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PRE 2010 DOCS0 4 -Xs v City of Fridley, Mi BUILDING PERMIT N° 7066 Date: d Owner: " Builder Address - Address _�f L OF OU�ILDING No. Street��P )'®a �� Part Iw Lot Block Addition or Sub -Division . Corner Lot — Inside Lot _ P--- Setback .3 (57— S _ Sid and Z ® d Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING TCP91 Used Front Depth Height Sq. Ft,�U_�y � � Cu. Ft,�-D t Depth RAght pp Sq. Ft. Cu. Ft. Type of Construction _ '--- Est. 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. , k - - In consideration of the payment of a fee of $�'permit is hereby 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 e in,74d dley,hin thnances Building Inspector • NOTICE: This psrmlt deo net cover the construction, instollolon for wlrin& plumbing, on hooting, sower or water. Be euro to see the Building hupocter for separate pore to for thea Mena. J APMTCgIQN FOR : $UILDING PERMIT ,. c. �... _ CITY .. QF F::MoEY, MINNESOTA , OWNER'S NAME;, BUILDER` ADD SS AUDR,ES . s�. . LOCATION OF,.BUILDING ' N6'; ! Marc' Street +�� f: F t'. of Lot 11n W,,- r Lot Y tI1c '` Addition .or Subdlvtsion t Corner tot_Inside LotSetback �,. Side Yard SEWER ELEVATION FOUNDATION ELEVATION r Applicant att$ch ..to tiiLa form Two, rtiftestes of '.Suswrey: of ya►t ".and proposed build- t►g locatiod drawn on these' 4rti,f nates DESCRIPTION OF BUILDING :r ~ To be used as: Frit Depth Heigh A , r Eq• r.... _ ,, Front. Depfh He►iEl i� Type of Construction- 'stimated'Cost; To be 66mplet#4 6 `c*s The u$dsrei#ned hareby makes applicatio,n'for a_permit for the wuxk herein specified, agreeing to do. all worlt 1n 'strrvt accordance with 'the City of Fridley Ordinances and rulings of {. he . Department of Buildings, and .hereby declares that all. the facts and represeritatlopis stated in this application are true and,,;correct, DA — SIGNATURE Schedule of Fee Costs can be found on the Reverse Side). C� CJ U City of Fridley, Minn. BUILDING PERMIT Date: June 1,1965 N° '7609 Owner: Donald Hippen Builder Urd Bros. Address "A 57th ice N. E. Address 52&5 University Aye. N. E- 464 OF BUILDING No. � Street 57th Place N. E. Part of Lot Lot 3.1 _ Block 12 Addition or Sub -Division City Vlew Addition Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation -- Foundation Elevation To be Used as: Front Front Type of Construction Storm MAW= Repair DESCRIPTION OF BUILDING Depth Height Sq. Ft. Ca.. Ft. Depth Height sq. Ft. Cu. Ft. _... Est. Cost 10000 _._. 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 a'll provisions of ordinances of the city of Fridley. /7 C�-� In consideration of the payment of a fee of $_10-00 , permit is hereby granted tcHM= Bird to construct the building or addition as described above. This permit is granted urn the express condition that the peon to whom it is granted asci his agents, employees and workmen, in all work Lund and upon said buildFrnesota g la atioty limitar�� permiordin Allen Jensen Building Inspector NOTICE: 7th pamir don rM eovw the wwruedee, huftilarton ier whbg, plumbing, an heating, smw n water. Be we to we iia Building hope ten for apardle pdrmba ler dwa limen 19100.00 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEYi MINNESOTA OWNER'S NAMEDonald Hippen BUILDER Bird "Bros ADDRESS 464 -57th Plaoe N.E. ADDRESS 5245 Unveristy Ave N.E. LOCATION OF BUILDING No. Street Parti of Lot LOT BLOCK '�- ADDITION,OR SUBDIVISION " Corner Lot.Inside LOTSetback Side -Ya SEWER ELEVATION FOUZATION 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 Depth Height . Sq. Ft. Cu.' Ft. Front • Depth Height Sq. Ft. Cu. Ft. Tape 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 of Fridley Ordinances and. rulings of the -Department of Buildings, and hereby declares that all the £acts and representations'stated in this'application'are true and correct. DATE , SIGNATURE (Schedule.of Fee Costs,can.be'found on'the Reverse Sidb). APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME—1Dox4azO ,P�p�Al BUILDER .S�,0,12 ADDRESS 4�6e .S% �.�E /I/C. ADDRESS 1 I LOCATION OF BUILDING NO. STREET �� T��l•4C� /1/�. LOT // F%Z BLOCK ADDITION OR SUBDIVISION C1 Ty CORNER LOT INSIDE LOT X SETBACK SIDXYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As:. DESCRIPTION OF BUILDING Front c- a, --r Depth oPO4,4—�'r height /O � Square feet S�oZ O Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction Estimated Cost /�®D 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 �.36�' SIGNATURE 1l (Schedule of Fee Costs can be found on the Reverse Side.) 2�7 S IG r V ?ay P / �' � ` / p Ar IT" E 71. 0 1 A E M RE. DD In M 0 Vj /A C Al", 2625 HARRIET AVE. MINNEAPOLIS, MINNES07A I A k8.1171 C( V 9 IL" qu C( L rd I:. (D9 S U P, V F." V For ZIPCS, INC, 57 p,, L 80.7-- 0 L: f i Mfr ey C" r) j1 J4 Ir t J: - N, L:- J L DESC-R I PT I M: 0 Lits 11 and 12, -11ock City Vi J'4 g Scale: 1" 30, A,7 )7 W-rvi Ava. 1-1 F We hereby certify thal this is a true and correct representation of survdy of the boundaries of the land above described and of the location ofall buildings, if any, thereon, and all visible encroachments, if any, from or on said land. Dated. this 7th _day of P", a y I aLI EGAN., FIELD & NOINAK /Surveyors [F i I e I by Cit y of Fridley SUBJECT I,'. -� ® 13'754 AT THE TOP OF THE TWINS PERMIT r BUILDING REtffi. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � ICITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY .-_- '� L J ` 612-560-3450 910-F15 9/ 13/76 JOB ADDRESS 464 57th Place N.E. 1 LEGAL LOT NO. BLOCK OR ADDITION SEE ATTACHED DESCR. 111 12 5 JTRACT City View SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Donald R. Hippen 464 57th Place N.E. 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. 6 USE OF BUILDING residential 7 CLASS OF WORK ❑ NEW CC ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Constructing a fireplace on west side of house 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. masonry 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 1 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 $1'000 .5O 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 SIGN E OF COINTRACTOR96R RUTH R EDAGENT IDATEI HEN PROPERLY IS YOUR PERMIT 9-1-f �e Isw BLDG. INSP VAL�IDHIS f' 9 DATE _ S NATURE OF OWNER IIF OWNER BUILD RI IDATEI W& I I W1 I .%.-S APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME: z' I'Vwz'o 'e �'�i�i�'�� BUILDER: ADDRESS: 1/641.7 ZEA-2/4�' /lam ADDRESS: NO:. '��4 STREET: 5?'d!�G'0C6F LOT: / /2 —BLOCK: 0 ADDITION:- X17-1 OiE;:W CORNER LOT: INSIDE LOT: 1,-' SETBACK: SIDEYARD: 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 :OU W657 -T A5�aAe�!e a&e- 14�5e' ��re,e^ Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth; Height: Square Feet; Cubic Feet: Type of Construction:I/ Estimated Cost: $ A5700 C10 -d To Be Completed: / IL-o'®'t,.7 w 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: �?- IY- 7g� SIGNATURE: (See Reverse Side For Additional Information.) i6r4c- I SUBJECT P IT City of Fridley o 18852 AT THE TOP OF THE TWINS BUILDING PERMIT. ' //'I RE r.y ...... COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 0210 r PROTECTIVE CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/2/87 10B ADDRESS 464 - 57th Place N.E. I LEGAL LOT NO. BLOCK T RACT OR ADDITION SEE ATTACHED DESCR. 11-12 5 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Hippen 464 - 57th Place N.E. 574-9474 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 10'6" Addition and Reside House & Garage and Reroof House & Garag 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Provide products of combustion fire alarms in basement and in.hall near bedrooms of existing house. SEPARATE PER, WIRING, C�1t 10�a1 uta�;��:z HEATINGfT LREQl7TRED FOR before d��'nELE01%t `��'� EA�- UMBING .AND S1GN�o iELEP��NE LNX REQU1 E') D i 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 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 $15,000 $7.50 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 Oft LOCAL LAW REGULATING CON- $110.50 OCONST STRUIT R HE ERFORMAN RUCTION. r �% PLAN CHECK FEE TOTAL FEE $ 27.63 $245.63 HORIZE GENT (DATE) �� `, SIG A E OF��s WHEN PROPERL ALIDATED THIS IS YOUR PERMIT ab BLDG INSP DAT SIGNATURE OW I OWNER BUILDERi IDATEI NEW [ ] City of Fridley ADDN. [ R-1 AND R-2 ALTER. [ ] Building Per t Application Construction Address: Legal Description: Effective 4/1/86 Owner Name &Address: JEM®d L Tel.�1=� Contractor:_ "a'12&' Tel. Address: ! 4z^je 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 10 Height Via- , Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground ,, Sq. Ft. OTHER: � 07 Corner Lot [ ] Inside Lot De Ft. Yd. Setback Side Yard Setback 210--4- Type ®---4-Type of Construction: ►'�i!✓�� Estimated Cost: $ l�_ W - ® 0 90&� Approx. Completion Date: r� 2.52;C ff.(101 ` 17-, `ZG`�.'?, , Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: %fI G,,� Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL CITY USE' ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: 2fL L, rzw� �jF}5 m r T1s, A1L SUS& 0.5,0®d A ®vo— 39'So //0.�(j 6 9C Al g r,� A1INNEAPdL1 NNESCTA I 2629 HARRIET AVE.% S, MI ,jttlj '"1[2 V9b'aC( n rd c 0 P f3UP.VU.6V Of l For Z 1 PCr, - ItlC-. B0.7� - -- 0 E 7t S; cKt+>'F ti 00 ,r I � ?.:A 1 ME DESC4IPTi('N: ' Lits 1 l and 12, 91 ock 5, city View. scale: I"- 30' -- 30.72 - - W -r vi Av , �,IUF We hereby certify that this is a true and correct representation .of a survdy of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. Dated this 7th day of may , 1 EGAh, FIELD & NOWAK /Surveyors �^ i le Ro.�_�0�7 P,00k No.1 I y-4 - - by CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE VES I DEBT IAL RATE Furnace Shell and Duct Work. Burner (Also replacement furnace) $ 20.00 Gas Piping $ 10.00 (piping needed with now furnace) Gas Range $ 10.00 Gas Dryer $ 10.00 • Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations It of Value of Appliance or Work COMMCRCIAL/INDUSTRIAL it of Value of Appliance or Work State Surcharge T(ML !EE Reinspection Fee ($15.00) Rough Insp. Date Final Insp..�� Date Approval for Permit ' ^466-j MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE TOTAL S Job Address Department of Buildings 6411 University Ave. N.E.. Fridley, NN SS432 City of Fridley Tel. 6571-3450 The undersigned hereby asked application for a permit for the work herein specified sgreeinq to do all work in strict accordance with the City Oodee and rultstgs of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Kinn. / / 19�% OWNER KIND OF BUILDING ��,c,� �"Jls l r ✓/ (f G �� r `�f USED AS CPOMCG! le v / TO BE COMPLETED ABOUT / — —� ESTIMATED COST��!� OLD - NEW BUILDING PERMIT NO. PERNIT NO. DESCRIPTION OF'FURNACE/BUMER HEATING or POWER PLANTS, Steam, Not Nater, Nara Air- No. �t c Trade Name i.Z ? 519 y% size No. Capacity Sq. Ft. EDR STU 100 0O NP Total Connected Load Kind of Fuel �J 7� BURNER - Trade Name Sire No. VICa' city Sq. Ft. EDR BTU NP Attach stack verification fors with replac.taent furnace permits *Air Cntditioner% can not too- placed to •.t d.• yard without written ptrntvNlun fr4n aduo►ntng tr•tgtd•.r. SUBJECT PERNULLUQ.__ City of Fridley '2 7 6 0 7 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT N COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. NUMBER REVDATE 9/8/98 PAGE OF APPROVED By CITY HALL FRIDLEV $5432 �.__.11.' '•� 612-571-3450 910-F15 JOB ADDRESS 464 57th Place NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11912 5 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Hippin 464 57th Place NE 55432 574-9474 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Olsen Construction 3110 167th Ln NW Andover 55304 753-2681 20093663 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 52 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof xx%4L;tx4ic house & 25S 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 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 1 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 $2,142.00 $1.07 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- $74.75 Fire SC $2.14 STRUCTION OR THE PERFOR ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL F E License $5.00 -/ $82.96 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N ROP ALIDATE AK.WA BLD SP If T $ I$ Y R P RMI MATE SIGNATURE OF OWNERoF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0 ConstructionAddress: Legal Description: Owner Name & AddressTel. # Contractor: �/%,� � � .� s p a u MN LICENSE &2 9� � Address: 45�" ee/ � .� �ti, �3" �6 Tel. # :,5-376 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: G A 039 Construction Type: Z,?gLoo 5 Estimated Cost: $ 2 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ 71 ?f-/- $ �-.1- Sewer Main Charge $ TOTAL STIPULATIONS: $ 62• 2 G 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 [ ] SUBJECTIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT _ COMMUNITY DEVELOPMENT DIV. R SEI T NO. r PROTECTIVE INSPECTION SEC. NUMBER REV OATH vAGE OF APPROVED By CITY HALL FRIDLEY 55432 l 612-571-3450 9t0 -F15 9/28/98 JOB ADDRESS 464 57th Place NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11, 12 5 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Shiffner 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D M Tranby Siding 9131 178441-6399 3289 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 O NEW O ADDITION ❑ ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside house and garage 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY 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 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 $6,000 $3.00 DOES NOT PREsum5..T6 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE STATE OR LOCAL LAW REGULATING CON- ANCE OF CONSTRUCTION 112.25 Fie SC 6. PLAN CHECK FEE TO AL FEE ' R!iIGNATO d / Lice S$5.Q R AUTHORIZED AGENT IDATEI EN R P /VALID tjHI IS R T S-GNATURE OF OWNERIIF OWNER BUILDERI IDATEI /, - ------------------ BLO N5� - GATE NEW ( ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: y)M - —R W$ X _S < Address: 911 ? 9 &1 %2Rytrt� Effective 1/1/98 6 eq-I�FQ Tel. # 5 MN LICENSE # , 0 F Tel. # & LIZ 7 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: � s Construction Type: Estimated Cost: $ O v (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: — Tel. # /� OAPPLICANT: CITY USE ONLY Permit Fee $ Z— Fee Schedule on Reverse Side Fire Surcharge $ LW .001 of Permit Valuation (1/10th%) State Surcharge $ 3. 6C) $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ , OD $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 [ J TOTAL $ L�(o . o?.S STIPULATIONS: 6431 Univarsiiy Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: 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 NYes () Nc Type W141</ -' Reinspection Fee $47.00/Hr 111;a0IIIIIIIIIIIIIII:7f&4 $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 B $15.00 TOTAL JOB ADDRESS 46tl- 57 7""A4,464' AA5 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. 'g -�� , 20dZ Owner 7DOW-440 'p, % 7,0 41 Building Used As Estimated Cost Zy PERMIT NO.�� PLUMBING SIGNED BY TEL N0. �� `-fllZ�e ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # 1.5% of Value of Fixture or Appliance 4n � Approved By Rough -In Date Final Date State Surcharge .50� �y MINIMUM FEE F ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ �p -So PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNTVFNT CONNECTOR AND COMBUSTION AIR VFRIFICATION When raIn acing an eYicting furanria, 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 (► 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( ) 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( ) No( ) The P -Anti nmh ,sinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When required to install a new _omh stinn air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When "n-cfallong a now v _nting evtpm, 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( ) No( ) 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( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height 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: Signed By: Date: City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 - Water and Sewer_ Permit Application Date: " — Job Address: New Connection Existing KA DUtility Line Repair/Relocation ``Water and Sewer Connection Name of Applicant (Plumber): T�k` Name of Property Owner: -00 P tp,- A L �� Existing Structure Permit # 2,00&— 06l 1 Permit Type: Sewer Fee: Water Fee`77 Meter Fee: Repair Fee: Relocation: State Surcharge: r SZ) SAC Charge: Special Assessment Fee: Total: $ 411-0 `SV Applicant Signature: 0• w Inspector approval: Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit Sewer Connections Permit Cf, ___ Inspection Fee for Water/Sewer Line Repair Special Assessments See Engine ' Cost of Water Meter See Utility Billing SAC Charge $1550 State Surcharge $ .50 Water Tap See Engineering 04/04/05