PRE 2010 DOCS•
u
C
City -of Fridley, Minn.
BUILDING PERMIT
Date: _ July 3, 1967
owner: _Ray Scherer Bider
Address 6541 tad Street N. E. Address
Same
Same
LOCATION OF BUILDING
No.. __L9 0 ____ Street _ 6 2nd Way NN . E . _ Part of Lot
Lot ._.__2 Block 1 Addition or Sub -Division ._._potasAIs
39' 15'
.P -3 ,P®
N9 9344
Addn.
Corner Lot — Inside Lot ____ X Setback Sideyard
Sewer Elevation -- 822.25 825.25
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 26' Depth 42 Height 20 Sq. Ft. 1092_ Cu. Ft.
Garage Front Depth _ _ Height 10' Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _ $162500 __ To be Completed Jan. 1, 1968
SEWER LOCATION - 21' East of Manhole on Riverview Terrace
WATER LOCATION - 55' East of Manhole on Riverview Terrace
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 inm li with ah provisions of
ordinances of the city of Fridley.
$100.00 Seder ComUction Charge
In consideration of the payment of a fee of $ 3 7- 00__, permit is hereby granted to ROY SCHERER
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 d
ordinances.
CLARENCE BELISLE
Building Inspector
NOTICE:
This permit does not cover the construction, instatlallon for wiring, ph"UhIng, gas heating, sewer or water. Be sum to see
the Building Inspector for separate permits for thea Items.
A1vr 1C 1V_'1rX3 MR B?IILDING M- r IT
Mill OF i�.1 *X4Ei, MMIiESOTA
OWNER'S NAME _`_/1.�..t -DER y
ADDRESS j� S l 1Y p_
LOCATION OF BUILDING ,
N0. d STREET ND PART OF LOT
LOT BLOCK ONE ADDITION OR- n S, -'S"
CORNER LOT INSIDE LOTSETBACK 39 SIDE -YARD
SEWER ELEVATION ?;P� � � -FOUNDATION ELEVATION
Applicant attach to this t3 cafes, o Survey of Lot and proposed
building location 4rawn on thes Cert
DESCRIPTION OF BUILDING-
To
UILDING
To Be Used Ad:
d- Front Depth % Height
Sq. Ft. lo7c4 Cu. Ft.
Front Depth Height
Sq. Ft. -Cu. Ft.
Type of Construction Estimated Cost /6, S_0 G
To Be Completed / ST 1 9/
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 J U Lf 3 0_ SIGNATURE
(Schedule of Fee Coats can be found on the Reverse Side).
-:..
U•
Application for Povaer Pianin and Nocalbig. 21mg. ven0avion, R 0g, amNan. Grad
Air Conditioning Systoms ®nd Devi=
PARTIAL RATE SCHEDULE Dept of Bldgs. Phone 560-3450
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ..:.........
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE
TOTAL
$
LocaYioR
$10.0a
Each add. 200 sq. ft. EDR Steam ......................
`
$
6000
City of Fridley:
kdac
$
6000
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
over 3 gal. per hour --Pee Fee Schedule
$
3.00
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
$ ®. �
$10.00
Fridley, Minn �� 19
$
GAS FITTING fig: 199-1000 BTU
3.00
Owner
14
$
6.00
Kind of Building C94__4 ��
k4a
$
6.00
2.00
.......... x
$
3.00
Used as Com/
To be completed about.
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
fft
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
$
Each add. 200 sq. ft. EDR Steam ......................
Each add. 320 sq. ft. EDR Hot Water . ................
9$
OIL BURNER—to 3 gal. per hour ................ .......
J
$
over 3 gal. per hour --Pee Fee Schedule
99
GAS BURNER 1 BTU)
�
(tip to . ... .................
5.00
$
GAS FITTING fig: 199-1000 BTU
NO
RATE
TOTAL
1st 3 Fixtures ...................... _ x
$
Additional Fixtuures..... , . x
Gas Range to
2.00
.......... x
$
AIR CONDITIONING
g
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS TOTAL FEE
$
ROUGH
J
FIN
$10.00 Estimated Cost, $ 76 ® _
10.00 Old New. wilding Permit No. __�/t_3"6/ Pmmit No.
3.00 _
3.00 DESCRIPTION OF WORic
6.00 HEATING or POWER PLANTS—Steam, Hot Water, <rm Air 0—
Trade Name 4e ''-2 07 e if Size No. Q�V.2 " %/
Capacity Sq. Ft. E.D.R O O 0 ® BTU H.P.
$2000 Total Connected Load 'Cil . % Kind of Fuel
• 75 BURNER —Trade NameSize No.
$5.00
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
eaV
Signed TIPl6 Auwn eiR CONDITIONIM
By 4U0 }tC61S101t BLVD. MINK
14-42 Business Phone No
A
CR NSTROMS HTG. & AIR COND., INC. „lob Nam Ps 5evn
D 76 4410 Excelsior Boulevard, Minneapolis 16, Minn. s•`e�'4t - / Sj� Vs
ze NEAT LOSS CALCULATIONS Zi fires' (� G�/
Weatherstrips A.S.H. Guide .E. Construction No. I Insulation
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof FloorI Find How Applied
Yes—No Yes—No 19—
FQ ,..P W Room Length / 2 -Width // 2. Height Fl I Room I LengthWidth Height
Windows and Doors—Crackage and Area ,+. Windows and Doors—Crackage and Area
Width Height No. of ineal f . Area / Width Height No. of Lineal ft Ares
No. of pane of pane lights of crack sq. ft. No. of pane of pane lights of crack sq. ft.
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
-99
F1.1 Room ( Length Width
Windows and Doors—Crackage and Area
I No. 1 of
Btu
Coef.l Btu
Infiltration 14 2
Glass
Exp. wall
Net exp. wall
Inc. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.1 I Room I Length Ir Width
Windows and Doors—Crackage and Area
width Helght No. of Llneal ft. Area
No. of pane of Dane lights of crack ea. ft.
Infiltration f®
Glass �.
_ Exp: wall
Net exp. wall
_ Int. wall
Ceiling
r Floor
Total Btu.
rol
Infiltration
Glass
Exp. wall
Net exp. wall c1
Int. wall
Ceiling 72 0
Floor
Tbtal Btu.
Required sq. ft. ED R. or sq. ins. WA. Leader area
Btu
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area T
*F F1.1 V. ��.��Room I Length / Width / V Height P-
Windows an
oors—Crackage and Area
Width HeightNo. of Lineal ft. Ares
No. of pane of pane lights of crack aq. ft.
4
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glasskcv
Exp. wall
Net exp, wall
4/o 6
(�
Coef.
Btu
Infiltration
0
Glass
/ U aExp.
wall
J
Net exp. wall
e)
1,7 9 C)
Int. wall
Ceiling
Floor
-
CJ
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
l Fl.li eii .� Aloom I L.enath 4' / Width 17– Height
Windows andboors—Crackage and Area
Width HeightNo. of Lineal ft. Ares
No. of pane of pane lights of crack aq. ft.
4
Coef. Btu
Infiltration
Glasskcv
Exp. wall
Net exp, wall
4/o 6
(�
Int. wall
Ceiling
Floor
Total -Btu.
ft. E.D.R. or sq. ins. W.A. Leader area
CRONWROMS HTG. & AIR COND., INC. Job Names , 5ekoeeye-
D-5k 4410 Excelsior Boulevard, Minneapolis 16, Minn. 149--a t9!
26 HEAT LOSS CALCULATIONS Job Address
Weatherstrips _ A.GHd • Construction No.
WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor I Kind How Applied
Yes—No Yes—No 19—
F1.1 A& rj wRoom I Length 11 Width .40 HeightV II FI.I Room I Length Width Height
Windows and oors—Crackage and Area
Width Heig t No. of Lineal f . Area
No. of pane of p e lights of crack sq. ft.
10 J�
Coef. Btu
Infiltration
Glass .267
Exp. wall *I e,
vu ® O
.22-
Net exp. wall
67
Int. wall
Ceiling
Floor
Total Btu. 1
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft Area
No. of vane of pane llghts of crack 84
. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width
Windows and Doors—Crackage and Area
Width Height No. of Lfaeal ft. Area
No. of pane of Dane llghts of crack on. ft.
Btu
Infiltration 1
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Tbtal Btu.
Required sq. ft. E.D.R. orsq. ins. WA. Leader area
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
Net exp. wall
Int. wall
Ceiling
-1 Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width 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
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width I Height No. of Lineal ft. Area
No. of pane of ;ane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Ezp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
• Date:
•
0
City of Fridley, Minn.
BUILDING PERMIT
10/5/67
N9 9486
Owner: _ Drew Scherer Bider A, R- Co.
Address 6525 2nd St. N. E. Address — 1308 Main St. N.E .
LOCATION OF BUILDING
No. 190 Street 62nd Waw_ part of Lot
Lot ___ Block
Corner Lot —_ Inside Lot
Addition or Sub -Division ._—
— Setback — . - Sideyard
Sewer Elevation -- Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front _ _ Depth Height — Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft _ Cu. Ft
Type of ConstructionAsphalt Drive Fit cost "_...i3 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 �t forth and in compliance with a'll provisions of
ordinances of the city of Fridley. //
In consideration of the payment of a fee of $ 5 , permit is hereby granted to A.B. C.
Blacktop Co. 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.
CLARENCE BELISLE
Building Inspector
NOTICE:
This penult does not cover the construction, Installation for whbg, plumhing, gas heating, sewer or water. Be sure to no
the Building Inspector for separate permits for these Mme.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NA
UILDER
0
ADDRESS l9 52 S-_
�%, 11i >
ADDRESS
LOCATION OF BUILDING
NO. �7 Q STREET__r c W,4a- PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION
TOP OF FOOTING
Applicant attach to this form two certificates of survey of lot and proposed
building location drawn on these two certificates.
To be -Used as:
DESCRIPTION OF BUILDING
Front Depth
Sq. Ft. Cu. Ft.
Front
Sq. Ft,
Depth
Cu. Ft.
Height
Height
Type of Construction ASP/ ,9L7" D.,Vi aa- Estimated Cost 1(�
To Be Completed -a 0 4' 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 of Fridley 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.
DATE C% SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1991
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
JOB ADDRESS I "1 U u0c, /`1-0 Ukj�I Y-1, U,
New Fixtures
$ 7.00
The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture 1
$ 4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin
$ 7.00
and representations stated in this application are true and correct.
Catch Basin
Rain Water Leader
$ 7.00
$ 7.00
11991
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$ 7.00
Water Heater - Gas
$10.00
Building Used As
Gas Range
$10.00
—
Gas Dryer$10.00
Estimated Cost -PERMIT NO.
Back Flow Preventer Required ( )Yes () No
'A
Type
$5.00
PLUMBING COMPANY C
Reinspection Fee $30.00
SIGNED BY TEL N0. k4t2 l-qq V3
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
.,
i Final Date --��
Approved By Rough -In Date
State Surcharge
.50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
TOTAL FEE
$
PLUS THE $.50 STATE SURCHARGE
I
0 -D'D c
`tj
SUBJECT
P
City of Fridley
21415
1
AT THE TOP OF THE TWINS
B U I L D I N G PERMIT
Ir
E2
IPT
1 __ COMMUNITY DEVELOPMENT DIV.
-___;
L
�� �/
r PROTECTIVE INSPECTION SEC.
o
CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED BY
612-571-3450
910415
6/23/92
JOB ADDRESS 190 - 62nd Way NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
1
Potasek's Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Marleen Gibson 190 - 62nd Way NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Custom Repair Co„ Inc. 6726 5th Street N, Brooklyn Center 560-2755 PENDING
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 Ek REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install new kitchen cabinets and countertops
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. 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
$5, 500
$2.75
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-
$81,00
Fire SC $5.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$94.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIENP
PqLY, )WAALI12ATX0THIS IS YOUR PERMIT
-1
6-2-3
LIZ,
DG I SP gA7E
SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI
NEW [ ] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: /20 6 2 tid l& C
Legal Description:
Owner Name & Address:
Tel. #
Contractor: �0!5 74 aY2 l e.0 A i e C Z — MN LICENSE #
Address: ,.%� S� t)� �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: 1 � V -
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date:
Ft. Yd Setback
Side Yard Setbacks
Estimated Cost: $5�
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $
c
DATE: ( t 1�- S APPLICANT: Tel.
CITY USE ONLY
Permit Fee $ C> %r a ® Fee Schedule on Reverse Side
Fire Surcharge $ off® .001 of Permit Valuation (1/10th%)
State Surcharge $ e ��® $.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:
L4)
12t
w
y o
O
SUBJECT
PERMIT NO.
City of Fridley
28433
72®D4 THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
`
J
r PROTECTIVE INSPECTION SEC.
��
`%
NUMBER
REV
DATE
PAGE OF
ApvROVED Br
CITY HALL FRIDLEY 55432
L J` 612-571-3450
910-F15
10/27/98
JOB ADDRESS
190 62nd Way NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
2
1
Potasek's Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Marlene Gibson574-0309
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Right Way Roofing 1200 EA53-0049
14999
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION §Ek REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garage 25 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
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
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
$2142
$1.07
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
THER STATE OR LOCAL LAW REGULATING CON-
CON-
NCONSTRUCTION]4,]5
Fire .S Ci 2.14
ZTMT
PLAN CHECK FEE
TOTAL FEE
'1 ���
License SC
5.0
82.96
S�GNATU CON'AACTOR OR AUTHORIZEO AGENT IOATEI
WHEN PROPERYVJVALIDATED THIS IS YOUR PERMIT
BLD INSP
FIAYE
S-GNATURE OF OWNER SIF OWNER BUILDERI IDATE,
NEW ~ [ I
Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: Im
Legal Description:
Owner Name & Address: MCL(k , &I l Tel. # S74tj-y` t
Contractor: IZIgVU wCU'] Roo��:vMN LICENSE # ( fAcjq
Address: 17-00 E . "� C� j-. Tel. # S-�)-WQC4
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF AWROVEMENT
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:-, W
Driveway Curb Cut Width Needed:
Estimated Cost: $
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x $
mg?
DATE: 101ZLOM, APPLICANT: Tel. #
Permit Fee
$ 76
Fire Surcharge
$
State Surcharge
$
SAC Charge
$ .�
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $-f (
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreemeftt Necessary [ ] Not Necessary [ ]
Building
BUILDING
Permit No.: -i- 44.1
Inspections
RESIDENTIAL APPLICATION
Received By:
763-5,,72-5604
CITY OF FRIDLEY
Date a 'd:
DATE
��00
YOUR E -MAI DRE I iri I it SSU-- r U S C U C U YYl
SITE ADDRESS
Curb Cut Escrow,
$
THIS APPLICANT IS:
C NTRACTOR
Park Fee
PROPERTY OWNER/
NAME:
$
TENANT
ADDRESS: CITY
STATE ZIP
PHONE:
CONTRACTOR
NAME.
SUBMIT A COPY OF
STATE LICENSE # !73 EXP DATE 3TA/0
YOUR STATE LICENSE
L�-e- 55313
ADDRESS: 515.73 . CITY �Y)t,�-a- STAT�
WITH APPLICATION
PHONE 9S2 • 935 !po g FAX 452 - 9.3.5 ' 95Vq
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
Q ADDITION ❑ GARAGEISHED ROWS
❑ BASEMENT FINISH ❑ ROOF DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMKING POOL
TYPE OF WORK:❑
w 13 ADDITION
ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE• 0 I 0
off- 1. S
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT d
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
PROPOSED HEIGHT:
❑ DETACHED GARAGE
3.
List of structural members to be used
SIDING
/ G
FOR NEW
CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit %�
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia 3 pwn i
and proposed project
WINDOWS
2.
2.
Two sets of construction plans
3.
Energy Calculations
IN EXISTING OPENINGSA Yes
[No ATION OF WINDOWS 0
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
TOTAL JOB VALUATION S (USING . X1 -00 .B.0 FEE SCHEDULE)OOCCUPANCY
TYPE
Permit Fee
$1i 31i. �S
Plan Review
$
Fire Surcharge
$
Surcharge
$ ! P - %O
License Surcharge
$
SAC Charge
$
Curb Cut Escrow,
$
Erosion Control
$
Park Fee
$
• Sewer Main Charge
$
Total Due
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
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 rmit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which uii es r ' w and ap roval of plans.
SIGNATURE OF APPLICANT PRINT NAME / ( VO4ATE