PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N? C5C4f,,)
Date:'..'_,,
r�
Owner: ' Builder •�' ` —
Address _ _ Address
LO OAF BUILDING
No. Street r�� .c`,,=/ --x-�-e" __ Part o t
Lot % 0 - Block . 0z— Addition or Sub -Division
Corner Lot _ Inside Lot Setback L . __ ideyard ,Sr =0,5; -`r�
Sewer Elevation _» Foundation Elevation —
DESCRIPTION OF BUILDING
Tye Us '
A
Front Depth ,eight Sq. Ft. +r Cu. Ft, -
4
Depth Hight Sq. Ft. — Cu. Ft.
Type of Construction '^ _� Fst. Costs=��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 set forth and in compliance with all Provisions of
prdinances of the city of Fridley.
In consideration of the payment of a fee of $(A,l " — , 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 time upon violatio any of the provisions of said
ordinances. w ,"
"+ r� -.mac Zf Building Inspector
NOTICE:
This penult does not cover the construction, hutaWHon for wiring, pluml&g, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these Items.
,, 4. . , s 0 4 0
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's.
Address Address �� �r (U4
LOCATION OF BUILDING
No. Street „"'), 1'1" S- - Part of Lot
ao
Lot o Block ?/ Addition or Subdivisions P GG"�
Corner Lot ✓ Inside Lot Setback -31-r Side-Yard/L/,//'f z
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: CA-"- 4=+
Front epth Height
Sq. Ft. Cu. Ft.
—
Front _��eight
Sq. Ft. 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 of Fridley Ordinances and ruling of the Department of Build-
ings, and hereby declares that all the facts and representations
stated in this application are true and correct.
DATE b - Lr, SIGNATURE— 6�
(Schedule of Fee Costs can be found on the Reverse Side).
Application for Power Plants and Healing. Coding. Vehtilation..Rehigmal� no 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 ............................. 5.00 $
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. IDR 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 Q�
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOT&L
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 & REPAIRS TOTAL FEE $
ROUGH—
OUGH
FINAL—
FINAL
Dept.
Dept. of Bldgs. Phone/SSU. 4-7470
Location
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, inn.
Owner
Kind of Building
Used as
To be completed about
Permit No. Permit No. l ��
DESCRIPTION OF WORK
HEATING or POWER PLANTS—,Stea=4 Hot /Waatter�W-a�rm Air—No/
Trade Nam�iy.e�C/UU L1/ize No- /
Capacity Sq. Ft. E.D.R.v BTU H.P.
Total Connected Load / _ Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Business Phone N
D•S6 ' s
HEAT LOSS CALCULATIOn DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V. . Construction No.
Guide'
ind rvs oo Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
Ye No' I Ye!22!o 19_ `
/ . Room I Length--' "e Width / ' Height I Fl.� Room 11
Win ows -a4-
M--oors—Crackage and Area
Btu
Required ft. E.D.R. or sq. ins. W.A. Leader area
Width Height No. of Lineal ft. Area
No. ofpane of pane lig of crac/k� sq. ft.
Fl.•�,L`
/te
07 V
Coef.1
Btu
Coef.
Bty
Coef.
Btu
Infiltration
Glass
Net exp. wail
Exp. wall
�-
Glass
Exp. wall
Net exp. wall
Q
Int. wall
Net exp. wall
Ceiling
Floor
. E.D.R. or sq. ins. W.A. Leader area
/
Total Btu.}
Required sq
.D.R. or sq. ins. W.A. Leader area
Int. wall
Fl.1
Room I Length Width IR
Heigh
Ceiling
Floor
d'{/
Total Btu.
I I I Coef.
Btu
Required ft. E.D.R. or sq. ins. W.A. Leader area
Width
Fl.•�,L`
oom ( Length, Width Height /
Windows and oors—Crackage and Area
Width Weight No. of Lineal ft. Area
No. of pa!!v of ang lights of crack sq. ft.
.a /
9M,
Othl /
Coef.1
Btu
Coef.
Bty
Infiltration
Exp. wall
Q
Glass
Net exp. wail
Exp. wall
�-
/49 I'Me
Net exp. wall
Q
Int. wall
%
Ceiling
Floor
. E.D.R. or sq. ins. W.A. Leader area
/
Total Btu.}
Required sq
.D.R. or sq. ins. W.A. Leader area
Fl.1
Room I Length Width IR
Heigh
Windows and Doors—Crackage and Area
I I I Coef.
Btu
Width- HeightNo. of Lineal ft. Area
No. of pane of pane lights of crack aq. ft.
Width
Helghi
No.
No. of Dane
Coef.1
Btu
Infiltration
Glass
if
4�`
IV
Exp. wall
/Ova
Int. wall
Net exp. wail
&62
Int. wall
/49 I'Me
Floor
Ceiling
Floor ZZY
Total Btu.
I Total Btu.
ft. E.D.R. or sq. ins. W.A. leader area
MINNEAPOLIS, MINN.
Insulation
How. Applied
h Heigh
to and Area
II
I I I Coef.
Btu
Windows and Doors—Cr+
Width
Helghi
No.
No. of Dane
Ot pane
lig
413
//
Net exp. wall
MINNEAPOLIS, MINN.
Insulation
How. Applied
h Heigh
to and Area
II
I I I Coef.
Btu
Infiltration
%
7/7�'
Glass
/
5�
Exp. wall
413
//
Net exp. wall
/W /®
/Ova
Int. wall
Int. wall
Ceiling
/49 I'Me
Floor
7`a?
Total Btu.
%
Required sq.
. E.D.R. or sq. ins. W.A. Leader area
F'I_I .f
/li,R.tn l Lenath /I/ WidthHeight.
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of lights of crack eq. ft.
/pane
Coef. Btu
Coef. Btu
Infiltration
Glass
//
Glass
Net exp. wall
Exp. wall
Int. wall
Net exp. wall
/49 I'Me
Int. wall
Ceiling
Floor
%
Total Btu. 161 5— -5
Required sq. ft. E.D.R. or sq. ins. W4 Leader area
F1.1 4,9W,-6kol/Room I Length W Widt HeishtOr
Wintiows and Doors—Cracka and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Q
Glass
Exp. wall .�
Net exp. wall
/Q
Int. wall
Ceiling
Floor
Total Btu.
h. E.D.R. or sq. ins. W.A. Leader area
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK ��
Number, Kind and Location of Fixtures Location
O
<
c
Future Fixture Opening ................
z
��
rc�p
LL
2
V1
Q
joy
LL O
S
a~a'�
U m
5
<
�qqd
Ly G
�`z
i� Sn
0
�a
i� O
F
N
WATER HTR.
GAS
EI-Fr-
LEG
Base
x
3.25
$
GAS FITTING FEES:
z
RATE TOTAL
1st 3 Fixtures ..........................
Z x
$1.50
$_i, •5
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer �
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures' O
...................... � x $1.50 $�O
—
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $
City of Fridley:
The undersigned hereby makes application for a permit for the work here!
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Mrin, ✓�— 19�
Owner
Kind of Building
Used as
To be completed about
6 ®-o
Estimated Cost, $
e uilding Permit No� Permit No. Q
Signe
By
Business Phone No
ROUGH `� S
FINAL
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
$ 02 - O
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
Z x
$1.50
$_i, •5
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 here!
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Mrin, ✓�— 19�
Owner
Kind of Building
Used as
To be completed about
6 ®-o
Estimated Cost, $
e uilding Permit No� Permit No. Q
Signe
By
Business Phone No
ROUGH `� S
FINAL
•
0
City of Fridley, Minn.
BUILDING PERMIT
Date: APRIL 29, 1966
4-;'-�V-47
N° 8802
Owner: LARRY WADSEN Builder ANDREW KRUTZIG BUILDERS
Address 5801 - 7th St. N. E. Address 4231 North Lilac Drive
Fridley, Minnesota 55421 Minneapolis, Minnesota
LOCATION OF BUILDING
No. 5801 get 7th Street N. E. Part of Lot
Lot 10 _ Block 2 Addition or Sub -Division _ Lyndale B1drs ., 7th Addition
Corner Lot _X Inside Lot Setback _ - Sideyard
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft.
Type of construction REPAIRS Est. Cost _ 65 0.00 To be completed
REPAIRS AFTER STORM
In consideration of the issuance to me of a permit to construct the building
the proposed work in accordance with the description above�s � in cc
ordinances of the city of Fridley. ✓✓
Cu. Ft.
cu. Ft.
to do
ns of
In consideration of the payment of a fee of $ 6.00 , permit is hereby granted to ANDREW KRUTZIG
to construct the building or addition as described above. This permit is granted upon
the express conditi7ttheSIho
thato wm it is granted and his agents, employees and workmen, in all work
done in, around aupon saiing, or any part thereof, shall conform in aII respects to the ordinanceds�gosP
wit ythe olimiffi and n, construction, alteration, mup ti n of any of tmheo prgovY ions of said
�t may be revoked at any time vic
ordinances.
ALLEN G. JENSEN
NOTICE:
ihb pennh don not corer the eemtrnedw, Mdagaim Por wMh& pkwbing, gn heating, ewer w orator. Bo acro to m
69 BoBdhm mveftr for aiparato permits Por thea ft"M
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S BUILDER
�-Q� Ll
ADDRESS 4J / - ADDRESS
r
LOCATION 0 UILDING
N0.� , "" STREET
LUT__ L� BLOCK _2— ADDITION OR SUBDI
OF
CORNER LOT�INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION
FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction . ��1/ Ea imated Cost��j, Ate'
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
declares that all the facts and representations stated in this application
are true and correct.
DAT /i4
SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
T
City of Fridley, Minn.
BUILDING PERMIT
per: Larry G. Wadsen Bider
Same
Address 5801 --7th Street N _E _ Address Same
V ioaso'�
LOCATION OF BUILDING
No. 5801 Street ._._ 7th Street N.E. Part of Lot
Lot_ 10 __Block 2Addition or Sub -Division �ndale Builders 7th Addition
Corner Lot —_X Inside Lot — Setback —_ Sideyard
Sewer Elevation —_ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24' Depth 24' Height 10' sq. FL 576' cu. FL 5760'
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost $1,850.00 __ To be Completed July 1, 1971
Provide Hardsurfaced Driveway
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 f and in mpliance with ill provisions of
ordinances of the city of Fridley. 4 �'/������
0A ��
In consideration of the payment of a fee of $ 11.00 , permit is hereby granted to Larry N Wadsen
to construct the building or addition as described above. This permit is granted upon
the 7re
ss conditionadone around and up7dyMinnesota regarding location, construction, alteration, maintenance, repair and. moving of buildings
the dty limits aainances.
Building Inspector
HANK MUNICH
NOTICE:
lids permit does not corse the construction, installation for whing, Plumbing, gas boding, sower or water. Be sure to we
the Bull" Inspector for separate permits for these hone.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: /-#0 /5y ('-' � s�.v BUILDER: ivc'lrff
ADDRESS : 37,CJI -'7 22� .S7__4, e, ADDRESS:
NO:. STREET: `7 ST
LOT: /D BLOCK: ADDITION: L yXD)�kr-
f l
CORNER LOT: Ix INSIDE LOT: SETBACK: SIDEYARD:`2 --2
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front: " • Depth: V - S
Hei ht•
Square Feet:. -'S- �%� Cubic Feet: 10
Front: Depth: Height:
Square Feet; — Cubic Feet: �-
Type of Construction: W60D 11111 Estimated Cost:
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing 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:'
9 SIGNATURE.
(See Reverse Side For Additional Informat n.)
77
77. 7777 7-7777-
r A
V.-
STt�rrt� _ N M ' 9. ® 1Nr,,,.'
r,5 Sur ve ors
age o _ SCHU`MACHER MORTGAGE CO.
w or •
ki �t — I I . 1% -- —
_ 5$ AVE. N.E.LOT T
BUIL 7"All
-- --10,. -.DLOCK Z'
LMID •r�.•�_. ter-.,.._
r�'rdy, mat. �A�
p w r
►f . - s� gip. 0� cc.� �d �e�r,���s �c d�►r� � ���.��� � a*�� �»t. '
t�
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604: REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
0
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value'of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2002
T
JOB ADDRESS 50001 7TH STP-eE7 *-*-
OWNER s-E�6 WoD
TOTAL
BUILDING USED AS 96iIDUN W
ESTIMATED COST 1731.00 PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_ Circle One (Steam) (.Hot Water)
$ Trade Name FVVD Size No.
BTU_ 70, OW HP EDR
$ Fuel hlfrT. 6R'S Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ ,50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$2!0 -9
DATE
HEATING CO Mix M�FGriAr/ rc.A r,
Signedwetz—TEL #-7277-
FAX # loll-- — 4714 7
Approved By Rough- In Date Final Date
(37-11 -3o .SD
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
CQMMQN VENT, VENT r-QKINFCTQR AND COMR1ISTION AIR V RIFI .ATIC)N
When replang an _xic ingf urs ant -p, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes k) No ( )
The venting system is plasticlPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes (k No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes No ( )
The ' com19 ®coon air is sized and installed to meet the current codes
and manufacturees specifications. Yes No ( )
When mired to kmbfl a a= combustion amt will be sized and installed
to meet ft reit codes and manufacturers specifications.
Yes No ( )
a ME , the undersigned hereby verifies that
it is a ftled assenribly and nmets the azrerd codes and manufacturers
speci1icaft is. This does inckLde AGA-GAMA Category I Central Furnace
Veretiry Tates for fan assisted and natura9 &M appliances.
Yes No ( )
Is the comnm verd and vent conroclors sized and installed correctly after
an qWbance has been removed from the moron vent and vented
sepamWy as per currsM codes.
Yes No ( )
AmIjance Ime and SizeComman Vent and Vent Connector
Inform inn
Appf ce #1 Type 1 -,,ye 'Fwir4 BTU Input 'P ,m Fan Assisted or Nat
Appliance#2 Type WA-Im N -y/1. BTU Input yo.000 Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter
inches
Appliance #1 Vent Connector Height ft Length ft Diameter
Appliance #2 Vent Connector Height ft Length ft Diameter
Appliance #3 Vent Connector Height ft Length ft Diameter
in Type
in Type
in Type
KSI/w,,17 WA-ttm- KeA--Tot
HEATING CO: NVeLHA-NICA-,
Signed By: SGV Date : ly I go l riL-
A
SUBJECT
P
City of Fridley
3324
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
#6
O.
COMMUNITY DEVELOPMENT DIV.
r 1 ______ v PROTECTIVE INSPECTION SEC.
6 ,97,15
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
11/12/02
JOB ADDRESS 5801 7 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DescR.
10
2
Lyndale Builders 7th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Erick & Melynda Ondich 5801 7 Street
NE
763-533-1081
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Four Season Builders & Remodelers 1410 Quant
Avg N, Maringof
st rrnix, mx 55047
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
651-433-2443 20153478
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underla-ymert must comply with the State Building
Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
$2,894
$1.45
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-
$83.25
Fire SC $2.89
STRNOR THE PERFORMANCE OF CONSTRUCTION
111
PLAN CHECK FEE
TOTAL FEE
S , � ��
Licenfie SC $5.00
1 $92.59
SIGNATUAEOFCON 7A CTORORAUTHO WEDAGENT IDATE,
EN PROPERLY VALIDATED
NSR
THIS I$ \ R1PERIT
DATE
S-GNATURE OF OWNER,JF OWNER BUILDERI (DATE.
A
NEW O CITY OF FRIDLEY Effective 1/1/2002
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572,3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: le_/ C- /v,8
Owner Name & Address: f-" t y1%n 'c. Tel. # 0
�! Contractor. �1NA��� MN LICENSE#
o lAddress: \ v� -� ` u �r�. N Tel. #
e of gurve df the
Attach to this application, a Certificat y ®�
lot, with the proposed construction drawn on it to scale. , j 3
DESCRIPTION OF IMPROVEMENT /� J
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
71
Construction TYP. �V,e— (C Estimated Cost: $ �
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: I I I D APPLICANT: 0
Sj Tel. #��
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee Fee Schedule on Reverse Side
Fire Surcharge $ a. ji .001 of Permit Valuation (1/10th%)
State Surcharge $ 1 VS $.50/$1,000 Valuation
SAC Charge $ $1200 per SAC Unit
License Surcharge $ 5� o o $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 $ qC9• 51 STIPULATIONS: