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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PERMIT Date: "....6'�® ..................... Owner....................................... Address...................................... 1817 Builder .. 00c! ..... .. �- .. ......... . Address............................................. LOC TIAN OF BUILDING No. .. .. !.... Street ....... ................... Part of Lot ............. .. Lot ..... 7 ...... Block ...... d......... Addition or Sub -Division . 4021 ... �y Corner Lot ........... Inside Lot ...�... Setback ..3 . .. Sideyard ..... ..................... DESCRIPTION OF BUILDING To be Used as: ... �1 .. ... ........ ........ Front ."T. � . Depth !'�: �! � Height j.`r Sq. Ft. Cu. Ft. ................... Front ........ Depth .... Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ...... Est. Cost f .��. �....... 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 village of Fridley. ®v In consideration of the payment of a fee of permit is hereby granted to orro . . ......................... 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 with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ..... V ``�! ....... Building Inspector NOTICE: This permit does n cover th onstruction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be surto se a Building Inspector for separate permits for these items. SUBJECT PERMIT City of Fridley 12;9 6 6� AT THE TOP OF THE TWINS BUILDING PERMIT T RECEIPT • ___ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ,J 612-560-3450 910-F15 JOB ADDRESS 621 - 58th Avenue N.E., Fridley, Minnesota. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 8 Donnay t s SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas R. Corbett,. 621 - 58th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Robert Hammes, 3908 Edgewood Avenue North, Minneapolis, Minnesota 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residence 7 CLASS OF WORK ❑ NEW N ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Family Room - 16 x 22 Garage - 2116" x 24' Estimated Cost $5,800.00 9 CHANGEOFUSEFROM TO STIPULATIONS WARNING Provide Hard Surface Driveway. Blf"I digging cap local Utilities TELEPHONE - ELECTRIC-. CAS Etc. REQUIRED By LAW WERATE P-MTS R-Q,w- REV F -aft WIRING, WIATMI, PLUMM +ai-No' :stG14'S:. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. 352 CU. FT. 4,224 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 516 5,160 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 $5,800.00 $5.88 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. $37.30 PLAN CHECK FEE TOTALFEE $43.18 SIGN OF CONTRACTOR OR AUTHORIZED T (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT —/ �'l 7f �� 5-2%-7S BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI I ATEI Es APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDI•NG PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: / �Gdl�ir �1 ��',B$�"% BUILDER: tfQ&�7-- lay/leS ADDRESS: % - 70 �� eV ADDRESS: ��®r NO:. STREET • LOT: "% BLOCK: ADDITION: - CORNER LOT: INSIDE LOT: ✓ SETBACK:SIDEYARD: Applicant attach to.this.f.orm Two Certificates of Survey of Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING TooBe Used As: 4F 14u Front : -W Depth: 2 Z Height: ee-, Square Feet: s _ Cubic.Feet: Front: /° G Depth: Square Feet; (o Cubic Feet: 51 (00 Type of Construction: / /fG�l�-�_ —Estimated Cost: $ 5X'3CD To Be Completed: �(%s The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict 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: V12L, S- SIGNATURE: &,�� (See Reverse Side For Additional Information.)' ADO. 9. V 1X ,� ��� �c 3`0 S. fig 1,90 71y �� V 4 Y Land Planning sfkf,�,tlwjo 4875 Highway No. 65 N. E. Land Surveying • • ��/1f Minneftpolis, Soils Testing `' ����1�1�7�7��J��) l • I Minn. 55432 Civil Engineering (/ Telephone 784-6066 Municipal EngineeringEngineers & Surveyors Area Code 612 r- r-- s� T't � '� `` •- t-07 7, /J. This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encrouchm.,nts, if any, from or on said land. This survey is mode only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or uny other interest acquired by the reason of such mor tguge �t is understood and agreed n4 ptonuments have been placed for the purpose of establishing lot lines or boundary corners. Dated this.duy of A' , . A. D. 19 SUBURBAN ENGINEERING, INC. Engineers Surveyors by. . . . a El I ort�ag!e Loan Survey fog %! �ril l �.: TT t o_6j4 3 S` -42"&d P1 67"f'4> a- p� -/C.. X 2215 ' /�� �C-rJ�C �EiR� (3-2�$x�df� — -;l�,X• i�-1.:1f�i.� r'f=r�;-cr rt CrG, ]DO Vi Ed'A I�rPP%s�ooFs 2�Soy/ IG'i�C��F,42 C'E,G✓�%J4%JjS J 6�,� i6•Cct17�,�s wlr� z�CG .174e.,) J xGS) ���ss -aaFr - �GcQ�e SEs oa 4', , dirty �od,n� Csr X_ � �2--► 40 / — — —_ 4. 3:caeo ., 11�13c2 1 4 0 - 24.6 " { 4 kc r- r-- s� T't � '� `` •- t-07 7, /J. This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encrouchm.,nts, if any, from or on said land. This survey is mode only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or uny other interest acquired by the reason of such mor tguge �t is understood and agreed n4 ptonuments have been placed for the purpose of establishing lot lines or boundary corners. Dated this.duy of A' , . A. D. 19 SUBURBAN ENGINEERING, INC. Engineers Surveyors by. . . . a El 01, SUBJECT •. '26 City of Fridley 2 6 412 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. I COMMUNITY DEVELOPMENT DIV./ _ v PROTECTIVE INSPECTION SEC. 1 , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/30/98 JOB ADDRESS 621 58th Avenue 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 8 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE XXXX xx Ty Grainger, 621 58th Ave, Fridley 55432 571-8731 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Warrpn Fidler, 3800 48th A -venue S. Minneapolis 722-9203 20007396 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO - Roofing Specialist 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CK REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (tear -off) 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must meet 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 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 $2,335.20 1.17 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- STRUC ON OR THE PERFORMANCE OF CONSTRUCTION. $74.75 ire SC $2.34 � PLAN CHECK FEE TOT FEE I License 00 $83.26 SIGNATURE OFC TRACTOR R AUTHORIZED AGENT I EI O odroo - -BLV INSP. VALIDA THIS IS YOUR PER r OW OA q SIGNATURE OF OWNER IIF OWNER BUILOERI IDATEI 01, NEW [ l ADDN [ l ALTER [ ] ConstructionAddress : Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 Owner Name & Address: If �{ KS �j ('-R�� Tel. # 5 �% - ��3 Contractor: ilkm MN LICENSE Address: �& 46711 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 1_ %fig- orF Construction Type: ����� o� Estimated Cost: $ `7 7d (Fee Schedule. on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: U fi 2 1l APPLICANT: Tel. STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ , 3 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 6-1 $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 $ 3. STIPULATIONS: Building # BUILDING $ e Permit No.: RW Inspections '7--V RESIDENTIAL APPLICATION $ -(0 Received By: 763-572-3604 $5.00 (State Licensed Residential Contractors) CITY OF FRIDLEY $1550 per SAC Unit (Plans to MWCC for determination) $ QQ 0 $ DATE ®. /Dp . YOUR E-MAIL ADDRESS Fee Determined by Engineering SITE ADDRESS 162.1 — p S8 � /1 L7 $ / THIS APPLICANT IS: ❑ OWNER ACONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: Z ' S CITY S _ IP PHONE: 7J )C7,5/ j CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY //�� ITA_2` WITH APPLICATION PHONE q254 FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDDOWS IJBASEMENT FINISH ❑ ROOF ❑ RAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: l% SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S. Ft. OR OFING 13HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used 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 plans IN EXISTING OPENING es ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -D CRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ru.a. Jvr ZO eucr, DAM,u vIN vA1.uA11v1N, UNULUll11NU THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0SCHEDULE) TOTAL JOB VALUATION $ f 3 aO - P 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 $ Id- 5., - See Back Page for Fee Schedule $ e 65% of Building Permit Fee $`' .001 times the total job valuation $ -(0 .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 payable to: City of Fridlev Attach 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 a permit and 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 which requires rev .ew and ap roval of plans. SIGNATURE OF APPLICANT T NAME DATE— DATE