PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N° 4 5 6 4
Date: .. ._.�`• • _ _ _ �..___.__
oe
Owner: .:...._ C.. _...._.:. .. Builder _ �".... _......_.._.. _�! _.__...._
Address ------ x _' _ ! Address __.
TION OF BUILDING
No.. .--( ._.. Street _: _.. _. it /--;-............. ....... _ Parfqof Lot _......
iLot .-..,."`,?............... _... .:... Block ............. ----_...._..._....��Addition or Sub -Division . �' ,�
Corner Lot ..................... ............. Inside Lot ....._....... ..._................. Setback ..... _............. _............. _........ Sideyar --........._.......... - - .._..
r
Sewer Elevation....._..........................._.._..._...._............._............................_........ Foundation Elevation
DESCRIPTION OF BUILDING
To be
_.___... ......0 -.... -U?... Front 1 .._.. Depth ..: ._-. Height .... --- Sq. Ft. ji- Cu. F t.....+�t
...... t ..... ............. _.. Depth ....- ..._.. Height ....., Sq. Ft. ----- ............ Cu. Ft. .... .................
of Construction .:..°� '° ,C�'�:9........ Est. Co f.... ..:. . To be Com
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 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
within the city limits and this permit may be revoked at any time upon violati. any of the provisions of said
OPdiIIaIICeS.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, KMNESOTL
Owners Name
Address
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block Addition or Sub.Div.
Corner Lot Inside Lot Set Back
Side -Yard
SEM ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location..
DESCRIPTION OF BUILDING
To be used as:
__.__..._...Font J. ._Depth Height
Sq. Ft. Cu. Ft,
Front Depth Height
Sq. Ft. Cu. Ftp
Type of Construction �'c Estimated Cost/
To be completed ----err
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 representa-
tions stated in this application are true and c.rrect.
DATE /` IGY l et �C SIGNATURE .,
(A Schedule of Fee costs can be found on the Reverse Side.)
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SUBJECTIT
NO.
City of Fridley
2 9775
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
��
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REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432NUMPER
612-571-3450
9tQ-F15
6/25/99
JOB ADDRESS 660 58th Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
7
1 Donna I s Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Beverly Pfeifer
572-2282
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 O ADDITION O ALTERATION X® REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garage (23 S) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
$2010
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1.01
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$83.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire SC $2.01
PLAN CHECK FEE
TOTALFEE
$86.27
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
��ATi
$GN4T E OF 0W iIi NEA BUILDEAi IDATEI
BLD -NSP
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRWLEY
ALTER [ ] SINGLE FANDLY AND DUPLEXES R-1 AND R-2
BUII,DING PERMIT APPLICATION
Construction Address:(�Q
Legal Description:
Owner Name & Address: ��lu ��P, hnrr.S�rr►® ia5 e�on tr,4 Tel. # Ll�la�
Contractor: e/"" 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 IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: /7p/, rZU Estimated Cost: $_ 91D,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: %/�,g APPLICANT: Tel. #61-7
CITY USE ONLY
Permit Fee
$ ., rj—
Fee Schedule on Reverse Side
Fire Surcharge
$ -0-2.61
.001 of Permit Valuation (1/10th%)
State Surcharge
$ G/
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
$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
STIPULATIONS:
$ t.�