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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: Owner: ___......._......... Builder Address Address alAV.....- a T,.._ _. -...-�- J'� + CAF BUILDING P. Street _.__ G..._......._..... Part of Lot .... _..... __..._... _ ._.._ Lot .............. Block ............. ......... _................. Addition or Sub -Division ..._:. _.___..._ :'.P_........._. _ .. E Corner Lot ................................... Inside Lot ....._. _................. Setback .... �,;L ............... deyard ...,f.. _. Sewer Elevation .... .... ... ............................... __............._......__.._......._.............. Foundation Elevation DESCRIPTION OF BUILDING .. ba Used as: r Front .. .._.. Depth ...s _ Height . _.- Sq. Ft. ..W Cu. Ft. ' .......... ................ ......._..... ............. n. ------------------._. Depth ..-............... eight ....................... Ft. _..._............._.. Cu. Ft- . ,�+� �Sq. Type of Construction .. ............'"� ... Est. co ........�,".... ++� 4 .. 'o"`�ie Completed ..... _........... _.._--•----- 711, R 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 of any of the provisions of said ordinances. ,+''" } ..��-_. . wilding 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 hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder l C/ Address ���/- .�7 Address -D <D ,5�L�,� LOCATION OF -BUILDING r _ No. Street JC` Part -of Lot Lot :Block 'Z Addition or Sub.Div. ��D`el tel- ... .._ Corner Lot Inside Lot et Bask Side -Yard SEWER, ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building ' location. DESCRIPTION OF.BUILDING To be used as: _ "Front �� �® Depth 2 o e Height -A .0 -'-. Sq. Ft. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Tstimated Cost_ �b To be completed The undersigned hereby makes application for a permit for the stork 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 fact's and repreeents- tions stated in this application are true and correct. DATE 7� SIGNATURE 5 (A Schedule of Fee costs can be `found'on the.,Reverse Side.) MINDEAFANGDiEMING CO3wq1NCw ENGINEERS AND SURVEYORS LAND SURVEYING SOILS TESTING CIVIL d, MUNICIPAL E40INEEMINGi LANG PLANNING 6418 -SGT" AVENUE N. MINNEAPOLI5 Tr.MINN.- KE 7- 3637 Copuptificate of It qp SURVEY FOR Tom 51LVI5 N � - I c 6 I � mil I �r til I _ IRo r1 ICON I LOT 29 BL'K. Z UPLAN® 2 ND ADDN. WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM ort On► SAID LAND. MINDER ENGINEERING CO., INC. OPTED THIS DAY OF Nov. A,p,H54 ENGIN A'41D ;L ORS _..� . by City of Fridley Application for Plumbing and bas Fithting Permit Dept. of Bldgs. Phpne SII 4-749 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL dG 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 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 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___ 2 7 Owner Kind of Building ✓�� Used as To be completed about Estimated Cost. It Old—New. Building Permit ROUGH FINAL / / — / — o fF,4' J®i e 7,- o IV [flAP (I r)A., U nl l3 /�- s/u1s -QEW42 2M 7-59 i x �ea^ z r1 �c Q t<Taj - O u<jS O 0 z z F N WATER HTR. GAS ELEG C"i 3 � '02�o U <3 �d (�9d �O � Base 1st % -HI 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer � Now Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL dG 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 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 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___ 2 7 Owner Kind of Building ✓�� Used as To be completed about Estimated Cost. It Old—New. Building Permit ROUGH FINAL / / — / — o fF,4' J®i e 7,- o IV [flAP (I r)A., U nl l3 /�- s/u1s -QEW42 2M 7-59 4110. Uty of Fridley, Minn. BUILDING PERMIT N© 6 3 2 A Date: .- ZI Owner: Builder Address R Address OAL-01: BUILDING No. Street _ Part of Lot Lot Block Addition or Sub n .OOKU Corner Lot _ Inside Lotye� %Wback _ _ yard -- Sewer Elevation _. _— _ ro dation Elevation DESCRIPTION OF BUILDING Tomu ase . r Front Depth, Height. Sq. Ft. Cu. F -- Front, DepthHeigh Sq. Ft. Cu. Ft. Type of Construction EstrCodE' 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 ail provisions of ordinances of the city of Fildley. i In consideration of the payment of a fee of S '_r , 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= 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. NOTICE: This permit don not cover the construction, huhllation for wkkt& ph ndslog, an hsathm sewer or wsbr. Be sure to sse the Buihiine hector for npm to pe:mhs for thea items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S Mm 45�, ��e orBUILDER -5wg se / �--2d 1-a4g ADDRESS_ ���/ �"�� $7' 11l;i� ADDRESS /F -.SS® (20 -no _St LOCATION OF BUILDING No. Street Part of Lot Lot_ Block_ Additioa or SubdivisionC-a 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. DESCRIPTION OF BUILDING To be used as: be- 4 e -j _ai, & gg Front /(� Depth � � Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fi-d nt�e. Estimated Cost % 6-0 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 correct. DATE— / �� SIGNATt1RE o (Schedule of Fee Costs can be found on the Reverse Side). LOT id1am cc r po®* C. ��'�./.� � � ��e� .� �SIZE BLOCK ADDRESS 4/2/ _ 4 �'� � � v AL'T A:rION �.a� "2 ADD. ® C/4 ►TYPE ,Jew "ti l7! e %�% ��j Q 0 w o i� c • �0 - 2 39 - /9'. City of Fridley, .Minn. N° 7597 BUILDING PERMIT • Date: May 27, 1965 Owner: Murk Builder Metrn R„ j l d _= - Inn • Adm 6191 5th. Street N. E. Address 2909 I1ieg31et Ave. SQ. LOCATION OF BUILDING No. 6191 street 5th. Street N. E Part of Lot Lot 29 _ Block 2 Addition or Sub -Division Uplands. grid. Addition Corner Lot _ Inside Lot — Setback Sideyard Sewer Elevation — Foundation Elevation To be Used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft Front Depth Height Sq. Ft. Cu. Ft Type of Construction Est. Cost 84 s` -0-999 To be Completed • Storm Damage Repair In consideration of the issuance to me of a permit to construct g described above I agree to do the proposed work in accordance with the description above set fo in pliaace with ail provisions of ordinances of the city of Fridley. j%/� In consideration of the payment of a fee of , permit is hereby granted toKetr Bq' 1 dors t 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, Minnesota location, construction, alteration, maintenance, repair and moving of buildings wiord n nom. city limits a� permit may be revoked at any time upon violation of any of the provisions of said • NOTICE Ub pormIt does no own the constn 0m, huteliat n for WMh& phmbiae, aes heafts sewer or water. Be an to m the Bniidb* h"e ter for sopa permhe for thea items. a AP7.ICATIOW FOR BUILDM! PEP,MIT CITY OF FRIDLEY, MINNESOTA i BUILDEM _L2 f- ADDRESS LOCATION OF BUILDING No. X/ ��/ Street 15-- 70 Part of Lot Lot -1 cy Block , Addition or Subdivision/��.�r ,_ _ 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 BUILDIM. Front 'epth Height Sq. Ft. Cu. Vt. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimsted Cost � �® e 6 ��'ev To be Completedv�®� 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 correct DATE -_ � Z 7✓ SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT PERM City of Fridley 13156 AT THE TOP OF THE TWINS BUILDING PERMIT RECE `L ______ COMMUNITY DEVELOPMENT DIV. INSPECTION e PROTECTIVE SEC. 1 � = 1 /'--1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 8-26-75 JOB ADDRESS 6191 - STH STREET N.E. FRIDLEY MINNESOTA 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29 2 1 UPLANDS 2ND ADDITION SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE R. PETERSON 6191 - 5TH STREET N.E. FRIDLEY MINNESOTA 3 CONTRACTOR MAILADDRESS 1-.6/_ofd ZIP PHONE LICENSE NO. RAND CONSTRUCTION, S WILIJOW 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENCE 7 CLASS OF WORK ❑ NEW =ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK CONSTRUCT SUN PORCH AND GARAGE ADDITION 9 CHANGE OF USE FROM TO STIPULATIONS BOTTOM PLATE TO BE REDWOOD PROVIDE HARD SURFACED DRIVEWAY FOR WIRIN,I gEPER ATE OERMITS REQUIRED PLUMBING AND - HE.gtNC, VI►An mKING Before digging call local utilities TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. ET AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 180 320 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 21 An 3200 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING '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 $4,250 $1.85 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- ST ON OR THE PERFORMANCE OF CONSTRUCTION. $9.91 PLAN CHECK FEE TOTAL FEE P $11.76 IGNATURE0lTRACTORORAUTHORIZEDAGENT (DATE) WHEN PROPE ALIDATED THIS IS YOUR PERMIT , 8-26-75 BLDG INSP nATE SIGNATURE OF OWNER(IF OWNER BUILDERI IDATEI t AP ' A ALTV6A1•ION • PLICATION FOR RL•SIDLNTI L,, OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA OWNER ' S NM1E : L, ` BUILDER:_ UL�.cC Qnz t ADDRESS:- 4 / gI-:rS�'A! 2k. e-, ADDRESS:Gy3 � P-�✓-C esi/ NO,:-. 61 ze. STREET : .5 4 �• `yi , L, n LOT: 5• --BLOCK: ADDITION: J CORNER LOT: INSIDE LOT: A— SETBACK: � SIDE-YARD:��_ ' Applicant attach to this form Tcao Certificates -,f Survey -of Lot and .proposed building location dawn on these Certificates. DESCRIPTION OF BUILDING - To Be Used'As: o -., - Front: /�. A r.S- Depth: Height: • Square Feet: a� Cubic.Feet: ,Z1G n o �. Front: /( J;d Depth: Height: Square Feet; (3 Cubic Feet: 32 C) Type of Construction: Estimated Cost:� s��.,a To Be Completed: The undersigned hereby makes application fora 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 correct. DATE:' SIGNATURE • �.�..,., • ���-�- -- .(See Reverse Side For Additional Information.)' 5360 4 0 u ,0"cl 9/ 32 ox i.�G - �3Gg:oo V AGREEMENT owner of the property located at have no objection to the City allowing the construction of L a :!7�thout to be located at t91 tl wi the r the certificate of survey that the City ordinarily requires for all new construction. Signature2'�7-4� Address Dat Witness' SUBJECT P 0' City of Fridley 21414 AT THE TOP OF THE TWINS BUILDING PERMIT • COMMUNITY DEVELOPMENT DIV. ______ r ~ I PROTECTIVE INSPECTION SEC. 4 �R7 i = CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/23/92 JOB ADDRESS 6191 - 5th Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29 2 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Anna Peterson 6191 5th Street NE 571-0962 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 3700 553-0020 2406 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 j] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside House 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. 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 $41`300 $2.15 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- $72.00 Fire SC $4.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $5.00 License SC $83.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)HEN P OP Y VALID TE THIS IS YOUR PERMIT ^ LDG IN5P Z DATE SiGNATURE OF OWNER 0F OWNER BUILDER) IDATEI NEW [ ] � Et%ctive 3/l/92 ADDN [ J CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address:- Legal Description: Owner I Contract Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot _[)� Ft. k Side Yard Setbacks �� Type of Construction: , Estimated Cost: $ Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = (Cost on Back) Ft x $ _ DATE: (-� '�� '� APPLICAN- Tel.�� Oe Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agregment Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: 4,1- ���� SUBJECT P City of Fridley 77 2 AT THE TOP OF THE TWINS ? BUILDING PERMIT: r IPT NO. I ` _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. /, /D I- Lr/ NUMBER REV DATE PAGE OF APPROVED By i v---�CITY HALL FRIDLEY 55432 �j 612-571-3450 910415 17/21/98 JOB ADDRESS 6191 5th St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION. SEE ATTACHED DESCR. g 2 Uplands, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Anna Camella Peterson 6191 5th St NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION (A REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 27 S Tear -off; side front 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment mustcomply with State Building Code. Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2751 $1.37 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. $74.75 Fire SC $2.75 PLAN CHECK FEE TOTAL FEE 78.87 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY LI DATED THIS IS YOUR PERMIT /d 7 ,2 [ BL INSP f GATE S(G A W F OW UILDERI (DATE 4,1- ���� NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address:Tel. # C �l�:C.z Contractor: � � C ,� MN LICENSE # Address: 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: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Width Height Length Width Height Length Width Hgt/Ground wo Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: 4A .Sr'of'e Sq. Ft. Sq. Ft. Sq. Ft. 411 Estimated Cost: $ (Fee Schedule on Back) _Ft x $ _ $ APPLICANT: Zvwc Qk Tel. # CITY USE ONLY Permit Fee $ , J'7S' Fee Schedule on Reverse Side Fire Surcharge $ Z ?Y'--.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 [ ] TOTAL $ STIPULATIONS: CITY OF FRID LEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 �1 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO RE INSTAI I Fn ON FACH Fi nno Effective On January 1, 1999 PLUMBING FIXTURE RATES: -e NO. RATE TO New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader _ $ 7.00 Sump/Receiving Tank $ 7,00 Water Treating Appliance $10.00 Water Heater —Electric 7.00 Water Heater — Gas** V" $10.00 Gas Range" $10.00 Gas Dryer** $16.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ 50 y� JOB ADDRESS_ I I N 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. 9-3-6.2,sa Owner Building Used As Estimated Cos 91) 0 �U PERMIT NO. f 3 7 PLUMBING COMPANY f"i McGUIRE 8 SoNS 605 12th Avenut South =: i SIGNED BY Hopkins. !" �� N6. ,q Approved B Rough—In Date Final Date MINIMUM FEE FOR ANY PLUMBING/ PLUS THE $.50 STATE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. Building $ BUILDING Back Page for Fee Schedule Permit No.: Inspections RESIDENTIAL APPLICATION Surcharge Received By: 763-572-3604 (.0005) times the total job valuation - Minimum $.50 CITY OF FRIDLEY $ Date Rec'd: DATE ®— 2 0 ' YOUR E-MAIL ADDRESS $ SITE ADDRESS (O I �► S S �- .vi SAC Charge THIS APPLICANT IS: I] OWNER &ONTRACTOR $1450 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: ^ aot S -e /Z- 2TENANT TENANT ADDRESS: I41 � S..- A-,e CITY F STAT&P,* n-517— PHONE: 3 r'o 2 3 Park Fee CONTRACTOR -7-1p NAME: To INAURN MY HOW - ' SUBMIT A COPY OF STATE LICENSE # EXP DATE 7-31-0(0 8, big Lft Pr Wr YOUR STATE LICENSE ADDRESS: CITY ZIP -2 WITH APPLICATION PHONE FAX 7 2• Z F 7 Y (MoM. PROPERTY TYPE 9BNGLE FAMILY/NEW CONSTRUCTION SIZE 515968 ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED RMVINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIlvIMING POOL TYPE OF WORK: W ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: U%••.6' _ w SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S . 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 LQCATION OF WTNDQWS3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF /V C(��jf Ad'4&4 -- OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S Z Z &V o OCCUPANCY TYPE Permit Fee $ 73,237 Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ l 1 O (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ . 2 0 .001 x Permit Valuation (1/10%) License Surcharge $ '00 $5.00 (State Licensed Residential Contractors) SAC Charge $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 5-5— Make checks payable to: City of Fridley Attach Stipulations 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 code f the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f a e ' 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 w ' u'k s r i d approval of plans. SIGNATURE OF APPLICANT PRINT NAME ��`� ��✓�O �/A✓DATE /Q " l a "d Y� BuildingDEC 15 M BUILDING Permit No . Inspections RESIDENTIAL APPLICATION Received By: 763-572v 604 CITY OF FRIDLEY Date Rec'd: / O � rn ► it neso-I a— iuSCU C U YY'1 DATE W YOUR -MAI ADDRESS ( _– SITE ADDRESS W NE 5 SSy32— THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: .'&W, CITY STATE—ZIP PHONE.1103• S -I y - 71412 CONTRACTOR NAME. 3 � STATE LICENSE # aA %7.3 EXP DATE 3/9//07 L `�- �Y�t�A- 553` 3 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: SSSS CITY -STAT� WITH APPLICATION PHONE 9S2 - 9-S5 • g4P[e9 FAX `?SZ • 935. 957zlq PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE q ADDITION ❑ GARAGE/SHED WS I ❑ BASEMENT FINISH ❑ ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: (16) SIZE OF IMPROVEMENT of U LENGTH WIDTH AIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. 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 I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS�n� / k� IN EXISTING OPENINGS Yes ❑No LOCATION OF WINDOWS 2. 3. Two sets of construction plans 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S /0, 900 "00 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 $ 0•$0 $ S'. #0 $ 5— 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) $1550 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 Davable to: City of Fridley Attac 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 whi reggire view d�pproval of plans. /l I q �/ SIGNATURE OF APPLICANT I �IIX� PRINT NAME` �U DATE 1 �— i D"