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PRE 2010 DOCS• • City of Fridley, Minn. BUILDING PERMIT Date: Ku 27IsX65 N° '7589 Owner: Ralph Somner Builder George A. Gross Construction Co. Address 6101 6th, Street N. E. Adm 2= Mesman Street St. Paul, Minn, LOCATION OF BUILDING No. _� street 6th. Street N. E. .....^.. Part of Lot Lot 39 _ Block 1 Addition or Sub -Division UPD-and . 2nd it Addition Corner Lot _ x _ _ Inside Lot — Setback __._ Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING DMI l ing Front Depth Height Sq. Ft Front Depth Height Sq. Ft Type of Construction Frame Est. Cost $ Ian– __ To be Completed Storm Damage Repair 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 of l ons of n ordinances of the city of Fridley. ,' In consideration of the payment of a fee of $ 1()e0Q , permit is hereby granted to anwhM.-IoMon --6 express condition that thecepe�rson t trwhom itis or ranted aonnd�hisdageenntts, embed ployees and This workmenis �in all wted ork done in, around and upon said building, or any p thereof, shall conform in all respects t the ordinances of Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings w city limits permit may be revoked at any time upon violation of any of the provisions of said MAL NOTICE Tris po mb don no ewa the eeaienetion, budslis = for vrkk& plumbing, ge hestbw awa or wrier. Be an to see tl» Bonding I I - r for apm to pmrmhs ter them items. APPUdATION FOR BUILDING PERMIT Cift , OF FRIDLEY, OWNER'S - ADDRESS • .. ..� u iii LOCATION OF BUILDING No. r , O -street jPart ,o£ Lot LOTBLOCK / ADDITION OR SUBDIVISION ,�C Corner Lot_Insfde .LOT' -,-y-Setback -�� !O Zd ' —, Side and ... o� SEWER ELEVATION '*O11J0ATION• ELEVATroN Applicant attach to this form Two Certificates of Survey of Lot and prop.sed building location drawn on these Certificates. - DESCRIPTION OF.BUILDING To be ed as; Front � � �• Depths eight /, . V 0 Sq. Ft. Cu. Ft. Front Depth Height Sq, Ft.' Cu. Ft. Type of Ooaetructioni� Estimated Coat ��'• 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.FrOley Ordinances and rulings of.'the Department of Buildings and hereby'declares that all' -the, facts and representations stated in this applicati re truea correct, DATE ' SIGNATURE (Sched a of Fee Coots can be found on the Reverse Side). City of Fridley, Minn. BUILDING PERMIT Date: - May 262 1970 Owner: _RU Mr. Ralph Sourer Builder Address 6101 -6th Street N.E. Address Same Same LOCATION OF BUILDING No. _ 6101 Street 6th Street N.E. ____ part of Lot Lot ._.__19 __ Block 1 Addition or Sub -Division _ Upland 2nd Addition Corner Lot __X Inside Lot _ _ Setback __ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING t7,S-6 N° 0665 To be Used as: Garage Front 20' Depth 22' Height 10' Sq, Ft. 440' Cu. Ft. 4400' Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost _ $1,000-00 ___Tobe Completed Jan. 1, 1971 Provide Hardsurfaced Drivwway 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 cotpliance with a'11 provisions of ordinances of the city of Fridley. n _ y In consideration of the payment of a fee of $____2, 00 _, permit is hereby granted to Ralph Sommer 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 andmoving 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. / f ;Zle — Bwllding Inspector HANK MUHICH NOTICE: This permit does not cover the construction, hutaONlon for whing, plumbing, on heating, sewer or water. Be wro to as fire Building Inspector for separate permits for these here. .00 APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S. HAM: �� �i?/� BUILDER ADDRESS: CA71 A) ADDRESS: NO:. STREET: n LOT: I BLOCK: 0-rLk ADDITION: CORNER LOT: l/ 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: cr �' Front: Z O Depth: , Height Square Feet:- Cubic Feet: I/ q" Front: —Depth: Height: Square Feet; Cubic Feet: Type of Construction: 4E-Lq' ?ted Estimated Cost: $ /"V.a-V To Be Completed: 7Q >1 / The undersigned hereby makes application for a permit for the work herein specified, Agreeiug'to do all work in sttict 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: e ``� — � �' � b SIGNATURE: C 'g� (See Reverse Side For Additional Informari.) r City of Fridley, Minn. BUILDING PERWr N® 3074 � Date: .47/. ....... _5..................... Owner ` �'_ .. ` Builder' �?* ..-.' Address ... (9. /. . �...... [d�.... ...... ... Address ... �� �. . �. .. ... ........ L TION OF BUILDING No. ®/. Street .:. .... .:........................ Part of Lot . ... .. ......... Lot ...� .. Block ..�.............. Addition or Sub -Division .. .<r. ...... / ... Corner Lot ... �� ... Inside Lot ............ Setback . 9. ... ideyard . `.? .7 1 :'. DESCRIPTION OF BUILDING To be Used . .. Front .. Depth °? ! .... Height Sq. Ft. / A.� Cu. Ft. ........ . ....... Fr nt ........ Depth .... d Height .. Sq. Ft. ........ Cu. Ft. .. e of nstructuon ... Est. Cost. I. �� !��. �.. To be Completed .... j� 7. In consideration of the issuance to me of a permit to construct the buq&ag desribed above, I agree to do the proposed work in accordance with the description above set fo compliYeall visions of ordinances of the city of Fridley. A. ..... ..... ......... O� In consideration of the payment of a fee of �. ....., permit is hereby granted tU7 :........ ......................... 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 city 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, Installatloip or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. City of Fridley18942 AT THE TOP OF THE TWINS suB,IEcr BUILDING PERMIT WE MIT NO. `y _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 = � CITY HALL FRIDLEY 55432 L 612-571-3450 RECEIPT NO O NUMBER 910-F15 REV. DATE 5/11/87 PAGE OF APPROVED BY JOB ADDRESS 6101 - 6th Street N.E. 1 LEGAL DESCR. LOT NO. 19 BLOCK 1 TRACTOR ADDITION Upland 2nd Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ralph. Sommer 6101 - 6th_ Street N.E. 571-03 44 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue N.E. 784-7543 , 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 Cgi ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE, 8 DESCRIBE WORK Aluminum soffit & facia 9 CHANGE OF USE FROM TO STIPULATIONS 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $978 SURTAX $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 17.50 d 3GAT PLANCHECK FEE TOTALFEE/�1 18.1x.0 URE OF NT ACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VAL T D THIS S YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSD �A NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: Of V/ Legal Description: T J9 / .P pCl An �iyDdA� - Owner Name & Address: q//0/ 1 �d/I'/�'1 C 1� Tel. # _ Contractor: �)'"b %�A P' Tel. # 7$ 2 Address: 7'qGi CeAirg1 /VC, N,�f 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 Length Width Height Length _ Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: !1 2�fs 6!� Estimated Cost: $ 22 'Or Approx. Completion Date: 5--3o --6,1"7 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ _ $ See Back Page for Explanation DATE: � / APPLICANT: Z 0�5�0A/ Tel. CITY USE ONLY Permit Fee $ / %,� O Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $525 per SAC Unit Park Fee $ Fee Determined by Engineering Sever Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ /a.On STIPULATIONS: SUBJECT PE City of Fridley 2 0 6 3 2, AT THE TOP OF THE TWINS BUILDING PERMIT r RE COMMUNITY DEVELOPMENT DIV. v r PROTECTIVE INSPECTION SEC. LMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/17/90 JOB ADDRESS 6101 - 6th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 1 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ralph Sommer 6101 - 6th Street N.E, 571-0344 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue N.E., Fridley - 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 O 8 DESCRIBE WORK Reroof Dwelling (12 Squares) 2nd layer 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be 2nd laxer but not 3rd, 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $60.0 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $17.0,0PLAN STRUCT)7 THE PERFOR ANCE OF CONSTRUCTION. CHECK FEE TOTAL FEE e $.60 $18.10 IG A UR ONT A 0FI-0R iLITH61TIVEDAGENT (DATEI WHEPROPE LY =THIS IS YOUR PERMIT INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 8/16/90 ADEN [ ] R-1 AND R-2 AIM [ ] Building Permit Application,Construction Address: j! /Gad A� Legal Description: Owner Name & Address: �/� '® �C /�✓ Tel. # 5-7/-0—SW Tel. # F.'041q �- 1 Attach to this application, a Certificate of Survey of the lot, with the proposed cronstruction, drawn on it to scale. LIM G AREA: length Width Height Sq. Ft. GRPAGE AREA: Length Width Height Sq. Ft. DDCR AREA: Length Width Hgt/Grocuxl Sq. Ft - OAR: Corner lot [ ] Inside t. Yd Setback Side Yard SetbacJcs Type of Construction: 15VA&I ®Uep-0W-Estimated Cost: $ �o DC7 Approx. Ocupletion Date: 1Z -'25--M /a 6 *nev Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLICANT: Tel. # Permit Fee $ / D O Fire Surcharge $ 1," 0 State Surcharge $ �( SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ / S . / STTPLIIATIC NS: CITY USE CINII,Y Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] v SUBJECT City of Fridley 33924 AT THE TOP OF THE TWINS BUILDING PERMIT r ` v -------COMMUNITY DEVELOPMENT DIV. R IPT NO. r E � PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 763-571-3450 910-F15 9/29/03 JOB ADDRESS 6101 6 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 1 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ralph Sommer 6101 6 Street NE 763-571-0344 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Image Remodeling 3013 82 Lane NE, Blaine, MN 55449 763-784-9797 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20204899 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House 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 1 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 $59700 $2'85 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. $125.25 Fire SC $5.70 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE cen a SC $5.00 $138.80 iGNATUP OF CON 7 PAC TOR OR AUTHORIZED AGENT tOATE. EN PROPERLY VALIDATED THIS IS Y UR PE MIT S,GNATURE OF OWNER, -F OWNER BUILDER. [DATE, G -NS' v NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADON [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 671-1287 Fax BUILDING PERMIT APPLICATION Construction Address. 10 J (� `y Si rj , Legal Description: Owner Name & Address: !!'-�>®ade._ w U l , &-- Tel. # 7U.4 -6-71 Contractor: 4w LqA*cje= y16la,ajj(n MN LICENSE #. z z.oda-749 Address: 3l A 82AD 1_1j el. #°Tt' ��1 7 -IW-7 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/Gmund Sq. Ft. OTHER: Construction Type: NLw Estimated Cost: $ 1-5-, 'oc- Driveway Curb Cut Width Needed: -°#t: + 6 Ft = Ft x DATE: GI z4C-S APPLICANT: , 'DAL%,®, -4.`q -i< Tel. -4.`q -7 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1267 If using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - $ % cS Fee Schedule on Reverse Side $ 1P .s :001 of Permit Valuation (1110t10/0'ti $ yj� $.50/$1,000 Valuation $ $1275 per SAC Unit $5.00 (State Licensed Residential $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Revied $ Fee Determined by Engineering $ Agreement Necessary[ ] Not N TOTAL.e Ca • ~ $ � 09. .. 4� . STIPULATIONS Contractors) NEW [ ] CITY OF FRIDLEY 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: `� Tl� S� Al,!: -- Legal Description: r Owner Name & Address �� �Ps ����✓v Ila Tel. # 71� 3 S -%t- -q-q,—,7 Contractor: �' �� MN LICENSE # Address. &// � T-1/ 57- zV K 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: Construction Type: C lFz��ss LJNa�� Estimated Cost: $ S� c� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT• '`� Tel. # 76 3 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 Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ STIPULATIONS: ��r•�-moi/ate Building PLUMBING Permit No.: -. Inspections RESIDENTIAL APPLICATION Received ByN120M 763-572-3604 CITY OF FRI�DLE'Y . ILAI DATE July 13.2007 YOUR E-MAIL ADDRESS wnelson larsonplumbing.com SITE ADDRESS 6101 - 6th Street NE THIS APPLICANT IS: 11 OWNER ®CONTRACTOR PROPERTY NAME: Star Sthween ADDRESS: 6101- 6th Street NE CITY Fridley STATEMNzIP 55432 OWNER/ TENANT PHONE L 7b,3 1 -518.«Z 8 � CONTRACTOR NAME: Larson Plumbing Inc. STATE LICENSE # 3341 PM EXP DATE 12/31/2006 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW CITY Andover STATEMN zip55304 LICENSE WITH PHONE 763/427-7680 FAX 763/427-9448 APPLICATION PERMIT TYPE IN SINGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: D NEW 181 REPLACEMENT DETAILED DESCRIPTION OF WORK Water Heater Replacement 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 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) SINK/LAV FLOOR DRAINS _ SHOWER _ WATER PIPING —BATH GAS PIPING RrFoW71.1ca4z) _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. (S15) _ DISHWASHER LAUNDRY TRAY X WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER :.., .,.•.... ... ;. .:••.: ,': i.. t .-Y ':•i.;i4:-2:.'':.�tr;3^;".•c=.:.;~'.�stJ7� ,.?e. .17>�.,na.�:;�,v %;i;: E'`IZl'��+ '}, }� y.,,r,-.•4+�y,. y y. yt•y., ;e:+,.;,.c..$.: .:itlL.r..;n•..� < .:r+:x:!r�n •:trx.42',� t�;��,,�y !'P"Q.1C+'Vl•"il'J,OV;d^.rR�V�; '.,I�E12I�`�.�°I'•' 'v N• ,.,!?ti w�X%... r,�1�"r,'�'' $.. Permit Fee. $ 35 00 Number of fixtures @ $10.00 x $10.00 = $ _. Surchar •e .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 35.50 Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ TIMS IS AN APPLICATION FOR A PERAUT--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 thealln%rk whit requir review and approval of plans. SIGNATIJREOFAPPLIC�� PRINTNAME Michael Malinoski DATE July 13, 2007 .::.r yv-. .; ...- ... .... ~. ... _.�rf.. L .. x.�... ',i." li % f:..,. J• . ,-ri :j Lt )`:• !-. ., �!y� �r� �'. ^t yy.j �yy��y �y `S-W,�j�`��4.�}. �•sya"�j '�) y� '(`�, .�7 .::'r-e`i�L�JS1.",.i#i��.'•d�1��iJ:�'3'arT�17�Ys1'l'.'.E's�•�xA^a7�.` Q;lJ7la'�it�:R�7Y'_......~....:...__...�L_ ,_ ._ .�:. City of Fridley )Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Engigeering WATER AND SEWER Permit No.: 0t 7 763-572-3552 PERMIT APPLICATION Received By. 763571-1287 fax CITY OF Y OF FRIDLEY UTU APPLICATION DATE: � 22 ` / d YOUR E-MAIL/FAX: THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR JOB ADDRESS: G f a C; & &' " NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME:54rar SrAG�j., OWNER/ ADDRESS: GAG/ Got` A-1 41.6` CITY 7e-"dArte STATEA/WZIP TENANT PHONE: -76?-6-71. 5/ CONTRACTOR NAME: APPIP 1h, �a-ny c.... CITY S�.�atvL l STAT�/�/�ZIP­7�'L_� SUBMITACOPY OFDRESS: YOUR STATE LICENSE WITH _ PHONE 6 G Y -C3 Ca CELL PHONE: APPLICATION LIC # STATE BOND: EXP DATE: °,SSTATE 1. NIIarr,rative/writte�4escription:l W.t wi �/ /'�C�Y�%' �4l ��l��t./r' .S,Pa-y, i.P �A♦ �!1 �i-f /'bn?�S.w� 2. Please attach sketch showing curb line, utility line, building, etc. with distances on back page. 1. 9 3. Stipulations: -7 2- At A) 6211 WP410 P, A �MM 3, V �.l.ti. Ja-c v —"++ l� �' _ �i'r� tee. •'r a PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 ❑ WATER LINE REPAIR $40 SEWER LINE REPAIR $40 ❑ ADD STATE SURCHARGE $5.00 5 ❑ SAC CHARGE @ $2100 = 'S TOTAL $ OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / EVENINGS, WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) permit and I acknowledge that the information above is complete and accurate; that the work will be ' formance with the rdinances and codes of the City of Fridley. I understand this is not a permit but only an application for a pe it and ork is n t art ut a permit.`� r: Q SIGNATURE OF APPLICANT PRINT NAME: ✓SSS{P �ih//�PYJ� DATE: /G�"-2 RC1 �►+ APPROVED BY: 1LZ411nA&4 DATE: G 01 [� COPY G : ❑ ILII BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINEERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3552 FAX: 763-571-1287 .1 '01 STAT Nor1�1, ter„