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PRE 2010 DOCSVillage of Fridley, Minn. BUHMING PERMT Office of INSPECTOR OF BUMDINGS Architect Fridley, Minn. 19 Builder CATION OF BUILDING �d No. Street .r ° u Part of Lot Lot I, Block Addition or Sub -Division DESCRIPTION OF BUILDING Front � Dep IL aHeight Stories er of Cp nst tion—l! To be used as To be completed n Estimated Cost `° `* � Permit is hereby granted to the building 4A{- 121'1,r�wst$ descriJ in the above statement. This permit is granted upon the express co dation that the p ; son to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, 00nn., regarding the construction, alteration, maintenance, repair and moving of buildings within the citys, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances,71 ti ° ' ' a-11_1_,�1srector of Buildings. AGREEMENT AND SWORN STATEMENT In considerajion of the issue anddelivery to me by the Inspector of Buildings of Fridley of the above permi, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby itate and say that the facts stated by me and contained in the above permit are true as therein sated. _ rc Subscribed and. sworn to before me at Fridley, Minnesota, this day of �-- A.D. 161-0— Pillage of Fridley, Minn. 'No* 4196 BUILDINGPERMIT` U Date: .d Owner . :........ ...... .. ... Builder ........;.....:.,..+................ ........ , Address .'t Address .... , . ._z . C Tl©N OF BUILDING y . No. S Pari of Lot .. eat 9: «Y.�: .:...'!Y' .. . . Lot . Bl , Addition or Sub -Division . ... ... Corner .Lot ,. Inside Lott.+!"':.. , . r Setback . 5' Sideyard id DESCRIPTION OF BUILDING To) jUsed as: Id 01 Front ,...�..3eight Sq. Ft . , . t✓u. k't. ....... . . ............ Front . .... ,. Depth ........ Height ........ Sq. Ft......... Cu. Ft....... Type of.' Constructions. d`��r�: :^ �'! . Est. Cost To be Completed • . Nj r.. 'I n consideration ttie issaance to me df a permit to construct the building described above. i agree to do the proposed Work -in , ccordaace ,with the description .above set forth ancl.-in compLfarice wi}h: an provisions of -ordinances of :the Milia 1~'ridley. e'ofo. f in consideration the payment of a -fes of $.5 ..'*:"`; permit is hereby granted .. ............. ... . to construct the - building or addition as described above. Tris peranit is granted upon the, express condition= t that pawlMum it Is granted and his agents, employees and workmen, in all woirk done in around, and said building, or, a iy pari thereof; . shall ' conform in &11 respe� to the, ordinances of Fridley, Minnesota ding location, construction, alteratloA maintenance, repair and moving of buildings with' in the village limits d this permit may be `revoked at any time upon violation- of any of the provisions of said ordinances, " L ding NOTICE: This permit dt as not cover the oonstructdon,- Installation or alteration for wiring, plumbing, gas heating, sewer or water. B sure to se®• Building Inspector far separate 'permits for eee: items. • CJ Date: 26, 1965 Ron Sorensen City of Fridley, Minn. N° Builder R. F. Danek Address 5632 6th. Street N. E. Address 530 h. Ave. N. W. 7570 LOCATION OF BUILDING No.5632— Street 6th. Street N. E. Part of Lot Lot l¢ 2 —Block 2 Addition or Sub -Division Hamiltons Addition to AiechoicsVille Corner Lot _ Inside Lot Setback Sewer Elevation Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: DleTel l inn Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Repair Est. Cost 82,9D0..QQ __ To be Completed Storm Repair Damage 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 21 provisions of ordiaanoes of the city of Fridley. s In consideration of the payment of a fee of $ , permit is hereby granted to Roman F. Panek 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 is 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 M permit does riot coves the construction, hutaMon for wbteg, phmbing, ges heating, ewer or wafer. Be sure to see the Building inspector for separate permits for these Rena. MEMEMEMMMEMW A# - APPLICATION FOR BU ING PERMIT. CITY OF FRID%RY, NNESOTA " OWNER'S NAME BUILDER • DDR �i. �� �� �. DDe X<- LOCATION P of Lot " Lot-/- V 02 ---Block Additioat or Subdivis Corner Lot Inside Lot _1.$etV4wck Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to thi3 form, Two Certificates of, Survey of Lot and proposed build--. ing location drtwn oft these CA-ttificates. DESCRIPTION OF BUILDING T+a be used as: • d Pront Depth Height sq. Ft.� Cu. Ft. Front Depth IHeight Std. Ft. Cu. Ft. Type of Construction Estimated Cost0a, _ --Completed :a., �» The undersigned hereby makes* pplication for a permit for the work herein specified, agreeing to do all work ift 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. .1Z Schedule of Fee Costs can be found on the Reverse Side). 0 0 - City of Fridley, Minn. BUR DING PERMIT owner: Ronald Sorenson Buildex Owner Address 5632 — 6th Street N.E. Address N° �30 3 s -y 8417 LOCATION OF BUILDING NO. 5632 Street 6th Street N.E. _ Part of Lot Lot I & 2 _ Block 2 Addition or Sub.Division Hami lton t s Add. to Mechanicsville Corner Lot _ Inside Lot .—. YL Setback of house _ Sideyard 31 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Det. Gar, Front 22, Depth 21L_ Height 3D sq. Ft. 528_ Cu. Ft 0 Front Depth Height Sq. Ft Cu. Ft Type of constriction Fraw Estcost 81 v 5L.00 —To be completed In consideration of the issuance to me of a permit to co et the uildig d gibed above I agree to do the proposed work in accordance with the description abov set forth � cram Bance with a'll provisions of ordinances of the city of Fridley. %' l / > y In consideration of the payment of a fee of $-5=--, permit is hereby granted to MrOAMOt3 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. NOTICE ills permit does net sever the eonstrustion, testsllaften for whiag, plumbing, gas halos, sewer or wster. Be sure to me 69 Building Wspemr for sepsrtle permits for those hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY2MINNESOTA OWNER'S NAM BUILDER ADDRESS ADDRESS LOCATION. OF BUILDI N0. �j J °_STREET PART OF LOT LOT / e BLOCK ?I ADDITION OR CORNER LOT INSIDE SIDE -YARD __12 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 se as; Front - g- - 4Height Sq. Ft. ' j Cu. Ft. (� Front Depth Height Sq. Ft. Cu. Ft. J �� Type of Construction �Z Estimated Cost �4 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 declareb that all the facts and representations stated in'this application are true and correct. DATE =�� — cS SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT City of Fridley 24134 AT THE TOP OF THE TWINS BUILDING PERM I T r RE NO. • COMMUNITY DEVELOPMENT DIV. r I v PROTECTIVE INSPECTION SEC®ca-1 1 � � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 1'' 612-571-3450 910-F15 5/2/96 JOB ADDRESS 5632 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 2 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charlene Welton -Smith 5632 6 Street NE 571-7489 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 ❑ REPAIR ❑ MOVE ❑ REMOVE R 8 DESCRIBE WORK Reside Garage 7 S 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. 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 $400 $.50 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- $21.00 Fire SC $.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $21.90 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY V DATE THIS IS YOUR PERMIT Cv,X1— ? — `7l� D_S'!GNAT 'BLDG" SP a J -2 G1® GATE R8UILDERI (DATE) NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF, FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2� v a 1 Building Permit Application ConstructionAddress: -x 6.6ox S Legal Description: Lo T / e �e c z D - Owner Name & Address:3 �'`�� `' s'�°, E , Tel. # 5 7 ) - -74Y-9 � Contractor: s -&X- F MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%4PROVEMENT Length Width Height Sq. Ft. Length Width .� '' Height NSq. Ft. &L�(g Length Width Hgt/Ground Sq. Ft. 46-5 I b E �o Atieii�o 6- Corner Lot 0 Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: v i A.) Y 4- Estimated Cost: $ �/ p Approx. Completion Date: G - i - 9 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLIC-0 Tel. # 5 71- 7 CITY USE ONLY Permit Fee $ 'Fee Schedule on Reverse Side Fire Surcharge $ `/C' .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 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 [ ] -a TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE ' Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR nth Wash t7rtrak Floor Caxch .' Auto. Urinal Tukz `Shower SEnk Tray ...................Fiauli Drain B.Wash NO. RATE TOTAL Effective On January 1, 1997 Gas hNis' Water Heater Range 1=1xt,. _ ; Gas Elec JOB ADDRESS �2 �',-S'w e f � New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 p "/ Sump/Receiving Tank $ 7.00 (�ZJ 3 1997 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 a Water Heater - Gas** $10.00 Building Used As-�A Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost+PERMIT NO. C/CZ Back Flow Preventer Required ( )Yes () No Type_ $15.00 PLUMBING COMP r 10 Utz Reins ection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS" SIGNED TEL N0. 7c2/- Y910 1.5% of Value of Fixture or Appliance e31? QLQQ,Q, �j 2 Approved By Rough -In Date Final Date ( ; 7 G% State Surcharge $ .50 MINIMUM FEE F R ANY PLUMBING GAS PERMIT IS $20.00 1)eol TOTAL FEE $ - 7 PLUS THE $.50 ISTATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES. ISODERLIN- Plumbing, Heating & Air Conditioning CHARLENE WELTON-SMITH 5632 6TH STREET N.E. FRIDLEY MN 55432 ( ) 571-7489 F1-1 _�-�� 3612 CEDAR AVENUE SOUTH • MINNEAPOLIS, MN 55407 FAX 721-8091 DATE: 09/05/97 REF. NUMBER: 0021908 LISTED BELOW IS THE WORK FOR THE FOLLOWING ADDRESS: CHARLENE WELTON-SMITH 5632 6TH STREET N.E. FRIDLEY, MINNESOTA 55432 INSTALL NEW LAUNDRY TUB - INSTALL HOME OWNERS LAUNDRY TUB - SECURE TO FLOOR AND WALL - INSTALL NEW 1-1/2" P -TRAP - INSTALL NEW 1-1/2" PUSH GASKET IN HUB AT FLOOR - INSTALL NEW CLEAN OUT TEE TO CODE - INSTALL NEW 1-1/2" ABS WASTE LINE TO P -TRAP - OPEN ACCESS IN CLOSET WALL - INSTALL NEW 1-1/211 TEE FOR VENT PIPE TO BASEMENT - INSTALL NEW 1-1/2" ABS VENT PIPING TO CODE - CHECK FOR LEAKS MAIN WATER VALVES REPLACEMENT - CITY TO TURN OFF WATER MAIN - REMOVE OLD VALVES AND INSTALL NEW CODE VALVES - REPIPE AS NEEDED - CHECK FOR LEAKS I SODERLIN 24 HOUR EMERGENCY SERVICE `J SINCE 1914 pDERL1N_ ``s Plumbing, Heating & Air Conditioning CHARLENE WELTON-SMITH 5632 6TH STREET N.E. FRIDLEY MN 55432 ( ) 571-7489 3612 CEDAR AVENUE SOUTH • MINNEAPOLIS, MN 55407 FAX 721-8091 DATE: 09/05/97 REF. NUMBER: 0021908 REPLACE WATER PIPING - REMOVE OLD WATER PIPING AND RECYCLE - INSTALL ALL NEW 3/4" AND 1/2" WATER PIPING TO ALL FIXTURES - INSTALL NEW OUTSIDE HYDRANT - INSTALL NEW WATER EMERGENCY SHUT OFFS AS NEEDED IN KITCHEN AND BATHROOM - SECURE ALL PIPING TO CODE - TEST FOR LEAKS KITCHEN VENT - INSTALL NEW 1 1/2 ABS KITCHEN VENT PIPE TO LAUNDRY VENT - INSTALL NEW 1 12 HANGERS TO SECURE VENTING - CUT THROUGH WALL AS NEEDED TO ISNTALL - CHECK VENTING m— -Fs _g� i wNn 24 HOUR EMERGENCY SERVICE �� SINCE 1914 SUBJECT MITWO. City of Fridley P25667 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. v INSPECTION SEC. p� Q r PROTECTIVE � CITY HALL FRIDLEY 58432 NUMBER REV DATE PAGE OF APPROVED BY L „ 612-571-3450 910415 11/5/97 JOB ADDRESS 5632 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 2 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Char Welton Smith 5632 6 Street NE 571-7489 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Four Seasons Builders & Remodelers 1410 Quant Ave N, Marine of St Croix, MN 55047 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 433-4846 6334 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CI REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House (18 Sq) 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 1 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 $1,501 $.75 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- STR N OR THE PERFORMANCE OF CONSTRUCTION. $51.25 Fire SC $1.50 PLAN CHECK FEE TOTALFEE G 11 5 i Lic nse SC $5.00.4 1 $58.50 SIGNATURE OF CONT FACTOR OR AUTHO EDAGENT IDATEI WHEN PROPERLY V DATED BLD INSP THIS IS YOUR PERMIT DAT SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: % --� _ I �➢ Legal Description: Owner Name & Address: �� �,,- �rV c o r, sm:�; , Tel. # Contractor: FOvr- S-ZSo^s ��•\�u� � ������} MNLICENSE# Address: i '�d U Q-vo, 'N W ") Tel. # 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: i S Avs�5 — l Z. r o++ i'b -X 9 �5dy (7 Construction Type: Estimated Cost: $ 16 )� . C'U I -j C) 1 L (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ v DATE: I `� APPLICANT: O,j\j—A S Tel. # V �� q CITY USE ONLY Permit Fee $ 151 D Fee Schedule on Reverse Side Fire Surcharge $ ! , r, .001 of Permit Valuation (1/10th%) State Surcharge $ m `j $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ 15, C C-, $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: _- ///"... _ 1 -- 0 SUBJECT City of Fridley 2 2 AT THE TOP OF THE TWINS BUILDING PERMIT f ` RECEIPT NO.'5 COMMUNITY DEVELOPMENT DIV. 4?e r PROTECTIVE INSPECTION SEC. 0 NUMBER REV DATE PAGE OF APPROVED 8Y /"'1 CITY HALL FRIDLEY 55432 �'""'� I'J 612-571-3450 910-F15 8/12/98 f' JOB ADDRESS 5632 6 St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 2 Hamiltons Add. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charlene Welton -Smith 5632 6 St NE 571-7489 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 1417 $.71 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. $48.50 Fire SC $1.42 PLAN CHECK FEE TOT EE .63 OF CONT-RRAACT�pOR OR AUTHORIZED AGENT (DATEI ENP O VALID HIS ISOUR PERM /�SIIGNATURE �s �j IL )NSP s MATE SIGNATURE OF O01 WNER OF OWNER BUILDER) IOATE) 0 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �(j 1 ConstructionAddress: �- 3 I -r-t- 57-- /U J" Legal Description: Owner Name & Address: 51vi r —1,4 Tel. # 5 71- -7`f 2=) Contractor: ,5' MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ,QE - X2.0® F 6,44-.4 C't'C / 7 54. Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Y - /-x -'39 APPLICANT:C'--�' '-0- -t'j, 0�---- Tel. # 5 74- '7 4,89 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] w Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: S-�l ,06 3, d DATE i` / YOUR E-MAIL ADDRESS SITE ADDRESS yN _� — ti E THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: �� S TENANT ADDRESS: _ 7" 3 Z lP CITY STA NZIP Sr 3Z - PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY —STATE—ZIP. WITH APPLICATION PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECKSIDING 13OTHER SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODEL G DESCRIBE WORK BEING DQNF: C�- SIZE OF IMPROVEMENT LENGTH I WIDTH 2--S HEIGHT S . Ft. SD ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum❑ Trim p -- tv.. 1. Site Plan/Survey showing the existing structures �er ❑ Fascia and proposed project. R'INDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. 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 $ _a�9 - 60 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 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 +6 ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks uavable to: Citv of Fridlev Attach 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 cpdq 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,pe '=k ann 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 r6q ' es re tew and approval of plans. SIGNATURE OF APPLICANT PRINT NAME Sf DATE $ -$ 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 +6 ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks uavable to: Citv of Fridlev Attach 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 cpdq 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,pe '=k ann 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 r6q ' es re tew and approval of plans. SIGNATURE OF APPLICANT PRINT NAME Sf DATE Building BUILDING See Back Page for Fee Schedule Permit No7' --' 0—Czq`t Inspections RESIDENTIAL APPLICATION Received By: 763-572- CITY OF FRIDLEY Surcharge Date Rec'd: 4 1 1U 763-502-49774977 FAX License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge EFFECTIVE 1-1-2010 $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow 'Z7/v ft + 6 ft = ftx $24 = $ Erosion Control DATE YOUR E-MAIL ADDRESS $450 Conservation Plan Review Park Fee SITE ADDRESS S (' 3 Z NI= Fee Determined by Engineering Sewer Main Charge THIS APPLICANT IS: A0VV7,MR ❑CONTRACTOR Agreement necessary ( ) Non Necessary ( ) Total Due PROPERTY OWNER/ NAME: Jgcob TENANT ADDRESS: Zo 3-L CD S ¢,Nt CITY r STATE/LN ZIPS'-Sr-V%i �— PHONE: 7(p 3 — S75/ — 2.3 a 5 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPEINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH *ROOF ❑ DRAIN TILE ❑ DECK t] SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: K SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING OUSE ONLY NUMBER OF SQUARES 7 0145' OUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. 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 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW, 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) COTAL JOB VALUATION $ 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 $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ftx $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 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 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 pe and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all wor r es review and approval of plans -- J-," SIGNATURE OF APPLICANT PRINT NAME -," - s4"-�e- DATE Z /