PRE 2010 DOCS•
•
City of Fridley, Minn.
BUILDING PERMIT N° 6346
Date:
Owner: Builder ---
Address Address
LO TIN OF BUILDING
No. �� Street �t_ __ ._.._—_ Part of Lot
Lot Block _ ____ �_ — Addition or Sub -Division
Corner Lot _ Inside Lot - !� Setback .' —_ Sideyard l < a
Sewer Elevation _ -- Foundation Elevation
DESCRIPTION OF BUILDING
To U
t tJ 51- Depth Height 99 a Sq. Ft./_---" Cu. Ft. 3 C�
Frronnt, Depth Height Sq. Ft. _ _ Cu. Ft.
Type of Construction��-� ®x Fit.-�_ eso
�� 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 pr ja► compliance witi�%all provisions of
ordinances of the city of Fridley. /
In consideration of the payment of a fee of $ c LX' , 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 andel thils permit may be revoked at any time upon viola" of any of the provisions of said
ordinances. /1 a
NOTICE
This permit does not corer the construction, Installation for wh'ing, phmrhing, gas heating, sewer or water. Be s9re to as
the BuNh* Inspector for separate permits for these Isms.
V
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name
Address A drn
LOCATION OF BUILDING
No. Street� - /� f 0 Part of Lot
Lot Block Addition or Subdivision/ "k&e_
Corner Lot Inside Lot Setback OX —Si e -Yard -10/ I
SEWER ELEVATION FOUNDATION ELEVATION
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:
� �-(rJ • Front �-�-- Depth � Height
Sq. Ft. A Cu. Ft. — Z!t
Front Depth Height
Sq. Ft. Cu. Ft. el
Type of Construction Estimated Cost q ,3ee®
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 st ed in this application
are true and correct.
DATE -
(Schedule of Fee..Costs can be found on the Reverse Side).
Application for Power Plants and Hearing, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $l0 , e --d
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ o�
Additional Fixtures ............... x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE $ '�
ROUGH
FINAL
Dept. of Bldgs. Phone SII 4-7470
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. /
lley, Minn /� 19 (��
Ownery
Kind of Building
Used as
To be completed about
D- v
Estimated Cost, $
OldNew. Building Permit No.
DESCRIPTION OF WORK
HEATING or PO PLANTS—Steam Hot Water, Warm Air . o. 2
Trade Nam Size No 6
Capacity Sq. Ft. E.D.R ®BTU H.P.
Total Connected Load Kind of Fue
BURNER — Trade Name Size No
Capacity.
(REMARKS -OVER)
i 42 2M
Sq. Ft. E.D.R BTU H.P.
S AY N. W E LTE R HEATING 00.
4637 CHICAGO AVE.
ByMINNEAPOLIS 7. MINNE-zaujA
Business Phone No
City of Fridley
Application for Plumbing and C n Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
07
in
c
12
Y
o�
Z
�D
aa VI
V
<
�°d
W
?
0O
F
N
WATER HTR.
GAS
ELEC.
Base
1st
�-
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings
Connected with
Sewer Elcesspool
Dept. of Bldgs. Phone SU 4-7470
Location C 2 3 5.— %& ,
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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 are true and correct.
Fridley, Minn ���"� S 190
-�
c
Owner
%Kind of Building
Used as
To be completed about m _�
PARTIAL RATE SCHEDULE
Estimated Cost, $ er am
PLUMBING FIXTURE RATES: �N—]RATE TOTAL A0 O Old—New. Building Permit No j permit No.
Number Fixtures ......................x $1.50 $ Q ° Signed
Future Fixture Opening x 1.20 $ By / ;
New Fixture Old Opening .............. x 1.00 $ Business Phone No- % d
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. ............ x 3.25 $ ROUGH
FINAL
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ 3,00
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ............................... ...........$-�a��'�s`� ®�
TOTAL FEE $ /6 az 2M
v
City of Fridley, Minn,11433
7--,
6431 University Ave. N.E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date:
Owner: Adolph Kukowski. Builder S4Me
Address 6234-32 - 5th Street N.H.Address Same
LOCATION OF BUILDING
6232-34 5th Street N.E.
No. __ _ _... ___ _ Street Part of Lot
Lot —5 Block Addition or Sub -Division ._.sandy Terrace Addition
Corner Lot _.._._ Inside Lot Setback Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation _-..
DESCRIPTION OF BUILDING
Alterations Front Depth Height Sq. Ft Cu. Ft
Front _ Depth Height Sq., Ft. Cu. Ft
Type of Construction Est Cost .$450 00 To be Completed Aug. 30, 197
In consideration of the issuance to me of a permit to construct the building described above I agree tg do
the proposed work in accordance with the description above set forth and in compliance with 21 provisions of
ordinances of the city of Fridley. , / d/�
(9,4 '/d/ A r
.50 State
In consideration of the payment of a fee of $ 5.00 , permit. is hereby granted to K Adolpli Kukkawski
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. i
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sura to we
the Building Inspector for separate permits for these Items.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:,444,2 G/ &u IL o,_, BUILDER:
ADDRESS: �i "Lj Z -- /, 2 4_ /1-"ARESS :
NO:. STREET:
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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:
4;2 roAk, Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $ c.
F
To Be Completed: r Pl 7 y
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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.
(See Reverse Side For Additional Information.)
r
City of Fridley
SUBJECT
15068
AT THE TOP OF THE TWINS
BUILDING
PERM T
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 ; �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
�•-" ' �J 812-580-3450
910-F15
%
JOB ADDRESS
6232-6234 - 5th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Sandy Terrace
SHEET
-F-PROPERTY OWNER MAIL ADDRESS
ZIP PHONE 560-9494
Riversedge WayN.E. - Fridlgy 55432 854-2400
-7-CONTRACTOR MAIL ADDRESS
qaMin
ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CL SS OF WORK
❑ NEW ❑ ADDITION X1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remodeling in lower level
9 CHANGE OF USE FROM TO
STIPULATIONS
1. Install smoke detector.
2. Use louvred door on furnace room.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$3,000
1.50
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.
112X10 $18.00
PLAN CHECK FEE
TOTALFEE
,
1 A19.50
SIG ATUREOF NT ACTOR ORAUTH RIZEDAGENT
EN PRO
R�` VALID/ATED HISJ IS YOUR PERMIT
a(DAEI
Adff- BLDG INSP
DATE.
I N TU OF OWNER IIF OWNER BUILDER, ID EI
M
CITY OF FRIDLEY
• APPLICATION FOR RESIDENTIAL BU11_DING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
o1-n2EM'
—10 �� %���� nUILDL'R: Csj�-�
Address: Address:
Tel. 140.: S66 — iY oQ gay— T-Voo
I FF�e #--
No. :
--
No.: ZvZ G Z3 Y
LOT:
Street:
4-A/1 • €e,
$LOCM.: ,' ADDITION: J ;)Aj Q -Y Tr- R'2'
COPMER LOT: 111SIDE IAT: .4� S;:TBACK: SIDL•'YARDS: .
Applicant attach to this form 1Vo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Rfr-muoy-- ON t Front: Depth: Height:
Square Feet: Cubic Feet:
'Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ���— Estimated Cost: $ Z000
To Be Completed: _ (v WVfl dUTP S Alt. A Alt. B
Proposed Driveway Width If New Opening is Desired � $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein'
specified, agreeing to do all work. in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side aclditional information.
Mme: �� � % SIGNATURE:
Stipulations:
(�r'- a.'-" , ®boa •
TY, /, s"
iI� /,.a
01
SUBJECT
PERMTT N
City of Fridley
20895
AT THE TOP OF THE TWINS
?
BUILDING PERMIT
r
HFtct:IPTw6--
COMMUNITY DEVELOPMENT DIV.
r v PROTECTIVE INSPECTION SEC.
if 0153
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
"'j 612-571-3450
910-F15
6/27/91
JOB ADDRESS 6232-34 5th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
1
Sandy Terrace SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Joe Maertens 144 River Edge Way NE, Fridley, MN 55432 571-4701
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION f�7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Structure (25 Squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
On all new roofs or tear -offs and replGcem�jt
reofis,
State Code requires that 2 IaYCrs of ib lb.
f4ix,
mopped together, be installed to a 24 in0as
point
Up from exterior wall line, or the use of other
approved underlayment membrane.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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
2
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
$1,300
$.65
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SACCHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$31.00
Fire SC $1.30
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL EE
18132 . 95
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPER01 VAT D T I YOUR PERMIT
"BLDG.INSP 0ATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
01
NEW [ l
ADM [ ]
ALTER [�
Constnicticn Address:
Legal Description:
R-1 AND R-2
Building Permit Application
213� . "'S r 44
Effective 1/1/91
owner Name & Address: OIL /1ZAVtT".I R(( 1�aLoc � r� /. )t v Tel. #
Contractor: Tel #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
MITT 3K of IIArROVHMff
LIVnG AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
BE= AREA: length Width Hgt/Grm-id Sq. Ft.
Corner Int [ ] Inside Int [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: A/au'J®ff41r--r A= Estimated Cost: $ /3Z 0
Approx. Completion Date: is
Proposed Driveway Width If New Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: '7 % APPLICANT: Tel. # v 71-Y201
Permit Fee $ Z h oo
Fire Surcharge $
State Surcharge
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
STIPULATIONS:
L
QTY USE COZY
Fee Schedule on Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined mrd by RVi mpri ng
Agreement Necessary [ ] Not Necessary [ ]
[-" (3 U
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Effective On January 1,1991
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS ANDDEVICES
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace $ 20.00 $ that all the facts and representations stated in this application are
true and correct. '1991
Gas Piping (Needed with new furnace) $10.00 $ _
OWNER2
Gas Range $10.00 $
BUILDING USED AS '
Gas Dryer $10.00 $ vv
ESTIMATED COST 19-60 60 PERMIT NO.
'Air Conditioning - All Sizes $10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
Commercial/Industrial .
1 % of Value of Appliance or Work $
State Surcharge $ .50_
TOTAL FEE $ C�o'
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating U 'tCircle One (Steam) (Hot Water) arm Air )
Trade Name Size No. Q
BTU HP EDR
Fuel egY, Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY
Signed By "AA �
Approved By
Tel No.
Rough -In Date Final Date/0s
'Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
RIMM9HEATING AIR CONDITIONING HOUSE HEATING TEST RECORD
AND ELECTRIC. INC.
ADDRESS �" � e
OCCUPANT
HEAT LOSS DATE HTG. INST.
SOLD BY D,. o
Electrical Work By e'l M F I P
TYPE OF HEAT GA FA )C' HW STEAM_ SPACE HTR. _
GAS DESIGN
MAKE
Model
Serial _ic 09 V1 ms( `-. 34<1
INPUT
APT. FLOOR CITY CP I,jSUBURB
OWNER
INSTALLED BY
Gas. Line By
UNIT HTR._ OTHER
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
CONVERSION
CONTROLS el
THERMOSTAT TI10 o `1 Heat Plug Vent Size
11
Valve W t 1� KIND OF LINER SIZE NONE
Limit %ore M t'—'o Draft Hood Regulator
rr
Limit Setting ® Filters sizeL'�x l Number
Fan Setting ` Chimney Location Inside Outside
Pilot Type 16- OM Chimney Construction�' G�.Gi `�IVI
Pilot d
Pilot d
Pilot 7
L W. Cut Off "*-`
Pressure 1-1 Percent CO,
Input CFH Percent O,
Stack Temp. !� Percent CO
Form 235
Smoke Bomb
Wiring
Draft i 6:S
I Test Tag
Door Pressure
Lighting Inst. e S
Date Tested
�—
Company Testing
Name of Tester e 5 e
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On March 1, 1996
�4 �M l
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
Gas Range**
NO. RATE TOTAL
Gas Dryer** _
Back Flow Preventer Required ( )Yes () No
Type
$ 7,00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 z O c.
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONSLI] (,/
1.5% of Value of Fixture or Appliance (90 "
State Surcharge $ .50
�� /ISO
TOTAL FEE 4,._
JOB ADDRESS 9 3,�? - L5 .)
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Building Used
v ( ,1996
S';Pl- 41,303
Estimated Cost qod- G PERMIT NO. 0%rl
PLUMBING COMPANYc2lu
SIGNED BY G % TEL N0. �� �1
Approved By Rough—In Date Final Date
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
72-CM14- -Ex pl" A y4sp-
OCT -26-2005 16:16 CITY OF FRIDLEY
Cit, nfFridley
6431 University Avc NE
Fridley MN 55432
(763) 5723602 or Fax (763) 50M97i
Water and Sewer Puniite Application
❑ New Conncclion
❑ Existing
Date: 20' % a
Job Address:
Name of Applicant (Plumber): ,Z
P.01/01
�i !41ITh,� Line E�(�a►r-T.gl�c;Tfi�n
;� ��aLer clflrl �?t[�np t�'nriYinr_,f1Rl�
Narne of Property
Existing Strwtw+e Permit #
Petmit "type: Suver Fee: !2ba
Water Fee:
Meter Fee:
Repair Fee:
Relocation: �' R
State ;Surcharge:
SAC Charge:
S eeial Assessment Fee: �'�� .
P C
Total: $JXA4
Applicant Signature:,
Inspector approval:
Water Meter Repair — Weekend & Holidays $125/hour
vt,, =
Sewer Connections Peanut
Ins action Fee for 'Vt Oer/Sewer Line Repair L ��
Special Asmomenta See ] n 'Hearn
Cost of Water Meter See utility13i11in
SAC Charge
State Surchar a .SD
Water Stering
Ta
04104/05
TOTAL P.01
Z/Z'd L62tiZLS:01 :WOJA LZ:SZ 5002-92-ioo
Reference No. 602-05-0641 Request For Service Report
City of Fridley
Service Requested Sewer Inspection _ Date t 7 5
Public Works
Department
Location of Service need
owner or Agent of Property
6232 and 6234 5th St. NE
Division Sewer
Time 8:20am
Phone: (H)
Name of Citizen Kevin Koski/Deans Prof. Plumbing Phone: (H) 69773
K
Address
s
Details of Request
Action taken (include date & communication with citizen)
Date Cleared
Signature of person clearing request
Citizen notified Yes No
From: 6517700495 Page: 1/1 Date: 6/23/2008 3:51:12 PM
Building
UUC:UPANCY TYPE
BUILDING
1?elalit No.:
Inspections
Plan Review
RESIDENTI.A►L APPLICATION
Received $�
Fire Surcharge
S
.001 times the total Job valuation
�
763-572-3604
.0005 X Permit Valuation Minimum $.50
CITY OF FDLEY
=° a.
DATE 06/02/08 _ YOUR E-MAILADDRESS estherd@probuiltam.com
srrEADDRESS 6234 5th SC NE
S
TIIIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
$
PROPERTY OWNER/
NAME: MarlVg Rechiemmer
$
TENANT
ADDRESS: same as site CITY
S I'A I'F._Z1P
Fee Determined by Engineering
PHONE 612-802-5267
S
CONTRACTOR
NAME: ProBuilt America
S a
STATELICENSE# BC -20356847 F.XPt)ATE Us/uy
—
�
SUBMIT A COPY OF
YOUR STATE LICENSE
k 2 11 11 Lri Ave >•;
ADDRESS: CITY North St® STAfE_Z1P
WITH APPLICATION
PHONE 651-770-5570 FAX 651-770-0495
PROPERTY TYPE
❑ SINGLE FAMILY/NRV CONSTRUCTION SIZE
❑ TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
0 ADDITION ❑ 31ARAGEISHED 0 WINDOWS
O BASEMENT FINISH 17 ROOF ❑ DRAIN TILE
❑ DECK O SIDING 13 OTHER
0 SWIMMING POOL
TYPE OF WORK:
G NEW ❑ ADDITION
❑ MAINTENANCEIRSPAIR ❑ REMODELING
DESCRIBE WOMBEING DONE: Ravlacinq 2 window, and storm door not
changing sizes
SIZE OF MIPROVEMENIT LENGTH WIDTH HEIGHT scl, Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
Q LIOUSE & GARAGE
0ASEMEN1!REMODELINCI
SUBMIT:
GABA .FS
13 ATTACHED OARAOC
1' Existing Floor Plea
2, Proposed floor plan
PROPOSED SITE;
DI TA(•FIRD GARAGE
tura3. List of sisucl memers bm be umd
PROPOSED BRIGHT;
SI. DING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ vinyl
❑Soffit
ADDITIONS.
& PORCIIC.S UBMIT:
❑ Alurntrimn
❑ Trim
1. Sin Plao/Survey showing the exWng snvewm
❑ Odwr
❑ Fasoia
and proposed pmje cL
WINDOWS
2. Two sets of conswedun plane
IN EXISTING OPfNIN(:S OYcs ONo LOCATION OF WINDOWS
3. EneW Calculadoos
OR FOR NEW OPENINOS-DESCRIBE SIZE OF
OPENING CHANGES & 4
TYPE OF WINDOW TO BE INSTALLED
NUMBEROF W1NDOwS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
1U1ALJU13 VALUA'1'lULN �i COo
UUC:UPANCY TYPE
Permit Fee
$'7C0
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
S
.001 times the total Job valuation
Surcharge
$
.0005 X Permit Valuation Minimum $.50
License Surcharge
$ r,,tXJ
$5.00 (State LIcensed Residential Contractors)
SAC Charge
S
$1675 per SAC Unit (Flans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 fe — ft x S21 = S
Erosion Control
$
_
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
S
Agreement necessary ( ) Non Necessary { )
Total Due
S a
Make checks payable to: Citv of Fridlev Attach Stavulations
THIS IS AN APPLICAI )ON FOR A PERMIT•NOT VALIL7 UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the inFonnation 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 it: that the work will be in accordance with the approved
plan in the case oral] work which reqes xP
'approval of plav
SIGNATURE OF APPUCAN L _ f ; �� pRp� X Dahl )ATE 06/02/08_L::.
Building
BUILDING
Permit No.:
or
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
OF FRIDLEY
Da 'd:
DATE 06/02/08 YOURE-MAILADDRESS estherd@probui1tam.com
SITE ADDRESS 6 2 3 2
5th St NE
THIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: Marlvs Rechl emmer
ADDRESS: same as site CITY
STATE_ZIP
TENANT
PHONE: 612-802-5267
CONTRACTOR
NAME: ProBuilt America
STATE LICENSE # BC -20356847 EXP DATE U .i / U y
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: z z i i i i t n Ave E CITY North Sig STATE ZIP � � 1j,WITH
APPLICATION
PHONE 651-770-5570 FAX 651-770-0495
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCUREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: Replacinq 4 window,and storm do4r not changinq sizes
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
4
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 $ 1Z7. ;FR OCCUPANCY TYPE
Permit Fee $�, , �� See Back Page for Fee Schedule
Plan Review $ . — �— 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ , / G Make checks payable to: Citv of Fridlev 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 codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which remd r s revie and approval of pla
SIGNATURE OF APPLICANT fd a�� p' PR se r Da
RJ hl DATE 06/02/08
James D. Nelson
10917 Nord Ave. South
Bloomington, MN 55437
To whom it may concern:
I, James D. Nelson, owner of the addressed property of 6242/6244
5th Street, Fridley, MN. give my permission to Marlys K. Rechkemmer,
owner of 6232/6234 5th Street, Fridley, to, place a paved parking pad
next to my property line at the above address.
I acknowledge that this work will be approved by the City of Fridley and
begin as soon as possible this Summer.
Signed,,6� ' t� , r
James D. Nelson
Building BUILDING
Permit No.
Inspections RESIDENTIAL APPLICATION
Received By:
763-572-3604 CITY OF FRIDLEY
D : I
DATE 09/26/09 yOUR&MAII.ADDRESS estherd@probuiltam.com
wEADDREss 6232 5th St NE
THIS APPLICANT IS: ❑ OWNER OCONTRACTOR
PROPERTY OWNER!
NAME: Marlys Rechkemmer
TENANT
ADDRESS: same as site CITY
STATE ZIP
PHONE:
CONTRACTOR
NAME: r B i a
STATE LICENSE# BC -20356847 EXPDATE 03 10
2211 11th Ave—E-CHry
551$9
SUBMIT' ACOPY OF
YOUR STATE LICENSE
ADDRESS: North SIR STATE zip
WITH APPLICATION
PHONE 6 51- 77 0 - 9 315 FAX{ 651-770-0495
PROPERTY TYPE
0 SINGLE FAMFLYINEW CONSTRUCTION SIZE
0 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
0 ADDITION 0 GARAGEISHED 0 WINDOWS
0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE
0 DECK 0 SIDING 0 OTHER
0 SWIMMING POOL
TYPE OF WORK:
O NEW 0 ADDITION
❑ MAINTENANCE/REPAIR 0 REMODELING
DESCRIBE WORK BEING DONE: Replacing 9 window,
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
RCKUBM 0 HOUSE ONLY
NUMBER OF SQUARES 0 HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT -
0 ATTACHED GARAGE
1.
2.
Existing Flom Plan
Ptopoxd floor pian
PROPOSED SIZE: 0 DETACHED GARAGE
3.
List of sirutxutal members to be used
PROPOSED HEIGHT:
SiDt
FOR NEW CONSTRUCTION INCLUDING DECKS,
D Vinyl DSoffn
ADDITIONS.
& PORCHES SUBMIT:
0 Atandri mt 0 Trim
L
Site PIan/Siueey showing the existing sbuemres
0 Other 0 Fascia
and proposed project.
2.
Two sets of caasfzuction plans
IN EXISTING OPENINGS DYes ONo LOCATION OF WINDOWS
3.
Etum Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES & 9
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
0A
Permit Fee $ ?S j �J j See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ 62 -1 � .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $SO
License Surcharge $; L $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21, $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks rmvable to: Citv of Frldlev Attach Stipulations
THIS 1S 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 ordinance and codes of the City of Fridley and with the Minnesota Construction Coles; 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 worm which review d approval of pians
SIGNATURE OF APPLICANT PRINT IEJt6rr Dahl 09/26/09
DATE