PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: .4 ...�
IQ
Owner: .....� "''.:..._ ............."" _....._..:..:...
Address _..j
N° 4'769
Builder _............ .....
Address _......_......
LOC TI N OF BUILDING
- ' � . SLI..
No. _. .. Street _ _ �._. Part o t .
d Block on or Sub -Division ._.
Lot --- " ..... , , Block, ,._. ...--------.......... Addition on � �-•9k low� / •,�
Corner Lot ._.... _-_ Inside Lot ...._.::..._...._ ................. Setback .....4j .. ......... Sideyard +r ......a..
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To beUsed as:.
..: Front ••eg.--. Depth Height ...:. Sq. Ft...`t' Cu. Ft.,6�
................... ........................ Front ....... Depth ..... _.. . Heigh ��,TSq. Ft. ............. ........ Cu. FL ...................---
Type of Construction % Eat. Cost... o be Completed ....._ ............._............._..
. _....
C .' , ' D N
THIS PERT [-.-,)L,, N01 AUTHORIZE VIOLAT-
ION OF ANY PRkATE LAND COVENANTS AND
BUILDING RESTRICTIONS.
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.,
et &1690
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: pon Vipla�f any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation, for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits fairthesehems.
r�
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name )74 CO— Builder �%� 6 -
Address c=fr,;�-r2n- Y0 _6� )f f Addressa® �•�`-�
LOCATION OF BUILDING
No.�S®® Street % Part of Lot
Lot_ Block Addition or Sub.Div
Corner Lot__!�_Inside Lot Set Back �;.? Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front 2 Depth a:5� Height
Sq. Ft. Cu. Ft. 0
Sq. Ft.
Front Depth Height
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE --AZ�/-- - SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK �
Number, Kind and Location of Fixtures Location
in
61
yy
Z
m
Z
N
N
�4a
3 1-
Y FZ
sp
LL
N
O�QQa
LL p
_
u 0
S
S�
Q 3
`a 6°
i� Q
`�QZ
6'
Z
O
F
N
WATER HTR.
GAS
ELEG
Base
®�
1st
2nd
3rd
4th
Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer El
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE BATES: NO. RATE T AL
Number Fixtures ...................... x $1.50
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ �_
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... ✓ x $1.50 $
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description .................................$
TOTAL FEE
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this applicatio true and co•rect.
Fridley, Minn
Owner v� ✓ 19—
Kind
9Kind of Building . 119—
Used as
To be completed about - 17 —1'/✓�
Estimated Cost, $
Old e . Building Permit No-
/
By `�� '
Business Phone
Connection Permit No . .......................................................
�i �' °✓ 1 �'''� ��° � " � ' Water Z� °
Sewer---Sr!!� - "k -V
Meter Deposits E
11 IM -8-58
*/?"l
City of Fridley
Application for Plumbing and Gds Fitting Permit
RRi 9 4
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location
.�
K
x
m
Z
Number Fixtures ......................
=?
F
Z
cy
s m
Z
�n
Z
w
O=
x
w
z
y
WATER HTR.
GAS
ELEC.
Y
F Vl
QG,...77
3
Z
Vl
<m
'�
Y
Z
`��
3
Z
sp
=
R
New Ground Run Old Bldg. ............
x
3.25
$
F
N
GAS FITTING FEES:
U
m
m
N
F-
LL
N
LL O
U m
6 3
G Q
U' a4
(J O
Gas Range to 200,000 BTU ..............
x
2.00
Base
1st
2nd
3rd
4th
• Future Connection Openings
Connected with
New Fixture, Old Openings
Sewer El
Cessp001 El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
O.
RATE
TOTAL
Number Fixtures ......................
x
$1.50
$�
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE
TOTAL
1st 3 Fixtures ..........................
x
$1.50
$
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ 6
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, 1VCnn 19
Owner Q' 19—
Kind
gKind of Building -- 19—
To be completed about - �d✓
Estimated Cost, $
Old�uilding Permit
Connection Permit No . .......................................................
Water !_
--Sewer—
lip(}' II Meter
0 j
11 1M-8-58
r
Application for Power •�
Apph Plants and _Heating, Cooling, Ventilation, .Reffigerathon and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU. 4-7470
GRAVITY WARM AIR:
RATE TOTAL,
Furnace Shell & Duct Work ..........................
8.00 $
Replacement of Furnace .............................
5.00 $
Repairs & Alterations—up to $500.00 ..................
5.00 $
Repairs & Alterations each add. $500.00 ...............
2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 80,000 BTU ....................... 2.00 $
Replacement of Furnace P.00 $
Repairs & Alterations—up to $500.00 ....e ............ 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal, per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTL) ....................... 5.00 $
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS 8r REPAIRS
TOTAL FEE
ROUGH
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn- 19"
Owner
Kind of Building���
Used as Zd-64-1&
To be completed about z9�
Estimated Cost, $ l9Dd x-4-1
Old eW. uilding Permit No. Permit No. �Z
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Ste of Water. Warm Air—No,.!
Trade Name Size No "
Capacity ® Sq. Ft. E.D.RBTU H.P.
To Conn teed4 oloae
f � .� ' /Ll Y /4 ?�
.
Kind of Fuer
BURNER — Trade
Size No
Capacity Sq. Ft. E.D.R BTU H.P.
2 2M 7-59
4 &C -:a FINAL �
(REMARKS-OVER)
>F
Application for Power Plants and. Heating. Cooling, Ventilation .Refrigeration and
Air Conditioning Systems and Devices
• PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ........................ 2.00 $ _
Replacement of Furnace ............................. .§.00 $
Repairs & Alterations—up to $500.00 ... ............ 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam.......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ................('3) . 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. %fix .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH
FINAL
Dept. of Bldgs. Phone SU. 4-7470
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley,
Owner 'CV 0/
Kind of Building
Used as
W
To be completed about /
Estimated Cost, $
Old New Building Permit No. Permit No. / l
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
18 o
Capacity Sq. Ft. E.D.R- BTU A.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name . Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signe "
By
2.
4 2 4M �.se Business Phone No- l
pity 04 Fridley
.., -- — --•- D®pl. of Bidv. Phone SM -3430
DES Cal PT, OF V1011
Lox�o�
Humbbzr. Y,'id dnd Locrikm of Fimtares .
Fur=* Ccr :sci'.-a Gj; alr.� Sowar
* Na® Fiz:-ara. Old Ccupool 0
PARTIAL RATE SIC.0"HEDULE
City of Fridley'..
The undersigned hereby makes application for a permit for the- work her -el
specified, acr eeing to do all work in strict accordance with the Cita O:d?r-an:a
and ruling of the Department of Build..'nzs, and hereby declares that 14 Lhe fac
and representations stated in this application are true arxl correct'
Fridley, Minn. �� • 1�
Owner
Kind o1 Building ---
Used as '
To be completed about
Estimated Casi, S
Old New. Building Permit No. permit 2.'.0.
PLUM F'I;CTJ?E RATES:
NO. RATE
TOTAL
.7
WATER HER.
~
" Ix p
I` t 8 z 5<
`�
7
V
z
z
7"
c7 5
o
►
s
H
GAS MC.
x $1.50
I f c c v< 3
0
u a
BusinPhone
1ew Fixture Old Opening.
150 S _..-
-
Catch Basin ....................
- -- x $3.25 $
--
E3sr
.
Water Beater 'Vp to 99,000 BTU).. • •
x $3.00 $
--
ROUGH
few Ground Iiun Old 81dg....:....
x 3.25 S_-----
Eleetrie Water Haatar• • ...:........
a $2.00 $
FINAL -
AS nTTI`%G FEES:
130. RITE
TOTAL
Ist 3 Fixtures .......... a • • • • • • ----
x 52.00
,
Additicnal Fixtures ............... ----
x $ .75 S
Gas R:.:.ge to 199.000 BTU .......... .----
x $5.00 S
2r.d
:
.50 State
Surcharge
r
- v�'?A:R3 � ALTERATIOMS—P.afor !o Codd
.
—�
•
.Yic:.crip:lon...............:.........................,
•
TOTAL FT:.:.
3:d
!.h
Fur=* Ccr :sci'.-a Gj; alr.� Sowar
* Na® Fiz:-ara. Old Ccupool 0
PARTIAL RATE SIC.0"HEDULE
City of Fridley'..
The undersigned hereby makes application for a permit for the- work her -el
specified, acr eeing to do all work in strict accordance with the Cita O:d?r-an:a
and ruling of the Department of Build..'nzs, and hereby declares that 14 Lhe fac
and representations stated in this application are true arxl correct'
Fridley, Minn. �� • 1�
Owner
Kind o1 Building ---
Used as '
To be completed about
Estimated Casi, S
Old New. Building Permit No. permit 2.'.0.
PLUM F'I;CTJ?E RATES:
NO. RATE
TOTAL
Signed
Number Fixtures ................
Future Fixture Opening .......
x $1.50
By -N�o�.� - - -
BusinPhone
1ew Fixture Old Opening.
150 S _..-
-
Catch Basin ....................
- -- x $3.25 $
--
.
Water Beater 'Vp to 99,000 BTU).. • •
x $3.00 $
--
ROUGH
few Ground Iiun Old 81dg....:....
x 3.25 S_-----
Eleetrie Water Haatar• • ...:........
a $2.00 $
FINAL -
AS nTTI`%G FEES:
130. RITE
TOTAL
Ist 3 Fixtures .......... a • • • • • • ----
x 52.00
,
Additicnal Fixtures ............... ----
x $ .75 S
Gas R:.:.ge to 199.000 BTU .......... .----
x $5.00 S
.
:
.50 State
Surcharge
-
'
- v�'?A:R3 � ALTERATIOMS—P.afor !o Codd
.
'
•
.Yic:.crip:lon...............:.........................,
•
TOTAL FT:.:.
suedEcr
PERMIT
City of Fridley
13834
AT THE TOP OF THE TWINS
PERMdl
r
BUILDING
ECEIPT NO.
`L _ COMMUNITY DEVELOPMENT DIV.
73
r PROTECTIVE INSPECTION SEC.
1 �
� CITY HALL FRIDLEY 55432
�
NUMBER
REV.
DATE PAGE OF
APPROVED BY
L••"� ,'J 812-560-3450
910-F15
10/19/71
JOB ADDRESS 5400 - 7th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
14,15
9
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bert M. Virgillo 5402 - 7th Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Gorco Construction Co. 3384 Brownlow Avenue, St. Louis Park 55426
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
X
6 DESCRIBE WORK
Construct a 361 x 22' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Provide a hard surface driveway.
w IX
Blmfore digging.call local utiiii�.g
SEpERATE PERMITS REQUIRED F.4�. WIRING, TELEPHONE . ELECTRIC • GAS Etc,
MEATINGII PLUMBING AND SIGN& REQUIRED BY LAW
---IMPORTANT--
NOTIFY THE FRIDLEY ENOR,
DIVISION REGARDING CURB
REMOVAL AND REPLACEMENT
AT DRIVEWAY OPENINGS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST. "
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 50 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
792
7920
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
3
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
$2.93
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,860.80
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.
$31..68
PLAN CHECK FEE
TOTALFEE
4-19.746
$34.61
SIGNATURE OF CONTRACTOR OR HORIZED AGEN (DATE)
A
WHEN PRO PERL V LIDATED THIS IS YOUR PERMIT
I /p- 1q-9 L9
BLDG INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
CITY qF FRIDLEY
APPLICATION FOR. RESIIDENTIAL BUILDING PERMITS
NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME:
ADDRESS:
NO:. 5400 STREET:
LOT • y 15 BLOCK:
CORNER LOT: W_ INSIDE LOT:
Gored Cv wd' 'C=
ADDRESS: Im,.- Av-..'
TEL. NO.:
ADDITION: Lj"./+,,..s Adel •fie Me�ilnnieSv.1/t
ETBACK: SIDEXARD:
Applicant attach to this form 7.t,7o Certificates of Survey of Lot and proposed
building location drawn on these Cert'ficates.
To Bq Used As:
DESCRIPTION
Front • 3(.1 D
Square Feet:
OF BUILDING
the Z.1' Height: /d'
Front: Depth:
Cubic Feet: -7,92,0
Square Feet; Cubic Feet:
.Height:
Type of Construction: Fro.mt Estimated Cost: $'q(. p =-O
To Be Completed: 'Heti.
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict 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: 1 8 - l S • SIGNATURE: ,
(See Reverse Side For AdditInform ion.)
—j'108 0('
��.q3
CERTIFICATE OF SURVEY '
8713 DUPONT AVENUE SQUTH
AW60K OIC _ 188-2084 -
ARLSOM.
55,420
LAND SURVEYORS
Survey for: GORCO CON`:TRUCTION CO.
31
j 3e. ' -570. Z
TPK*
t1I,S'd�
--- , - s
�► S®, ...
a �
1 w 39. z
G.o -
%dr1
i
C
r Descriptio%: Lot lb and 15, Block 9, "HAMILTON'S ADDITION TO
MECHANICSVILLE" including the East .Half of vacated alley adjoining.
6. We Hereby certify that this is a true and correct representation of
a survey of the*boundaries of the land above described and of the
location of all buildings; if any, thereon and all visible encroach—
ments, if any, from or on said"land.
1
Dated this 15th day of Ocotber, 197F.
be
Innes a{ egistration No. 901.
N° :Z1,f4 /,57--.-7a
i
GORCOCONSTRUCTION COMPANY, INC.
L� Garage Building Contractors
929-7868 JOB ORDER
JOB a 1304
NAME: 5402 - 7th Street N.E. CUSTOMER'S PHONE: 561-3098 DATE: 9-
-STREET: Bert M. Virgil.l.o CITY: FSridlmy STATE: Mien
SALESMAN' Nod Sorrell HOME PHONE: 929-3830 SUB -CONTRACTOR
WORK SHEET
JSITE DIAGRAM
I ( N ) I L
INFORMATION
*PROMISED STARTING DATE: Soon as Possible
WORK SPACE
(1) 361x 221x 21 Slab & Apron
(1) Course 6" block North.West & South
NOTES:
-
A ' ' ' { ---- --� t�,; -
# Place belts for partition walls as pictured
=,
below.
Call Ned night before starting so he may
i
arramge to meet you on job.
# See Attached survey for lines.
WORK SPACE
'
SUBJECT
i
City of Fridley
=6�
AT THE TOPOF THE TWINS
BUILDING
PERMIT
72m36�4
COMMUNITY DEVELOPMENT DIV.
p�®
r PROTECTIVE INSPECTION SECvj'
E ,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
11/20/98
JOB ADDRESS
5400 7th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
14, 15
9
1 Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Van ie Nicklow
475-9903
3 CONTRACTOR MAIL ADDRESS 533-6422
ZIP PHONE LICENSE NO
x Lund's Handyman Service 4009 Louisiana Ave N New
Hnpp 55427 20113674
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 0 ADDITION ❑ ALTERATION 7x REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof triplex and garage 33A S Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO 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
$2828
$1.41
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
$74.75
Fire SC $2.83
PLAN CHECK FEE
;TjA L FEE
SIGNATURE OF CONTRACTOR OR AUTHORQED AGENT (DATE,
I
MEN RO
Y VALIDAT THIS ISYOUR PERMIT
S,GNATURE OF OWNER,IF OWNER BUILDERi iOATE,
BL G INSF'
f,A�E
NEW " [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 61400 h ST N, ,
Legal Description: 'Tx
Owner Name & Address:Tel. # 4-75-9103
Contractor: MN LICENSE #_ 2011 3(077 N
Address: Lo lJ )'s "d_ n ca, Nyt N� , Tel. # U Z Sl3 � q ZQ
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:
Fe Does-
fry )2)Qx 4- 2Y'ckq:p_ 3 ? Ste- Tas 2=== o�'
Construction Type:
R�
---�
Estimated Cost: $�
(Fee Schedule on Back)
Driveway Curb Cut Width
Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: l 125 `6
APPLICANT:
, S4-etjP_n L -U ''101 Tel. # 53 3
CITY USE ONLY
Permit Fee
$
2.77
Fee Schedule on Reverse Side
Fire Surcharge
$
3
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$
1,4111
$.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 $ '760 7
STIPULATIONS: