PRE 2010 DOCSDate
Owner
Address //(26,
BUILDING PERWr
Village of Fridley, Minn.
. ...........
Builder .... ....... ......... .
r►+Piiil Address ........................................
LOCATION OF BUILDING
No.. ? :........ Street A
l� t�'41 .. .. ........ .. Part of Lot ....... ............. .
`�t ,r•
Lot ......:al:: , ..... Block .: a *.. ...... Addition or Sub -Division .. ..... .
_ /?tea �
Corner Lot ............
Inside Lot ..: Setback ,,� 5�1 '. Sideyard . ..... .......... .
DESCRIPTION OF BUILDING
To be Used as:
�9���� • j ft.
�ie�: Front .: �a.. Depth oTX ..: 'Height � .. ...... Sq. Ft......... Cu. Ft........ .
.................... Front ... Depth ......... Height ......... Sq. FL ........ Cu. Ft........ .
Type of Construction i .d 004* Fst. Cost ........... To be Completed /..'•":! ...
In consideration if 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 vM ge of Fridley.
In Ideratfon c I 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 hat the.person to whom''it Is granted and his agents, employees and workmen, in all work
done in, around and t M said building, or; any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota re ardipg location, construction, alteration, maintenance, repair, and moving of buildings with-
in the village limits ajd this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
.'.' .. Building Inspector
NOTICE:
This permit
sewer or water.
S not cover the construction, Installation or alteration for,wiring, plumbing, gas_ heating,
sure to see the Building Inspector for separate permits for .these Items.
0
CJ
•
�iof Fridley, Minn..
tY Y�
BUILDING PERMIT N® 7301
Date: // — r/�— '6 e/
ftner:A0 A
Address
LO ION OF BUILDING
No. Street _ Part of Lot
Lot Block Addition or Sub -Dion .
Corner Lot Inside Lot Setback —_ SAL 4
Sewer Elevation �') 4) Elevation �a
Fe�'a4A/p
DESCRIPTION OF BUILDING
v e jB
Front Depth � =�— Height Sq. Ft Cu. Ft 12
Front 9 Otepth Height Sq. Ft XW Cu. Ft
Type of Co coon Est C — 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 orth and in compliance with all provisions of
ordinanoea 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 tj ups violation of any of the provisions of said
ordinances. y�/I // .--i
Building Inspector
NOTICE:
Als pormM does not cover the condrueflon, huteliation for wM h& phnnbing, gee hearing, sower or water. Be sun to me
the MIA* inspector for separate peradis for them items.
"\'b�, (J�
I
APPLICATION FOR BUILDING PEi
SUBJECT
P }
City of Fridley
'
2 7 6 4 i
2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
F?
T NO.
_ COMMUNITY DEVELOPMENT DIV.
tr PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
9/9/98
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
JOB ADDRESS 6020 6th Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
11,12
2
Hyde Park Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
Steve Haynus 6020 6th Ave NE
ZIP PHONE
55413 571-0612
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Four Seasons Roofing & Remod 7930 Univ Ave NE Fridley 55434 795-9410 20138780
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 #i#xmff house & garage (19SQ) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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 1 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
$1,628.00
$.81
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
P VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$54.00
Fire S�.' $1.63
TR CTO O�MANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL E
/J
License
$5.0
$61.44
SIGNATURE OFCWT RACT R AUTHORIZED AGENT (DATEI
p p
BLO (NSP
000AT I IS R PERI^�IT
DATE
SIGNATURE OF OWNER pF OWNER SUILDERi (DATEI
NEW [ ] 11 Effective 1/1/98
ADDN (] CITY OF FRIDLEY 44
ALTER [ ] SINGLE FAMILY -AND DUPLEXES R.1 AND R-2 40P
BUILDING PERMIT APPLICATION
ConstructionAddress: 1`1 .
Legal Description:
Owner Name & Address:q e)R Tel. #
T
Contractor: Four s_e 6. cm s RO6�< n' r d- n5 MN LICENSE #
Address:. 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.
OTE,,ER: PO' "vn d v e., cl- kepi . ,� og 6i f, -� s hyY114 I s
Construction Type-"0VC, tl.lC.e„p�G� P_ �i' Estimated Cost: $ >�oo70
(Fee Schedule. on Back)
Driveway Curb Cut Width Needed: Ft. t 6 rt = Fto = $
DA'Z'E: q' .APPLICANT:
Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
/
Fee Schedule on Reverse Side
Fire Surcharge
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 All. "B" Above
Erosion Control
$450.00 Conservation Plan Review
Park Fee
Fee Determined by Engineering
Sewer Main Charge
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
�' L
STIPULATIONS:
SUBJECT
City of Fridley
C
3862
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
NO.
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 � r
NUMBERREv
DATE
PAGE Of
APPROVED BY
CITY HALL FRIDLEY 55432
' 763-571-3450
910415
9/8/03
JOB ADDRESS 6020 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11, 12
2
1 Hyde Park Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Steven Haynus 6020 6 Street NE
763-571-0612
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Cities Home Improvements 640 Mendelssohn Ave N, Golden Valley, MN 55427
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
763-591-0332 20076414
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
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
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
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 THE GRANTING
@
$5,000
$2.50
HEREIN OR NOT. OF A PERMIT
DOES NOT PRE ME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$111.25
Fire SC $5.00
CTION O HE PCONSTRUCTION
TR ER RMA OF
/J
(�!Jbr4ens4
PLAN CHECK FEE
SC $5.00
TOTAL FEE
$123.75
SIGNAT 0; N' ACTOA OR ANT.VoWtzEDAGENT IDA TIE,
WH N PROPERLY
VALIDATED THIS IS YOU PERM T
SIGNATURE Of OWNERaF OWNER BUILDER, IDATE,
BL Oft k6gp
pA I 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) 5714287 Fax,
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: Tel. # 7§1 r s'7 /' A2
Contractor. l � � �° a__ MN LICENSE #--Re "(0 'Y/
�
Address: 1P'1'9 �� �� G► v -e L v% tA11JL1 Tel. # 76
63:-Vvq %
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:
1 / ` �
Construction Type: V '� ` � 1 dQ "2M Estimated Cost: $ �o�o
Driveway Curb Cut Width Needed:
Ft. + 6 Ft =
Ft x $
_ $
DATE: (��3 APPLICANT:
CLP(-
z� & -.-I
Tel. # %& 3
__0
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
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 � 3 ��
6431 University Ave NE
Fridley MN 55432
(763) 572-3604 or Fax (763) 502-4977
Water and Sewer Permit Application
❑ New Connection fBUtility Line Repair/Relocation
❑ Existing ❑Water and Sewer Connection
Date:
Job Address: D h S -t
Name of Applicant (Plumber): CG 0- e U rn
Name of Property Owner:
Existing Structure Permit #
Permit Type: Sewer Fee:
Water Fee:
MeterFee:--�
Repair Fee:
Relocation:
State Surcharge:
SAC Charge:
Special Assessment Fee:
Total: $ ` % s �;- 0
Applicant Signature:
Inspector approval:
Water Meter Repair — Weekend & Holidays
$125/hour
Water Connections Permit
$50
Sewer Connections Permit
$50
Inspection Fee for Water/Sewer Line Repair
$40
Special Assessments
See Engineering
Cost of Water Meter
See Utility Billie
SAC Charge
$1675
State Surcharge
$ .50
Water Tap
See Engineering
Building
PLUMBING
Permit No.:2C,%Z-UISg1
Inspections
RESIDENT', APPLICATION
Received By:�
763-572-3604
CITY OF FREDLEY
Da d.
763-502-4977 FAX
EFFECTIVE 1-1-0>I
DATE _az�L-p O a YOUR E-MAIL ADDRESS
SITEADDRESS (00a n n F.
THIS APPLICANT IS: ❑ OWNER ,CONTRACTOR
PROPERTY
NAME:
OWNER/
ADDRESS: CITY STATE ZIP
TENANT
PHONE:_5 7 /— 0 &Z 7-
CONTRACTOR
NAME: River City Plumbing
SUBMIT A COPY OF
Go
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE, BOND AND
STATE BOND #Frid�' eyMPI 55432 EXP DATE
CERTIFICATE OF
ADDRESS: n -,�. STATE ZIP
INSURANCE
-C—
PHONE
PERMIT TYPE
❑ SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
D NEW REPLACEMENT
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = plus .50 surcharge
OR
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE $15.50.
BATH SINK/LAV DRAINS _ WATERPIPING
_ _FLOOR —SHOWER
GAS PIPING (NEED CITY LIC) SWIMMING POOL —WATER SOFTNER ($35)
—BATHTUB _ _
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_ _ _
DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
—WATER METER —OTHER
SfBY
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
OR Number of fixtures @ $35.00 x$35.00=$ 35.
TOTAL DUE $
State Surcharge = $ .50
(MINIMUM $15.50)
(MINIMUM $15.50) Total = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 on site; that the work will be in accordance
with the approved plan in the case all wort which requires review and approval of plans.
-o�f
SIGNATURE OF APPLICANT �- I'!/ �L�/�A'�'C PRINT NAME �/C LCIS O`G( DATE / 'L Z"0 lC
APPROVED BY DATE
: 1'I:EA;$E N6 A�� V1�1 RE .il1�a��1 R>B1�11�T�is�+I.C"L1�If:�t.
City of Fridley
]Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977