PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N° 2516
Datei — +1. «fir .......................
Owner ! Builder .........................
it
Address........L ....................
II............ Address ..........................................
LOCATION OF BUILDING
Part of Lot
o. .. 7 49... Street . j f .,•fir c, '... R ........... ...................... .
Lot ...... ..... Block .../a......... Addition or Sub -Division .................:..............
Corner Lot ...... ..... Inside Lot ............ Setback ,;;, • Sideyard R. .......
DESCRIPTION OF BUILDING
To be Used as:
. . ' '.. ......
Front .. Depth S;� `Leight
......... Sq. Ft.
Cu. Ft, ........
.............. I .....
Front ........
Depth ........ Height
......... Sq. Ft.........
Cu. Ft.........
Type of Constructi in:
............
1"'rl~_60
Est. Cosi � � 00'. -OW........
To be Completed -..................
.
w -
J
In consideratio i 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 v Rage of Fridley.
.x n_
........�.....................................
In consideratio of the payment of a fee of $..,� . permit is hereby granted to..........` .......... .
• ..• • ttheperson to whomnstruct the it addition as described above. Thianted upon
ed and his agents, employees and workm , in all work
done in, around an 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 i and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
......... Building 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.
City of Fridley, Minn.
BUILDING PERMIT N° :59:8 5
Dater
00,
owner:
wner Builder
Address Address
L
CAPON F BUILDING
No. Street Part t -
Lot _ _ __ 'Block ZZ2 Addition or Sub-Di on f 201
Corner Lot Inside Lot _! itrtbackSideyard
Sewer Elevation__ _ _ _ _ Fo dation Elevation
DESCRIPTION OF BUILDING
To
Cu. Ft. "
Front Depth Height .: Sq. Ft. '��:�-� �.
Frop,rDepth Height _ . � Sq. Ft. _ Cu. Ft.
Type of ConstructioniG _ Fst. �•r►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 conditia� that the person io whom it is granted and his agents, employees and workmen, in all work
done in, around an upon said building, or any Bart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota ;regarding location, construction, alteration, maintenance, repair and moving oY buildings
within the city limiks and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner `s
Nameyed` /P/)M
Builders 7"eR
�°iT��
-a Ra 12 Lueg
Address -6
f o -:57 7 -Ave N, ff
Address Zf
LOCATION OF BUILDING
No. Street 7Av, Part of Lot 13aek x -
Lot Block Addition or SubdivisionDA/V� VS
0
Corner Lot Inside Lot_,,' Setback•=� Side -Yard �T
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
DESCRIPTION OF BUILDING
To be used as:
Front c. 1 Depth a® Height 7 1*`�
Sq. Ft. Y! o Cu. Ft. 16 9 -0 -
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction LS'J&LO Estimated Cost �1
d®
To be Completed J V 1. _ 1 6 �--
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_d Uff a/ 6 :?- SIGNATURE
(Schedule of Fee Costs can be found on the ieverse Side).
Application for Power Plants and Healing, Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ........................... $10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00
each add. 60,000 BTU ....................... 3.00
Replacement of Furnace ............................. 6.00
Repairs & Alterations—up to $500.00 ................. 6.00
Repairs & Alterations each add. $500.00 .............. 3.00
STEAM or HOT WATER SYSTEM
Dept. of Bldgs. Phone 560-3450
Location �d �p® o 67: 4l -e a
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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, Minn19ea'�
$ owner ��:D` L � 9d�1✓� �l D�
$ Kind of Building
Used as
To be completed about
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam ...................... 3.00 $
Each add. 320 sq. ft. EDR Hot Water . ........... .... 3.00 $
OIL BURNER—to 3 gal. per hour ........................ 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x$ 2.00
$ ®D
Additional Fixtures .................
x .75
$
Gas Range to 199,000 ..........
x$ 5.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$ '
ROUGH
FINAL
Estimated Cost, $
Old New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No
Trade Name�2&4AWad6 &, e No
Capacity SS�gq..Ft. E.D.R BTU H.P.
Total Connected Load_' 4&4Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
s
SUBJECT
PER
City of Fridley
1. 5 4;0_0AT
THE TOP OF THE TWINSB
U I L D I N G P E R M I T16
_
ECEIPT NO
i a:------ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
�� Q�
J
CITY HALL FRIDLEY 55432
NUMBER
REV.I
PAGE OF
APPROVED BY
L J\ 612-571-3450
910-F15
_IDATE
8/20/79
F/ /
JOB ADDRESS
690-57th,�Ave. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
10
Donnay's Lakeview Mannor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Emil Spiczka. 690 - 57th Avenue N.E. 571-2848
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
6 DESCRIBE WORK
Install chimey for wood-burning stove
9 CHANGE OF USE FROM TO
STIPULATIONS
SEeERATE PERMITS REQUIRED FOR WIRING.
HEATING, PLUMBING AND SIGNS.
WA200
eefere ditina Coll taco, ON"
IREPHONE • ELECTRIC - GAS E tc-
RFQUIRED BY LA
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 BO 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
l
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
$200
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$7.50
PLAN CHECK FEE
TOTALFEE
$8.00
SIGNATURE OFC TRACTOR OR AU RIZED AGENT (DATE)
HEN PR P R A ATED THIS IS YOUR PERMIT
e
BLDG INSP DATE
SIGNATU EOFO RIIF OWN UILDERI IDATEI
s
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER:Z.
Y
ADDRESS: ell P S % gr -c
TEL NO: S71- 2 2:q fir'
BUILDER:
ADDRESS:
• TEL NO:
Construction Location
STREET NO:
690
STREET: SE 7
66LLP
LOT:
02
BLOCK: _�
ADDITION:
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.
DESCRIPTION OF CONSTRUCTION
Front: 0 Depth: Height:
(—sZ)D® SjaV� Squane. Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: _ /4 l' Estimated Cost: $ ea
To Be Completed: T . �T l
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET'
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.
DAMP, 2 - /,9 SIGNATURE:
Stipulations:
a
°7. S7-0
CITY OF FfK)LEY INSMCTION DIV,
8431 University Ave NE
Fridley, MN 55432 .
572-3604
RATE SCHEDULE
Effective On Jammry 1, 1997
APPLICATION FOR POWER PLANTS AND HEATIK COOLJNG, VENTILATION,
REFF RATION AND AIR ORLON G SYSTEMS AND DEVICES C
�90 Y7
JOB ADORE
Residerdfal
Furnace SW and Duct Wodc, sumer --
Also Replacement Furnace
P& Vent - Fill Out Back)
Gas Piping f*mdad wkh new furnace)
Gas I
Das Dryer
*Air Conditioning- - All Sizes
AN Othem/Repairs & Alterations (UST ON BACK)
1 % of Value of Appliance or Work
Commerciaillnduatrkl
1.25% of Value of Appliance or Mark
Rate TOTAL
$ 30.00 $ 215) -6
$10.00.. $
$10.00
$
$10.00
$
$ 25.00
$
State Surcharge
TOTAL. FEE
The undersijned hereby makes application for a emit forthe work herein
specified agreOng to do all work in strict accordance wkh 6* City Codes and
ruin of the &Wng Division, and hereby declares that all the fads and
representations stated In this appilcation. are Imre and correct.-
®c�k--w-v- zc ,1�7
-6 Psc2K- s"7® -,,2 4 `Iq
BUILDING USED AS
ESTIMATED COST I , 3'1 S . coo PERWT NO.
DESCRIPTION OF FURNACE AND OR SER
$ No. of Heating Urts Circle One (Steam) (Not Water} (Warm Air
Trade Name Size No.
BTU �.2fl[ a_—,�..,., 'HP EDR
$ Fuel Total Connected Load
$ .50 Burner Track Nirm Size No.
G, STU HP
MINIMUM FES FOA ANY HEATINGICOOLJK98=LATION
REI�'iiMATIONIAIR CANOIIIOMNGt PM1i$T IS "I.
PLUS THE 5.50 STATE SURCHARGE
'Air Conditicmers can not be plata in a side yard without
whiten perrnissior! from Odning property owner.
HEADW4XWPANYIZ caa Aei d- r Sl
IJ
- edB Te1No.CQla-neo �3�06
Approved Sy/4 Rough. -in Date Final Date
Fitt our BACK SDE P STACK VERIRCATION Oh!
m
m
m
ti
2 R
JUL-17-1997 12:12 CITY OF FR? DLEY
612 571 1297 P.02r02
CH MMY AND VAM YNNEW&UM
'The un&mdgwd bereby verift that the.wdsting chimney or stack:
1. Has been carefully examinod• .: Yes No ( >
2. b fmc from r, an deteriorat a : Yes (VNo. )
.3. Has no forcip objects .laded wit W
Yes (Vf No
(
..q. Is secutely suPPorow
Yes 611 ND
( )
S. Meds an current Code rawkwAmts for size
and total BT'CJ's connected Yes (✓f No ( )
6 Has total heating BTU's of 4=0, OCR>
All outer BTU's -1 Z, S— O
TOTAL BTU's `9 2, rc, a
7. Inas a liner been provided. for water heater Yes) No ( )
8. Has combustion-abew provided for.. -waw. heater . Ye�+.) No ' t )
'�1}per:,, :, s" ••.+` •r` ''~ �e�.�.''}. .;�'+�.... �':�.a.�;,•.:� °tii •'.�. .�1�•�• "'�'` ..'r.'„' ::� ,'
.. �• <.4':. .ik.^�. Ux`�`. 5��?yq ✓�'+� �t�}t i yds i.; eq r 'q {r3, •.�. -
Yom..'. ,.�C: a.. fF Y 1'�: •� ..i. �'f9YY` 'M1 � ! � •
Rotnarb:
HEATING Co:
Signed By:
Date.
TOTAL P.02
SUBJECT
city of Fridley
7
AT THE TOP OF THE TWINS
BUILDING
PERMIT(E0.
r
_ COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
I . I
4/(per
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
4/9/98
JOB ADDRESS 690 57 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
10
Donnay's Lakeview Manor
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Tracy Spiczka 690 57 Avenue NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Gates Roofing 4640 Ximines Ln Plymouth MN 55442
550-0043 6793
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
T CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION p REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage 25 S 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
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 1 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
$1,566
$.78
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$51.25
Fire SC $1.57
PLAN CHECK FEE
TOTAL FEE
$5.00
$5)e.160
SIGNATURE OF CONTRACTORO UTHORIZED AGENT IDATEI
P OPEAIDATEDHIS YOU PERMIT
;MSP
DATE
SIGNATURE OF OWNER i IF OWNER BUILDERi IDATEI
NEW [ ] Effective 1/1/9$
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION Y -
ConstructionAddress: d�� p"7'4za -All Ile -
Legal Description:
Owner Name & Address6,?O Sit'Alt ALL Tel. #
Contractor: MN LICENSE #
Address: ` %� L s +-- �,U1i?C►Gc l �iTel. #
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:
i2 e n l� �- �A.�
b
62,L) b
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $
(Fee Schedule on Back)
Ft x $ = $
DATE: ` APPLICANT: c 4 cl*'-- S Tel. # ,-'c a Y
Permit Fee
$ . a2Sr
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
$ d
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ LIS- & 6
. 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 [ ]
LUM
SUBJECT
City of Fridley
2596-
AT THE TOP OF THE TWINS
BUILDING PERMIT
,
1 �
COMMUNITY DEVELOPMENT DIV.
1 L PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
4/22/98
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 690 57th Avenue
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
10
1 Donnayt s Lakeview Manor Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Trac Spiczka, 690 57th Avenue, Fridley 55432
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Gates Roofing, 4640 %imines Lane, Plymouth 55442
550-0043 6793
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
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
PAID DIFFERENCE BETWEEN 2ND LAYER AND TEAR -OFF (See Building Permit x{'25917)
9 CHANGE OF USE FROM TO
STIPULATIONS
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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$519.00
$.50
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-
$23.75
Fire SC $.52
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
�:-2z--_'z$24.77
(GNAT EOFCONTR OR AUTHORIZEDAGENT IDATEI
WHEN PROPERV JALID TED THIS IS YOUR PERMIT
BLW INSP -
4A TE
SIGNATURE OF OWNER OF OWNERBUILDERI IDATEI
SUBJECT
City of Fridley
777
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i �
O.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
r
1
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
4/9/98
JOB ADDRESS 690 57 Avenue NE
I LEGAL
LOT NO.
BLOCK
TRACT OR AODIIION
SEE ATTACHED
DESCR.
2
10
Donnay's Lakeview Manor
Addition SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Tracy S iczka 690 57 Avenue NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Gates Roofing 4640 Ximines Ln Plymouth MN 55442
550-0043 6793
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK �❑
❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE
x
8 DESCRIBE WORK
Reroof House & Garage (25 -Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd. _ ,_---
1
j CV
r
TYPE OF CONST.
OCCUPANCY GROUP
OCCU Yf LOAD
SEPARATE PERMITS ARE REOUIRED 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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,566
$.78
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
SC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$51.25
Fire $1.57
PLAN CHECK FEE
TOTAL FEE
!//'�
oe�o r -��
v&O--SIGNATURE
License
5.00
$5,0.60
OF CONTRACTORO UTMOAIZED AGENT IOATEI
PCCCS4OPER (DATED TH IS YOU PERMIT
r
BL (NSP
BATE
SIGNATURE OF OWNER OF OWNER BUILDER( IDATEI