PRE 2010 DOCS0
City of Fridley, Minn.
BUILDING PERMIT
N° 6816
,r 5-A
Builder — -
Address
/ �'� L TIOZF BUILDING
No. 4�9� Street _Part f
Lot _ . __ Block � Addition or Sub-Dhv;s a
Corner Lot Inside Lot /f� Setback _ _ Sideyard
Sewer Elevation n�
TOP aii:
DESCRIPTION OF BUILDING
be U as: / f' , a
Front Depth Height IX Sq. Ft. Cu. rt lzjz �[��,�'
..b
Front 's Depth _, Height _ _ Sq. Ft. Cu. Ft. Z
�r
Type of etio Est. . -- be Completed
In consideration of the issuance to me of a permit to co ct the building described above, I agree to do
the proposed work in accordance with the description above serth and in compian
the city of Fridley. ce with all provisions of
ordinances oY f
In consideration of the payment of a fee of $ , permit is hereby granted to
the
to construct the building or addition as described above. This permit is granted upon
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 thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any tune upon violation of any of the provisions of said
ordinances. _
NOTICE:
This perndt doer not corer the construction, installation for wiring, plumbing, gas heating, sewer or water. Be ane to see
the Building Inspector for separate permits for than items.
i*
crAPPLICATION
Y aFOmrII DoPERMIT.. 'C17 -Y OF FR1DLE
Y
Owner's Nam -AJ e'l• Builder 2
Address A?v Address
LOCATION OF BUILDING
No. Street ,ZZ1 S-�� G. Part of Lot
Lot /1z-- Block _ Addition or Subdivision
Corner Lot _,Inside Lot Setback Side -Yard /o ' is
SE4aTEEt ZMATION FOUNDATION ELEVATION 97 4-S'
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
1'.5—
Sq. Ft.
Cu. Ft. o? / SL&® „
--JL— Frnnt /-'3P % Denth e?o2 Haight f
Sq. Ft. . Ft. .2 Y /-®
o? V. yr«
Type of Construction Estimated Costes \
1 �-!7 ' -
To be Completed /4,//6 3
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. /
DATE �D / y SICAITAT-�
(A Schedule of Fee Costs can be found on the Reverse Side.)
CITY OF FRIDLEY
53 -�It -9915 0 51 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Nu;.ber Fixtures
x
$3.00
$
Future Fixture Opening
k
$2.00
S'
waterE
J.
u
S
Catch Basin
x
$5.00
$
e
a
a
$
a"�i
x
w
tp
Water Softener
Heater
$7.90
S
New Ground Rua Old Building
x
$5.00
S
Electric water Heater
x
$5.00
S
GAS FITTING FEES: '
1st 3 fixtures
x
$3.00
S
Additional Fixtures
o
°p
,°,
afi
x
xd
a..cia
REPAIRS & ALTERATIONS
o
S
�iM�
First $100.00
m
m
each add. $100.00 or fraction
in
$2.00
$
State surcharge
r
$ .50
S
aw
w
w
u
u
w
N
lst
1
0 r
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
(•) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Nu;.ber Fixtures
x
$3.00
$
Future Fixture Opening
k
$2.00
S'
New Fixture, Old Opening
x
$2.00
S
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
S
Water Softener
x
$7.90
S
New Ground Rua Old Building
x
$5.00
S
Electric water Heater
x
$5.00
S
GAS FITTING FEES: '
1st 3 fixtures
x
$3.00
S
Additional Fixtures
x
$1.00
$
.Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State surcharge
$ .50
TOTAL FEE
$ 8.00
REINSPECTION FEE
($10.00)
Job Address 0849 7 STREET NF:
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work hereL
specified agreeing -to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and torr
Fridley, Mn. 12-33-76 , 19
OWNER TY)YALD PULLEN
KIND OF BUILDING frame
USED AS res
TO BE COMPLETED ABOUT 12-20-76
ESTIMATED COST 10100
OLD - NEW BUILDING PERMIT N0. PERMIT N0.
4 / ` � v
Company
Signed By MINNEGASCO
Tel. No. _
ROUGH INSP.
Date
FINAL INSP. 'S
Date
APPROVAL FOR PERMIT ag�l�
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
CITY OF FRIDLEY
' 53-81x-879001 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
m
PLUMBING FIXTURE RATES: NO.
a,
a
h%=ber Fixtures
m
$3.00
c
Future Fixture Opening
x
m
S
Water
x
$2.00
S
Catch Basin
x
$5.00
E
c ,,
5
M
a
$
y
ro
x
w
5
Water Softener
Heater
$7.40
as
�
rs
x
C
•a
0
Electric Water Heater -
u
d
M
C C
a
d
W H
.t
m
is
p
- o
.°i
w
a�M
»+
w
ro
a
w o
o
$
H
+�
ro
p ro
q
a
p
lec
4.1�i
-4
v
ro
m
v,
a
aw
.c
h
w
c�w•c�
as
H
'lst
conmct
r14er
HHad
3rd
r4th
(R) - Future Connection Opening
Connected with Sewer
(•) New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
h%=ber Fixtures
x
$3.00
S
Future Fixture Opening
x
$2.00
S
Now Fixture, Old Opening
x
$2.00
S
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU,
x
55.00
$
1004-000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.40
$
Ned Ground Run Old Building
x
$5.00
$
Electric Water Heater -
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures x $3.00 S
Additional Fixtures x $1.00 $
.Gas Range to 199,000 BTU x $10.00 $
REPAIRS 4 ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE $ 8.00
REINSPECTION FEE
($]0.00)
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herei
specified agreeing -to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and cor:
I Fridley, Mn. L2-16-76 , 19
OWNER PULLER
KIND OF BUILDING frame
USED AS rPa,
TO BE COLLETED ABOUT 12-23-76
ESTIMATED COST 10.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
�/1
' Company �
Signed By n� rren n onn
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
. -
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
RATE
TOTAL_
$ 20,00
$_
$ 10.00
$
$ 10.00
$
$ 10.00
$
$ 10.00
$ �®
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp, A?/— s{ 7
Date
Approval for Permit 1A
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
Attach stack verification form with replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Job Address'
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. 3 !Z8 , 196Y
OWNER _)Cn Pa
Lttn
KIND OF BUILDING
USED AS re -s
TO BE COMPLETED ABOUT
ESTIMATED COST •C)CI
OLD - NEW BUILDING PERMIT NO. PERMIT NO. to lC "
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. (J
arc J 4- S$ f4LlXa 08
Trade Name Size No. ,
Capacity RL6 - 2'/Z foin Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel T ��
BURNER - Trade Name
Size No.
4
Capacity Sq. Ft. EDR BTU HP
Company
Signed By ,,\\
Tel. No.
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (,)
2. Is free from rust or deterioration Yes ( )
3. Has no foreign objects lodged within Yes ( )
4. Is securely supported Yes ( )
No ( )
No
No ( )
No ( )
5. Meets all current Code requirements for size and
total BTU connected Yes ( ) No ( )
6. Has Jotal heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company
Signed By
Da to
t
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPUCA11ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (UST 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
Effective On January 1, 1997
JOB ADDRESS �9, -774 t5r. At.. 67F
The undersigned hereby makes application for a permit for the work herein
TOTAL specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
$ representations stated in this application are true and correct.
1997
$ 25.00 $
State Surcharge
OWNER.
,UILDING USED AS
L
ESTIMATED COST a l �ll,0.0 PERMIT NO.
/1 -;?&113
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units_ Circle One (Steam) (Hot Water) (Warm Air) _
Trade Name 44% Size No.
BTU �V 7Cgjf-2 HP EDR
$ Fuel_ Total Connected Load
.b0 Burner Trade Name Size No.
BTU HP EDR .
TOTAL FEE S$
t
HEATING COMPANY-
MINIMUM
OMPANYMINIMUM FEE FOR ANY HEATING/COOUNGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By 1) Tel No, 631--3�S%tom
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Approved By Rough—In Date
Final Date _� ( d!�t
D,'0 Asw�' a'�--I
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON '
written permission from adjoining property owner. REPLACEMENT FURNACE O //' rA Cl&'( 2�'
HEATING CO:
Signed By:
Date:
CHIIVINEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney
or stack:-
tack:1.
1.
Has been carefully examined :_
Yes O
No
(
)
.2.
Is free from rust or deterioration
Yes O
No
(
)
3.
Has no foreign objects lodged within
Yes O
No
(
)
4.
Is securely supported
Yes O
No
(
)
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()
No
(
)
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided. for water heater
Yes (
) No
(
)
8.
Has. combustion air been provided for water heater
Yes (.
) No
(
)
Remarks:
HEATING CO:
Signed By:
Date:
s
SUBJECT
City of Fridley
26282
AT THE TOP OF THE TWINS
III DIN %�
BUILDING
PED A A I T
�
Dv L `J
"'v, I
R
COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
r �
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
6/18/98
JOB ADDRESS 6852 7 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
15
3
1 Rice Creek Terrace Plat 7 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kathy Pullen 6852 7 Street NE
571-6559
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Midwest Siding & Roofing 18979 Gladstone Blvd Maple Grove MN 55311
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
416-4804 20010277
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO,
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION fi REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 60 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
$1,834
$.92
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
PRO SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$59.50
Fire SC $1.83
edTRUC ON OR THE PERFORMANCE OF CONSTRUCTION.
J
PLAN CHECK FEE
License
$5.00
TOTAL E
$ 7.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
p PP
BLD INSP
LIDAT ISIS YOUR PERMIT
�j
MATE
SIGNATURE OF OWNER I IF OWNE R BUILDER) (DATEI
s
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 69, o? 7 t-6 5;
Legal Description:
Owner Name & Address: kg Tel. # � /-
Contractor:
Contractor: W jwCS � , S, �/, G l�o �� G MN LICENSE # R06106� 77
Address:) S c/7� & /ctdeSfd.-rC /. Vc.4 ^10 lr warox , ,� Ss�3% Tel. # IV
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: 16Use
Construction Type: o�oz S,� T -(/-Off Estimated Cost: $� Z3 3 7
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #
CITY USE ONLY
TOTAL $ ��
STIPULATIONS:
-e3
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
�--
$ Z �i�
$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 $ ��
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1999
PLUMBING FIXTURE RATES
NO. RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin — - -
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas"
$10.00
Gas Rangel
$10.00
Gas Dryer"
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge .50
TOTAL FEE . $,2!2.56
JOB ADDRESS
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
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this applic,-4ian are true and correct.
1999
Building Used As
6116 �
Estimated Cost® PERMIT NO. 719
MR. ROOTER OF ANOKA COUNTY
PLUMBING COMPANYR-25IndustFy Ave Ni U114
Ramsey, MN 55303
SIGNED BY 421-6140TEL N0.
421 -6198 -FAX m
Approved By ugh-lri Date Final Date—LI��
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 l�wo
PLUS THE $.50 STATE SURCHARGE
"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.
From: City of Fridley, To: 7637542908 Page: 214 Date: 419 6/2009 11:00:09 AM
.3uilding MECHANICAL Permit No.:' -V6r54
inspections RESIDEINTLkL APPLICATION Received By:
?63-572-3604 j
76 50? -46? r FAX j CITY OF FRIDLE Dat ji:
EFFECTIVE 2-19-00
DATE q- 3 O- V 7 YOUR E-MAIL ADDRESS _
SITE ADDRESS (02 S'Q I E• SJO N E
THIS APPLICANT 1S: ❑ OWNER ;ICONTRACTOP•. I
PROPERTY NAME: w
OWNER/ ADDRESS: S E L �
�cyy+ t,
TENANT .7C• Iv � CITY gl Iol-1 5TATbM�S'
ZIP 4�(3a
PHONE: 'I i 3 S71 (0S-' 9
CONTRACTOR COMPANY NAME: luty Ca, �,tx.4- L %J
SUBMIT A COPY OF CONTACT PERSON: Ch r C4 t'_pfo
YOUR STATE STATE LICENSE -ft EXP DATE
LICENSE WITH ADDRESS: aq0 x'18-:11 Sb NC CITY STATE Ka+LIPSWIi
APPLICATION PHONE63
� '►S4 atGi FAx
PERMIT TYPE �iINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: ❑ NEW JeREPLACEMENT ❑ ALTERATIONIREMODEL
DETAILED DESCRIPTION OF WORK Ty SFA (1 i1 a l �c u-t�,n�- VwR- '` Qt r,�� 0,41
FEES ARE BASED ON $10.00 PER F1X•rURE, EXCEPT WHERE NOTED. FIXTURES: (LNDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Irwalled
MFG: MODEL: 5VWV3Ta
SCLE/BTU 0
MFG: Ctr�tR-�"�- MODEL: 04PA930
lava
SIZE/BTU 1>0/L76^
'ZA/C
MFG: MODEL:
SIZE/BTU
$75.00
_FIREPLACE (GAS) $15.00
_GAS RANGE/OVEN $10.00
TO Alit EXCHANGEER $ IS
( WOOD) $35.00
NEW GAS GRILL $10.00
_AIR
BOILER $35.00
_FIREPLACE
� FURNACE $35.00
_GAS UNIT HTR $10.00
LINER $10.00
DRYER $10.00
_POOL HEATER $35.00
_CHIMNEY
DUCT WORK $10.00
_GAS
GAS PIPING $10.00
_VENTILATOR $15.00
1:.:.:::' PL••FASENOTE.::SEFAI�:r�TE PER:ItgITS.A�R:E.R:EOI�IREI7 FbR>Bt:ILIIIN%_ EL•EC'i'RI?�I:AN1J 1�+IECfT:4IJICA. WOCZ.1�>=, 1
City of Fridley
Building inspections Department
6431 University Avenue NE, Fridley, NLN 554321
763-572-3604 FAX: 763-502-4977
Building
$
BUILDING
Plan Review
$
Permit No.:
Inspections
$
RESIDENTIAL APPLICATION
Surcharge
Received "Ju
V4-2
763-572-3604
License Surcharge
CITY OF FRIDLEY
$5.00 (State Licensed Residential Contractors)
SAC Charge
Date 0'0
763-502-4977 FAX
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
EFFECTIVE
EFFECTIVE 1-1-09
$
Fee Determined by Engineering
Sewer Main Charge
DATE & - 2--3 - 69 YOUR E-MAIL ADDRESS
Agreement necessary ( ) Non Necessary ( )
SITE ADDRESS 660'Z — 'moi . /✓C�
$
Make checks payable to: City of Fridley Attach Stipulations
THIS APPLICANT IS:
❑ OWNER JgCONTRACTOR
PROPERTY OWNER/
NAME: I4 tr
TENANT
ADDRESS: 6 L - .�J CITY �' �� �,
STATE444-'ZIP
PHONE: Ste/ ' S
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: / �q,�,ic /1/ C/11
CITY lgr1''-�Jt STATEA01VZIP S Dpi
INSURANCE
PHONE 411Z - % ' S-���' FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ¢FSIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
'11 MAINTENANCE/REPAIR IPREMODELING
DESCRIBE WORK BEING DONE: E Gu��
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
I.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
�
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
So it
ADDITIONS. & PORCHES SUBMIT:
❑Aluminum
E3 Other
II> a y�► M
I .
Site Plan/Survey showing the existing structures
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
TOTAL JOB VALUATION $ '�A q 7 N�C�THE 1997 U.B.0 FEE SCHEDULE)OCCUPANCY TYPE
Permit Fee
$
1!53, 21 See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
q 9n .001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -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 on site; that the work will be in accordance with the
approved plan in the case of all work whiires review and approval of plans. n
SIGNATURE OF APPLICANT(/PRINTNAME&,,f/d-X-,a-AJ DATE
Building
BUILDING
Permit Na- _ ® IT
inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
EFFECTIVE 1-1-119
YOURR E-MAIL ADDRESS eG K YI R 021 210 a
SITE ADDRESS
- 7 _
! PL o e Ir `I l A) /%i S5+.7
THIS APPLICANT IS:
11 OWNER WONTRACTOR
PROPERTY OWNER/
NAME: T ,erg
TENANT
ADDRESS: 60 -71-4 ! 4zA Ad. F ` ary-RICI
STATE ZIP
PHONE:
CONTRACTOR
y
NAME: rL® ` !�
SUBMIT A COPY
YOUR STATE LICENNSS
* STATE LICENSE t3 n Co -2 EXP DATE
� J off✓E
AND CERTIFICATE OF
ADDRESS: Q V V e. CITYY�
sTATEZIP S
INSURANCE
PtwNE6— WA —342V FAX
PROPERTY TYPE
Af SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED O WINDOWS
❑ BASEMENT FINISH ❑ ROOF 0 DRAINTILE
D SIDING D OTHER
13 SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION �qq
OV V
13MAINTENANCE/REPAIR O REMODELING
DESCRIBE WORK BEING DONE% 16%.)
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
[3 Aluminum
❑ Other
O HOUSE ONLY
❑ HOUSE & GARAGE
D ATTACHED GARAGE
0 DETACHED GARAGE
OSoffit
O Trim
❑ Fascia
FT
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
I . Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
M EXISTING OPENINGS OYes E]INo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�y.�C5(USMG, THE�--49W6,—Ta
9? LI.B.0FETE SCHEDULE)
TOTAL JOB VALUATION $ /. ®C� OCCUPANCY TYPE
Permit Fee $
Plan Review $
Fire Surcharge $
Surchar>ee $
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times -the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
—ft +6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks Davable to: City of Fridley Attai
THIS IS AN APPLICATION FOR A PERMrF-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 on site: that the work will be in accordance with the
approved plan in the case of all W r wh' h requires review and approval of pl // p
SIGNATURE OF APPLICANT /�-�` PRINT NAME L e�I DATE (0 O I
i'p V'W1 �zr� lv4k N'llgJ.
l �¢ c� l�l�(j miov • 2 — lCQ`% O.Ci,
�- (� sly r� o� 5 (n►��fes +4�
cotiuE'c�S �02 /4cmZ-�
cant 2 feet U
9'-0"
2x10 green treated
6x6 g.t post verify height space from top of deck
/ \ to bottom rail 4 Inch
00
post anchor
12 Inch fig 42" deep
bell bottom °p
Cl)
i i�vw•I off!
4 �# 00,
2x2 cedar spindles 4x4 cedar
posts 2x6 cedar bottom rail
and top rails
CNamr
Stairs verify rise per
exisiting grade
10 Inch tread
green treated stringers,
treads and risers
rounded Inside handrail
min. 1.5 Inch diameter
COPS r- i 3„
-- �lbui�� Zu y1��p�V cjr��12P�
rows -IAf
c.264 4-ri�4,.
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5ee
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�k (o" a� f��
a
2x10 green treated joss
16" O.C.
2x2 cedar spindles
4" o.c. 2x6 cedar side ra
2x6 cedar top rail
triple 2x10 green treated
beam
3-2x12 green treated stringersri;v)
6x6 treated post'typ post anchor
green treated treads and
risers
h footing 42 Inch dee
ottom C")
2x10 rim joist/flash anchor
bolt 8 Inches on center
stager
2 FOOT CANT N
�a
existing house wall
22'--0"
p 2 10
N
8' -On
W-0" 6 X 6 GI
DOUBLE 2 X 10 POSTS
GREEN TREATED NEW DECK 16'X 22'
6852 7TH ST.
FRIDLEY, MINN. 55432
2 A Cafes'
sit 16-0 fibs
2 X 10 GREEN
TREATED LEDGER
ANCHOR PER CODE
STAIRS 14 R
VERIFY GRADE
INSIDE HAND RAIL
vMr-1,sf •
BRE PLAN 8852 7TH 8T. N.E.
FRIDLEY &MN. 88032
• , LAND SUR V EYORS�
ffan y S elohNson
sorrepors Certificate sso�ioqles
10636 FRANCE AVE. SOUTH
MINNEAPOLIS 31. MINNESOTA
TUXEDO 6.2100
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