer Elevation ................................... _......... .... _................. .................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: �`..........' Depth 7V Height ....... GG q. Front ... Q 1f7.'V-Sq. Ft_1---- Cu. Ft 1..� - �- L`01 f�� �®.�O Cu. Ft. ®_ �rf ... Front .�7............. Depth dam.......`...._ Height-/0..�.. Sq. Ft....__..._... Type of Construction............................................................ Est. Cost ..A;VY—?...:...'....'..... To be Completed ................... .... ........................... In consideration of the issuance to me of a permit to cons the building described above, I agree to do the proposed work in accordance with the description above set orth mpliance all provisions of ordinances of the city of Fridley. /�� ------..... ........ ... -.... ..... —._.__.._......__..._............. ... --.......... In consideration of the payment of a fee of �� p $.e�..........._....... permit is hereby granted ......................................... 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 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 PERMIT, CITY OF FRIDLEY, MINNESOTA Owners Name Build Address` LOCAT ON.OF BUILDING No. / C)eet _ Part of 'Lot Str a ILel Lot 4 Block `'1 Addition or Sub.Div. , Corner Lqt_,Inside Lot Set Back Jr Sidi -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 S Ate; Front Depth Z Height Sq. Ft. Cu. Ft. _...._. Front` Depth L Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed p �� G The undersigned hereby makes application for a'permit for thew ork herein specified, agreeing to do.all work in strict accordarice�with the City Ordinances and ruling of the Department•of Buildings, and hereby declares hat all the facts and representa- tions stated in this application are true.and coftectj DATE ���° ' �''� SIGNATURE�44 S (A Schedule of`Fee costs can be found on the Reverse Side.) Application for Power Punts and Hearing. Coding. Ventilation, Refrigeration 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 $ ,r 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. IDR 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 ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 Locatfond 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. �+Q Fridley, Minn /v // 19$L Owner Kind of Building t �? .e%k Used as To be completed about Estimated Cost, $,e a Old—New. Building Permit No. Permit No. JZ:5� DESCRIPTION OF WORK HEATING or POWER PLANTS --.Steam, Hot Water, Warm Air—No Trade Name Size No 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. lew /. Signe By vv ()' q 422M 7_59 Business Phone No --7,e- (REMARKS—OVER) e City of Fridley Apprication for Plumbing and Gas Fitring Penna Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK_.? Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Y Number Fixtures ...................... Z m _ $ Future Fixture Opening ................ w Z • • WATER HTR. 1.00 ELEC. Catch Basin ............................ x 3.25 $ m N 3 1- C LL New Ground Run Old Bldg. ............ p4 LL U m a U� G UK U� O RATE N GAS $1.50 UY7 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st i 2nd _ 3rd — 4th • Future Connection Openings Connected with Sewer * New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE �TOTAL Number Fixtures ...................... 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 BTI) ...... x 2.00 It New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE 1st 3 Fixtures .......................... x $1.50 �TOTAL $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $1, 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 / 4 19 � Owner 611 17 Kind of Building i�d Used as A9411re__ To be completed about Estimated Cast, Old—New. Building Permit ROUGH FINAL .QgROW42 2M 7-59 Business Phone ti i I OF 1 RIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PE EMIT Job Address Department of Buildings. City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the Wrk 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 application are true and correc Fridley, Mn. , 19 OWNER KIND OF BUILDING r USED AS 6 / TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE m PLUMBING FIXTURE RATES: a 0 RATE TOTAL ro PERMIT NO. o x K ej Water Future Fixture Opening °.� : $ Company N G n $2.00 • $ 7j M w Heater V .+ W U q $5.00 m C JJ WG 47 $4 m .9 C E rJ pd', ,C Water Heater - to 99,000 BTU x 14 $ Tel. No. Le n0 $10.00 $ xm C N x $7.00 $ AS n, u v: New Ground R.in Old Building m m $ ROUGH INSP. 1 -4 a�.J h $ N 7 O O m o FINAL INSP. U 1st 3 fixtures c ci' L ' Date o w vii w u w 3 u 0 x 'as lec APPROVAL FOR PERMIT REPAIRS 6 ALTERATIONS First $100.00 $5.00 $ , each add. $100.00 or fraction $2.00 $ ls` State Surcharge $ .50 TOTAL FEE $ 5 . REINSPECTION FEE 2n•' ($10.00) 3rd 4 th 1 :J _T (R) = Future Connection Opening Connected with Sewer {�} - New Fixture, Old Opening Water Job Address Department of Buildings. City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the Wrk 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 application are true and correc Fridley, Mn. , 19 OWNER KIND OF BUILDING r USED AS 6 / TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO. N•.L tier Fixtures x $3.00 S�'_ �r Future Fixture Opening x $2.00 $ Company New Fixture, Old Opening x $2.00 • $ 7j s Signed By Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Tel. No. 100,000 BT{] to 199,000 BTU r. $10.00 $ Water Softener x $7.00 $ New Ground R.in Old Building x $5.00 $ ROUGH INSP. Electric Water Heater x $5.00 $ Date � ' GAS FITTING FEES: FINAL INSP. 1st 3 fixtures x '$3.00 $ ' Date Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x S10.00 S APPROVAL FOR PERMIT REPAIRS 6 ALTERATIONS First $100.00 $5.00 $ , each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.SO STATE SVR0WL= State Surcharge $ .50 TOTAL FEE $ 5 . REINSPECTION FEE ($10.00) SUBJECT P City of Fridley 14'76 AT THE TOP OF THE TWINS PERMIT` TF r BUILDING CEIPT r COMMUNITY DEVELOPMENT DIV. v PROTECTIVE S� INSPECTION SEC.4467 / / a 1 =� /"-0 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 6/16/78 JOB ADDRESS 5810 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 7 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Martha Salas 5810 - 5th 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION [I ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Finish and remodel basement 8 CHANGE OF USE FROM TO !STIPULATIONS Contractor to apply for and receive a general contractor license before June 26, 1978. SEPRATE PERMITS REQUIRED FOR WIRING, W.EATUVG, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,000 $1.00 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- $12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $13.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) A�� 6 /6 `7A -- HEN PROPER Y VALIDATED THIS IS YOUR PERMIT � I J L,(�, / 6 BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI • CITY OF FRIDLEY- APPLICATION FOR RESIDENTIAL BUILDING PEIZ14ITS (NEW., ALTERAT,lOfdS, ADDITIONES, O(7 REPAIRS) OWNER: v 2 ,q 54L "Qs BUILDER: Address: ���� Address: Tel. No.: No.: Street: LOT: BLOCK: ADDITION: 2M f 2f__ COMER LOT: INSIDE IAT: SETBACK: � SIDEYARDS: Applicant attach to this form A-io Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �> 5d� ��t Depth: Height: _ Square Feet: Cubic Feet: Front: Square Feet: Depth: Height: Cubic Feet: Typo- of Construction: Estimated Cost: $ �® To Be Completed: 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 L=uildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional ii-ormation. DATE: SIGNATURE: 1 Stipulations: /W 9 / 1 SUBJECT City of Fridley F-�18135 AT THE TOP OF THE TWINS BUILDING PERMIT r � CEIPT NO v _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. J 1 1 � ` 1 �"'1 CITY HALL FRIDLEY 55432 �'"""A"� NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/29/85 JOB ADDRESS 5810 - 5th Street N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 5 Bennett Palmer Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Martha Fuentes 5810 - 5th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Telle Construction 3941 - 10th Avenue South. M ls. 55407 827-7672 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 Ek ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 181.x 171 Three Season Porch. 9 CHANGE OF USE FROM TO STIPULATIONS Post footing to be 1.7 sq. ft. or 1.51 diameter holes. %Nis��� p 4*00991ng call local utilities dqlV® �A TELEPHONE - ELECTRIC - GAS Etc. 4 REQUIRED BY LAW 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 A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,750 $2.88 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRPVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST UCTION OR THE PERFORM NCE OF CO STRUCTION. $56.50 PLAN CHECK FEE TOTAL FEE A45 $14.13 $73.51 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDnrE WHEN PROPERLY LIDATED THIS IS YOUR PERMIT s ` 8p1�w BLDG WSP DA E SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) / 1 NEW [ ] City of Fridley Effective 4/1/84 ADDN. R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address:" s s;t-11 St O Legal Desc-'' " -' Owner Name Contractor Address: 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 GARAGE AREA: Length Width DECK AREA: Length Width OTHER: -;?> lo Corner Lot [ ] Inside Lot_[V Ft. Yd. Setback _ Type of Construction: Approx. Completion Date: Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. t& !U Side Yard Setback Estimated Cost: $ Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL CITY USE ONLY Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS • r r. NUNDER F-.,NGrNE . G co,.,,INC,, ENGINEERS AND SURVEYORS SOILS TESTING LANG OUR`lEYINO LANA PLANNING CIVIL r. MUNICIPAL ENOINEERINO 6418-SGTM AVENUE N. MINNEAPOLIS 7!, MINN- KE T- SG37 Cortilicaio of tl����� 14 �i '7op OF THE DMIES WE HERE ®Y CERTIFY THAT THIS IS A TRUE MID CORRECT (tEPRESE FTp^JTJY 19ERE RNAID oALL VISIBLENEN R MAMENTS, LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, , IF MY, FROM OR ON SAID LAND- MINDER ENGINEERING CO., INC. DATED TWIS DPYOF //,(.: w ` pA-19j< EN611JiERS AND sv%LvsyorXs F � SUBJECT P City of Fridley 1910 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ' COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. I l CITY HALL FRIDLEY 55432 �•j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910415 8/7/87 JOB ADDRESS 5810 - 5th Street N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 5 Bennett-Palmer Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Martha Fuentes 5810 - .5th Street N.E. 571-6750 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 UX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 10' x 12' Shed in Rear Yard 9 CHANGEOFUSEFROM TO STIPULATIONS Shed must be 5 feet from rear lot line and 3 feet from side lot line. 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 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 Z ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE'IOF 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- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $15.50 SIGNATURE OF CONTRAC OR THORIZED AGENT IDATEI WHEN PROPERLY (DER ATED THIS IS YOUR MIT F O R IIF OWNER gOILDERI (DATE) BLDG INSP ATE EKING CO.,INC. MINDERFNGrq YOBS ENGINEERS AND SURVE pO+L.a TEST1IJo LANG pLI.NN+lJa LANO %vw•.sEv+NO C+v+L O MUNIC+SAL LNOIN[ERINO %418 -SG Tr AVENUE N• MINNEAPOLIS 'ZT.IVIINN• KE T- SG37 �eo•�e�i��i+� Of IES OF THE TtO O WE KMEby CEAtT1FY T11I1T TM1S IS k TRUE ANO CORRECT �p(�SENTAT EREOQ , KME) ML VISIBLE �0 CHMENTS, OF ALL ButLO1NGS, IF My, LD rWVE DESCRIO&D AND OF THE LOCATION F W AI �L� n itt '•'� •.. - ANIF ANY, F awn MON SAID LA%D. MINDF t7 y s5.7 1� 1 -S E , �� ze f CA pQ IES OF THE TtO O WE KMEby CEAtT1FY T11I1T TM1S IS k TRUE ANO CORRECT �p(�SENTAT EREOQ , KME) ML VISIBLE �0 CHMENTS, OF ALL ButLO1NGS, IF My, LD rWVE DESCRIO&D AND OF THE LOCATION F W AI �L� n itt '•'� •.. - ANIF ANY, F awn MON SAID LA%D. MINDF t7 y \1 NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: Legal Description Owner Name & Address: R Tel. # IS Contractor: 0wNkv-� Tel. # Address: 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: Corner Lot [ ] Inside Lot qw. Yd. Setback Sr Side Yard Setback Type of Construction: [J.� � U� �'fi.� -A- fSe Estimated Cost: $ � 0,00- Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: �- 0) o APPLICANT ' '' Tel. Qi�Y USE ONLY -77 Permit Fee $ AS40 Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ . J Q $.50/$1,000 Valuation SAC Charge $ $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: F, SUBJECT City of Fridley 26365 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/26/98 JOB ADDRESS 5810 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Martha Fuentes 5810 5 Street NE 571-6750 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Juan Seles 5810'5 Street NE 571-6750 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 & Garage (22 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 I 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 1,834 $.92 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- STRUCTION OR E PERFORMANCE OF ONSTRUCTION. PLAN CHECK FEE TOT FEE 62.25 SIGNATURE��. CTORORAU RIZ DAGE T IDATEI EN O VALIDA D HIS IS ?UR P IT ,SLD INSP IV GATE S.GNATURE CTF OWNEROF OWNER BUILDER) IDATEI F, NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 P141k BUILDING PERMIT APPLICATIONS ConstructionAddress: 5-0' 1 O ���` *� - r;�?^ ` S Legal Description: Owner Name & Address: Tel. # 7 /—Z"7� v Contractor: F ��dl`O ��2� 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 GARAGE AREA: Length DECK AREA: Len OTHER: Construction Type: Driveway Curb Cut Width Needed: DATE: — 2,P—MAPPLICANT: Width Height Sq. Ft. Width Height Sq. Ft. Width H Ground Sq. Ft. A.2- nom' Estimated Cost: $ (Fee Schedule on Back) I-, __ & - Q Permit Fee $ - Fee Schedule on Reverse Side Tel. Fire Surcharge $ .'73 .001 of Permit Valuation (1/10th%) State Surcharge $ ,. $.50/$1,000 Valuation SAC Charge $ $1000 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 [ ] 11 e - TOTAL $ 6). STIPULATIONS: ITY OF FRIDLEY INSPEC-1 SON DIV. 0\ S� 431 University Ave N -E `, ��' �� APPLICATION FOR PLUMBING AND GAS FITTING PERMIT ridley, MN 55432 63-572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR <.::_; Floora_` Auto. :Y Wash14�f::x ::.:,� Tr:avDrain Washer Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Factures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range" Gas Dryer" Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ =- Effective On Jan 1, 2001 Gas aHeater ::111M1.as ElecRannp AV 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 correct. Owner . 20C:Y Building Used �11 /�- Estimated Cos- PERMIT NO. PLUMBING COMPANY 22SIGNED B TEL N0. Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes ( ) No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height _ Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : UNOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 7, 2003 Ms. Martha Fuentes 5810 5 Street NE Fridley, MN 55432 Re: Final Inspection at 5810 5 Street NE Contractor: Shiloah Water Co Dear Ms. Fuentes: A plumbing permit was issued on August 14, 2001 to install a water softener at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY PERMITo.: 2004-01581 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/13/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 5810 5 ST NE PIN : 233024240030 LEGAL DESC : BENNETT-PALMER ADD LOT 7 BLOCK 5 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 2,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. INSTALL NEW WINDOWS AND RESIDE HOUSE. APPLICANT BUILDING PERMIT FEE 69.25 KEN BAKER FIRE SURCHARGE 2.00 5810 5TH ST NE STATE SURCHARGE, VALUE 1.00 FRIDLEY, MN 55432 TOTAL 72.25 OWNER KEN BAKER 5810 5TH ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of other state or local law regulating construct' r the perf ance construction Applicant Date Bldg Insp Da SEPARATE PERMITS 4QUfR4ED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ j CITY OF FRIDLEY Effective 4/1/2004 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763 71-1287 Fax BUILDING PERMIT APPLICATION Qr Construction Address: +h 5� NE J)e .Icy✓ SSN 3Z Legal Description: .5'�i o S �-�• S f .vim Owner Name & Address: Y -e,:1. /3cx Ler- Sst3 i Tel. # 74!> -S71 -?-?SS Contractor. Al 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. 3; y GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: 0=944 :f s" d rt"Estimated Cost: $ , 000 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ '` Fee Schedule on Reverse Side $ 65% of Permit Fee $ o(SO .001 of Permit Valuation (1/10th%) $_ $.50/$1,000 Valuation $ $1350 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 [ J $ � STIPULATIONS: aoo-5- 0 0 3 7 11wS4 NEW ��� i CITY OF FRIDLEY Effective 1/1/2003 ADDN l J 64431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 6910 6'141 S+ Ne Legal Description: Owner Name & Address: n int of Contractor: "r �6MN LICENSE # �- Address: - d� `�'������ Tel. # �1`a � -7-1 ( S 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: Wt. rld() l Estimated Cost: $ Z q ° 00 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ /I nn DATE: WIN; APPLICANT: Tel. # 6� ILP Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 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 [ ] BudgetExteriors -�571_ 3450 B . MAY 1 9 2005 Y Date: q 191Z)5 To: City of --j- d I �" Re: Job ready for final inspection Budget Exteriors, Inc. has recently completed a Vv r nc-(LYVJ project at the following address: E6 f D '�J`l'h �- F9 E� The homeowners name is: �� I k i The homeowners permit number is: ? The homeowners phone number is: —7(p'j - 15-71- a6VE95 We have asked the homeowner to contact you and set up a final inspection, but we all understand how that gets put off sometimes, so this letter is intended let you know the job is ready for final inspection. If the homeowner fails to contact you, please call the homeowner, and if that fails, please call Budget Exteriors, Inc. We appreciate your help in completing this project. Sincerely, Gary Kro ger Production Manager Budget Exteriors, Inc. (952) 887-1613 -PA ve C-,ncq9y 4-o0y-- L-! P rO(blern `"' C 69gI N6 8017 Hicollet Avenue South 200 Western Ave. Faribault Mall 5702 Miller Thunk Hwy Bloomington, MN SS420 Faribaulk MN 55021 Duluth, MN S5811 Phone (952) 887-1613 Phone (507) 333-9701 Phone (218) 729-4576 FAX (952) 887-1659 FAX (507) 333-9702 FAX (218) 729-4579 NEW [ ] ' 4 L�� CITY OF FRIDLEY Effective 1/1/2003 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER P4- SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: -6� lv 6+ "4 P9 Legal Description: Owner Name & Addrl. # esss: 1�� YL � �Y �J� l D �� �" e� low s(1 ( Z�( S �"'� Contractor ��k;�[�P�'LD MN LICENSE Address: l n kk P V QcrU1n� e1. # 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 Widthnn Hgt/Ground Sq. Ft. Z�) OTHER: bil OPLA)]LO" s abJD IL'G I A.�i i�J Iii%/!'i�%�L� � Construction Type: 6&kk ,S \,y/NLt v�lS _ Estimated Cost: $ �cd6. DD Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE:APPLICANT: Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 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 [ ] Building Qon BUILDING Permit No: -7 r co--,) -;;�( Inspections RESIDENTIAL APPLICATION Received Byc 763=572=3604 CITY OF FRIDLEY Date Rec'd: 5&/'0:J DATE , C7� YOUR E-MAIL RESS SITE ADDRESS �(� �� s'I' ,NC THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANTADDRESS: ~ Ak CITY STAT�LIP 5 3Z — PHONE: 763--51 — ZA 7 (. — ZZ2 - 3 a( CONTRACTOR NAME: -7-U w-,BUd \ t L-�- C-. STATE LICENSE # Z05& 'ZSR EXP DATE D� '�� 7,6P-] SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:ZO55 L.f4Y,�y L%)G-V �,,,.1 �y/� CITY m STATA �LIPD 51 WITH APPLICATION PHONE3Z-ZZ5-- 00SN- FAX 7(-2-Z-I-OGL O PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ ❑ SWIMMING POOL TYPE OF WORK: 1 ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR G DESCRIBE WORK BEING DONE: �S SIZE OF IMPROVEMENT LENGT D Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan - 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 WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -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: (USINWHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ W— OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ 22.& $ 9100 $ t1. 00 $ :5-'00 See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building 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; that the work will be in accordance with the approved plan in the case of all work which re iew and approval of plans. SIGNATURE OF APPLICANT , — PRINT NAME lid f!'�12 f�9Q �f DATE l C-4 (Y,;7 If X m m Pst L LZ WIT C4 1' C9 5 e City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ON Permit No.: — QT Building PLUMBING Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: Zi_s� DATE O - 1a -o"7 YOUR E-MAIL ADDRESS SITE ADDRESS T THIS APPLICANT IS: 0 OWNER ®CONTRACTOR PROPERTY NAME: ).(e in OK A i �l STATE i A/ZIP OWNER/ ADDRESS: S S !—CITY TENANT Z ?(p 3 6-71 225Y PHONE: CONTRACTOR NAME: i o �t �+ I S i STATE LICENSE # bEXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: I � 27 102 1/l' `�- CITY 1�ci r✓� STATE LIP LICENSE WITH PHONE 3 Z r, b l9 7 20 FAX 3 2 e& I? 7 Z n (v APPLICATION PERMIT TYPE U(SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW @PREPLACEMENT DETAILED DESCRIPTIqN OF WORK e pd2 j=1 c, e.( j CA ma rt /-4a6 izJb PERMS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)WATER PIPING I BATH SINK/LAV 1 FLOOR DRAINS _ SHOWER — WATER SOFTNER ($35) j BATHTUB _ GAS PIPING (moo ci7wicEM) _ SWIMMING POOL _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) 6 - 1CLOTHES WASHER _ DISHWASHER t LAUNDRY TRAY J_WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER s O, . = � �f f ;� _ KIM _....... .... ...�.. $10.00 x $10.00 = $_ Number o fix Permit Fee $ tures @ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ $35.00 = $— 7 TOTAL DUE $ Number of fixtures @ $35.00 x State Surcharge = $ .50 Total = $ �® o THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building 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; that the work will be in accordance with the approved plan in the case of all w kic� ires review and approval of plans. } �s DATE %/ 1�e (CYn S 7___&7 SIGNATURE OF APPLICANT PRINT NAME ti0. ___�= n. . s City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ON Building MECHANICAL, rem r4eQz;� � � z Inspections RESIDENTIAL APPLICA'T'ION Rew;ei ed sy:Z4 763-572-3644 CITY OF FRIDLEY Date ec'd: a-743-7 DATB_��� YOUR E•MAR. ADDRfsti5 I • C OY� SITE ADDRESS ,. �_u rs — THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY NAME ADDRESS: CrrY _ STATE ZIP dwnw TENANT PHONE: CONTIMACTOR COMPANY NAME: SUBMIT A Cpl' Y OF CONTACT PERSON: YOUR STATS STATE LICENSE # EXP DATE CIS 301 LICENSE WITH ADDRESS: ���,`Z�SP CITY STATE •�!z-P A --i4 dF3 APPLICATION PHONE �� �, , FAX �2 Q 7 1 >0413 PERMIT TYPE)ORNGLB FAMILY ©TWO FAMILY a TOWNHOUSE TYPE OF WORK., o NBW ❑ REPLACEMENT RATI0N1R.EM0D13L 13ETAILED DESCRIPTION OF WORK dwl PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is &teeter, for the improvemwit, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect oi ly the cost of labor ) Labor cost under $300 - $15.00. Labor cost between $300 to $500 =cost of labor X.05 = FOR PROJEG'TS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10,00 PER FIXTURE, EXCEPT' WHERE NOTED. FIX NUMBER OF EACH BELOW) 3 S - Equipment Lmalkd MFG: LAS MODEL: 1 Sim MEQ: MODEL: i7 S17.Bd MFG: ^ MODEL; SUM A/C $?.5.00 FIRRPLACE (GAS) $15.00 GAS RANGIVC. A1R TO AIR EXC14MOMR $15 LACE (WOOD) $55.00 NEW OAS CHU NCHOH..ER $35.00 1RNACE $35.00 GAS UNrr H17 IMNEY LINER $10.00 GAS DRYER $10,00 ...._POOL HEATEI �GUCT WORK S10.00 OAS PIPING $10,00 _VSNTUATOR Pew Fee —$ - O -A Number of fixtures (a3 $10.00 L Surcharge s Number of fixtures @ $15.00 TOTAL DUE $ Number of fixtures ® $25.001 Number of fixtures Q $35.00 State (INDICArE TOTAL MN $10.00 1$10.00 $10:00 $35.00 x 3i1U.Uu = 3--LLL— x$15.00=$ --LLL^x$15.00=$ x225.00=$as x$35.00=$ 35 Irolune = $ 50 Total = $ 7n THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurst ; that the work will be in conformance with the or ces and codes of the City of Fridley and with the Minnesota Construction Codes; that i understand this is not s permit but o an applion for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan the case of all o •rk vvfiii mires review and approval of plans. SIGNATURE OF City of Fridley Building Inspections Department 6431 University Avenue NF, Fridley, MAT 55432 763-572-3604 FAX: 763-502-4977 Td WUt?z:OT LOW 9z '9a-4 L8zttLS£9L: 'ON XUA haIPTUA .+o 61IO: WOW Building PLUMBING Permit No. I Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE -7-Z- -07 YOUR E-MAIL ADDRESS SITE ADDRESS Sts % Q SS% A/ THIS APPLICANT IS: ''OWNER ❑CONTRACTOR PROPERTY NAME: JCt ONE ADDRESS: Ss r 0 S'` S'% N Z CITY Fr + 01 e ti STATE MAIZIP `i3 Z PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE ,SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK o -(T u,lve -�'nr r✓��cF Le - C rs 6eg;; u e 9�r< PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING _ _ GAS PIPING amo crrrrrcEmm) SWIMMING POOL —WATER SOFTNER ($35) —BATHTUB _ _ CLOT IES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER OTHER <w/ r,i. .x r`l _ ~FJ.iI✓ R� b 7` 'N'u y t Permit Fee $ Number of fixtures @$10.00 x$10.00 = $ Surcharge -50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $=.50 Total = $ 5-0 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building 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; that the work will be in accordance with the approved plan in the case of all work which requires reviewand approval of plans. SIGNATURE OF APPLICANT SPRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ri