PRE 2010 DOCSVillage of Fridley, Minn.
BUH DING PEBXM
N° 1 3 Office of INSPE OR OF BUILDINGS
Owner. ,`' /t•
Architect Fridley, Minn., 6 ° ,
Builder
LOCATION OF BUIMING
DESCRIPTION OF BUILDING
Front Depth Height � Stories Manner of Construction "
i
To be used I'
- ' ' Y ` ">n To be completed kL ': ° ' � Estimated Cost -56, i.
Permit is hereby granted to
the building; iAir+ described in the above statement. This permit is granted
upon the express condition that the apepson to whom it is granted, and his agents, employees and workmen, in all
the work done in, aroundand upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley; Minn., regarding the 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.
Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated.
Subscribed and sworn to before me at Fridley,
day of A.D. 19 °"
1]
Minnesota,
Is
2-; �e'd`zf
Cify of Fridley, inn N° 8766
BUILDING - PERMIT
Date: APRIL 142 1966
Owner: Builder AL WMLIAMS
AddressAddress 8562 East River Blvd.
Minneapolis,. Minnesota
LOCATION OF BUILDING
No. 131 Street 5TH PLACE N -E. part of Lot Has lie- of Lot 3
Lot 4—__ Block 1 Addition or Sub -Division . CITY VTEW
Corner Lot _ Inside Lot _ . 8 Setback 3 -- Sideyard 10'
Sewer Elevation _ 837.75 MMOMIk Elevation 840.75
DESCRIPTION OF BUILDING
To be Used as:
DWELLING Front 40 Depth 26 Height 20 Sq. FL 1,040 CtL Ft. 20.80
Front Depth Height' Sq. Ft. Cu. Ft.
Type of Construction FRAME Est. Cost _ 14.50 .00 _ To be Completed
WATER d 122' East of Manhole
SEWER - 136' East of Manhole
In consideration of the issuance to me of a permit to et the b7,1n!D
described above I agree to do
the proposed work in accordance with the description above set 01
p ce with ail provisions of
ordinances of the city of Fridley.
P
In consideration of the payment of a fee of2g 1.00 , permit is hereby granted to al WILLIAMS
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 reg location, construction, alteration, maintenance, repair and moving of buildings
within the city Iimits and permit may be revoked at any time upon violation of any of the provisions of d
ordinances.
ALLEN G. JENSEN Building motor
NOTICE:
M ponn1t don not corer dw condroddon, bmagdion for wkhm phanbing, on boding, :war or wdor. Be eon to as
the Boibling Impntor for aperde pammfa for thea ftem
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER
ADDRESS ADDRESS
LOCATION OF BUILDIW,
N0. STREETZdPART OF La 2—ZOT
1 aa
LUT BLOCK % ADDITION OR SUBDIVISION l
CORNER LOT INSIDE LOT '----SETBACK )\ SIDE -Y LL
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 b=sed A
Front Depth Height
Sq. Ft. Cu. F
Front
Dept h Height
Sq. Ft. Cu. Ft_
Type of Construction` Estimated C �_
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.
S
(Schedule of Fee Costs can be
found on the Reverse Side).
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ........................... 8.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 ® O
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $
{ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
s Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $1.50 $
Additional Fixtures ............... x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $����
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH
FINAL
Dept. of Bldgs. Phone SU 4-747700
Location /_:�?/ l
d�
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct. f
Fridley, inn-
Owner
Kind of Building
Used as
To be completed about —
Estimated Cost, $
Old New. '/lding Permit No. 766 Permit No. 4�1�
ew
DESCRIPTION OF WORK
HEATING or Pteam, Hot Water, Warm Air—No
J
Trade Name (/��� r Gi�� No' _ O
Capacity. Sq.. Ft. E.D. 0 �� BTU H.P.
Total Connected Load a�d of Fuel
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
PERFECTION HEATING COMPANY, IN.C.
2936 FOURTH AML SM i IA. 3-5287,
Signe h► 0115 B' MINNESOTA
X42 2M Business Phone No y — S� �✓ /
DJ6 /
HE.KT SS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips AS.H.V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes—No Yes—No 19—
Fl. Room � Length �/ Width / Height Fl.� Room Length /� Width // Height
Windows and Doors—Crackage and Area
Width Height No. o[ Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Windows an oors—Crackage and Area
Width He No. of Lineal it. Area
No. of pane of pane lights of crac eq. ft*
Total Btu.
Required,sq, ft. E. sq. ins. W.A. Bader ar-$
Room I Length 6
Width Y
-
Windows and Doors—Crackage and Area
Net exp. wally
VO 413
Width Height No. of Lineal ft. Area
No. of pane oft pane lighhts� of crack sq. ft.
7i
�Z
Coef.
Btu
Infiltration
57
Coef.1
Btu
9
Glass
Exp. wall
xo
�®
a
Exp. wall A 5-y
g
1,24 4
1 .3 7 5--0
Exp. wall1-3a
Net exp. wall
1
1.7 O
Int. wall
(� /
®
1610
Int. wall
Ceiling
/
Floor
S
d
Floor
Total Btu.
Required,sq, ft. E. sq. ins. W.A. Bader ar-$
Total Btu. // 7,10
Requiredsq. ft. R. or sq. ins. W.A. Leader area
Fl.I ei Room I Length / z Width ff Height
Window and Doors—Crackage and Area
Room I Length 6
Width Y
-
Height K
Windows and Doors—Crackage and Area
Net exp. wally
VO 413
Width Height No. of Lineal ft. Area
No. of pane oft pane lighhts� of crack sq. ft.
1, 3 v -2—
�� ® 9 7
Infiltration
Floor
2�2
57
Coef.1
Btu
Infiltration
Z/tom®
Exp. wall
xo
1 3.3
Glass
Net exp. Beall
Oz 57/
420
1 .3 7 5--0
Exp. wall1-3a
1
Net exp. wall
(� /
®
1610
Int. wall
Ceiling
S
d
Floor
Total Btu. // 7,10
Requiredsq. ft. R. or sq. ins. W.A. Leader area
Fl.I ei Room I Length / z Width ff Height
Window and Doors—Crackage and Area
9 "
Glass .
Width Height No. of Lineal ft. Area
No. of panne of Dane lights of crack sq. ft.
Exp. wall
Net exp. wally
VO 413
Int. wall
Coei.
Btu
Infiltration
Floor
2�2
57
Glass
v�
ZI D
Z/tom®
Exp. wall
�
Net exp. Beall
Oz 57/
Dfe,
67
Int. wall
Ceiling
Floor
Tbtal Btu.
ired sq. ft. E.D.R. or sq. ins. W.A. Leader area
7- Z21
Btu
Infiltration
9 "
Glass .
.S,?> -,?- / v b
Exp. wall
Net exp. wally
VO 413
Int. wall
Coef.
Ceiling
/ o
Floor
2�2
Total Btu.
Glass
Requir s . ft. E.D.R. or sq. ins. W.A. ader area
Rnnm I Length / Width / / Height
Windows and Doors—Crackage and Area
l'zlo
Glass
Width Height No. of Lineal ft. Area
No. of pane of pane I lights of crack eq. ft.
*0 � Z
Net exp. wall
VO 413
Int. wall
Coef.
Btu
Infiltration
Floor
2�2
Total Btu.
Glass
`-
ZI D
Z/tom®
Exp. wall
Iflo
Net exp. wall
�'
b
/3F6
Int. wall
Ceiling
Floor
Total Btu.
quired sq. ft. E.D.R. or sq. itis. W.A. Leader area
l.� Room I Length/® Width
Windows and Doors—Crackage and Area
Width I Height No. of Lineal ft. Area
Of pane of pane lights of crack sq. ft.
Btu
Infiltration�0
l'zlo
Glass
iy/
Exp. wall
Net exp. wall
VO 413
Int. wall
Ceiling
�� y
Floor
Total Btu.
ft. E.D.R. or sq. ins. W.A. Leader area
Application for Power Plants and Heating, Cooling, Ventilation, Re1frigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work ..........................
8.00
$
Replacement of Furnace ............................
5.00
$
Repairs & Alterations—up to $500.00 .................
5.00
$
Repairs & Alterations each add. $500.00 ...............
2.50
$
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .. 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water ................. 2.50 $
OIL BURNER—to 3 gal. per hour . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ .J.
GAS FITTING FEES: NO RATE j TOTAL
�
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................ x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
TOTAL FEE $L
Dept. of Bldgs. Phone SII 4-7470
Location_
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are
true and correct.
Fridley, Minn- <�-7 19
Owner 'G • ��.ye-!%l�ra�c���
Kind of Building
Used as
To be completed about
Estimated Cost, $ /
Old--(5)Building Permit No. Permit Nov� (�.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water Warm No l
Ps
Trade Nam Size No -'10-2
Capacity Sq. Ft. E.D.R 02,11 BTU H.P.
Total Connected Load�_"�;' Q"�d Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. EMM BTU H.P.
(REMARKS -OVER)
Signe
17
By r�
<z Business Phone No- / Z 2-
560-3450
cit Of riaffe
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55421
December 5, 1966
Re; 131 57th Place
We the undersigned agree to remove 8' x 45'
house trailer - "Palace Ranch Home" or apply for a
permit to park same by Council approval by January 1, 1967.
Permission granted this date by Mr. Earl Wagner,
City Manager.
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
-
PERMIT
PERMI
6 2 61
1
� rr
`L __-__- COMMUNITY DEVELOPMENT DIV.
r 1 PROTECTIVE INSPECTION SEC.
1 �
1 i � CITY HALL FRIDLEY 55432
j 612-571-3450
o
/
NUMBER
s� o-F� s
REVDATE
A E 6/16198
PAGE OF
APPROVED BY
JOB ADDRESS 131 57 Place NE
1 LEGAL
DESCR.
LOT NO.
4
BLOCK
1
TRACT OR ADDITION
1 City View Addition
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Carmen Mack 131 57 Place NE
571-0318
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Residenital
7 CLASS OF WORK �
❑ NEW ❑ ADDITION ❑ ALTERATION pX REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (12 S) Tear -off
9 CHANGEOFUSEFROM 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
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$1,000
SURTAX
@
$•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.
$34.75
Fire SC $1.00
PLAN CHECK FEE
TOTA EE
$;6:25
?SGATUREOFCONT RACTORORAUTHORIZED �AGENT
� DATE/i
H PRY
LOG NSP
VALIDA
HO
IS IS YUR PE IT
PATE
S.GNATURE OF OWNER OF OWNER BUILDERi iDATE�
I
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 31 J���-� ( S -3
Legal Description:
Owner Name & Address: e(A 1rm.'r n Tel. # °/ — D J ��
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 L%4PROVEIVIENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width _ Hgt/Ground Sq. Ft.
OTHER: 7d S a, -�
Construction Type:
Driveway Curb Cut Width Needed:
DATE: � _14_ F �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Estimated Cost: $ J
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x $ _ $
APPLICANT: Tel. # 511-O J/9-9
.v
CITY USE ONLY
$ ��7, `�� Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ S) $.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 [ ]
CITY OF FRIDLEY INSPECTION DIViSION
Effective On January 1, 200(
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING
SYSTEMS AND DEVICES
JOB ADDRESS ��J — S.`1TI'
i-P�cQ N • �. .
RATE SCHEDULE
OWNER Q P qump. ti �
AC k
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS_ ,) Liffe L_Uk
61
Also Replacement Furnace
$ 30.00
$ 00
(Side Vent - Fill Out Back)
ESTIMATED COST D 0 .00
PERMIT NO.
Gas Piping (Needed with new furnace,
$ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00
$
No. of Heating Units_ Circle One
(Steam) (Hot Water)arm Air
Gas Dryer
$ 10.00
$
Trade Namei0v se, 1n -r
Size No.aa3KAV n4zo_q
�,
BTU 22 - ooQ_ HP EDR
*Air Conditioning - All Sizes a ?on Jo Sem-
$ 25.00
$ 00
Fuel Wk GAS Total Connected
Load
'Pw-4awr s&.1czXo L4
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name
Size No.
1% of Value of Appliance or Work
$
BTU HP
EDR
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE
DATE 4:.— 0 &
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CRO er City Sheet Metal, Inc.
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00N.W.
PLUS THE $.50 STATE SURCHARGE Signed Coon Rapids, RAN 55433 TEL #
9
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved By 4Roughdn Date Final Date "r9 -y/
written permission from adjoining property owner.
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, 1998
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS /-'/ i'°/` &_P'
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ .50
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 application are true and correct.
JVv►-e-
`� 2 mal
Owner f � k-7 C ✓�_ )41 t (/4
Building Used As_/&V.' ' ae,
Estimated Cost .5 PERMIT NO.
PLUMBING COMPANY Celltr&4 ei G
SIGNED BY 4 TEL N0.G6
Approved By // s iI Rough -In Date
OR ANY PLUM
PLUS THE $.50 STATE SURCHARGE
?V .
Final Date 6-(f-0 /
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES.
SUBJEct
IT NO"~y
City of Fridley
3 i 927
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
LV ___ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
�
s®
572- 604
O
r � PROTECTIVE
ICITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
6/22/01
JOB ADDRESS 131 57 Place NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
1
1 City View SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Carmen Mack 131 57 Place NE
763-571-2864
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Pella Windows & Doors 15300 25 Ave N, Ste
100, Plymouth MN 55447 763-745-1400
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20165884
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 10 windows within existing openings
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997
Uniform Building Code. Caulk
and flash all exterior openings.
Per" lospecdon Car ds
W111
Wall 8e Mail d
TO
T
®Posh
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 A13ANOONED 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
$8,117
$4.06
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-
$167.25
Fire SC $8.12
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
Licens $5.0
.$10.43
SIGNATURE OF CON'RACTOR OR AUTI+ORIZED AGENT IDATEI
EN ROP R DATED S IS Y R R �
BLD ,NSP DATE
S-GNATURE OF OWNERJF OWNER BUILDER, IDATE,
NEW [ ] Effective 5/10/99
ADDN [ l CI'T'Y OF FRIIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: I-6% (`j .� . � -' h -f C�¢
Legal Description:
Owner Name & Address: Ck kpM— r,1 MQx� Tel. # 4to3 T • ao�r�
Contractor:; PELLA WINDOWS & DOORS MN LICENSE #.
15300 -25TH AVE. N. STE# 100
Address: PLYMOUYH, MN. 55447 Tel. #
Attac 763/745-1400 irvey. of the
lot, V► LICENSE# 20165884 ,n it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION OF VVIPR OVEMEINT
Length Width
Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
�
Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ -
DATE: ._� �� r itO�,'`s__11► �i� L►. &I
TOTAL $ U y 3
STIPULATIONS:
CITY USE ONLY
Permit Fee
a�
$ lu
Fee Schedule on Reverse Side
Fire Surcharge
$ =►
.001 of Permit Valuation (1/10th%)
State Surcharge
$ OSP_
$.50/$1,00 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ S
$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 $ U y 3
STIPULATIONS: