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PRE 2010 DOCS• City of Fridley, Minn. 0 BUELDING PERMIT N® 3344 Date:.....1............................. Owner ....................................... Buildertg... ........ . Address...................................... Address ............................................. LOCATION OF BUILDING No. ® , ®... Street e ............................ Part of W ......................�........ Lot ....../.... Block ...��............ Addition or Sub-Divisi� ... ... ... .... .. ...... Corner Lot ......... a ... Inside Lot .....�.... Setback �."�71..... Sideyard �......... .... ...... .. DESCRIPTION OF BUILDING To be Used as: C . ... Front Depth .. Height ... 2... Sq. Ft.. L .� ®. Cu. n /. ty ....... Front . � `�.. 6 Depth ...?. P. Height ....t?.. Sq. Ft......... Cu. Ft:......... of Construction : , ..... Bst. Cost. 1.L.! J .0........ To be Completed ................... o In consideration of the issuance to me of a permit to construct the building desribed 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. , l In consideration of the payment of a fee of $. Z .., 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 worlanen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects td the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. A . ...... Building Inspector Ldu-c - NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley SUBJECT 2276-) AT THE TOP OF THE TWINS BUILDING PERMIT f -RECV—PT O. COMMUNITY DEVELOPMENT DIV. '1 I r � , PROTECTIVE INSPECTION SEC. q, �( "� CITY HALL FRIDLEY 55432 NUMBER REV PAGE OF APPROVED By 612-571-3450 910-F15 JDATE 8/2/94 JOB ADDRESS 6010 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 Bonny SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kenneth Swanson 6010 5 Street NE 571-1679 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Exterior Innovations 2187 Overlook Dr, Bloomington MN 55431 884-0814 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 .0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $49019 $2.01 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63.00 Fire SC $4.02 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $74.03 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI P BLDG LY VALIDATED THIS IS YOUR PERMIT 0ATE SiGNATURE OF OWNERIIF OWNER BUILDERI IDATEI N NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: 6V0[0 f ~ Legal Description: Effective l/ 1/94 Owner Name & Address: P -F �� �'� � r� Tel. # 7 K 7 Contractor: sc7,c MN LICENSE # 3l Address: �l�r�e .� (��.C, 2r— Tel. # �'� 'D 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 [ ] Ft. Yd Setback Side Yard Setbacks Type of Constructions £a Estimated Cost: $ Approx. Completion Date: (Cost on Back) Drivewa Curb Cut Width NeedeCd:. Ft. + DATE: APPLIANT Ft x $ TOTAL $__,? qp _fqp 3 STIPULATIONS: „ . . CITY USE ONLY Permit Fee $ 43,069 Fee Schedule on Reverse Side Fire Surcharge $ �3(,O Q .001 of Permit Valuation (1/10th%) State Surcharge $ C9,61— $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $__,? qp _fqp 3 STIPULATIONS: „ . . SUBJECT AwElf N IT NO• City of Fridley 26731 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. ~ r I PROTECTIVE INSPECTION SEC. 1 � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 ,j 612-571-3450 910-F15 7/21/98 JOB ADDRESS 6010 5th St NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 Bonney SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Swanson 571-1670 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Wellington Window & Door Co 3938 e d r 2 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 933-6300 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [I REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replacement windows 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,000 $3.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $124.75 Fire SC $7.00 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$140.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WH PROPER PROPER ALI`D/ATED THIS IS YOUR PERMIT BILDIF INSP DATE SIGNATURE OF OWNER I iF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER pC] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:. 0DID 'J' '' q-/ OrE pG vN 5-54-52— N Legal Description: /-) /au. n9 Winal�S Owner Name & Address: iii 6 U -Qz Z, Tel. #-57-1 10 17-0 Contractor: `/ I'� W1,r ew-t CQ, MN LICENSE # Nllq Address: 9 3c fl� o(!, WbPVDk Ad-, R--4 �G 0 loa4-1? /'YIN Tel. # q 3,3— ow 01W 4 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT 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: 9W-1aZ&1^JerV— W%nQ%VS Estimated Cost: $ '=6e�- QM0 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Fux $ _ $ I DATE: 7/110 - APPLICANT: Tel. # 9,33— 6300 CITY USE ONLY Permit Fee $ 1.24.7s- .24.7SFire FireSurcharge $ 7.00 State Surcharge $ 3-S-6 SAC Charge $ License Surcharge $ 6.00 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ 14D•Z S STIPULATIONS_ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 [ ] CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYS`T'EMS AND DEVICES , vy �c7 S4 JOB ADDRESS V/ 1 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 $ / OWNER Gas Range BUILDING USED AS /yam Gas Dryer $ 10.Q0 $ ESTIMATED COST PERMIT NO.. *Air Conditioning —All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appiiance or Work $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work r $ Fuel' Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE HEATING COMPANY 2JZ4,fiD MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION -, Z 4 No.�/ REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed B 2 1 Tel PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Appeoved ByRough—In Date Final Date 107 J *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE HIMNEY AND STACK VERIFICATI The undersigned hereby verifies that the existing chimney or stack: I. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes( ) No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes (} No ( ) 8. Has combustion air been provided for water heater Yes O No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Effective January 1, 2003 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 FAX (763) 571-1287 r / / C JOB ADDRESS �¢� [ l v ► c� J V RATE SCHEDULE OWNER ke Residential Rate TOTAL cic=/ Furnace Shell and Duct Work, Burner - BUILDING USED AS �S / lam Cgs Also Replacement Furnace $ 30.00 $ �� - Bo (Side Vent - Fill Out Back) ESTIMATED COST �� � PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) 4Z�r) Gas Dryer $ 10.00 $ Trade Name /� 'Vry Size No. 3 SS BTU (o0 �O HP EDR *Air Conditioning - All Sizes $ 25.00 $ �-S , ©� Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 15 of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true d crect. TOTAL FEE $ �S ' -1o DATE )a MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION TING Cb STANDARD HEATING & AIR CONDITIONING 0- REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 410 WEST LAKE STREET PLUS THE $.50 STATE SURCHARGE MINNEAPOLIS, K i5LWO8-2W8 FAX # 612-824 58 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By A Rough -In Date, Final Date written permission from adjoining property owner. - FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When ffi In acinn an_g ,. 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 A/No The venting system is plasticlPVC 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 (�4/No ( ) The eY�ting,Snmb istinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to Install a new cnmbtistinn air__ it will be sized and installed to most the current codes and manufacturer's specifications. Yes( No (d)'�) When jpStalling a new venting sy em, 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 () A— 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 (O/No ( ) Appliance Tuna and R 7a/Common !Vent and Vent Cnnnectnr Infermatinn b Appliance #1 Type BTU Input o O 'D Fan Assisted or Nat ebl�� Appliance #2 Type ZT BTU Input 'q 9 d Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 4d, 0 9 0 r Common Vent Type y jr� Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter V= in Type V Appliance #3 Vent Connector Height ft Length ft Diameter in Type N HEATING CO: ��' `'% f . / ' u— �✓ 1 /L�. Signed By: Date : CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: (763)571-1287 ADDRESS : 6010 5TH ST NE PIN : 233024210045 LEGAL DESC : BONNY ADD : LOT 4 BLOCK 3 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING VALUATION : $ 11,782.00 PERMITO.: 2004-00764 DATE ISSUED: 05/21/2004 NOTE: PER R703,2000 INTERNATIONAL RESIDENTIAL 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. RESIDE HOME WITH SELECT CLAPBOARD VINYL SIDING. STATE LICENSED CONTRACTOR 1 APPLICANT RMA HOME SERVICES INC 3200 COBB GALLERIA PKWY #200 ATLANTA, GA 30339 - OWNER SWANSON KENNETH E & C K 6010 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 wort 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 any other state or local law regulating cons ction or the performance of construction. Anuli ant . ' . Date , Bldg Insp. BUILDING PERMIT FEE 209.25 FIRE SURCHARGE 11.78 STATE SURCHARGE, VALUE 5.89 LICENSE SURCHARGE 5.00 TOTAL 231.92 PAID WITH CHECK # 35218 CMD ADATL'DLDXATTQDCl1TTTDLn rl1D II/l1DTlr*1'ILWD-TLTARTT"% Q!1DTI2T~Tl A71111M 04/02/2004 FRT 13:21 FAX ELDER JONES ISO .2jq 1 0001/001 y NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ I SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address Q� _ `��i��c)P Contractor. RMA HOME SERVICES INC. Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Atlanta, GA 30339 763-542-8826 BC -20268257 Tel. # MN LICENSE # Tel. # ificate of Survey of the )n 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., 14e..t &_ QAo.R6ca. ccsI S;6 c Construction Type: Estimated Cost $ Driveway Curb Cut Width Needed: Ft, + 6 Ft = Ft x DATE: APPLICANT: JVN-p Tel.#`7SZr3tiS-(00g1_ Call (763) 672-3604 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 Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CRIT USE ONLY - $ oafUCl • �S Fee Schedule on Reverse Side 65% of Permit Fee $ 1..�'i .001 of Permit Valuation (1/10th%) $ t.32� $.50/$1,000 Valuation $ $1350 per SAC Unit $_ 5 • y C) $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 [ ] q2 $ r�. I STIPULATIONS: - CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PERMI NO.�2004�-01206�� DATE ISSUED: 07/28/2004 ADDRESS 6010 5 ST NE PIN 233024210045 LEGAL DESC BONNY ADD LOT 4 BLOCK 3 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE : SHED (GREATER THAN 120 SQ FT) 'VALUATION : $ 2,049.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 14 FOOT OCTAGON GAZEBO PER APPROVED PLAN. APPLICANT SWANSON KENNETH E & C K 6010 5TH ST NE FRIDLEY, MN 55432 OWNER SWANSON KENNETH E & C K 6010 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 wort 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 any other state or local law regulating , structio�} o e%Performance of cons�tio . Annlic l �l,raolh Datel/210#4 Bldg BUILDING PERMIT FEE 83.25 PLAN CHECK FEE 54.11 FIRE SURCHARGE 2.04 STATE SURCHARGE, VALUE 1.02 TOTAL 140.42 PAIDWITH CHECK # 1965 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW®9'CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] t 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax 4t,�9 BUILDING PERMIT APPLICATION Construction Address: 610 - S f'jci a Legal Description: Owner Name & Address: U----SW-A0&00 Tel. #-7(eS-�1I - I L.P'79 Contractor. n SAA a-- MN LICENSE # Address: U0 t ® X4-1% Sit WE Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT WING -AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: �Length Width Hgt/Ground Sq. F A OTHER: � ® 6 4 � � t�� 0 L'i`A61r) N 1(05 S4. Fr Construction Type: I4o®.D MAnna E Estimated Cost: $ °� �• �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: al /2,t 10 (f APPLICANT: Tel. # -7 G3 - 527 /— / 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 e Fee Schedule on Reverse Side 65% of Permit Fee .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 ( ] TOTAL $LAC) A'—� STIPULATIONS: COLLAf?- R A FTIE'R- AT w A u- Zz R M E -Q. Z- �rA Ci 4 ql/z:' A'"Frt • 2ztCo RAFTtic^2. ASPH+AL:r P rZc'H l TL-c1-tu 2 A %,- �� � SWiNb4e� Oa i P e DGS' 1 Ar &-" SKIRT Lf -((v Pas;'I 191' SOmol*uee w /Col,se eel -E QIP e 2vss s.ri a ( w rn+ cotw hs; V o o oF J1 51APPOIZ L. AYc M C T--,Z:L-r lz p RATE" NN A:TC K rL- I -,Roo 27r: 01, IN 2 xfo S K, wr Srv► D M, I A-OP2e� OA*4' m 4A7'li LA)14 LL :5 1 D E- 'T`f ICAL I PLv,ct-Ts �.� S �� Sow 0'Tu ISE � I I TYPICAL, aAck Sl DE Dw-ar— to ! cKl-r SuBsKI(2C—t 6 -P05 T- 14! i ArPH �-�.i Cii L--U � N �. �= Iy k'_ � %'f �DEc�►n►�.-[�t°�, w.t, � ►. cd-- �qo NOS S CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 ADDRESS : 6010 5 ST NE PIN : 233024210045 LEGAL DESC : BONNY ADD : LOT 4 BLOCK 3 PERMIT TYPE : ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION PERMIT NO.: 2004-01207 DATE ISSUED: 07/30/2004 NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL UNDERGROUND WIRING TO GAZEBO. # INSPECTIONS 2 APPLICANT SWANSON KENNETH E & C K 6010 5TH ST NE FRIDLEY, MN 55432 OWNER SWANSON KENNETH E & C K 6010 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 wort 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 any other state or local law regulating construction or the performance of construction. Applicant Date Bldg hasp Date ELEC PERMIT FEE - MIN (RESI) 40.00 ELECTRIC FORM FEE 1.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 41.50 PAID WITH CHECK # 1966 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.