PRE 2010 DOCSVillage of Fridley, Minn.
BUILDING PERMIT
Date:i�. l.... ............ .
Owner.......................................
Address......................................
1867
BuilderW.
G;
Address . � . B�.. �'..``i
LOC IOI� OF BUILDING
No. ..... Street ... �� . �' :�� . ............ ........... Part of Lot
Block ... � .�............. Addition or Sub -Division .. , ............... .
Corner Lot ........... Inside Lot .... Setback ... x Sideyard :,.........
DESCRIPTION OF BUILDING
To be Used as:
3t ...... Front . a'+� . Depth Height Sq. Ft. ........ Cu. Ft. ........
..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
Type of Construction ...... Est. 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 village of Fridley.
....................... ...��. .
In consideration of the payment of a fee of $.42 ....... permit is hereby granted to x. �:"� . ��.
......................... 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
/te
Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
illage limits and this permit may be revoked at, ":ytime upon 'ation of any of the provisions of said
ces.
..... ........................ Building 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.
City of Fridley, Minn.
BUILDING PERMIT N° 45s
Date:
Owner: '`
_..� �.._.....%-_....
Address Address _ ...:.......� -?�
_. ._...._� o_.._._
J-140
� ��,; O TI N�OOF BUILDING
No. .ca�....�!-.�„�'......_ Street .._. ............. _.............. Part of Lot._._......._._._.__._..._.._..__._......._...._........_.__..
Lot............................._ ... Block ....._...... ........................ Addition or Sub -Division ,....._............. _.... ,...,..,................ _.......... u ..... _..................... -•- .... ......
Corner Lot .......................... ......... Inside Lot ..... _....... :........................ Setback ....._............._............----... ... Sideyard
Sewer Elevation ..... .............................. ............._............._......._........---.................. Foundation Elevation . ...............
DESCRIPTION OF BUILDING
To, ed c % Height _- Depth Sq. Ft.
Front / c�!�..... ...,/�..f !...... � , �-" Ca Ft.
- ..........._. _......._............. Front .............. ....._.. Depth.-.-............. Height ................... Sq. Ft. ....._............. ... Cu. Ft. ... _..................
k
Type of Construction ... c :. y� y........ Est. Co ...�..- .5 -- ----------- ----- 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 $1.3._:..._........_._------- 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, re� and moving of buildings
within the city limits and this permit may be revoked at any time upon violation oYl any of the provisions of said
ordinances. � i P /
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.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder
Address ��� ,r "L y �� Address�
LOCATION OF BUILDING
No. Street Pert of Lot
Lot ]lock Addition or Sub.Divi,
Corner Lot Inside,Lot .Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front Depth J Height (®.
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction a'- Estimated Cos & %�®, #c'
To be completed
The undersigned hereby makes application fora 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.
STamnum 4�i
(A Schedule of Fee costs can be found on the Reverse Side.)
- .1 - 0 -*--* I-
gat. VALWICU
._...... _..... _........... _ ......._....... ... ..........._ ......... ..,_ .� ._...........
s
Sak1 04 14®vE.6.
re::,..+ r 0 ST ® 0P.,
s r ate'
or- SToo Ps
SRO INC
/T L
®• iqi � b'P � �� !� a
'► C3 F F �" a /t. � jj
.�'VL *�poeooas
Hous:
-------- -------- --' .............. ..... ............
y
• f
I
4.
1�
SUBJECT
R°
City of Fridley
1463
THE TOP OF THE TWINS
PERMIT
i
BUILDING
Ir?AT
�
• COMMUNITY DEVELOPMENT DIV.
�y-------�
r � � PROTECTIVE INSPECTION SEC.
1 �
�
1 ''1 CITY HALL FRIDLEY 55432
�•-'• ,'J
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-560-3450
910-F15
4/12/78
JOB ADDRESS 270 - 61st Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1, 2,3
6
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Joe Hensen 270 - 61st Avenue N.E.
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Renewal Service, Inc. 1900 Hennepin, Suite "A"
874-8004
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
%
8 DESCRIBE WORK
Reside dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Steel
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 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,
$3,800
$1,90
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 -ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$24.00
STRU THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
/1(
$25.90
SI ATU CONTRACTOR OR AUTHORIZED AGENT )DAT
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
DL
BLDG INSP
" 7 'fie _ )A
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
1�
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PEWTS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: 'j -O F W—e N S E � BUILDER: 1` EitI EW L
o .
Address: 17 o Si'
�/ _
. � � JE . /�/� t• Address: 1 cj .d V �'i1/'.y 6'r/J/ MJ
Tel. No.: C) C)
No.: Street:
.LOT: I �f BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
Front: Depth: Height: _
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: �i�� Estimated Cost: $ 3
To Be Completed: 'YIz o la
—.If t Alt. A Alt. B
Proposed Driveway Widtth If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET).
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. See reverse side for itional information.
DATE: y 7 SIGNATURE:
Stipulations:
4, 0-0
qU
41 CITY OF FRIDLEY Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDE1�iTIAL ` RATE TOTALJob Address
�v - � /=�'� /Ile
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $
20.00
$
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping $
10.00
$� —
Tel. #571-3450
(piping needed with new furnace)
Gas Range $
10.00
$
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
Gas Dryer $
10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
* Air Conditioning (all sizes) $
10.00
$/B.C�
Fridley, Minn. cl , -5 19 ��
�
/
All Others/Repairs and Alterations
OWNER In
1% of Value of Appliance or Work
$
KIND OF BUILDING � %�4W
I 0/1
COMMERCIAL/INDUSTRIAL
USED AS 4/GC -e
- �U
1% of Value of Appliance or Work
$
TO BE COMPLETED ABOUT Uy
ESTIMATED COST
State Surcharge
$ .50
TOTAL FEE
$-dL SG1
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
.
Reinspection Fee ($15.00)
$
DESCRIPTION OF FURNACE/BURNER
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
HEATING or POWER
``PLANTS,
/Steam, Hot Water, Warm Air-
No.
J� ^�
Trade Name , L(v"��/ Size No. � Ys'
Capacity pV )(D) Sq. Ft. EDR BTU = HP 12�—
Total Connected Wad 1Zp�,(l�l'Oi'1i0_iiL� Kind of Fuel 44,1 X
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company IQQNhe, .-Y Lhed 11140/
Signed By kjlx1e�
I aAaL
Tel. No. <1/ -p2%7�
Fill out back side for stack verification on replacement furnaces
r
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes
2. Is free from rust or deterioration Yes
3. Has no foreign objects lodged within Yes C
4. Is securely supported Yes ( ;
5. Meets all current Code requirements for size and
total BTU connected Yes ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company _
Signed By
Date
No ( )
No ( )
No ( )
No ( )
No ( )
I hereby give John Henson, 270 -61st Ave NE, Fridley, the
neighbor to my west, permission to install a central air
conditioning unit on the east side of his house.
Name
�3 - -
Date
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
Effective Date May 1, 1988
Job Address —a? ?® C® is { - A U,�F. A'S
Department of Buildings
City of Fridley
Tel. 1571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated In this application are true and correct
J Fridley: Mn. 4.1. , 19 6?
OWNER /
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
RATE SCHEDULE
UeN
Water
0
9
44y
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
�°•
a
e
5.00
e
b w
w
w
$
3.50
Heater
N
Old Opening, New Fixture
$
1.50
$
Signed By
l
Beer Dispenser
$
u
ep
�
1q
Blow Off Basin
$
5.00$
Tel. No. 2
X54/0
U
D
a�
$
q
w
H
w
8A
Al"
c�
Hydraulic valveROUGH
$
o
a
lac
Sump or Receiving Tank
$
5.00
Data
Water Treating Appliance
$
7.00
$
FINAL INSP. �` �✓
Hot Water Beater
5.00
/
let
$
$
Dat
Gas Range
$
10.00
$
Gas Dryer
$ 10.00
$
APPROVAL FOR PERNIT
2nd
(
)
Type
$
S.00
S
`
ALL OTHAS AND/OR REPAIRS AND ALTERATIONS
3rd
$
MINIMUM FEE FOR ANY PLUMBING PERMIT
IS $15.00
PLUS THE $.50 STATE SURCHARGE
Reinspection Fro $ State Surcharge
.
$ .50
($15.00) TOTAL
4th
'
$ ��
(R) - Future Connection Opening
Connected with Sewer
(') - New Fixture, Old Opening
Water
Effective Date May 1, 1988
Job Address —a? ?® C® is { - A U,�F. A'S
Department of Buildings
City of Fridley
Tel. 1571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated In this application are true and correct
J Fridley: Mn. 4.1. , 19 6?
OWNER /
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
RATE SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES: N0.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERNIT NO. ID
New Fixturer
$
5.00
- o d
Future Fixtures
$
3.50
$
Company /'/'A'Z-
Old Opening, New Fixture
$
1.50
$
Signed By
l
Beer Dispenser
$
4.00
S
Blow Off Basin
$
5.00$
Tel. No. 2
X54/0
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic valveROUGH
$
5.00
$
INSP.
Sump or Receiving Tank
$
5.00
Data
Water Treating Appliance
$
7.00
$
FINAL INSP. �` �✓
Hot Water Beater
5.00
/
$
$
Dat
Gas Range
$
10.00
$
Gas Dryer
$ 10.00
$
APPROVAL FOR PERNIT
Back Flow Preventer Required. Yea ( ) No
(
)
Type
$
S.00
S
`
ALL OTHAS AND/OR REPAIRS AND ALTERATIONS
1t of Value of Fixture or Appliance
$
MINIMUM FEE FOR ANY PLUMBING PERMIT
IS $15.00
PLUS THE $.50 STATE SURCHARGE
Reinspection Fro $ State Surcharge
.
$ .50
($15.00) TOTAL
FEE
$ ��
SUBJECT
PE
City of Fridley
-69
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
I.0 .......
INSPECTION SEC.
�}
r PROTECTIVE
11 CITY CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
6/28/89
JOB ADDRESS 270 - 61st Avenue N.E.
1 LEGAL
LOT NO.BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
W, 1, 2r3
6
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Henson 270 - 61st Avenue N.E. 572-0201
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Murphy Bros. Building & Remodeling Co. 1337 Gardena Avenue, Fridley 571-9629
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 Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Alter basement bathroom
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide fire alarms on both levels of dwelling. Provide combustion air.
SEPARATEP'04410400 F6
W{RINGy'HE T(W" i LU ANG ANO SIGNS.
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
$4,5Q0.
$2e25
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$74.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER OF OWNER SUILDERI IDATEI
NEW [ ] Effective 5/1/88
ADEN [ ] R-1 AND R-2
ALTER P Building Permit Application:
0mistnictian Address: _ 0�170 Co /1 �U
legal Description:
Owner NaQne & IAe j �� uys U Tel 7R -CR 0 l
Contractor:MLA P�—ocketiviTel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the prq=ed construction drawn an it to scale.
DESCRIPI'I�T OF II�OVH�Tl'
LAVING AREA: Length Width Height Sq. Ft.
GARMM AREA: length Width Her cwt Sq. Pt.
D®C'!t AREA: length Width Hgt/Gxound Sq. Ft.
Off:
Corner Lot [ ] Inside Int [ ] ". d Setback Side Yard Setbacks
Type of Cmmtruction: J-3471kEnu m "er✓J0,01 z Estimated Cost: $
Apprnat. Cmq)leticn Date: 7 /'/r
/
Pzgmsed Driveway Width If New Opening Jr. Desired: Ft. $ $
Width + 6' See Back Page
DATE: APPLICANT: S--) ' u Tel.
Permit Free $ ,
State merge $ 2,
SAC Charge $
Driveway Esah:ow $
Park Flee $
Sewer Main Charge $
70M
S'TIRJIATIMS:
PC20U h
Pao uti*
W
F-ru (4L*a*vk
Free Schedule on laeverse Side
$.50/$1,000 valuation
$575 per SAC Unit c
Alt. "A" cr Alt. "B" Above .
Flee Determined by
Necessary [ ] Not Necessary [ ]
wo -d Z W J -
.
cpaa l
2.06(j— e-l� , ®®
3 5 0
00
MURPHY BROS. N IAE mwt4 $k S %Z -O ZO
Buildin & Remodeling Co. Z70 (p AVr-.
1337 Vrdena Avenue NE
o FRIDLEY, MINNESOTA 55432
(612) 571-9629 '
Mow L �L O Mt7f-�-
TO f=i-r Lj^joLtt
1 Cal/G . 13LK . VANnc� .
i ± BOX i rV wqN.
4
5:14 IL - ou, w Gds
perus>, t�'oAM
C'au�n ori, miaow Y-GJjX(02oov>:
vat
3lo x z'z"
10.1 1 37 " x cl,5 G.tL,.
MAAutm4 -7n'P
I Z4
Move w/a WAI-I—s
To Accomo p l*—rt.
13047#1 5o2L
5- -'extAmi.c-
A-TK D -/g" /•i le 'r -W cj41L
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1, 1993
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER
PLANTS
AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
JOB ADDRESS 270 61st . N. E.
.W .' .The undersigned hereby makes application for a permit for the work herein
Residential Rate
TOTAL
specified agreeing to do all work In strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00
$ 20.00
representations stated In this application are true and correct.
(Side Vent — Fill Out Back)
December 13th, _ 1994
Gas Piping (Needed with new furnace) $10.00
$ 10.00
_
OWNER John C. Henson
Gas Range $ 10.00
$
BUILDING USEDAS RESIDENCE
Gas Dryer $ 10.00
$
_
ESTIMATED COST $2600.00 PERMIT NO.
*Air Conditioning — All Sizes $10.00
$
DESCRIPTION OF FURNACE AN OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
Sealed unit, gas fireplace insert W/ side vent to tion
1
1% of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water) ami Air
Trade Name Heat 'n G 1 o Size No. BAY-GDV
Commercial/Industrial
BTU 321000 HP --- EDR ---
--1%
1%of Value of Appliance or Work
$
Fuel LPG Total Connected Load
State Surcharge
x.60
Bumer Trade Name Size No.
BTU HP EDR
TOTALFEES
0
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATLON
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING COMPANY Self installed
Signed By _ Tel No. 572-0201
r
Approved y Rough—In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
The, imdersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes {)
No
{ )
2.
Is free from rust or deterioration
Yes ()
No
( )
3.
Has no foreign objects lodged within
Yes (}
No
( }
4.
Is securely supported
Yes ()
No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (}
No
( }
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( }
8. Has combustion air been provided fbr water heater Yes ( ) No ( )
Remarks:
HEATING CO:
Signed By:
Date:
SUBJEtT
City of Fridley
f
28712
AT THE TOP OF THE TWINS
?`
BUILDING
PERMIT
RECEIPT NO.
: DEVELOPMENT DIV.
`�
------COMMUNITY
r PROTECTIVE INSPECTION SEC.
l/
1 � �
NUMBER
REVGATE
PAGE OF
APPROVED BY
1 1 CITY HALL FRIDLEY 55432
612-571-3450
910415
12/3/98
10B ADDRESS 270 61st Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR.
W 1/2
6
1Hyde Park
SHEET
2 PROPERTY"OVNER MAIL ADORES$
ZIP PHONE
John Henson
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 ME REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garageTear-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
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 1 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
$2228
$1 11
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
$78.09
SIGN A TUBE OF CONTRACTOR OR AUTHORIZED AGENT 40ATEi
WHEN PROPERLY/VALIDATgD THIS IS YOUR PERMIT
"11AI
_
O
BLpt
S-GNATURE OF OWNER OF OWNER BUILOERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ SINGLE FAMILY AN
] D DUPLEXES R-1 AND R-2 1
BUILDING PERMIT APPLICATION ( Ol
v
ConstructionAddress: ;.-? 7 Aum A,
Legal Description:
Owner Name & Address: o n Tel. #
Contractor: 'e> CAM E 2 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 Tyre: Wa G 2_4-:5q Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ * c2 2 c29
DATE:
APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
$ % 7�5_
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
$
$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:
'd 2 )-oho%
D
D
GNOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
Dear Property Owner:
Effective January 1, 1992, Minnesota Statutes require that most residential building
contractors, remodelers, roofers, and manufactured home installers be licensed by the
state. Specialty contractors who perform only one special skill (e.g. concrete &
masonry, excavation, carpentry, interior finishing) are exempt from state licensing.
Contractors who generate less than $15,000 in gross annual receipts are also exempt
from state licensing, but must obtain a certificate of exemption from the Minnesota
Department of Commerce.
The state license number of a residential building contractor must be placed on all
building permits and permit applications issued by a city or county. A license number
must also appear in a site plan review and all zoning permits. Cities and Counties are
prohibited by state law from issuing permits to unlicensed contractors who are
not exempt from licensing. In addition, it is a misdemeanor to perform
contracting work without a license unless the contractor Is exempt from
licensing.
State licensing is intended to ensure a minimum level of competency and to afford
consumer protection. To accomplish these goals, licensed contractors must pass a
two-part examination relating to the construction trades as well as business
administration and law. Licensed contractors are also required to take seven hours of
approved continuing education each year and provide proof of liability insurance and
workers' compensation insurance (if required by law) as well as business ownership
documents to the state. Also, licensed contractors and remodelers must contribute to
the Contractor's Recovery Fund. This Fund is intended to reimburse homeowners who
obtain judgments of up to $50,000 against licensed contractors and are unable to
collect on their judgments. Homeowners who use unlicensed contractors will forfeit
their rights to access this Fund. Licensed roofers and manufactured home installers do
not participate in the recovery fund, but instead are required to hold a surety bond in the
amount of $5,000 and $2,500 respectively.
Contractors are licensed and regulated by the Minnesota Department Commerce. To
determine the licensing status of a particular contractor, call the Department's Licensing
Division at (612) 296-6319 or 1-800-657-3978. Complaints against licensed contractors
can be directed to the Department of Commerce, Enforcement Division at (612) 296-
2594 or 1-800-657-3602.
The license number of a licensed contractor must appear in all advertising, business
cards, lien notices and statements, contracts and proposals.
CINOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
BUILDING PERMIT APPLICANT: HOMEOWNER
I understand that the State of Minnesota requires that all residential building
contractors, remodelers and roofers obtain a state license unless they qualify for a
specific exemption from the licensing requirements. By signing this document, I attest
to the fact that I am building or improving this house myself. I hereby claim to be
exempt from the state licensing requirements because I am not in the business of
building on speculation or for resale and that the house for which I am applying for this
permit, located at 274 w"/ A/o /2-E , is the first residential structure I
have built or improved in the past twenty four (24) months. I also acknowledge that
because I do not have a state license, I forfeit any mechanic's lien rights to which I may
otherwise have been entitled under Minn. Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and 1 understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund * in the event that any contractors
I hire are unlicensed.
qA j C -
SignaNire of Homeowner
/.,) - rr ?a
Date
Ucensed residential building contractors and remodelers are covered by the recovery fund. Ucensed residential roofers and
manufactured home installers are not covered by the recovery fund but are required to hold a surety bond.
To determine whether a particular contractor is required to be licensed, or to
check on the licensing status of individual contractors, please call the Minnesota
Department of Commerce, Enforcement Division, at (612) 296-2594, or toll-free at
1-800-657-3602.
P
E
SUBJECT
P
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
EI 7 9
`
RECEIPT NO..
• COMMUNITY DEVELOPMENT DIV.
tV -------
r � � PROTECTIVE INSPECTION SEC.
1 �
NUMBER
REv
DATE
PAGE OF
APPROVED By
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
4/7/00
JOB ADDRESS 270 61 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 1,2,3
6
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Henson 270 61 Avenue NE
572-0201
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Panelcraft of MN Inc 3118 Snelling Ave S, Mpls., MN 55406 721-6628 2179
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
0 NEW 0 ADDITION O ALTERATION 30 REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reside house; fascia/trim
9 CHANGE OF USE FROM
TO
STIPULATIONS
Call for building wrap inspection before
covering.
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
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
$10,700
$5'35
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-
Tq CTION 09 THE PERFORMANCE OF CONSTRUCTION
$.195.25
Fire SC $10.70
�
PLAN CHECK FEE
TOTAL FEE
��
Lfc-6kise S $5.00
1 $216.30
Sr RE :ON'RAGTORO44
R THORiZED AGENT �DATEj
H ROPERLY VALIDATED THIS IS YOUqFPERM1y
S,GNATURE OF OWNER,IF OWNERSUILOERi ATEA
• B G �NSo iE
P
E
NEW[ l Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER f to SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ,l3 00 U //3
fonstruction Address: o?-
7U
Legal Description:
Owner Name & Address: h lTeh 5ion , ,?70-&/ Ave A%E Tel. # .5-7 a - Oa O /
Contractor: r1,e /C h R f' T p /%A MN LICENSE # .217 9
Address: 3//8.sitr__dn �V�. S Nom, 111AJ �5 Yoke 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: 51W1 'a : �cs�;4f �h/rn Estimated Cost: $��, 7 Q Q _
Viveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: ` 6--00 APPLICANT: Tel. # 7,2 / - & &A9
TOTAL $ 216,30
•
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
% q- a 5
Fee Schedule on Reverse Side
Fire Surcharge
$
/0-70
.001 of Permit Valuation (1/10th%)
State Surcharge
$
3S
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
,� , v o
$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 $ 216,30
•
STIPULATIONS: