PRE 2010 DOCS�141
City ®f Fridley, Mian.. N? 7771
BUILDING PERMIT
•
Date: June 7, 1965
Owner: Wayne Saunders Builder ()Bannon Const. Co,
Address 500 63rd, Avenue No E. Address
LOCATION OF BUILDING
No. 500 Street 63rd, Avenue N, E, pari of Lot
Lot _ _ 5 __ Block 9 Addition or Sub -Division CBMTIE nnn._
Corner Lot Inside Lot — Setback — Sideyard
Sewer Elevation _. Foundation Elevation
To be Used as:
Front
Front
Type of Construction
• Storm damage repair
DESCRIPTION OF BUILDING
Depth Height Sq. Ft.
Depth Height Sq. Ft.
—Est. Cost 32- 000-00 To be Completed
Cu. Ft.
Cu. Ft.
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 se o in complianye'el
tit a'll provisions of
ordinances of the city of Fridley. � -� --i� ON'�
In consideration of the payment of a fee of $_1_0_A_00_, permit is hereby granted to.()Bannon Const. 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.
Anen Jensen
Building Inspector
NOTICE:
1bb permit don art cover tits construction, hudallaMon for whing, plumbing, gas bating, awer er water. Be sun to no
the Building Inspector for separab permits for thea hsnu6
Ate- -:2,-p 5'�-
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MYNNBSOTA
OWNER'S NAME UILDER �%"� CZ
ADDRESS J /�" ' . ADDRESS
LOCATION OF BUILDING;
No. Street _Part of Lots_
al&LOT BLOCK ADDITION OR SUBDIVISION e
Corner Lot Inside LOT Setback Side -Yard:
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of .Construction 14;1'7ZZ� Estimated Cost .O e/ ll
To be completed
..,.,:,The undersigned heroby 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. 0 SIGNATURE
(Schedul of Fee Costs can be found on:the Reverse Side).
•
City of Fridley, Minn.
BUILDING PERMIT
Date: - Sept. 12,L 1969
Owner: WAyn.e Saunders Builder Imperial Garage Blders .
Address 500 63rd Ave. N. E, Address 12483 - 73rd Ave.N.
Osseo, Minnesota
LOCATION OF BUILDING
No. 500 Street_ 63rd Ave. N. E. _ part of Lot
Lot 25 __ Block 9 _ Addition or Sub -Division . Christie Addn.
Corner Lot _ x
Sewer Elevation
Inside Lot — Setback —_.- Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
`7 0 e7
N° 10404
To be Used as:
Garage Front 241 Depth 241 Height 301 Sq. Ft __576— Cu. Ft. 5760
Front Depth Height ._ Sq. Ft -- Cu. Ft
Type of Construction _ _ Exam Est. Cost _ $245 0.00 __ To be Completed
40 Must have sidewalk Agreement .
Must have a surfaced driveway.
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.
In consideration of the payment of a fee of $ 9 .00 _, permit is hereby granted to Imperial
a
Gara Blders
� 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 anworkmen, in all work
dare in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of 7Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. moving of buildings
wIthe dty limits and this permit may be revoked at any time upon violation of any of tY►e provisions of said
A—ul-14 o Building Impef
Clarence Belisle
NOTICE:
Ub permN does not cover the construction, hutalWan for whing, phnabing, gas heating, sower or water. Be wro to me
the BuildhM Inspector for separate permits for these Nene.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER 'S NAME BUILDER
ADDRESS c-®® - 3 ADDRESS /.2Xf3 —7-3 �
LOCATION OF BUILDING
NO > , 500 STREET � ✓ 44"i -�' - i
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT � INSIDE LOT SETBACK SIDEYARD
SEWER ELEVATION TOP OF FOOTING
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 2 y Height
Square feet , 5 76 Cubic Feet = ®�
Front Depth
Square feet Cubic Feet
Height
Type of Construction Estimated Cost A'Se 0-
O
To Be Completed 2?-�'/ — 11� 4r
The undersigned hereby makes application for a permit for the work
herein apecified, 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 SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
�re.r.•tr....Pn�:�itl+i� rte. .... i - r.+•s......�...e.ni _ • * .4 rP $ c : » t }��
7 - 'lea sM a
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kIIR'� A CARTWRIGH'P J. E. HILL. C1VIi >;dfn► ».
14"OkA COUNTY SURVEYS Jm
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14FA1NF0®iN COUNTY SURVEYS L A ND.', S UR a/ fit' YT.R Ql �7 C.- F.
+t b1INNIZAPOLM SURVEYS
it fO flNAOYOAK LANE M @., CIYIL ENGIN$QR ,#
REGIOTBRI10, UNWIR LAWO OF GTATa OF MINNESOTA
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LIC6NSCD VY OROINANCG OF CITY OF MINNEAPOLIS
wvinca JAMES NEL
345 "PLYMOUTH 13UILOING LINCOLN $721�•
r IMDUSTRIAL — JUDICIAL t �
a t . '`05f"CSS TOPOGRAPHICAL {lTbf ►®r� �crtlticst�ri LTI$Q6�0 T �N
CITY LOTS — PLATTING i y41,44 �,, '9 t
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blilldings on: Jct 25, Blook "9; Chri.sti� AddiL3.pm, �rcak� Cc��ty-,
,4innesota, as locates by >Qethris 24th �a of �ia�'� 1���� �� � ����
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6700CUa& V4Utfa V&*4.
12483 73rd AVENUE NO.
U.2 OSSEO, MINNESOTA
PHONE 425 - 2818
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SUBJECT
City of Fridley
hi 17434
AT THE TOP OF THE TWINS
BUILDING P E R M I T
rp
RE .
1. Lu --COMMUNITY DEVELOPMENT DIV.
r I PROTECTIVE INSPECTION SEC.
I �
� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/2/84
JOB ADDRESS
500 63rd Ave. N. E.
1 LEGAL
LOT NO.
TRACT OR ADDITION SEE ATTACHED
DESCR.
[BLOCK
25 9
Christie Add. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Wavne Saunders 500 63rd571-19-47
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USEOF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22' X 12' three season porch.
9 CHANGE OF USE FROM TO
STIPULATIONS
'SEPERATE F' MITE REQUYRED FOR WRING.
HFATING, PLUMBING AND SIGN&
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
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
$4 600.00
$2.30
DOES NOT PRESUME GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OFA O ER STATE OR LOCAL LAW REGULATING CON-
STRU TI NOR THE PERF E OFCONSTRUCTION.
$62.50
pRf
PLAN CHECK FEE
TOTALFEE
JA 2
$15.63
$80.43
SIGNATURE ~11ACITOR OR AUTHORIZED AGENT I ATE)
WHEN PROPERLY XALI DATED THIS IS YOUR PERMI✓T�p�y�J'
�%-Z, V
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
CITY OF FRIDLEY
APPLILATIal FOR RESIDUNTI& BUILDING PE NITS
(U i. Alterations. Additions. or Repairs)
OWNER: l\Y / 7t �4 IVe SACIA/ Jr' its
ADDRESS�����2Ar����
TEL R0: S 7) i f�— 3- 7
Effective Aug. 1, 1981
A
BUILDER: TT A2!a X
ADDRESS: fetj ✓P'-
TEL 110: �; '� 2�,g" 2__
Construction Location
STRICT NO: STREET. % Pi
LOT: Z BLOCK: ADDITION: �`i/7 1,
Corner Lot: sc Inside Lot: j'- Setback: Sideyards:
Appliciult. attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOR OF CONSTRUCTION
cJ o't'pS�yPf e. Front:
Square Feet: pl�D
Depth: 49 r Height:
Cubic. Feet:
Front: Depth: Height:
Square Feet: � Cubic feet:
7 ape of Construction: Estimated Cost:
7b Be Cbrnpleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE PEVFiL;E SIDE OF SHEET
2be undersigned hereby makes applicaticn for a permit fcr the %:ork herein specified,
agreeing to cb .all work in strict accordance with the City of rridley Ordinances slid
rulings of tl:e Deixtrtment. of Buildings, and hereby declares that all the facts and
represen tatiens stated in this application are true and corgct.,,,' . �
DATE: �—z �`' SIGNATUry:
Stillulatio
C X02. J"
G 3
wgg3
AL COV.8tNING TME RECORDS
MARVI V A. CARTWRIGHT � � ® o'� J. E. HILL, CIvIL ENGtN6fiQ - -
.ANOKA COUNTY SURVEYS uTApLgMSD 11111".ItgA1N1:►1N COUNTY SURVEYS LAND SUR �'EY6RS C. F. SANDHOFF'
MINNRAPOLIS SURVEYS
k10 SHADY OAK LANE N IN REGISTERED UNDER LAWS OF STATE OF MINNESOTA CIT::`E„ ENGINEER
6URer� �•O07Y LICENSED pY OROINANC[ OF CITY OF MINNEAPOLIb
343 PLYMOUTH HJAMES NELSON.,UILDINO LINCOLN 0721 SURVEYOR;
iaTJpllp MtD ,eta •j ,
• INDUSTRIAL — JUDICIAL _ J
O:ISMCZS — TOPOGRAPHICAL �UTilt Ot'�9i �tCtlElLiltt METRoPoILITAN LA140
CITY LOTS — PLATTING C �URYEYORS, hrwpi*109tp„eft, t
V&1 J. iothcc?.`.J K�1 �r*.1 rvenar•
>-' � I,I _.._._t*��3-�J•_��.rraJSQt_I .- - _ •F����:;J �: -
C3 R° '4' N.F.
lC.4+..
In ,
M A,
O -
+.
E.?94.J1 47A T
I hareh3 ce::r. R true :pit -t t�c•Itic�;
Lot 25, Block y, Crriatio Addition, Anoka Ccunt;•, `
Ki:ut^rota, as locate! Cy IIID' this ?1;L� ea -,r e' !'.6m- ;cf. ,
A
SUBJECT
P
City of Fridley
'122241
AT THE TOP OF THE TWINS
BUILDING PERMIT
R T N
V _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
I
�`a I
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE Of
APPROVED BY
612-571-3450
910-F15
11/22/93
JOB ADDRESS 500 - 63rd Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
25
9
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Wayne Saunders 500 63rd Avenue NE 571-1937
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Twin City Storm Sash Co 10825 Greenbrier Rd, Minnetonka MN 55305 546-8160 3090
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install Bay WINDOW (Replacement)
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas
and in basement. See Chapter 54 UBC for glazing.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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 80 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 1 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
$3,200
$1.60
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-
$63.00
Fire SC $3.20
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$72.80
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIEn
OPER VALIDATED THIS IS YOUR PER-MIT
BL G o DATE
SIGNATURE OF OWNER OF OWNER BUILOERI IDATEI ., � '
NEW Effective Effective 1/1/93
[ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2�
Building Permit Application
Construction Address: 620 (o c� ,ll�f'?,[ Q %i• Lam_
Legal Description: /
Owner Name &es C �-1 � ll n, �'Y�OA ,4 Tel. #s&/ — 193 %
Contractor: 1.0M GREENBRIER ROAD MN LICENSE #
Address: MINNETONKA, MN 55x05 _ Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTION OF IMPROVEMENT
Width
Height
Width
Height
Width
Hgt/Ground
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback _
Type of Construction:���O�.cQ
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Sq. Ft.
Sq. Ft.
Sq. Ft.
Side Yard Setbacks
Estimated Cost: $ o�. a eo
(Cost on Back)
Ft x $ = $
DATE: 11--3- 9.3 APPLICANT: 1* -t J Q Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
. 00
$ '9. ao
Park Fee $
Sewer Main Charge $
TOTAL
-'T 4TIONS:
CITY USE ONLY
Fee Schedule nn RPvercP R;&-
.001 of Perr
$.50/$1,000
$750 per SA
$5.00 (State
Alt. "A" or
Fee Determir
Agreement N
SUBJECT
City of Fridley
27328
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
I ,
o
COMMUNITY DEVELOPMENT DIV.
I L PROTECTIVE INSPECTION SEC.
530
r i
i I
NUMBER
REV
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910415
JDATE
8/21/98
JOB ADDRESS
500 63rd Avenue NE
1 LEGAL
LOT NO.
BLOC K
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25
9
Christie Additi n
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Wayne & Milada Saunders
3 CONTRACTOR MAIL ADDRESS NW
ZIP PHONE LICENSE NO.
Professional Touch Paint 3931 172nd Lane Andover
-
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 jjk REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 13 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIREO 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 6D 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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1085
.54
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-
RUCTIO OR THE PE RM OF CONSTRUCTION.
$3],SQ
Fire SC 1.08
(�
PLAN CHECK FEE
TOTAL F
License 5.00
44
S GNA URE bF Cb&WCTOR OR AUTHORIZED AGENT IDATEI
N 7PPjbP
BLDG SP
V IDATED.THW IS YQUR PERMIT
DATE
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
NEW Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 J-7 /Z
BUILDING PERMIT APPLICATION
ConstructionAddress: p 0 �, �%,� p� f
Legal Description:
Owner Name & Address: d)wk;c ggallr QLLi Tel. #
Contractor: ZLOZ� ,q 1P��1--f1-- MN LICENSE #
•� S S3G
Address: �' '3 / 122 n� N w AA. ,A Q ver, y Tel. # Z j'F 5` 3 >'?
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:206EIAZ 2J2 n, r�ZReZiC f, 0 irrar
Construction Type: _ Estimated Cost: $ l� S
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
/1DATE:
APPLICANT: ,62 Arg,eE Tel. # 5 66? ,e
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
°% ��
Fee Schedule ca Reverse Side
Fire Surcharge
$
Oco
.001 of Permit Valuation (1/10th%)
State Surcharge
$
S
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
s. Cb
$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 NecessaryAil
TOTAL
$
i 7".
STIPULATIONS:
Building
PLUMBING.
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:�
763-572-3604
CITY OF FRIDLEY
D*T,
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS as �w�e.✓
THIS APPLICANT IS: ❑ OWNER *ONTRACTOR
PROPERTY NAME: ChrisBaratto 7635715061
OWNER/ ADDRESS:_ 500 63rd Avenue CITY STATE ZIP
TENANT
PHONE: Fridley,MN55432
CONTRACTOR
NAME:
STATE LICENSE #_5 056 EXP DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS- r Coe CITY .' & STATE,&Jd6P g
LICENSE WITH ,
PHONE 7— VO FAX
APPLICATION
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEw XREPLACEIVIENT
DETAILED DESCRIPTION OF WORK %
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the
improvement, 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 =
•FORXRO]ECTS WHERE LABOR EXCEEDS1500;-FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT"EWHERENGTED .FfXR- ikES,, (IMICATE T.O•TAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV _FLOOR DRAINS —SHOWER _ WATER PIPING
—BATHTUB _ GAS PIPING (Nm cwLicum) _ SWIMMING POOL _ WATER SOFTNER ($35)
_ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15)
_DISHWASHER -LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00_,4_x$35.00 = $ 35'.Oo
TOTAL DUE $
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 applic ' n for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case I o w ' r fres review and approval of plans.
/
SIGNATURE OF APPLICANT NAME J tE 10.el w I
PRINT /l d DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977