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
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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„