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PRE 2010 DOCSDate: Owner: Address City of Fridley, Mina. BUILDING PERMIT 7 N 4125 Builder Address ......._..... 071 LOTION OF BUILDING No. _._..._. Street.......... Part Part Lot ........... ..�. __.._..._..__......____ �r , _. Lot ._..!`._��'---...--•----..... Block ....._......... Addition or Sub -Division ..... CornerLot ..... .................... _........ Inside Lot ................................ Setback .............. .... ............. ... ..... Sideyar.....__....._...._..----..._._......._...._...--•----•---...__.. Sewer Elevation ..... ........ _.._.....__...._..__.__....... ..._....... ............................... Foundation Elevation DESCRIPTION OF BUILDING To be Uaed as Front +"* r * *0Cu. k't. _ '_i�' Depth «.��'._+�: �` Height �..`�.�- Sq. Ft. � ..._ . .. _.............._............._......._.............. Front ........ _... -..._.. Depth ....._..--... Height .......... _...... ._.. Sq. Ft. .............. ... ._.. Cu. Ft. ..... - ........... .... Type of Construction ............................................. ............. Eat C6�.. ' .. ...... 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 pr ons of ordinances of the city of Fridley. In consideration of the payment of a fee of $.._r-.:.::_'_.-_-- 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 violation of any of the provisions of said ordinances. _e I 1 0-0 "` 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 hems. * City oFridley, f FidlMinn BUILDING PERMIT N° 412 5 Date: ....._.. .. ._.477..._..__..........._.. 04000, Owner: ..... ..................... ..................................... ......... _........................ ..................... Builder..loddo.4..�......._............. ._.... -...___'.._...... Address............. ........ .... –._... - _ -- -. ._..... ._.. _....._..._.... Address �{'� LOCATION O BUILDING �% No. /.....1 . Street ... 4O..... --•-- . r.. ............... Part o Lot .................. ............._............._............._._ Lot .....117 .... .............. Block ..... _....... .... �....................... Addition or Sub -Division .....-:_..... _ ._... Corner Lot ............................. Inside Lot .)(............................. Setback .......................... ......... .......... Sideyar.... -............. _........................................... ....... _.. Sewer Elevation ..... .............. _............._......._....-..................................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: t u r c. �t •h � ................................_ Front . Depth ®...'47 Height/.._ %.......�J. Sq. Ft. Cu. Ft. *—OVID .... ................................................ _..... Front ........................ Depth .................. Height ........................ Sq. Ft. ...... ................. Cu. Ft....................... CAAP ...._ Type of Construction............................................................ Est. C .... ....... ................... 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 pr ions 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 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 see the Building Inspector for separate permits for these items. (�. APPLICATION -FOR BUILDING PERMIT �f CITY OF FRIDLEY, MIlJNESOTA Owners Builder G s4 L an, Cc NSI lav Address (ai l..... g.+h 6y-- o Z1 �N�A LE ' L , liE sa �' Address � #� LOCATION OF BUILD G / ©' SEki^jA, l- 0USC S f -R -0M S i -DZ' LOJ L/ N C No. (07/-- Street ,�/ Part of Lot Lot Block Addition or Sub.Div.V. Corner Lot Inside Lot Set Back Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach.-tD. this:form,_Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be u d ,asp G �9- .G C' Fronts Depth e9 Height , Sq. Ft. Cu. Ft. y Front Sq. Ft. Cu. Ft. Depth Height Type of Construction r -p -A -M E Estimated Cost To be completed 5.Q -P7- ! 19 Q 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 correct. DATE S SIGNATURE e (A Schedule of Fee costs can be found on the Reverse Side.) 13®D • • City of Fridley, Minn. BUMDING PERMIT N® �72�7�6 Date: '=�— Owner: Builder �� - _... a - Address Address LOCATION OF BUILDING No. Street _ _� d _ Part of Lot Lot _ . __ Block Addition or Sub -Di sion f Corner Lot _ Inside Lot Setback— ideyard Sewer Elevation — — Foundation Elevation DESCRIPTION OF BUILDING To be U f Front Depth ��` Height Sq. Ft. Cu. Ft. Depth,4r Height 0 Sq. Ft. Cu. Ft. Type of Construction ` Est. Cost , i ®To be Completed In consideration of the issuance to me of a permit to construct the building describ d above, I agree to do the proposed work in accordance with the description above set f rth and in pli i,,7b ovisions of ordinances of the city of Fridley. r 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 conditionthat 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 violation of any of the provisions of said ordinances. --% Building Inspector Nonce: 'fids permit does not corer the eonsnnallon, installation for wiring, plumbing, gas boding, sawar or wafer. Be cora to as the &eliding hapeder for separaM permit for thea Name. APPLICATION FOR BUILDING PE -MIT CITY.OF FRIDLEY, MINNESOTA. OWNER'S NAME, = _ BUILDER A-V //A 67®,1751 a hill ADDRESS/ ADDRESS r-5_ W^7 ' LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of.Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: 11','Qe,e 141'11'/';0 ✓ Front Da_.th /1/ Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction, ����� Estimated Cost-'1,6-ee- I" 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 Mepartment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT r,,.i277 � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ` � CITY HALL FRIDLEY 55432 612-571-3450 TN a(o%q NUMBER 910-F15 REV. DATE 11/18/87 PAGE OF APPROVED BY JOB ADDRESS 671 -• 58th Avenue N.E. 1 LEGAL DESCR. LOT NO. 17 BLOCK 4 TRACTOR ADDITION Domay`s Lakeview Manor SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Hyatt 671 - 58th Avenue N.E. 571-0009 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue N.E., Fridley 55432 784-7543 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 11 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED 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 60 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 $2, 850 SURTAX $1.48 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PERMIT FEE $38.50 SAC CHARGE AN CHECK FEE TOTAL FEE $39.9.8 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROP RLY I ATED THIS IS YOUR PER IT IN P �A E SIGNATUREOF OWNERIIF OWNERBUILDERI IDATEIBLDG NEW [ ] City of Fridley ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: �� �� Ave Effective 4/1/86 Legal Description: P�f�- Tel. # % ®oa9 Owner Name & Address: ?T� 7g 3 Contractor • /1t��►��/ Tel . Address: :2q6l Ceo� 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: Corner Lot [ ] Inside Lot Type of Construction: ��A�� 5idriW Ft. Yd. �TR�M Setback Side Yard Setback _ Estimated Cost: $ -5752'�' Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: 2r-0APPLICANT: V Tel. # 7g`%— Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: 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 [ ] 01 SUBJECT City of Fridley 210 2 0 eR AT THE TOP OF THE TWINS BUILDING PERMITECEIPT r COMMUNITY DEVELOPMENT DIV. ______ r 1 L PROTECTIVE INSPECTION SEC. i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910-F15 8/22/91 JOB ADDRESS 671 - 58th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 Domay 1s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dale Hyatt 671 - 58th.Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Ave NE 784-7543 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 j] REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof House (16 Squares) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING, SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $832 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $23 • 00 Fire SC 5.83 STRUCTI NOR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 24.33 ,tIGM0bR110FC TRACTORORAUTHORIZEDAGENT IDATEI WHE PROPE LY ID TED IS IS Y P IT - h ' INSP GATE SiGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 01 N [ ] Effective 8/16/90 ADEN [ ] R-1 AND R-2 ALTER [ ] / Building Permit A pplication Construction Address: 6-71 Mt. legal Description: Owner Name & Address: Tl Tel. #%���®9 Contractor: Tel. #-- 7 1; -�f,3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF Ilm{yV mw LIVIM AREA: Length Width Height Sq. Ft. QsMM AREA: length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. O7SM: Corner Lot [ ] Inside Tot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: C Siti��c Amse ,Qmro7�' Estimated cost: $ �� Approx. Completion Date:/� `� ft lexisi`iAP /yds Proposed Driveway Width If New Opening Is Desired: Ft. $ $. Width + 6' See Back Page DATE: !`20 ql APPLICANT: Tel. # Permit Fee Fire Surcharge $ State Surcharge $ SZ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main charge $ TOTAL $ 33 CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 3/1192 3 f Construction Address: & % / 5 -7/f Ay ., C, /Y E--, Legal Description: Owner Name & Address: L E �. y�j jL "% ! 7 1 -,MH 11� Tel. # 7 d 4 Q 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 IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ (cost on Back) Driveway Curb Cut Width Needed: -3 Ft. + Ft = Ft x $ _ $ PLI # DATE: APPLICANT: Tel. C � CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: 11, sUBJECT PER City of Fridley 2 9 9 3 2 A7 THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. A r PROTECTIVE INSPECTION SEC. �59 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 7/26/99 JOB ADDRESS 671 58th Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 1 Donna 1 s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr & Mrs Hatt 1-0009 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Patio Enclosures Inc. 2 6S1_6S1_1100 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 tic ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Construct a 91 x 201 addition 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan WARN119 Bdure digging call for all utility locations 454.OW2 RQUIR.ELI - BY LAW SEPARATE PERMITS ARE REOUIREO 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 1 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 11,000 cp5.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC C RGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- :T STRUCTION OR THE PE MANCE OF CONSTRUCTION 195.25 Fir$11.00 PLAN CHECK F ETOT L EE Lice e C • 6.75 IGNATURE OF CON' TOR OR AUTHORIZED AGENT IOATEI HE P O Y VALID YOUR PE IT 0/9 TISI S,GNATURE OF OWNEROF OWNER BUILDERS tOATEi -gr G �NSo pArE 11, NEW [ ] Effective 1/l/99 ADDN CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: hIP¢A jjs yy�ff_ (o -y flim. „c�.� Tel. # &iz-57/-600? Contractor: Pa -he) c lv sze e-�s, �. MN LICENSE # Address: 13r, 1o, Tel. # (off [ -(031-1100 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: LengthWidth �D , Height 'q Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:(, rp— Estimated Cost: $ 11, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: - Tel. # 6rl-4111146 TOTAL STIPULATIONS: $ 4,7 /G, 23- 11 CITY USE ONLY Permit Fee $ /9.'5.&��Fee Schedule on Reverse Side Fire Surcharge $ /-/, DO .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ �� $1050 per SAC Unit License Surcharge $ x!570 !J $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: $ 4,7 /G, 23- 11 ti SUBJECT - P ` 'NO:""�`� City of Fridley 3 2 l 7 AT THE TOP OF THE TWINS BUILDING PERMIT t ______ COMMUNITY DEVELOPMENT DIV. v INSPECTION SEC. RECEIPT NO. � r � � PROTECTIVE I � i '11"'1;. CITY HALL FRIDLEY 5 432 NUMBER REV DATE PAGE OF APPROVED BY __-•� 1 612-571-3450 910415 9/20/01 JOB ADDRESS 671 58 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 Donnay' s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Dale Hyatt 671 58 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Professional Garage PO Box 163, Champlin, MN 55316 763-427-4565 2460 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 j0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Add Garage roof supports, new siding and new garage door 9 CHANGE OF USE FROM TO STIPULATIONS 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 1 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OFArPY0THER ATE R LOCAL LAW REGULATING CON- Fire SC $6.00 $TRUCTION T E PE RFO NC OF CONSTRUCTION $125.25 PLAN CHECK FEE TO I FEE -" Licens $5.00 39.25 SIGN URE OF C( (DATE- NEN ROPuATID.THIS 1SXo8yR P RMIT I _ S-GNAivaE OF OW NEp qF OWNER BUILDER, IOATW .. BLD INSP gAtE ti NEW [ l Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5�3 7W Z�t ,c% Legal Description: Owner Name & b Contractor: ZW U /fly S7S_3W6 Attach to this application, lot, with the proposed con Tel. # MN LICENSE # ') S/�oCO Tel. # 7(n yd, 9 ysz�� G� or— Certificate of Survey of the Coo- Z _ �S -C _ate uction 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: !LE/{f /-S - '400 eY,w4­1 SiOr�6 - .Ecu C�its�-tom �ao� Construction Type: Estimated Cost: $e7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: f 2p o _ APPLICANT:4Tel. # t7l CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ /02S —"21-7 Fee Schedule on Reverse Side Fire Surcharge $ , d® .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ S_-66 $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 z - STIPULATIONS: Building PLUMBING Permit N'0 - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY mate Rec'd: DATE / YOUR E-MAIL ADDRESS SITE ADDRESS 1400- AIE- THIS APPLICANT IS: ❑ OWNER (CONTRACTOR PROPERTY NAME: CITY STATEP 55 ADDRESS:P� ; OWNER/ TENANT i PHONE: CONTRACTOR NAME: ' 3 STATE LICENSE #EXP DATE y P. PI�EWAF�ICS r An 3670 DODD ROAPATE ZIP �1 SUBMIT A COPY OF YOUR STATE ADDRESS: CITY EAGM, MN 55123 LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE KSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 11 NEW KREPLACEMENT DETAILED DESCRIPTION OF WORK I PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the iimprovement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINKILAV DRAINS _ SHOWER _ WATER PIPING _ _FLOOR BATHTUB PIPING (xEw cm'uCEn� _ SWIMMING POOL _WATER SOFTNER ($35) _ —GAS _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER _ PROJECTS FOT , iJL�ID��L PERMI7Penrm it Fee $ oc� Number of fixtures @ $10.00 x $10.00 = $ har a .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ 35- .50 State Surcharge = $ .50 Total = $ 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 ork whic uires d approval of plans. 1/ PP P 4 I�S�r�ATE PRINT NAME approved plan in the case ofDTE SIGNATURE OF APPLIC PLEASE NOTE.. _sF�RF City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 35 So C�t"