PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N? 2385
Date Al.'.: %S7 .......................
Owner. Builder ...........................................
Address...................................... Address .........................................
LOCATION OF BUILDING
No. 41... "$-
4 .......... Street .. . • . L.j,✓�.°t9'eP................ Part of Lot .......................
AF
Lot ....... f,,0 .. Block ......... ... Addition or Sub -Division
Corner Lot .. Arol ..... Inside Lot ............ Setback, !� j Sideyard ,/r' �% .. 1v........... .
DESCRIPTION OF BUILDING
To be Used as:
&�Q .dy e.. Front Depthot%V&C Height ,,�. �yS t. Sq. Ft......... Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft.........
Type of Construction ,rf4Att - - Est. Cos ,,rs�4OA . �...... To be Completed i...'*01 ........ .
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
t
ordinances of the village of Fridley.
In consid ratip o .the payment of a fee of $. !'fir„ . , permit is hereby granted to JWW ......
... to construct the building or addition as described above. This permit is ted upon
the expres 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 village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. // /
Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
0
City of Fridley, Minn.
BUILDING PERMIT N 4 8'7
Date:
Owner: _ ... - _ Builder i -
Address ....., :_.. ''.' _ s Address �r •••�-• _..
�}
OrAmON 5F BUILDING
No... .._/.f..:6_:. .. Street . _." _._ x -._..._.._ Part of
Lot ...:._..._ .......
..................._. Addition or Sub- vi n ......
Block ....._........::_....
Corner Lot ....._..�. !'*..._........ Inside Lot -_--------- :.:...._._............. S back::. Sideyard
Sewer Elevation....._...._..._.._............._..__..._.._......._...._......----.._......_...._...._.. F dation Elevation
DESCRIPTION OF BUILDING
To be Used as:
_.. .. d Front _ - Depth ---- .. ' Height ..... ._.. Sq. Ft.
.................... _...... .................:........ r J_41-4........... Sq. Ft......_............__ Cu. Ft.......................
Front
Type of Construction ......... ��..� Est. cost'*" ........_....... 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
ordinances of the city of Fridley.
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 tim upon violation_jany of the provisions of said
ordinances. - r .4 A
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 for these items.
4 THIS MIT DOES NOT AUTHORIZE VIOLAT-
ION OF ANY PRk,ATE LAND_GOYENANTS AND
BUILDING RESTRICTIONS:
APPLICATION FOR BUILDING PERM
CITY OF FRIDLEY, MINNESOTA
Awl�r� r ✓/lam' •= i� �> i �'
LOCATION OF BUILDING
No. _ Street t of Lot
rot %® 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:
Qj Front
�- % ® Cu. Ft.
Sq. Ft. -,.
Front Depth Height,;..
7
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 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.
_
nems Q` - T7 f_ C SICNATIIRE Q �
(A Schedule of Fee costs can be found on the Reverse Side.)
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.................. . .......... ; . .................. ................... ....... * ............
•
City of Fridley, Minn. N® 7663
BUILDING PERMIT
Date: - Jnne 2- L965
Owner: Dennis R. Wangen Builder Sussel Co.
Address 615 5th. Avenue N. E.
Address 1850 Como Ave. St. Paul$ Minnesota
LOCATION OF BUILDING
No. 615. sit 57th. Avenue N. E. Part of Lot
Lot ___ 10_—__ Block 9 Addition or Sub -Division Lake View Manor
Corner Lot , Inside Lot
Sewer Elevation
To be Used as:
Type of Construction
Setback Sideyard
____ Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. cu.. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
F� Cost 1.* 450.00 _ To be Completed
• Storm Dame4p Repair
•
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 ajl provisions of
ordinances of the city of Fridley.
in consideration of the payment of a fee of $ 10.0 , permit is hereby granted to Sussel Co.
Ll Ctu]st 0 1 to construct the building or addition as described above. This permit is granted upon
tie eupre� condition that the person to whom it is granted and his agents, employees ana 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 nngg location, construction, alteration, maintenance, repair and moving of buildings
wi city limits and permit may be revoked at any time upon violation of any of the provisions of said
Allen Jensen Building Inspector
NOTICE:
Thb psrmh don net cow His conshugm, hutalla w for wkbi . pbmibbie, en hedbq, newer or water. Be non to no
tho BoMM9 bqw for for apmes permhe for thea Name.
OWNER'S
APPLICATION FOR BUILDING PERMIT
/Z 1,/
CITY OF FRIDLEY, MINNESOTA t
ADDRESS_ 4� fay` - �'? t .:Ll /1>!�� ADDRESS
LOCATION OF BUILDING
No. / Street %"-t Part of Lo
LOT BLOCK ADDITION OR SUBDIVISION
Corner LotInside 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.
DESCRIPTION OF BUILDING
To be used as:
Front Cyt DepthHeight
Sq. Ft. Cu. Ft.
Front Depth _�_�Height,
Sq. Ft: Cu. Ft.
Type of Construction )Cr -d -" Le Estimated Cost
To be completed_
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work im strict accordance with the City of Fridley Ordinances
and tulings-of the Department of Buildings, and hereby declares that all the facts
and reptesentations stated in this application are true and correct.
DATE ` L J - /'7 4- 6r- .. , SIGNATURE - v
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley, Minn.. N° 7666
BUILDING PERMIT
•
Date: _ June 2, 1965
Owner: Demis Wangen Builder The Nelson CcdparY
Address 615 57th. Ave. N. Lo Address 7801--4 Bass Lk. R.
•
•
LOCATION OF BUILDING
No 615 street 57th• Avenue N. E. Part of Lot
Lot 10 —Block 9 Addition or Sub -Division Domays Lk. View Manor
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation ____ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Est. Cost 39M .50 _ To be Completed
Storm Damage Repair
1
In consideration of the issuance to me of a permit to construct the buildlp�
I agree to do
the proposed work in accordance with the description above set forte and inprovisions oarordinances of the city of Fridley. � // r,
In consideration of the payment of a fee of $10.00 , permit Is hereby granted to The Nelson Co.
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, Minnesotag location, construction, alteration, maintenance, repair and moving of buildings
withi ncesn the city limits a�this permit may be revoked at any time upon violation of any of the provisions of said
ordin
Allen Jensen
NOTICE
Ibb pumb don eot eowr the cendrudlon, hwtatF = for whfeg, phuebbs, gas hearing, awn or wder. Be am to ae
16 BuNIng b9pedor for operate pmft for thea hens.
OWNER'S NAM'
ADDRESS --&.Z
..APPLICATION FOR BUILDING PERMIT I�
CITY OF FRIDLETv MINNESOTA
ADDRESS ��9`'066.�r�
LOCATION 07 BUILDING
No. Street Part of Lot
LOT 6 BLOCK ADDITION OR SUBDIVISION y1 " �
Corner Lot_ Inside L Setback Side .Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building locatipn drawn on -these Certificates.
DESCRIPTION OF BUILDING'
To be used as:
Front Depth Height
.,. .Sq. F.t Cu. ft.
Front Depth Height
Sq. Ft.' Cu. Ft.
Type, of Construettan. 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 rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE SIGNATURE
(Sc edule of Fe Costs can be found on the Reverse Side)
0 � r
•
E
•
City of Fridley, Minn.. N° 10555
BUILDING PERMIT
Date: February 20, 1969
Owner: Dennis Wangan Builder Ching Johnson Builders
Address 615 - 57th Avenue NE Address 3057 W. 50th St.
p s, Minn inneapo s, nn
No. 615
Lot____ ___ -
Corner Lot —_ x
Sewer Elevation -
Street _
Block
LOCATION OF BUILDING
57th Avenue NE, Minneapolis, Minn
art of Lot
Addition or Sub -Division
Inside Lot _ _ Setback — Sideyard
Foundation Elevation
corner lot
DESCRIPTION OF BUILDING
To be Used as:
Remodel and-Ftontr Depth Height .__ Sq. Ft. Cu. Ft.
-- Front Depth Height ., Sq. Ft. Cu. Ft.
Type of Construction Tile Bathroom Est. Cost _$1500.00 _ To be Completed — 4/20/70
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 rth and in com Tian a with all provisions of
ordinances of the city of Fridley. / i 1J
In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Ching Johnson Bldr
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 violation of any of the provisions of said
ordinances.
_-- Building Inspector
ank Muhich
NOTICE:
'This permit does not cover the construction, installation for wiring, plumbing, gas homing, sewer or water. Be sum to see
the Building Inspector for separate permits for those hems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
3 / �i Za -/ 7`i%
OWNER ' S NAME �i J i� Ni!/! S l/1/ //� l �/ S t�.� / BUILDER �cA /A' Sci a/ O t- D
ADDRESS 1a j M t fy k ADDRESs 3 So 7 uj
LOCATION OF BUILDING
NO. r, / -5 STREET -57 % 4-
,///�
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT t:— INSIDE LOT
SEWER ELEVATION
SETBACK SIDEYARD
TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
DESCRIPTION OF BUILDING
;To Be IIs %d As:
Front Depth Height
Square feet Cubic Feet
Front Depth Height
Square feet Cubic Feet
Type of Construction W IL (Po Qlk, Estimated Cost l S Civ O
To Be Completed__, 2 U/ 7
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.
DATE r o2 D(J SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
NOTE: A Certified Survey of
once it has been constructed,
framing.
the lot, showing the location of the foundation,
will be required before proceeding with the
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City of Fridley
SUBJECT PER
-
AT THE TOP OF THE TWINS
_
BUILDING P E R M I -
f
RECEIPT NO.
• _____ COMMUNITY DEVELOPMENT DIV.
r 1 � PROTECTIVE INSPECTION SEC.
/
1 I �
--i CITY HALL FRIDLEY 55432
i
NUMBERREV.
DATE
PAGE OF APPROVED BY
----
L j\ 612-571-3450
910-F15
4/22/81
JOB ADDRESS 615 - 57th Avenue N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
� O
9
DOnnay's: Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Day 615 - 57th -Avenue N.E. 571-2790
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sme
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 10' Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
\tea` u�,,a�
-GPS tv,SEPERATE PERMITS RE QUIRE® FOR
WIR6N
HEATING.
P► PLUMBING AND SIGNS,
�QN
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
SQ. 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
STALLS I 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
$2,268.00
$1.13
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-
$9.60
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$10.73
GN TUREOFCONTRACTOR R 1UTHORIZEDAGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
s -Z
BLDG INSP DATE
IGNATURE OF -OWNER IIF OWNER BUI ERI IDATEI
CITY OF FRIDLEY
APPLICATION FOR RESIDLNTIAL BUILDUIG PER14ITS
(New, Alterations, Additions, or Repairs)
OWNER: Ou i D �A f BUILDER:
ADDRESS: %v� ADDRESS:
TEL NO: 571- 2 7 170 TEL NO: '
Construction Location j
STR , T NO: �O / S STREET:
LOT: /b BLOCK: _2^ ADDITION: a c -", 4^ J" 6_7 �_'t7U i &NV -1- biiq �z2.
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
Front: Depth: Height:
Square. Feet_: Cubic Feet:
. Front: 2- Depth: 9 Height: �®
•
Square. Feet: cubic Feet: ;2
Type of Construction: Ar /--��
Estimated Cost:
• J
To Be Cbripleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is - Desired: �j
SEE REVERSE SIDE OF SHEET
Mie undersigned hereby makes application for a permit for the tnrk'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 applicaticA are true and correct.
DATE: `f•/ Z/ /1'q / SIGNATUM:
Stipulations:
i .,
6, z /A - O QR'i1 •
LOT
NAME
SIZE
pEoUls R. e
°, 0 24')(bZZ'
BLOCK
b
IP
ADDRESS
`
r1 -
�' �+ — J -7 TM i
VALUE
1... iR
O
ADD'N.
AREA
TYPE
�iZll7�E
Fm, A,M E
d
'm
ri
I:
1
29,
2 - 2ouis
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SUBJECT
City of Fridley
229-3
AT THE TOP OF THE TWINS
BUILDING PERMIT
R E C
'r '
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
3 7�7 (a
r ,
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
9/21/94
/
JOB ADDRESS 615 57 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
g
Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Karen Day 615 57 Avenue NE
571-2790
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Thurs Construction 5717 113 Ave N, Champlin MN 55316
424-5624 934
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 a
❑ NEW El ADDITION ❑ ALTERATION X REPAIR
❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Reroof House (15 Squares) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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
]
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
$1,125
.56
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-
TION OR THE PERFORMANCE OF CONSTRUCTION
$29.00
Fire SC $1.13
PLAN CHECK FEE
TOTALFEE
��
��s----•- �21-� �r
License SC $5.00
35.69
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) -
„ HEN PROPERLY LI DATED THIS IS YOUR PERMIT
r
BLDG NSP
MATE
S.GNATURE OF OWNER of OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/94
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress• 6657
Legal Description:
Owner Name & Address:Tel. # -"5--2/
Contractor: -r-A V✓'S MN LICENSE #
Address: i D ).' h S-SIL4 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: R-e-r0®F
- /-h;) vSe-
4 r -a e o l -'P
25,j
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ //,2S7-
Approx.
/, 2SApprox. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft - Ft x $ - $
DATE: q -Al - S c APPLICANT: AIA- Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 35 - -9
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$800 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 [ ]
3uilding
$ ;23 ,S O
BUILDING l/
Permit N
inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Surcharge
CITY OF FRIDLEY
Date Rec'd:
)ATE o
YO E- L ADD S to 1/4 S o' C O�
;ITE ADDRESS
l e- �" fi
$
-HIS APPLICANT IS:
%jScDWNER ❑CONTRACTOR
$
PROPERTY OWNER/
NAME: fl' y3
$
TENANT
ADDRESS: r— 2 CITY n a def
STATEI��iS%j Z
Fee Determined by Engineering
PHONE:
$
CONTRACTOR
NAME:
$ b
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
MINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
I BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEw ❑ ADDITION
❑ MANTENANCFAUTAIR It REMODELING
DESCRIBE WORK BEING DONE: .$ e- "a t,� ► >ti
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
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
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
WINDOWS
2. Two sets of construction pians
IN EXISTING OPENINGS ❑Yes
❑No LOCATION O WINDO,}rJS
3. Energy Calculations
OR FOR NEW OPENNGS-DESCRIBE SIZE OF _� �dhh e_6v
—�
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S 41'0 ` OCCUPANCY TYPE
Permit Fee
$ ;23 ,S O
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ - fir— fj
.001 times the total job valuation
Surcharge
$ . SO
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ b
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 apoR d work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work whic review and approval of plans. r �j
SIGNATURE OF APPLICANT PRINT NAME 1 Il�-s S DATE
.1
3uilding
BUILDING
Permit No.:
inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Recd:
)ATE/r
YOURR�E-MAIL ADDRESS
�
;ITE ADDRESS (yam f �!
a
/''1- 4E /T4 o
A
HIS APPLICANT IS: ❑ OWNER
, �*ONTRACTOR
PROPERTY OWNER!
Nom; *q
,- S S
ADDRESS: /
"� ,�
5 -1-7 - '� �` ,/!/ ��CITY l/ �^ %� +�J STAO, ZIP 3
TENANT
PHONE:
CONTRACTOR
NAME: 70 bvTE-,E
.7";r" .
STATE LICENSE #
ADDRESS: 6
EXP DATE
.��' r� 7K o /f, CITY r i °P % ST `2ZIP
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PHONE-) FAX
PROPERTY TYPEGLE
FAMIL
CONSTRUCTION SIZE
WO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION
❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH)ZOOF
❑ DRAIN TILE
❑ DECK
❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW
❑ ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:4,t-p-&
".4,
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT Sq. Ft.
ROOMG ,1
O HOUSE ONLY
NUMBER OF SQUARES %
MOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
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
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
0 Trim
I . Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
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:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ /,q Q 4 X. ® OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ S'
$ / V7
$ {. CV
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)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
lations
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 th rdinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an p 'cation or a p it and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of al w rk wh h r re iew and approval of plans.
SIGNATURE OF APPLIC PRINT NAME �� N ` DATE G — a -7-