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APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, (MINNESOTA Owner's Name Builder Address Address LOCATION OF BUILDING No. U Street .�` J - Part of Lots Lot Block S_ Addition or Subdivision& Corner Lot Inside Lot _Setback 3,S' Side-Yard��� e4- 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 U Ls.� # S-` Y% FrontDepth Height Sq. Ft. Cu. Ft. Front__ depth Height 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE S '� SIGNATURES (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Mime BUR SING PERMIT N° 5917 Date: Owner:qBuilder Address _ Address ------ LO TON OF BUILDING No.Street, ' Part o Lot Lot Block �- - dation or Sub -Division Corner Lot __ _ Inside Lot Apf Setback ., la. '�_ _ _ Sideyya+rd�__ Sewer Elevation _ Foundation Elevation - DESCRIPTION OF BUILDING Tod�`` Used � Front Depth G2 Height Sq. Ft. 1Y49Cu. FL Depth ht Sq. Ft. Cu. Ft. 0A Type of Constructiop�� >.at. Cost , -, 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. 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, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation_o; any of the provisions of said ordinances. 'n ;1 Building Inspector NOTICE: This permit does net cover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley % Application for Plumbing and Gas Fitting Permit ll�� Dept. of Bldgs. Phone SU 4.7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location - Number, _ i_"_ NO. RATE TOTAL Number Fixtures ...................... x Y Z $--5Z G pZ< Z p 1.20 �' .U' Z • • N WATER HTR. GAS ELEC. x 3.25 � � Water Heater (Up to 200,000 BTU) ...... ? � o 2 $ �` O � V <w,j < 3 (�9 nd d1� (�9 0 R GAS FITTING FEES: NO. V23 1st 3 Fixtures .......................... x $1.50 $��—� / Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd 3rd 4th • Future Connection Openings Connected with Sewer e New Fixture, Old Openings Cesspool � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $--5Z G 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 $��—� / Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description .............................................. TOTAL FEE $—L��� 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 Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application a true and correct. Fridley, Minn 19 .10 Owner Kind of Building Used asy To be completed about Estimated Cast, $ Old ew. uilding Permit ROUGH -7— FINAL 42 2M By Business Phone No Permit Ngo. Q Application icor Power Plants and. dealing, Cooling, Ventilation, .Refrigeration and r 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 i Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU .... . .................. 2.00 Replacement of Furnace ............................. #.00 $ Repairs & Alterations—up to $500.00 ... ............ 5.00 $ Repairs & Alterations each add. $500.00 ........... — 2.50 $ STEAM or HOT WATER SY M Furnace Shell & Lines—t6.400 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 .Zo GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ S ' 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 $ 3� ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 Location 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, P inn.�k 19 6 2 - Owner Kind of Building+ �- !;sed as To be completed about E�s'timated Cost, $ J e •set=::'New. Building Permit No. Permit No. DESCRIPTIO/or WORK HEATING or POppWER PLANTS -steam, Hot Water, Warm Air—No Trade Name - 7 Size No -9� f11'Ae Cb Capacity Sq. Ft. E.D.R Q Q BTU H.P. Total Connected Load * 1-, 9 Kind of Fuel BURNER — Trade Name Size No .t Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe By 4j;R i'4E2M 7_59 Business Phone No- 0 n"ss 4 9 • HEAT LOSS CALCULATIONS /DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V,E. Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof I Floor e No Ie No 19_ ' i - F1.1 Room I Lenir/! r Width ' Height , P ' II 1 >F I et Windows an oors—Crackage and Area Required s . Width Height No. of Lineal ft, Area No. of pane olf�pane lligph�te of crack eq. ft. i / 0 U/L . L /8'•O OL • O..2 Width Height No. o! Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Coef. Btu Infiltration Net exp. wall p /� g 3 Glass Ceiling / Floor 90 Exp. wall S Net exp. wall f p Int. wall Ceiling ,3® Floor Total Htu. 8' Height f " Required s . .D.R. or sq. ins. W.A. Leader area Fl Room I Length 12-- WidthjV ' Height J9 ' Windows and Doors--Crackage and Area Width Height No. o! Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Coef.I Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required ssV. %,E.D.R. or sq. ins. W.A. Leader area Fl.' 'RAS'Room Length 'Y Width ' Height ' jaeWindows and Doors—Crackage and Area Width Helght No. of Lineal ft. Area No. of pane of pane Ilghts of crack sq. ft. / -V4 - 5 1 --2L . / '7, i I lam. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor LZ 9 128 Total Btu. y( Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS, MINN. Insulation Kind How. Applied Roofs I Lenat ./4/ Width /!n ' Height 9 ' Windows and Doors—Crackage and Area 8' Height f " Width Height No. of Lineal ft. Area No. of Dane of pane llghte of crack sq. ft. L, Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration / Glass Exp. wall Net exp. wall p /� Int. wail Ceiling / Floor 90 Total Btu. Required sq. t E.D.R. or sq. ins. W.A. Leader area n _ w .n,;�L Room I Length l ' Width lei" Height Q ' Windows and Doors—Crackage and Area 8' Height f " Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. L, Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 3/ Coef. Btu Glass Exp. wall ' Net exp. wall p /� Int. wall Ceiling Floor 90 Total Btu. Required sq. ft. E.D.R. or sq. ifis. W.A. Leader area FI.jjq&66 Room I Length ' s Width 8' Height f " Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling 90 Floor ,Sf Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area I i 11 • City of Fridley, Minn. BUILDING PERMIT �5 7 N° '7598 oma: B ernard Hartman Buildw Metro Builders!, Inc. Address nth St. N. E. 5860 Address 2909 N3 _o] l et Lyew So. LOCATION OF BUILDING No. 58W Street 5th. Street N. E. part of Lot Lot 2 Block 5 Addition or Sub -Division - NOMett Falmer Addition Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost $2, 50M0 — To be Completed Storm Damage Repair In consideration of the issuance to me of a permit to construct building described above I agree to do the proposed work in accordance with the description above set f and � compliance with 21 provisions of ordinances of the city of Fridley. , /% x In consideration of the payment of a fee of $–lQ= , permit is hereby granted to Inc • 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, Minnesotasing location, construction, alteration, maintenance, repair and moving of buildings within the city limits � this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: 11b permit den not emer the construction, hotaMon for whleg, plumbing, gn heating, sewer er water. Be sura to sn tin Building impeetor ter aepan to p -Wb for then dams. OWNER'S ADDRESS APIMI,CATION FOR BU?LDIX^. PEP.MIT CITY OF KtIDLEY, M.01NE GTA LOCATION OF BUILDING No. �TY�6 Street % IV PartofLot 4'l Lot IS Block Addition or Subdivision 9. Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location.drawn on these Certificates. To be used as: DESCRIPTION OF BUILMIG Front apth Ueight Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. CU. Ft. ego Type of Construction i,/��J' k�®moi �r Estimated Cost �/�d �ccr 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 true and correcty DATE _ _5',2-2 S SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). 40 o 0 • E LJ City of Fridley, Minn.. BUILDING PERMIT Date: Dec. 162 1968 Owner: Bernard iia Hartman Builder Address 5860 5th St. N. E. Address No. 5 86 0 Street Lot 2 Block Sussel Co. 1850 Como Ave. N° 10066 LOCATION OF BUILDING 5th St. N.E. _ Part of Lot 5 Addition or Sub -Division ._ _Bennett -Palmer Addn. Corner Lot _ Inside Lot — Setback Sewer Elevation Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 20' Depth 221 Height 10' Sq, Ft. 440 cu. Ft 4400 Front Depth N Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost _ $1500.00 _ 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 adl provisions of orrlinattces of the city of Fridley. in consideration of the payment of a fee of $ 7.00 , permit is hereby granted to Sussel Co. 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 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 within thee. city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinaBuilding Inspector NOTICE: M pormlt dos not cover the sondtrustion, IndaWan for whine, phunbine, gas htathm sewer or water. Be sura to as &a Building lespedar for separate permhs for thea item. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWM'S NAME_ ESQZLJ- .% -�.- 1&. ,e�%..IBUILDER ADDRESS SeC.,c3 -ST-4. -hvm. ADDRESS I elc�Mo LOCATION OF BUILDING LOT -- BLOCK '!�; ADDITION OR SUBDIVISION COR MR LOT INSIDE LOT SETBACK SIMARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form. Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front .2- 4=9 Depth 72 -Z- Height 1 Z> Square feet Cubic Feet Front Depth Square feet 44<:> Cubic Feet Height Type of Construction Estimated Cost 8 !S ®C::) 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 than Department of Buildings, and hereby declares that all the facts and x�.;resertations stated in this application are true and correct. DATE %-z 1O SIGNATURE —7"-4.1—� <=C:�) (Schedule of Fee Costs can be found on the Reverse Side.) Tal >44&:P' ;V"� �' . 'Xi Ladd Piun,ur, f / ;/ .01 ' ._..0 �i �1 U U, I •..-... U V u it `.1 �J v i� 1i V `..1r CIS;! i,- .•/,.Fal i . 4,5 j IJ • r �. I t �• ( � •/ I ~� ' 'ter i ^ � ;, ' fI1 1 -<�, , } Ti//,$ 15 a li a e crd ca-rec. repr c/7!U/1 / ''Pa >U!•::: / 2 j;; i. -2.:i "i i .l^ � > l � b.;.* . v . dS; r i� L:.�� %lia.'.:%1 � (i%/� GJl •:ai::�' G;:.7 i�:.U�'.i.a��li � Gii;/, �i:;./ ii' :ii .. /. �. � ...:.� I.i.:.: �� .. �• J/ i. •. • 1 •� •/ �/ .;.. ... .,' i i L... J f!•._ / �.1 i,:•� f;r; •.:/'f f c-r'./J r,:: /1;.;5iG��� �/1 v�i::.;'.:J �,::.:�:i' .:11:�.::'f,�f!.r.,/�s�::fi ,../. �.... , :/': :I/ �,:`..: i...:1;:.:f . .� .r ` . ,. ,' } i✓d: %(../:.1:.`(%.�. 1/{%�i �:i...i�/l::✓ L..%'J 1..`/L.::/%.J �:.�i/%Jil,,:%�..I �•Jiw ✓..../�/r.-.J i.J r...'C ����� �/til. r.... =. l i,( i.•...J ./-/ .. .. .. r _._ cif t:� 1��, ' � �_.... ��� t r:__..... _.. _', ._...._._. _.� � .::�.: •' .,.;..,:: � :�; `.::. ; �.:....•, ., , .... . SUBJECT PER City of Fridley 15874. AT THE TOP OF THE TWINS B U I L D I N G P E R M I T rp RECEIPT NO. �• COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. &12 1 ----I , CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY J` 612-571-3450 910-F15 841-3480 JOB ADDRESS 5860-5th St. N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 5 Bennett-Palmer SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Bernard Hartman 5860-5tiz St. N.E. Fridley 4571-0911 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Chas. E. Johanson IN974-9576 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Interior remodeling for rehab. work. 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, ORIF 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 $5,300.00 $2.65 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION OF NY OTHER STATE 90 LOCAL LAW REGULATING CON- STRUCT) O HE PE ORMANCE F CONSTRUCTION. $33.00 rPLAN 3 CHECK FEE TOTALFEE 35.65 SIGNATUREOF CONTRACT AUTHORIZED AGENT IDATEI WHEN PROP/EEULY VALIDATED THIS IS YOUR PERMIT 'y BLDG INSP GATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: ADDRESS: ®— T� 'rir. A.4& TEL NO: 7 BUILDER: ��f• �Gr�►So-� .__._ ADDRESS: e/ TEL NO: 71y- 1�7 • Construction Location STREET NO: STREET: 7,.� LOT: BLOCK: ADDITION: rt,-" - Corner Lot: Inside Lot: PC_ Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Sgpare.Feet: Cubic Feet: Front: Square -Feet: Type of Construction: Depth: Height: Cubic Feet: Lb Be Completed: Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ 5300, 6-7-' Alt. A Alt. B SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley.Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica DATE: '/ Y -_44-0 SIGNATURE: Stipulations: { a CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PEWIT PARTIAL RATE SCHEDULE $3.00 $ Additional Fixtures x PLUN13ING IIXTURE RATES: NO. $ RATE TOTAL Fixtures x $3. QO o c utL•re _ `xtsre Opening -4 � $ Water x _ $2.00 $ Catch Basin x $5.00 $ e x u $ . $4 a w c dater Softener Heater c y a x 0 $ N •a M $ $ m c C, L .s AJ Cl C J! ••y 7 O O m 0 N N X cn �: U a G 4 cq 3 o w° vii W U co 3 0 o as lec ist 2nd 3rd j 4 th i I (R) = :`.:tare Connection Opening Connected with Sewer (*} = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE $3.00 $ Additional Fixtures x PLUN13ING IIXTURE RATES: NO. $ RATE TOTAL Fixtures x $3. QO $ c utL•re _ `xtsre Opening x $2.00 $ New Fixture, Old opening x _ $2.00 $ Catch Basin x $5.00 $ :dater Heater - to 99,000 BTU x $5.00 $ 1C0,000 B:J to 199,000 BTU x $10.00 $ dater Softener x $7.00 $ 'Caw Grou.d n Old Building x $5.00 $ Electric Water Heater x $5.00 $ G..!,S FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $4:0.00 $ nEPAIRS & rlLTEZATIO\'S First $100.00 $5.00 each add. $100.00 or fraction $2.00 $ ,� State Surcharge $ .50 TOTAL FEE s175-0 REINSPECTION FEE ($10.00) Job Address -A Aa- X15 - Department of Buildings City of Fridley Tel, #571-3450 The undersigned hereby makes application for a pe;*mit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and roprosontations stated in this applicatio are true and correct Fridley, Mn. , 19 PCI OWNER Af✓z f� 7 7` r1n a .- - j KIND OF BUILDING USED AS J ' e-&�- TO BE CO:TLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PEXV.IT NO. ROUGH INSP. Compan Signed Tel. N Date FINAL INSP. / —le- - ff Date APPROVAL FOR PERMIT 0 MMINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE I SUBJECT P City of Fridley r71 4 0 AT THE TOP OF THE TWINS BUILDING PERMIT r EIPT NO • _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r I PROTECTIVE I i NUMBER REV. DATE PAGE OF APPROVED BY = 1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/8/84 JOB ADDRESS 5860 - 5th. Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 5 Bennett Palmer Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bernard Hartman 5860 - 5th.Street'N.E. 571-0911 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ament Pools & Const. 2239 Roosevelt Road, St. Cloud, NIN 56301 252-0130 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 321 Swirm i.ng Pool 9 CHANGE OF USE FROM TO STIPPULATION S See letter dated June S. 1984 from Environmental Officer. ti GAStEtc. SEPERATE PERMITS REQUIRE® FOR WIRING, call Befate d'�g}nE"toptkt- 'REATING, PLUMBING AND SIGNS. ReQu1R TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND= TH TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORD) CES GOVER IS TYPE OF WORK WILL BE COMPLIED $8/ 000 $4.00 WITH W THER SPECIFIED EREIN R NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES OT PRESUME TO VE AUT RITY TO VIOLATE OR CANCEL THE PRO V SI NS OF ANY OT R STATE R LOCAL LAW REGULATING CON - $68.50 TR CT N OR THE P ORMANCE F CONSTRUCTION. AN CHECK FEE TOTAL FEE • $72.50 SIGNATURE OF CONT TOR OR A UTFORIZED AGENT (DATE) WHEN PROPERLY V ATED THIS IS YOUR PERMIT C BLDG I -TE SIGNATURE OF OWNER IIF OWNER BUILDER] IDATEI NEW City of Fridley Effective 4/1/84 A DN. [� �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: .M OO S TW ST• tjr--- . Legal Description: L-07 E)lOc.V15- b:= w i-4 m'C -T t AL&4 Owner Name & Address: ' Tel . # G /2 '37J -D 'G/Z ?S-?-0132)Contractor: AMEAT �oo�-s f C�'►�=Si ' Tel. # Address • E7_31 31 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Corner Lot [ ] Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Widt Height Sq. Ft. Length id Height Sq. Ft. Length i Hgt/Ground Sq. Ft. Inside Lot [rte Type of Construction: Yd. Setback / Side Yard Setback Estimated Cost: $ POD °= Approx. Completion Date: Tf: -= Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ See Ba age for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge d /2 APPLICANT: LTel. # CITY USE ONLY Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ • 0 $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering C-) Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: If - J:� . 6 3 - y--- C -4r / 0 ?. S� C17YOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 June 5, 1984 Ament Pools & Construction 2239 Roosevelt Rd. St. Cloud, HN 56301 Re: Swimming Pool Construction at 5860 - 5th Street N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. Ament Pools 6 Construction June 5, 1984 Re: 5860 - 5th Street N.E. S. An automatic chlorinator should be provided With a suitable test kit. Page 2 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1-1/2 times the pool diameter and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval of the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, Z"le STEVEN J. OLSON, R.S. Environmental Officer SJO/mh CC: Mr. Bernard Hartman T k b e e r 4,olsAment Po N SOUTH VILLAGE o 2239 ROOSEVELT RD. • ST. CLOUD, MN 56301 • PHONE: (612) 252-0130 N G Ij6 X 3z ,fclz-7'f(cl4-rL5- u VoL+c. Li mb• Tws c1 Mr—1 T�4c— A PeL t eA -mo A,.-- 04 .401((and Plwni7y�.S-Xf�'i� 0. Load "iny SolsTestif ENGINEERING, 11 N C. Caw/ & "aziiapal morel Q uC:& En ineers Surve ori µ Tv2o gage Loan Survey for. i' C7y �a r : Lli I wILI C, t I Lo • 011 i�-� � ,1 X1.1 • �3i� ' C1 � � ' • � � r 0 i A,i rs a liw and cared .rpvsmlahon afa wrr y itr& ba..i&ws gf"khow and a}t`'/fi� I�icra o�sdl �c`�-Vis, i%amJ, f6prtan, avd d risible arcr iarrrfs, yl'any, a• Lid. & sr a o►a� ady n ta> ettacra arilb a .-� 1 7 ::�+ 'Zyq plead aA *proms/y oxd an lra:bil; y a msrnred suep� � l�fmbfei� g/suafi ma��r S e�'' .N�'' �resl �� ����; j c�' sura aao�}ya�P. Nis vnG��d arad��anma►�umtnts fore d�►,�ee� � ����� �i� ar�ic�y ar,: � �.: Ao%S Ha's 1 �4� ;u� A 4 2 ; SUBURB:4N EN6jMfFf OWL /NC. I�IZ P..�rc• l._wE•— FF I-(,Roller- '�T*--p @� Tn I 1EETUEN �l Pam TB 3 Z VOL. - ! - ----------- - I I, - II I L — E Tvt � 1 _ ���2. Sy- MMeJZ - - -_ J .J I 6 � Ma1N b�wut � I �i �¢ E M��a ��►.r 1 I fa I e' I/�► DESKaN �„/. L . 4 SUBJECT City of Fridley =20� AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 6 /10/98 10/98 JOB ADDRESS 5860 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lois Hartman 5860 5 Street NE 571-0911 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Tabor & Sons Inc 3716 St Francis Blvd, Anoka, MN 55303 789-1902 20014248 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 0 ADDITION 0 ALTERATION _❑ REPAIR X 0 MOVE 0 REMOVE B 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $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- $59.50 Fire SC $1.83 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 6&1`Le� PLAN CHECK FEE TOTALFEE License SC $5.00 $67.25 SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT (DATE$ WHEN PROPER VALI ATED THIS IS YOUR PERMIT I .8 G -NSP r�ATE S.GNATURE OF OWNER$IF OWNER BUILDER$ IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING -PERMIT APPLICATION fih ConstructionAddress: _Cg � O S e— fr.' d /' Legal Description: Owner Name & Address: � o > S te` � /��� � Tel. # 7,/— o :w Contractor: c MN LICENSE # Z 06 1 c1 2 y Address: i s 7 /s/c,/jS3 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DESCRIPTION OF IMPROVEMENT Width Width DECK AREA;-,,L� gth Width OTHER: Construction Type:I &V or?, sW oee X'00 r - Driveway Curb Cut Width Needed: Ft. + 6 Ft = t Height Height Hgt/Ground e"3< Sq. Ft. Sq. Ft. Sq. Ft. -' 9 Estimated Cost: $�'V /33 i (Fee Schedule on Back) Ft x $ = $ DATE: G --jd APPLICANT: Tel. # Permit Fee Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ 60 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ S 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 [ ] 7CC 5—/S D Z-_ GffY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 P �� V APPLICATION FOR PLUMING AND GAS FITTING PERMIT t"ectide VIl Jclll I, LVVu PLUMIWNG FIXTURE RATES: NO. RATE MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Old Basis VY�h Floor Aub. .Gas $ 7.00 S 111R ater Heater:;::<:':; Stories :Urinal . .:• Shover •: DrainWasher >�::>.: on harps" $10.00 On Dryer" Gas Elec Bas* Flow PremnW Re**W ( )Yes () No - - 4jv : :.• y� .•i%?:. �Y.l.:! ^:q.;ya.::. :';�i.>.PL: .iiD-.� ��f:p:Y.• I � Fbor 1 ,;:• ..:f•�:��:• •': Floor 2 ! Floor 3 Floor 4 �. vI.l. PLUMIWNG FIXTURE RATES: NO. RATE New Foctm $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Old Basis $ 7.00 Colds Bassin $ 7.00 Rain Vlf W I:eeder $ 7.00 S $ 7.00 WAN T(eadnq Apple= $10.00 VVdor H@dw tic $ 7.00 VliAm Heir - Gas" $10.00 on harps" $10.00 On Dryer" $10.00 Bas* Flow PremnW Re**W ( )Yes () No TWS $15.00 R *---,--i, n11 Fee $47.00ft ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fbdure or Appliance TOTAL FEE TOTAL JOB ADDRESS 5 S (o O - 6 r~ . nj e . The underm*ml hereby makes epplic -Im bre permit Ibr the work herein spedisd op - 6 eg to do a• work in s biot souordessoe wNlh the dq► oodse WW nsliegs of the Budding Orin, and hereby declm a Chet al the tack and repres--Rebores slated in thio appNs=ation aro true sled cmea 3--7 20©/ Beed m L%W As E 1 1, 'Coo PERMIT NO. I `� Tv tea rI J . PLUMBING COMPANY 11 � l SIGNED BY Approved By ropocuSTION AIR SRAL i_ 6E PRwiDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 March 8, 2002 Lois Hartman 5860 5`h Street NE Fridley, MN 55432 Re: Final Inspection at 5860 5th St NE Contractor: Lee Stull Plumbing Dear Ms. Hartman: A plumbing permit was issued on March 8, 2001, to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Code. 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 permit called for" 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. DAJENSEN Builping Inspector DJ/ls r CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $�S� State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 2002 JOB ADDRESS �Z �l'�� �• /�I OWN BUIL ESTIMATED COST /0"0' ob PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER 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 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 an rulings of the Building Division, and hereby declares that all -the facts and representations stated in this application are true and correct. Rough -In Date DATE �� Final Date (-- THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED rOMMON VFNT� VENT CONNFCTOR AND COMMIRTION AIR VFRIFICATION When reIngan Pxintina 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. ) No ( ) The venting system is plastic/PVC and meets all current codes and manufar specifications including sizing, length, number of elbows and termination. ct Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes�)No The existing cnmhustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new rnmhtinflan 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 manufacturers 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 #1 Type Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 AIT RATIONS M _c _rib _) HEATING CO: Signed By: I- X Date l S- 1 ^f V) SUBJECT P 0. City of Fridley 3 3 716 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. � rly� r 1 . � I i / CITY HALL FRIDLEY 55432 IL""�l, NUMBER REV DATE PAGE OF APPROVED BY 763-571-3450 910-F15 7/18/03 JOB ADDRESS 5860 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 5 1 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Hartman 5860 5 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Twin City Home Remodeling 6527 Central Ave NE Fridley, IIM 55432 763-572-2577 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20385210 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 Reside House; install bow window 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering or take pictures. Caulk and flash all exterior openings. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit Inspection Cards SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. WR lovFML Ll Oil CUPANC Y LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $14,000 $7.00 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- Fire SC $14.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $237.25 PLAN CHECK FEE TOTAL FEE icer SC $5.00 $263.25 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT iDATE. - N PROPERLY VALIDATED THIS IS YOUR PER, IT S.GNATURE OF OWNER..F OWNER BUILDER. IDATEI BL SP )Ali V) NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 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: s-9 &O S- ji 5A /V r— Legal Description: ll Owner Name & Address: 6AA!, /�Ziow1Lrn r9-rs Tel. # Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: MN LICENSE # Tel. # "i m Attad j a tion, a Certificate of Survey of the lot, vm0j2039LMV 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. Construction Type:z-&4ew4e , A&4u Lc9mJoc1 _ Estimated Cost: $� Driveway Curb Cut Width Needed: Ft. + 6 Ft zi Ft x $ _ $ ork DATE: fsv 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. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ 237. Z,5-- CITY USE ONLY - TOTAL $ 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 [ ]