PRE 2010 DOCSI
I
BUILDING; PERMIT
Vill e" of FAdle , Minn. N° 2327
nate, .. ... ..
Owner .i.: Builder ..................:.......
Address
.,. .............:..,...,..,...... .. "..Address ..,..:..
Ar Qjp►T10`QF BUI - ��ING
jNO. . Street .,. .I Part of Lot .......................
Lot ..' .. Block .. Addition Or Sub -Division A +V •* /�/
i
Corner Lot .. .. Inside Lot . . ,I.. Setback ..t Sideyar f .. ....
DESCRIPTION 'OF BUILDING
toUseds
IFrontDepth�;Height ,/�`.a... Sq. Ft: J�s�� .. • Cu. Ft. .,
Front ........ Depth ..Height. ..... ,.. Sq. FL .....:1 Cu. Ft•ru ' on .. F&L , ..;Q:.. ... . To be Completed
i
In consid
the proposed
ordinances of
In consider
es8
fini
done in, around
Fridley, Minns
in the village lig
ordinances.
i
�' II
on of the issuance to me; of a permit io construct the building described above, I agree to do
in accordance with the !description above set forth and in compliance with all provisions of
village of Fridley.
it
Ij
....:.............................................
AOn'
f the payment a of $. ""permit,is hereby granted t0to constru dior addition as described above. This permiit� upon
t the person to w, m it is granted and his agents, employees and workmen, in all work
c upon said building, or; any part thereof, shall conform in all respects to the ordinances of
regarding location, construction, alteration, maintenance, repair and moving of buildings with-
ts and this permit may tp revoked at any time upon violation of any of the provisions of said
'J
.. Building Inspector
NOTICE.,
This per It does, Aot cover the con�struation,
sewer or wat r. Be sure o' see 'the Building Inst
taliatlon or alteration for wiring, plumbing, gas heating,
or for separate permits for the$e items.
BUILDING PERMIT
Village of Fridley, Minn.
N° 2556
Date tj�•��.' / / 7-4.7
. .7 ....................... .
� 60 . Builder '""'°'�`
Owner' 1fI �s3.�' ........ ....................
Address . ........lf. ..!+ Address ..................
Lot ...... . .
Corner Lot ......
LOCATION OF BUILDING
Street 477 .,„ Ap...00 ............ Part of Lot .......................
. Block ..... 7 ....... Addition or Sub -Division �� ... ���� � , , , , ,
OF
.... Inside Lot ............ Setback Sideyard . V:?:0V W -*!0.......... .
DESCRIPTION OF BUILDING
To be Used as:
101(*7 .. .. Front . ,y,/ ... Depth ;,,t,.. Height � ... Sq. Ft......... Cu. Ft. ........
................ ... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft........ .
Type of Constru 'on Est. Cos ..` .:......... To be Completed
In consid
the proposed
ordinances of
on of the issuance to me of a permit to construct the building described above, I agree to do
in accordance with the description above set forth and in compliance with all provisions of
village of Fridley.
'XX44'.O& ::. ,
ee of $...permit is hereby granted to4r,
n of the payment of a f.............. to construct the building addition as described above. This permit is granted upon
on that the person to whom it is granted and his agents, employees and workmen, in all work
�4qe
ne in, ad upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minn to regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village is and this permit may be revoked at any time upon latio� y of the provisions of said
ordinances. #A
NOTICE:
Thisper it does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or wa r. Be sure to see the Building Inspector for separate permits for these items.
L •
BUILDING PERMIT
II Village of Fridley, Minn. N® 2580
Date .... a -Al ... % 9. jr 7 ......
Owner Builder .....................41.s
Address .. S.V ...d.. ..... ... Address .... �f' ai.�.... �� ,aP.1l�Lak! . »
LOCATION OF BUILDING
ow
No... Street ... 15,
_n R .............. Part of Lot
Lot ............. I• Block ................ Addition or Sub -Division .......................................
AP
Corner Lot ...... I} ..... Inside Lot ...... Jo!"... Setback ............ Sideyard ....... J'ar ...•.
DESCRIPTION OF BUILDING
To be Used as:
... X I Front Depth .. laie Height ......... Sq. Ft. ?110 Cu. Ft. ........
... Front ........ Depth ........ Height ......... Sq. Ft.. Cm Ft ........
Type of Constru on .. geaeutlo Est. Cost ............ To be Completed ..
In consideral4on of the issuance to me of a permit to construct the building described above, I agree to do
the proposed woii� in accordance with the description above set forth and in compliance with all provisions of
ordinances of the, village of Fridley.
• conslde. I 'on • f the payment of a fee of $. %f Ny, permit is hereby granted to .... ' Z'64 co�.... .
.. to construct the building or addition as described above. This permit is granted upon
the express con tion that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around O' d upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesta cregarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village 1its and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. 1
. Building Inspector
NOTICE: or
This per it does not cover the construction, installation or alteration for wiring, plumbing, gas heatino,
sewer or wa j r. Be sure to see the Building Inspector for separate permits for these Items.
11
City of Fridley, Minn.
BUILDING PERMIT
Date JUNE 18, 1965
Cjwner, ARTHUR GOODE
Address 655- 57th Avenue N. E.
Builder
FX -r— 7
LOCATION OF BUILDING
A. G. OLSON
126 Carol Lane
� i r
N° 7963
W. St. Paul, Minnesota
No. 655 Street 57th Avenue N. E. part of Lot
Lot 14 _ Block 9 Addition or Sub -Division Donnay's Lakeview 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 _$95.00 To be Completed
• REPAIRS DUE TO STORM DAMAGE
In consideration of the issuance to me of a permit to construct the bed above I agree to do
the proposed work in accordance with the description above set forth rhe° with ail ovisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to A. G. OLSON
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, Mhmesota location, construction, alteration, maintenance, repair and moving of buildings
within the city limits permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
ALLEN G. JENSEN
Building Inspector
NOTICE:
fhb pandt des Be eever the tonsf efin, huhllallon for vd&& P«lay, an headins, sewer or water. Be are to sa
the Building lespe r for apmft p malft for thea hems.
c
APPLICATION FOR 13UTLDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER
ADDRESS (v 5- e 45 ? 0v '-fit=,' DRESS
LOCATION OF BUILDING
��. Street Part of Lot
LOT .00IQ 9 ADDITION OR SUBDIVISION--' Aj t1,L1 r �i�ct �.•
Corner Lot Inside LOT SetbAck Side -Yard
_SEWER ELEVATUM k6wwiTiON ELEVAT$OX
Applicant attach to this form Two,CeA ificatei 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 DepthHeight
Sq. Ft. Cu. Ft.
Type of Construction'�J\'_"
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 applicati, are �tru and corn ct.
DA
SIGNATURE
(Schedule
of Fee Costs
can be found on
the Reverse
Side).
I
1
Duplicate Permit for AUMBING AND GAS WTING
N.B. When work covered by this permit is readq, the Plumbing Ordinance requires that request for
inspection shall be phoned in to the Plumbing Inspector, 660-3480 giving number of this permit.,
Number, Kind and Location of Fixtures
stories
J
O Z F m m Z
V 7 m F m 0
Basement
let
2nd
3rd
4th
Connected with Sewer -C
60'01 O I"QI"aI1t9i IOaIo I
WATER HTR.
OAS IELEC.
Piping for Openings
Permission is hereby granted to do the plumbing and
gas fitting in the building described in the statement hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
N° 50'78
,4Ws0,-6 z
Permit
Fee $
City of Fridley ,197
Owner QAIWt-
Location wd - S- 19 A •E
Kind of Building
{
Used as
To be Completed ,19_.
Estimated Cost
O ew. Building Permit No.
Roughing in Inspection Date
Inspector.
Final Inspection Date -//, q
Inspector.
42 1M -6-69-V
Date _ 3 -,74,
Inspector of Buildings.
City of Fridley
Applicafto for MwMftg and Cv=
Dept. of Bldgs. Phone SM -3950
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
Future Connection Openings I `'ems wua
* New Fixturs, Old Openings
PARTIAL RATE SCHEDULE
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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, Minn 3 ig7�
Owner
0 -
Kind of Building
SaverM Used as
Cesspool
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures
x $2.00
$
Z� g= o
x $1.50
$___
6
Z
•
•
WATER H TR.
x $3,25
$
Base
1st
x $3.00
$
New Ground Run Old Bldg.
x $3,25
$
Electric Water Heater
: $2.00
$
-
-
--
—
2nd
Additional Fixtures ... ..............
—x$.75
;
Gas Range to 199,000 BTU ..............
x $5.00
$
3rd
4th
_
--
Future Connection Openings I `'ems wua
* New Fixturs, Old Openings
PARTIAL RATE SCHEDULE
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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, Minn 3 ig7�
Owner
0 -
Kind of Building
SaverM Used as
Cesspool
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures
x $2.00
$
Future Fixture Opening
x $1.50
$___
New Fixture Old Opening
x $1.50
$
Catch Basin
x $3,25
$
Water Heater (Up to 99,000 BTU)
x $3.00
$
New Ground Run Old Bldg.
x $3,25
$
Electric Water Heater
: $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures .. .. ..... ..
x $2.00
$
Additional Fixtures ... ..............
—x$.75
;
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Reiss to Code
Description ......... ........................ .............
TOTAL FEE $ h
To be completed about
Estimated Cost,
Old—New. Building Permit No— _Permit No. �d 7d9
k
Signed
By- -
Business Prune
ROUGH
FINAL - (^
SUBJECT
PERMIT NO.
City of Fridley
2 5 9 4 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
I
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
a 7.pr
NUMBER
FEV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEV 55432
�j
612-571-3450
910-F15
4/20/98
JOB ADDRESS 655 57th Avenue
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
14
9
Donnays Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Michael Larson, 655 -57th Avenue, Fridley, MN 55432
571-5912
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Michael Larson
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Re-roof (tear-off) 19 S
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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 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
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATON
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
� 1, 584.60
$ . 79
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-
$51.25
Fire SC $1.59
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$53.63
SiGNITURE OF CONT PACTQDAMIA MORiZEDAGENT IDATEi/
HEN PROPERLY (DATED
BLDG NSP
THIS IS YOUR PERMIT 'fy]
DATE
SIGNATURE OF OWNED qF OWNED BUILDERi-IDATE� •'
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �� G
Owner Name &Address: �(� �{q� J L_ Lq,�$(�.)
u Tel. # §7 l 'Sl1 2—
Contractor: MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF ZIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: RQ®J�- W / McW
Construction Type: `RhjOV-P fkNO kaF Estimated Cost: $ 3. YO
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 4�2-()/qV APPLICANT: Tel. #,571-5" 7l Z_
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
.icense Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
QLD; OF FRIDLEY INSPECTION DIViSION ta,W61
6431 University Ave NE
/Z_sz ?a
Effective On January 1, 2001
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
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
JOB ADDRESS (55 S7 14W /v?�
OWNER RJcK Le {OCA K
Rate TOTAL
BUILDING USED AS
$ 30.00 $ �'
ESTIMATED COST 0/6oaoo PERMIT NO.
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating Units __/ _ Circle One (Steam) (Hot Water) Warm Air
10.00 $ Trade Name (Ax�Jox Size No. S U/13�
BTU -7o nso HP EDR
$25.00 $ Fuel A Total Connected Load 3),0 goo 67-H+
State Surcharge
TOTAL FEE
iMINIMUM 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.
$3a,5-0
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE %Z%o /0
HEATING CO
Signed'TEL #
Approved By 1�/ Rough -In Date Final Date
/%
BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS -
AND COMBUSTION AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, 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 (L�'No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No (✓f
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 WNO
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes (,�'No ( )
When installing a new venting system, the undersigned hereby verifies that
it 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 (JlNo ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes (q -1(O ( )
Appliance Type and Size/Common-Vent and Vent Connector Information
Appliance #1 Type AIC -L BTU Input '761 a&> an Assiste r Nat
Appliance #2 Type, yc t c BTU Input �� Fan ssisted or !a
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height 15 Diameter inches
Appliance #1
Vent Connector Height
ft Length ft Diameter
in Type
Appliance #2
Vent Connector Height
ft Length ft Diameter
in Type
Appliance #3
Vent Connector Height
ft Length ft Diameter
in Type
HEATING CO: Lek ��®!amu �✓�''�
Signed By: Date:
.k
ADDRESS: �S ' S C-� APT:
FLOOR:
�CITY:Fr-j&,�DATE-g
/ Ja 1.0
OCCUPANT: CaaumiOWNER:
)Z,
HEAT LOSS:
HEATING INSTALLED BY:
ELECTRICAL WORK BY:
GAS LINE BY: MAAA
TYPE OF HEAT: GA FA ROOFTOP SPACE HTR UNIT HTR OTHER
GAS DESIGN
MANUFACTURER: 14 n
MODEL: & -
SERIAL: SSO I S
INPUT:
CONTROLS
THERMOSTAT: J
VENT SIZE: �
VALVE: L&
KIND OF LINER:
SIZE NONE
LIMIT:
DRAFT HOOD:
REGULATOR:
LIMIT SETTING:
FILTERS.
SIZE: lbyjS-,ty EK
NUMBER:
FAN SETTING:
CHIMNEY-
!INSIDE
OUTSIDE
PILOT TYPE: S
CHIMNEY CONSTRUCTIONSC
PILOT MAKE:
PILOT MODEL:
SMOKE BOMB:
WIRING:
PILOT TIMING:
DRAFT:
TEST TAG:
L.W. CUT OFF:
DOOR PRESSURE:
LIGHTING INST:
PRESSURE: ,, Lo
% CO2 �.
DATE TESTED:
INPUT CFH:
%02
COMPANY TESTING:
STACK TEMP:
% CO
NAME OF TESTER:
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
March 77 2003
Mr. Rick Levchak
655 57 Avenue NE
Fridley, MN 55432
Re: Final Inspection at 655 57 Avenue NE
Contractor: Marsh Heating & Air Conditioning
Dear Mr. Levchak:
A mechanical permit was issued on December 13, 2001 to install a f imace at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date the inspection has not
been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
DJ/mh
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
F63) 572-3604 FAX: (763) 571-1287
ADDRESS 655 57TH AVE NE
PIN 233024420016
LEGAL DESC DONNAYS LAKEVIEW MANOR ADD
LOT 14 BLOCK 9
PERMIT TYPE BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
VALUATION : $ 4,500.00
PERMITO.: 2004-00547
DATE ISSUED: 04/20/2004
NOTE: PER SECTION 1402, 1997 UNIFORM BUILDING CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN
APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE
MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE & SOFFIT & FASCIA
APPLICANT
FANNON ERIC CONTRACTING
10237 YORKTOWN LANE
MAPLE GROVE, MN 55369 -
OWNER
RICHARD & DEBORAH, LEVCHAK
655 57TH AVE NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Avvlim t-� A Date 1/1.20101
Bldg
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
111.25
4.50
2.25
118.00
P au6�
NEW [ ] CITY OF FRIDLEY Effective 4/1/2004
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: S 3- S`" 7 *` Ave hle
Legal Description:
Owner Name & Address: ,LG>V eh&1<, 0e.6- Tel. # /76s) Y00 -Q2
Contractor. MN LICENSE #
Address: a 4 3 -7 Yo,. re- tyLAa lz CR -1 °Y� f ryl SX -3 1-1 Tel. # G I a yd a a $�-1
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 '71// Sq. Ft.
GARAGE AREA: Length Width / Height Sq. Ft
Length Width Hgt/Ground Sq. Ft.
Construction Type: Si 0 1 ^ICS + S Estimated Cost: $�
D Ft+6Ft= Ftx $ _$
DATE: ') �" APPLICANT: 'tri( LVI A 614 tinA, Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS: