PRE 2010 DOCSBUILDING PERMIT
Village of
Dater+'d"Ir..........................
Owner
Fridley, Minn. No 2067
Builder .r,- ..2:.:(- :.........................
Address ..r°�,l" . " ' .4ftw.. ........... Address .........................................
LOCATION OF BUILDING
No. .... Street W ejR ....... Part of Lot .......................
Lot ......... Block ............. Addition or Sub -Division
Corner Lot ....; ....... Inside Lot ....... Setback �. Sideyard . *',40w ..............
�'
DESCRIPTION OF BUILDING
To be Used as:,
Front q... Depth :.. Height .........
.. Front4R/ .9 Depth/,*57-. Height .........
Type of Construction ��.-.. ....�.... Est. Cost ...�;;fe � ..�":°........
Sq. Ft......... Cu. Ft. ........
Sq. Ft......... Cu. Ft. ........
To be Completed.-/ .. '
rte...■����� �`� �� � 'f
.
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.
In consideration of the payment of a fee of $... permit is hereby granted to4�).,�,
,�to construct the buildingaddition as described above. This mi�iar*ted upon
•?h Qrens"eon 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.
d f^
Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
0
SUBJECT
City of Fridley
12942
THE TOP OF THE TWINS
BUILDING PERMIT
fP
rAT
C O.
•
I Ly ------COMMUNITY DEVELOPMENT DIV.
�
1 � � PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
5/13/75
JOB ADDRESS 754-58th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
6
Donnay's Moore Lake Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Donald Wodmark 754-58th Avenue 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 ❑ ADDITION C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Finishing an unfinished room by enclosing and removing walls
9 CHANGE OF USE FROM TO
STIPULATIONS =2 - Provide frost footings and fire wall between garage and
living area
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,200
.60
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.
7.20
PLAN CHECK FEE
TOTAL FEE
$7.80
i SIGNATUREOFCONT, AC OR ITHORFDAGENI (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
,\
SIGNATURE ON N R ILDERI IDATEI
BLDG INSP ATE
APPLICA'T'ION FOR RESIDENTIAL., ALTERATION,
OR ADDITION.BUILDLNG PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME• f U-LDER:
ADDRESS: ��^ � A( - / ( E ADDRESS:
NO:. STREET:
LOT: BLOCK:
CORNER LOT: INSIDE LOT: 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:
F -P -V-A LC cr Punk Front : to Depth : i Height: 1Z
Type of Construc
To Be Completed:
Square Feet: Cubic -Feet: 16o a
Front: Depth: Height:
Square Feet:f Cubic Feet:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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: �� l S
(See Reverse Side For Additional Information.)'
i
SUBJECT
'
City of Fridley
dPE
3 21 1<
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
•
572 3304
-6-Yr
'5 071
�
NUMBER
REV
DATEPAGE
OF
APPROVED By
� CITY HALL FRIDLEY 55432
L „ 612-571-3450
910-F15
9/10/01
JOB ADDRESS 754 58 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
5
6
Donnay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Ron Dufresne 754 58 Avenue NE
763-586-0919
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
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION LR REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED 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 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
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
$3,001
$1.50
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 OR LOCAL LAW REGULATING CON.
$97.25
Fire SC $3.00
STRUCTION OR WFORMANCE OF CONSTRUCTION
TH
PLAN CHECK
TOTAL E
Jf
/1
$1 .75
OF N'R TOR ORAUTHORiZEDAGENi DAT i
EN PR PE L IDATE T IS IS Y
'7MITVNATUR
ATUR O O W BUR - DAT i
BLDG IASP IFpArE
i
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: '7��/ 5 �%f %�V .4J,9 -
Legal Description:
Owner Name & Address: R®A1 Tet. #7.13-S���-®gZ 5!
Contractor: 0'tjts6K- MN LICENSE #
Address:-S✓qy"4y- Tet. #
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 t.
, idth Hgt/Ground Sq. F
OTHER: �CL`� �t�®F^ L7 � 0" �i�M� -.2 4
��� —oc�
Construction Type:
Estimated Cost: $
Driveway Curb Cut Width Needed:
F 6 Ft =,,�
Ft x $ -=$-
o
DATE: 91.-16-0j
CITY USE ONLY -
Permit Fee -
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Tel. # M� -OW
Call (763) 572-3604 for Permit Fees if mailing in application
$ , �� Fee Schedule on Reverse Side
$ - O_O .001 of Permit Valuation (1/10th%)
$ /, _S O $.50/$1,000 Valuation
$ $1150 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 [ ]
$
SUBJECT
NO:- -.
City of Fridley
33921
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r 1
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L „ 763-571-3450
910-F15
9/29/03
JOB ADDRESS 754 58 Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
6
Donnay`s Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ronald Dufresne 754 58 Avenue NE
763-586-0919
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
Reside
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside house & garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires
that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions for this provision would be if sheathing is
an approved weatherproof
panel or when the siding is an approved weather barrier. Vinyl siding is not
a weatherproof covering unless the manufacturer states this in their application
guidelines. Call for inspection of wrap before covering or take pictures. Caulk
and flash all exterior openings.
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
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
$4,000
$2.00
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 HER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TH PE FORMANCE OF CONSTRUCTION
PLAN CHECK F
TAL FEE
$103.25
F NT ACTOPORAUTHORIZEDAGENT IDAT
HE P
RLY VALI ATED THIS IS YOU PERMI
AATU
of 1�2
B OG INS
�lA
DTURE OF NERirt OW NER BUILOERI IDATEI
NEW [ [ CITY OF FRIDLEY Effective 1/1/2003
ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 5724604 Bldg Insp
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fax
J ` BUILDING PERMIT APPLICATION
Construction Address: �5 - /C /T"V� L
Legal Description:
Owner Name & Address: 1?,b&A —,O b0����
�!-Tel. #�l
Contractor. nkJit/� 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:L—��
Construction Type:
'���yL S'�>yi�cliy Estimated Cost: $ /V®oo- o®
Driveway Curb Cut Width Needed: F . + 6 Ft
DATE: APPLICAN)mailing
Call (763) 52-3604 for Permit Fees if i p
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $ 1613 = ���
Tel.
lication. Fax to 763-571-1287 if using credit card and we will
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [