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PRE 2010 DOCS.,,.- , i • BUILDING PERMIT Village of Fridley, Minn. N° 2 R 8 1 Date................... , Builder �....................... .Owner Address /.awl... .......... Address ...................... P LOCCATI N OF BUILDING No. AS -6.1 /....... Street ... . , ...... . .. .. .............. Part of Lot Lot ................ Block .... f�.......... Addition or Sub -Division . .. . ....... ................. Corner Lot ............ Inside Lot ..... Setback .3.Mr .... Sideyard ..... ® ....... DESCRIPTION OF BUILDING Ta sed as ... Front .� . Depth . . height ......... Sq. Ft. 4?Cu. Ft........ . .................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........ Type of Construction .. FROM F— . Est. Cost ... l//...q. 0 ®®. .... To be Completed .. � ......... N 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 village of Fridley. .. '..T: .. .. .: ... ./. .. .. .. .. .... ................ or, ()In consideration of the payment of a fee of $ . :.... , permit is hereby granted to .. ........ .......... . T . , .. 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 with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. .... . Building Inspector NOTICE: This permit does not cover the construction, installation or alteration fo wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for sep,rate permits for these Items. • • City of Fridley, Minn. _ BUILDING PERMIT N® 7242 Date: 6____l', Ovmr: "//� Builder Address - Address LO TON OF BUILDING NO. �— Street L� %._ _ Part a Lot 64Lot —Block �_ Addition or Sub- an Z7 z P Corner Lot — Inside Lot + Setback $-" Sideyard Sewer Elevation — Fodation Elevation DESCRIPTION OF BUILDING T . M: T Front 1 _12 Depth Height Zfi Sq. Ft. Cu. Ft.4—" Front DepthHeight Sq. Ft. Cu. Ft. Type of Construction. '5'.e Est..� O� 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, construct[on, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any t� up viola f any of the provisions of said ordinances. / ➢ � / / / 1 Building Inspector NOTICE: We pomit does not cover the construction, installation for v mh& phrmbing, gas heating, ewer or water. Be lore to am the Building inspector for separate permits for these hemp. APPLICATION FOR BUILDING PETMET CITY OF FRIDLEY, MINNESOTA OWNER'S NAM�co Z� �Cd�- �-�-�-nJ BUILDER ADDRESS/�-' . %� r ADDRESS LOCATION OF BUILDING No. Street ✓ o .� Part of Lot. �I Lot Block Addition or Subdivision 4,c Corner Lot Inside LotSetback 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 BUILDING Front G, apth _Height l' Sq. Ft. Cu. Ft. 10 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 rulings of the Department of Buildings, and hereby declares that.,all the facts and representations stated in this application are true and correct. DATE_ / G �s�� SIGNATURE Schedule of Fee Costs can be found on the Reverse Side). E City of Fridley, Minn. BUILDING PERMIT Date: Jud 9, 1968 owner: HerbertzRitm Bloom Bider Herbert Bloom Address 5 611 6th S t . N. E. _ Address Same N° 9822 �:�3Os LOCATION OF BUILDING No. 5 611_ Street _ 6th S t . N. E. �.._ _ ._. Part of Lot �tPt . of 17 &12110ck l Addition or Sub -Division .._._ Hamilton's Addn. to Nechaniesvil le all oT-1 Corner Lot —_ Inside Lot ._ _ ._.._. Setback — _ —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Addition Front — 9 Depth 8' Height .__ Sq. Ft. Front Depth Height Sq. Ft. -- Type of Construction Frame Est. Cost — 40Q,90 __ To be Completed Cu. Ft. Cu. Ft. 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 a& provisions of ordinances of the city of Fridley. 14 In consideration of the payment of a fee of permit is hereby granted to Herbert Bloom 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. C (2- '� -6- ---- � Clarence Belisle NOTICE: This permit does not cover the construction, Installation for Whing, plumbing, gas heating, sewer or water. Be stn to see the Building Inspector for separate permits for these Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY" MINNESOTA { ` OWNER'S NAME ; BUILDER -� _, :_ .. �iiJDRESS _ LOd ON' OF BUILDING NO. STREET A}I14T.1 N OR SiJBD VISION LOTS, dna''/� �� CORIMR LOT �'I S1 -M idt SETBACK SIDEYARD.,_� _ SEWED .1VATION TOP OF FOOTING y,•. Applicant attach to this form Two-Urtificates of,S�3�'vey of Lot and proposed building. location drawer l6al Atyd :Geetificgtes . W114O MMON Or • BUUMNG z } To Be U+d iAg't ' Front' ''x•`c:i'+fi Depth.— Height +` Square feet_COic Fit Front Depth- Hii YAR Square feet _Cubic Feet Type of Construction Estimated Cost 'y/®®. 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� 9- / i6 `SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). f i� Or F SUBJECT City of Fridley 2 6 3 01 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. III 1 . , NUMBER REV DATE PAGE OF APPROVED BY ' 11 CITY HALL FRIDLEY 55432 612-571-3450 910415 6/22/98 JOB ADDRESS 5611 6 Street NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17,18,19 1 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Audrey Bloom 5611 6 Street NE 574-9529 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Solomon & Sons 12211 Olive754-5875 20055664 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residenital 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (18 Sq) RUM Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 $1,501 @ $.75 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- $51.25 Fir SC $1.50 STR OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEETOT EE License $5.0 $58.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN RO VALIDAT D IS IS Y UR P R IT BLD INSP F1ATE S,GNATURE OF OWNER IIF OWNER BUILDERI IDATEI F NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �,� / j Legal Description: Owner Name & Address: Contractor:ocw v Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # 524or- %� y MN LICENSE # Lf Tel. # 7S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: d -001'% Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ �(v (Fee Schedule on Back) f Ft x $ _ $ Tel. # TOTAL STIPULATIONS: y CITY USE ONLY Permit Fee $ e Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ L:"$.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: y CITY OF FRIDLEY INSPECTION DIV. Effective On Jan 1, 2000 6,431 University Ave NE O'()b Fridley, MN 55432 �' / APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 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** NO. RATE 0 Gas Range" . Gas Dryer*" Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL JOB ADDRESS 5'6 I I & r'N 55+, IV E . Fg�T 1, f y MAI�; �/ 57 - 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 &,98J -2-T 81 -0 -OM Building Used As Estimated Cost SZ�0, 00 PERMIT NO. PLUMBING COMPANY k�nT" iow.�e SIGNED BY� TEL N0. a`I Oso Approved By Rough -In Date Final DataFL $ .50 LA- - -X TOTAL FEE $2.0, PLUS,THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been. examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : C17YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 11, 2002 Herbert Bloom 5611 6 h Street NE Fridley, MN 55432 Re: Final Inspection at 5611 6`h Street NE Contractor: KCJ Enterprises — Mr. Rooter Dear Mr. Bloom: A plumbing permit was issued on February 10, 2000, 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. Cinrc+rr�ly DJ/ls 3 ITY OF FRIDLEY INSPECTION DIViSION S>o Elfeclive On January 1, 2002 ni 431 University Ave NE \, ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES IL h sf JOB ADDRESS �_I I le, © RATE SCHEDULE 11 r OWNER r residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ j (Side Vent - Fill Out Back) ESTIMATED COST L �� PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ 0 No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR rAir Conditioning - All Sizes $ 25.00 $" Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance.or Work $ BTU HP EDR �i A :ommercial/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 o State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and >- representations stated in this application are true and correct. TOTAL FEE $� DATE o BLAINE HTG. A/C ELECT., INC. tL NNIMUM FEE FOR ANY HEATING/COOLING/VENTILATION ?. CENTRAL AVE. N.E. HEATING CO 1356ANOKA, M14 59304 , ;EFRIGERATION/AIR CONDITIONING PERMIT IS $25.01) -LUS THE $.50 STATE SURCHARGE Signed �" FEL # ��� FAX t1 bL— G !EINSPECTION FEE $47.00/Hr Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final DateS'�' T iritten permission from adjoining property owner. EILL OUT BAC SIDE'F R S CK VERIFICATION ON REPLACEMENT FURNACE jpri-16-2002 08:32 FROM CITY OF FRIDLEY TO 7575701 P.02i02 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT. VENT CO NNECTOR AND C-QMR( IISTION AIR VERIFICATION When rpplaring an PjYiatinn furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (i No ( ) The venting system is plasticIPVC 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-GAIV1A Category I Central Furnace Venting Tables for fan . . assisted and natural draft appliances. Yes( ) No () . . The existingc-o►nhilstion air is sized and installed to meet the current codes and manufacturer's specifications. When required to inntall a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. When installing a new ventingsy�, the undersigned hereby verifies that it is a listed ass ambly 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. 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( ) Yes( ). No ( ) Yes() No( ) Yes( )No( ) Appliance Tynp and `i A/Common Vent and VPnf r-nnneCter Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date TOTAL P.02 M SUBJECT P City of Fridley 3 4 7 4 AT THE TOP OF THE TWINS BUILDING PERMIT E , pT NO. E • _____ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r E � 1 � � I 1 CITY HALL FRIDLEY 55432 ,'' NUMBER REV DATE PAGE OF APPROVED BY 763-571-3450 910-F15 4/28/03 10B ADDRESS 5611 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 17, 18 Pt 19 1 1 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Audrey Bloom 5611 6 Street NE 763-574-9529 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 B USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside house & garage 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. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 @@ @ $1.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHEK FEE TOTAL FEE $87.75 \ SSG AE OF CONTRACTOR OR AUTNOF+i2�ENTATEI VALIDATED THIS IS Y UR PE MIT 4E.NPROPERLY SjGNATUQE OF OWNEF+ WNEa Bw�DER. DATES B �Ar E NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 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 BUILDING PERMIT APPLICATION Construction Address: / / - Z, Lfl ° C Legal Description: Owner Name & Ac Contractor: Tel.# 5 MN LICENSE # Address: Tel. # 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. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type: l%/ rV V L , d i ry � Estimated Cost: $ 4 Q ®D ° Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:&)0 & APPLICANT: rte— Tel. # 76 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 Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ (9 9. ?s_ 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 [ ] CITY OF FRIDLEY PERMIT NO.: 2004-01507 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004 572-3604 FAX: (763) 571-1287 ADDRESS : 56116 ST NE PIN : 233024310006 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER BLOOM AUDREY M 5611 6TH ST NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 177431 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 convect. 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 Insp. Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW C l ADON ALTER t j Construction Address; Legal Description; Owner Name & Address: GIT'y or: rlRlhi FY 6431 Universlh' ke NE, Fridlev, NIN 55,1 �12 SINGLE FAMILY AND DUPLEXES R -i AND R-2 BUILDING PERMIT APPLICATION f�. NO & REMODELINQ, Tel. #. FrfCCtivc 1111"NM (7973) 572.1, 694 131rity insp (763),51,11-1281 i=ax Contractor: ST: LOUISpq " , , ` MN LICENSE* / 0 S gK 1.1e Address: _ 0#0001050 Tel. # 6'12 - e�Z:5 yd Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPk0VEMENT LIVING AREA: Length Width _ Height Sq. Ft. GARAGE AREA: Length Width Height Sq, Ft. DECK AREA: Length Width HgtfGround Sq. rf. t OTHER: Construction Type.- �Q%Ci! J `"� S�r `� -71 YP Estimated Cost: ,.��...�� _ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=S 13ATE: /0—`J APPLICANT'• Tel. p<� (Z 2 6,'0 6S 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 Ree Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE OflLY - Fee Schedule on Reverse Side .009 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5,00 (State Licensed Residential Contractors) Alt. "A" or All. "13" Above $450.00 Conservation Flan P,eviev.► Fee Determined by Engineering V Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: 2i1'd 62E'0N S310S 5NId008 013S WdZb:L S002't2'100