PRE 2010 DOCS•
City of Fridley, Minn.
BUILDING PERMIT N® 6872
Date:
Owner: Builder r — ---
Address Address
S v�1 O TIONOF BUILDING
/
No. ®Street R .CL t—_ Part o t
Lot ._._:� Block Addition or Sub -Division . �` �
j fl
Corner Lot _ Inside Lot ____ Setback 1:5 ��_ Sideyard —
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
T U _
' Front Depth Height ._ Sq. Ft. Z� Cu. Ft al&a)
t 1� Depth ,�Height Sq. Ft. Cu. Ft.
Type of nstructio Fit Cost�� _ 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. _ . A �
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 %m/_W tion of any of the provisions of said
ordinances.i61 / I
Building Inspector
• NOTICE.
ti'his permit don not corer the construction, haNaMen for wMng, plumbing, gn heating, sewer or water. Be wra to see
tiro Building Inspector for separaM permits for than ft"M
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS r 2 �?& ADDRE8I ,
LOCATION OF BUILDING
No. Street—&/.IL.4 4eit, of Lot
Lot Block_ Addition or Subdivision ��'� �
Corner Lot Inside Lot Setback j7 Side Yard
SEWER ELEVATION ���`� p �� N ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Sq. Ft. j/- e- Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost %!'wed
T
To be Completed _T �j e2 i
or
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_C, s ,__ �S SIGXATURE
(Schedule of Fee Costs can be found on the Reverse Side).
i
Application for Power Plants and Healing. Cooling. Ventilation. ReMgeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU .....:...... 8.00 $— '
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ r-
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ �•
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
$
See Fee Schedule
TOTAL FEE
JI
Dept. of Bldgs. Phone SII 4-74�_ �—
Location 5 TN 4 U E >tJ Ca
City of Fridley:
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 representations stated in this application are true and correct.
Fridley, Minn_ _J 02 19 Ly
Owner L.ANGLEy 7501 L0C-r2i it -AG.
Kind of Building '=' ir-- rA e7l
Used as D GI -1 4E7 Z_ I- / eao G
To be completed about
Estimated Cost,
21
Old e_w uilding Permit No. If O4 Permit
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, armWAir No C
Trade Name (Ai ) ; J-1 fir' M _!Za A/ Size No /V / -7 -
Capacity Sq. Ft. E.D.R / Q O� D ® tJ BTU Hp.
Total Connected Load 3 G,; 13 7 Arl'T Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Signed 6 �v
By -57 0 - v
GEO. SEDGWICK HTG. & AIR-CON07CO
.QR&42 2M Business Phone Nom Xenia_
Minneapolis 16, Minn.
(REMARKS—OVER) LI 51611
1VW?1a10A1, fvtiD S rso- vo,,;t-?9
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTIONS MINNEAPOLIS. M
Weatherstrips
A.
Weatherstrips, Construction No. Insulation
Guid
Windows Doors Reference Out. Wall jInt.WalI I Ceiling I Roof Floor Kind How Applied
Yes—No I. Yes—No I9_
F1 Rnnm I I.pnvth e --7 Width 1 -7 Heiaht 0' II Fl I W,gE Room I Length / Width / Height
Windows an
oors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of panne lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
® & }O
3 3 7-
Coef. Btu
Infiltration
Coef. I Btu
Infiltration
Infiltration
13
Glass
Net exp. wall
1�'® 5'0
Exp. wall
7-
Ceiling �, �. /
Net exp. wall
Floor
9'
Int. wall
Net exp. wall
Ceiling
Ceiling
Net exp. wall
/ g1 2
Floor
/
Int. wall
Total Btu.O p
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F1.1 oom I Lenath -1-Z Width // Height Ji'
Windows and cors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of panne lights of crack sq. ft.
2� a Q' /
Sib
51
Coef. Btu
Infiltration
3 y O
Glass
Infiltration
Exp. wall 33
lCoef.1 Btu
Net exp. wall
9P
Int. wall
3 // 7
Ceiling �, �. /
y
Floor
O
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 h Room I Lenath A/ Width q Height le
Windows and Doors—Crackage and Area
Width Height
No. of Dane of pane
No. of Lineal ft. Area
lights of crack sq. it.
6- Se / 6 Z 13 -4ZV—
Z �l� .3
Coef. Btu
Coef.
Btu
Infiltration
3 8
lCoef.1 Btu
Infiltration
Glass
3 // 7
Glass
Exp. wall -1, (a
03
O
Exp. wall
Net exp. wall
Ceiling
Net exp. wall
Int.
Int. wall
/
Int. wall
Ceiling
Ceiling
J/ ie
/
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area "—
Windows
--
Windows and Doors—Craekage and Area
Width Height No. of
No. of pane of pane lights
Lineal ft. I Area
of crack sq. ft.
6- Se / 6 Z 13 -4ZV—
:)6.
Coef. Btu
Coef.
Btu
Infiltration
3 8
Coef. Btu
Infiltration
Glass
3 // 7
Glass
Exp. wall -1, (a
O a
Exp. wall
Net exp. wall
Ceiling
Net exp. wall
Int.
Int. wall
/
Int. wall
Ceiling
Ceiling ® �/
Floor
Floor
Total Btu. I G S - S-/
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
,. FI_I Ae. s rr- Rtiam I Lenath Width / - Height 20'
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights oferack sq. ft.
6- Se / 6 Z 13 -4ZV—
:)6.
Coef. Btu
Coef.
Btu
Infiltration
3 8
f/ 0
Glass
Net exp. wall
Exp. wall -1, (a
Int. wall
Net exp. wall
Ceiling
2 -
Int.
Int. wall
Ceiling
Floor
Total Btu. 16 Z -;P-0
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
f FI.1 jR a 1w Room I Lenath ,,/ Width 6 Height,,?'
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall ,t
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. /
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area --J
Permit Fee $..................••........
r e APPLICATION FOR MECHANICAL WARM AIR HEATING PERMIT
No. P --------•---------------
Dateof issuance....................................................... 196--.... Location ........................................... .......................................
Minneapolis, Minn.,•-------•--•--------••-•--------------------- 196 ......
Inspector of Buildings
The undersigned hereby makes application for a permit for the installation, alteration or repair of
a heating, air conditioning or ventilating system, device or equipment, as herein specified, agreeing to do
all such work in strict accordance with the City Ordinances and rulings of the Department of Inspections
and the specifications set forth in this application as approved and filed in the Department of Inspections.
Owner.........: -------------------- ............... .......... ........------------- . ......... Iddress of Owner ................................ ...............................
Kindof Building.. ----------------------------------------How occunied............................................................................
Work to be started ---------•----•-----------------------------------r 196.----- Work to be completed ......................................... 196......
EstimatedCost$---------•----------------------------------------------------Old — Nezt, Building Permit Xo....................... ......................
DESCRIPTION OF WORK
Note: Insert the word install, add, alter, or repair, according to which is to be done. Under "Remarks," itemize removals, if any, and
alterations to equipment.
................................................ Mechanical Warm Air Heating Plants--Furnaces..----•----------•---•-------.......----------••-••-••-•...........
.Mrake---•-------------•-------...---...--------------------------------
-•--•----•-•----•----•-•-------•-------•Size......................... ....... ---------- - ---.........................
Connectedload -------------------------------------------------------------------------------------------- Capacity --------------------••-----....................................
Air Conditioning System: Summer — Winter — .4ZI rear; ---------------------------------------------------------------------------- -...........
Make......----•-------••------------------------•-•---..........---•--..............-•--•---• -- Capacity -................... _.................. Cfm.................................
•............................................••-.....•--------------•------•----•------•--•........... -••--••---•........•--•---••------••-........•-----•------•-----•-•-•....-••--•----•-----------------
Vrntilating System: Make ------------------------------------------------------------------ Capacity -----•-•-------...------•..... Cfm...............................
............................................................................................................................................................................................................
Remarks: ---------------------------------------------------------------------------------- --•---------------........-------.....-•---------------------------------------------...............
... --........ _............................... •-----•----••--••---••-..........----•••••------------.-------------...----•--•-------•---•----•-----------------....--•--•--•----•---....--•-------•--
.............. ....................................................................................... -----••---------------...----••---•-•-------•---•....-----•---•--•-------------•-•----- .............
.....--•------•---------••.....................•--------.....-------•---.....................----•-•--••-------...--•----•--...--•------•--....--------••--....---•......-•---•--: --•-...............•-----
Signed..-------•-•----------------------------------------------------------------------------
By---------------------•----------............---•---•------------------------------------
.4pproved----•------------------------•------------------------------------- 196.......4ddress--------------------------------------------- ----------------------------
---------•-.....---•----------••----------------•--------------------••---........-•••-----------..... Telephone --------------------------------------------------------------------
Inspector.
D-20 a a
City of Fridley
Apprication for Plumbing and Gas Fitting Femdt
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK -
Number, Kind and Location of Fixtures
Gl
rcQg�
3.25
$
2Y!
...... x
xy
Zti
'�
pz
3.25
$
GAS FITTING FEES:
i
•
R
•
N
WATER HTR.
GAS
ELEC.
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
aTut
O
Base
1st
2nd
_
3rd
_
4th
• Future Connection Openings
onnected with
CSewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU)
...... x
2.00
$
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$-,/
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description .............................................$
TOTAL FEE y�
City of Fridley:
,..e_ /
Z'
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 representations stated in this application are true and correct. ` /
Fridley, Minn. �. ' -p-9`'t 1
Owner
Kind of Building
Used as��-C'
To be completed about
Estimated Cost, $ G
Old—New. Building Permit No 0 mit No.
e-, Signe
BusinessP one
ROUGH
FINAL
42 2tA 7-59
q
City of Fridley a
Application for Plumbing and Gas luting Permit
DESCRIPTION OF WORK
Dept. of Bldgs. Phone 560-3450
� J?` 1; /z
on
Number. Kind and Location of Fixtures LocaZ
II
Q
m
Z 2rK�
ZZ
g Z a" Z W n W
WATER HTR.
R N GAS ELEC.
0 0
rn
Base
1st
2nd
3rd
4th
_
• Future Connection Openings
Connected with
Sewer
I
* New Fixture. Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
:L. 00
Number Fixtures ..................... x $i 3tr $ o o
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... ..................... x 3.25 $
Water Heater (Up to 200,000 BTU) ......
New Ground Run Old Bldg . ............
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
x 2.00 $ -
x 3.25 $
NO. RATE TOTAL
x $1.50 $
x .50 $
x 2.00 $
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley Minn C-l� iii-' 19
Owner 61 ✓!
Kind of Building
Used as .
To be completed about
Estimated Cost, $
Old—Now. Building Permit No Permit No.
Signe 'f_ Z%
By C. ._cam %(° .�iC.(�G^.",
Business Phone No. a a - .3 f!
ROUGH
FINAL
Description ................................................$
TOTAL FEE $__$�/� az
SUBJECT
City of Fridley
o -1702
AT THE TOP OF THE TWINS
g U I L D I N G P E R M I T
r
CEIPT N
L
L __ ___ COMMUNITY DEVELOPMENT DIV.
INSPECTION
9
r PROTECTIVE SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
;,� CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
6/29/83
JOB ADDRESS 1521 - 60th Avenue N. E.
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
�
Larry's First Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ronald Wng 1521 - 60th Avenue N.E. 571-8437
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Donald Justen Roofing, Box 113, Star Route Isle 612-684-2854
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
x
8 DESCRIBE WORK
Reroof Structure
9 CHANGE OF USE FROM TO
-STIPULATIONS
M52as Roof can be the 2nd layer but not the 3rd. Install ridged
galvanized valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Fiberglass
VENTILATING OR AIR CONDITIONING.
g
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
$1,000
$•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
ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$� 7.50
PLAN CHECK FEE
TOTALFEE
$18.00
SIGNATURE OF CONTRACT UTHORI2 AGENT IDATEI
WHEN PROPERLY V&LIDATED T IS IS YOUR PERMIT
+ C
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
BLDG INSP GATE
CITY OF FRIDLEY
APPLICATIM FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations*, Additions, or Repairs)
OWNER:
BUILDER:
ADDRESS: Loi ADDRESS:
TEL NO: S 7 i L 3 7 TEL 110: �a1
Construction Location
STREET NO: STREET: '. C) H P"<- J' / ��
LOT: BLOCK: ADDITION:
Effective Aug. 1, 1981
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CON'STMI CTION
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: (l bepth: Height:
Square Feet: Cubic Feet:
Type of Construction:
Tb Be Oor,ipleted: &UA(L
i
Proposed Driveway width If New Opening Is Desired:
Estimated Cost: S '/ d 6 a
Alt. A Alt. B
$ S
SEE P.P.vF.RSE SIDE OF SHEET .
lbe undersigned hereby makes application for a permit for the %:.,ork herein specified,
agreeing to do.all work in strict accordance with the City of rridley 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.
ANTE: -9-
� SIGNATUF.t: J^��
Stimulations:
01
suaJEcr
PE
City of Fridley
-5
AT THE TOP OF THE TWINS
BUILDING
PERMIT
13815-1 � � �
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
1 L PROTECTIVE INSPECTION SEC.
0
r
1 �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BV
1.' 612-571-3450
910-F15
10/17/95
JOB ADDRESS 1521 60 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
1
1 Larry's First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Kristie Duchenes 1521 60 Avenue NE
572-3848
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Panelcraft of MN Inc 3118 Snelling Ave S
M ls. MN
55406
721-6628 2179
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 KI REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside Dwelling; Install storm door
9 CHANGE OF USE FROM
TO
STIPULATIONS
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
1
STALLS
I 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
$lO,000
$S.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
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$182.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPER VALI ATED THIS IS YOUR PERMIT
r
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
Bl INSP
gaTE
01
NEW [ ) Effective 1/ 1/95
ADDN (J CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: i (1 1/�/'7r r'
N �:3cl s�),
Legal Description:
lhri S i C, 12xt 0,hC1-)C-S Tel. # � � - '�
Owner Name & Address: /50) -1222 ` . A- /-0 �/� -moi o11 _
Contractor: Mra r4 0 lel ! ry) sod MN LICENSE # ( QQ-:;� / cl
Address:3/ /� ) /� �n� 1�� Sa °'��/ It 9% I ��LX� Tel. # 119 l�)
?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: Std 1,0 Sfor- '1 dDOr"
Comer Lot [ J Inside Lot ( J Ft. Yd Setback
Type of Construction: j8(Q00(
Approx. Completion Date: �O a
(Cost on
Side Yard Setbacks
Estimated Cost:
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
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.50/$1,00 Valuation
$850 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Sewer Main. Charge $ Agreement Necessary [ J Not Necessary
IY2, 2 i"
TOTAL $
STIPULATIONS:
SUBJECT
City of Fridley
29335
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
SEC.`%��
r PROTECTIVE INSPECTION
1
`�
----1 � CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED By
t"""11•, 612-571-3450
910415
4/28/99
1013 ADDRESS 1521 60 AVENUE NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
1
1 LARRY'S FIRST ADDITION
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kris Duchenes 1521 60 Avenue NE
572-3848
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Tabor & Sons Inc 10547 Terrace Rd, Blaine, MN 55434 789-1902 20014248
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
S ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION? REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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 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
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
$12885
$.94
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-
Fire SC $1.88
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$59.50
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$67.32
SIGNA�C NTRAC TOA OR A�NOR ENT iOAiE�
N PROPER VALIDATED THIS
WHEN IS YOUR PERMIT
Bl G INSo
1 K^2
PATE
SIGNATURE OF OWNEROF OWNER BUILDERI IOATEI
NEW [ ] Effective 1 / 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: % / C �� , �� . `LI r7'
Legal Description:
Owner Name & Address: n.," V.ZCe-jC-C Tel. # ,6
Contractor:MN LICENSE #
Address: I oS iI7 , y 1['� 22,� Tel. # 2F2 -1205 -
Attach
F2e/2o5-
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:
2,
Construction Type: ( �.,, i � � Estimated Cost: $ z 00 c—
(Fee Schedule on Back)
.Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: �!– , Z 7 APPLICANT: 4L - v Tel. # 78 C - /gg J
Permit Fee
$ 7 ''
Fire Surcharge
$ g
State Surcharge
$ s _
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ �' > 2
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]