PRE 2010 DOCSi •
Village of Fridley, Minn.
BUILDING PERMIT N? 3-
Date: , ................
Owner . f �l ...... Builder... / ................../.. .....
Address . C?.. !! . ^ . .................. Address ....... �?.. .. .�//... ........ .
�A ION OF BUILDING
No. .�...... Street .. �. ...... ..... ......... ...... Part of Lot ... .... .
Lot .... � ...... Block ... 9 ....... Addition or Sub -Division . .
Corner Lot ........... Inside Lot ...4/... Setback /.. Sideyard
DESCRIPTION OF BUILDING
To be Used as:
TM
ko_lf_"O4!
......... ... ... Front .. Depth ?�.�. ".. Height . .. Sq. Ft. 7 ( Cu. Ft. ........
ront ........ 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 conWdjance
ibed above, I agree to do
the proposed work in accordance with the description above swith all provisions of
ordinances of the village of Fridley.
f Ol
In consideration of the payment of a fee of $. <......, permit is hereby granted to ./. 4�
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
d=lrl� � y.
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
City of Fridley, Minn.
BUILDING PERMIT No 4204
Date:....._..SFORMER..9..s....IM.......... ... -_.........................
Owner: Mgro� H. Stiekl -. Builder SUSS1±, , LMVMM
_.....- ............._......... s$ ....... -.............................. --------------...._.............._.......-..._..........__...._..- -- ------__
Address ...665....—._63rd _gveriue_N. E. Address............ 1850-.,Como_._Avenue_....... __,........................
_._._.
Minneapolis, Minnesota. St. Paul, Minnesota
LOCATION OF BUILDING
No. ..... 668........._........ Street .............. 63rd....Avenue.._N�.._$.......................................... Part of Lot ..... _......
Lot ......._ll ............._....... Block ............. _...........-9 .......... ............ Addition or Sub -Division ------- Christie
Corner Lot .................................... Inside Lot ....._......... .................. Setback ..... -......... ...._...................... Sideyard
Sewer Elevation .----- ............................ _.............. ............. ....................................... Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as:
De t8C118C1....Garage.. Front _Z..__.. Depth .... 22 t...... Height .....10_t....... Sq. Ft. .--352..__.. Cu. Ft. ._32 520
.... . .............._...................................... Front ........................ Depth ........................ Height ........................ Sq. Ft. ...... ................. Cu. Ft .................... _..
Type of Construction..........I'ra7n@...................... _..... ._ Est. Cost ..........1.,056.... .......... . ... To be Completed12A/5-9 ...................
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 setworth and in comp ance with all provisions of
ordinances of the city of Fridley.
.�._—
In consideration of the payment of a fee of $AAW.................. 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 upon violation of any of the provisions of said
ordinances. i
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see
the Building Inspector for separate permits for these Nems.
4
wil mm
BLOCK ADDRESS
ADD.
. . . ........ . ... . .......... . .. ........ ................. . ............ ........... . .. ........... . ...................
VALUATION
Fes
Property Idne
41 A1,6 V 00W C"'r r
SA*,&
tog $#
S+A0
CD
N:
War. if.
*A; 0%pll'
Front
ierty Line
0
C f 6 --2--/
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 rth and in ce with ahIl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $10.OQ , permit is hereby granted to Quality Homes. InC.
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
dame in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesotalocation, construction, alteration, maintenance, repair and moving of buildings
wioitthin � city limitsandel this permit may be revoked at any time upon violation of any of the provisions of said
inan
_ Allen Jensen Building Inspector
• NOTICE:
Thb psrmN dos not cmer the coestrueNoe, huftfldkn for wiring, Plumbing, gas heating, sewer or water. Be sure to ae
the Bouhm kgmter for apmte rMuft for thea Nene.
City of Fridley, Minn.
N° 8139
BUILDING PERMIT
Date: - July 7o 1965
Owner: Myron Stickley
Builder Quality Homes, Inc.
Address 668 63rd Avenue N.
E. Address 3701 Fremont Avenue
No.
LOCATION OF BUILDING
No. 668 Street mrd Avenue N. E. _ Part of Lot
Lot 11 Block _______9 _
Addition or Sub -Division Christie Add1 n
Corner Lot — Inside Lot —
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 Construction
Est. Cost $2,882. To be Completed
•
Storm damage repair
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 rth and in ce with ahIl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $10.OQ , permit is hereby granted to Quality Homes. InC.
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
dame in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesotalocation, construction, alteration, maintenance, repair and moving of buildings
wioitthin � city limitsandel this permit may be revoked at any time upon violation of any of the provisions of said
inan
_ Allen Jensen Building Inspector
• NOTICE:
Thb psrmN dos not cmer the coestrueNoe, huftfldkn for wiring, Plumbing, gas heating, sewer or water. Be sure to ae
the Bouhm kgmter for apmte rMuft for thea Nene.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME Myron Stickley BUILDER Quali*X - Home s, Inc. r
ADDRESS 668 63rd ADDRESS 3701 Fremont Ave. No.
LOCATION OF BUILDING
.No. Street
Part of Lot�_r
LOT I BLOCK / ADDITION OR SUBDIVISION,
Corner Lot Inside LOTSetback 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
REPAIRS DUE TO TORNADO
Front Depth, Height
Sq. Ft. Cu. Ft,
Front Depth _Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost $2.882„00
To be completed
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 SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
Replace roofing, house and garage Sand floors
Replace gutters Replace inside doors where necessary
Replace shakes Repair walls where necessary
Repair overhang Sand floors
Replace garage window, service door and garage door
Replace house windows .
Repaimh walls, refir_ishtanrk, refinish ceilings •
-
Application fOr Pearer Pkmft and N001hM Cooling. VeWaton, Retrigeruflon and
Air Cooping Systems and Devices
PARTIAL RATE SCHEDULE
GRAV*TY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ................ .. $10.00 $
Replacement of Furnace . .. ..... ..... .. 6.00 $
Repairs & Alterations—up to 5900.00 6.00 $
Repairs & Alterations each add. $500.00 3.00 $---
MECIL WARM AIA
Furnace Shell & Duct Work to 120,000 BTU ... .... ..$10.00 $—
each add. 60,000 BTU .................... .. 3.00 ;
Replacement of Furnace .. .... 6.00 $
Repairs & Alterations—up to $500.00 .. 6.00 $
Repairs & Alterations each add. $500.00 .... &00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. —
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_
Each add. 200 sq. ft. EDR Steam 4.00
Each add. 320 sq. ft. EDR Hot Water 3.00 $—
OIL BURNER—to 3 gal. per hour
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 189,000 BI
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
1st 3 Fixtures
Additional Fixtures
Gas Range to 199,000
AIR CONDITIONIIIa
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
'FINAL `l- ��/
6.00 $ —
8.00 ;
NO RATE TOTAL
- x$ loo $
- x .75 $
_ x$ 600 ;
4
See Fee Schedule
TOTAL FEE
Dept. of Bldgs. Phone 860-3490
/.r,_i z
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir.
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 aid correct.
Owner_
Kind of Building
Used as ----
To be completed about _ 1
Estimated Cost,
New. Building Permit No. Permit No.- --<_
DATION OF WORK
HEATING orP7—,4,,
Not Water, Warm
Trade Name_ Size N
Capacit. Y 0 J�_ Sq. Ft. E.D.R BTU H,p.
Total Connected Load Kind of Fbet
BURNER — Trade Nam¢ Size No
Capacity Sq. Ft EDR 131
Fur.
an -s t (REMARKS—OVER)
Application for Power Pkuft and Heating, Cooling, Vewna&n, RetEigeratioe and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .. $10.00 $
Replacement of Furnace .. ..... ..... 6.00 =
Repairs & Alterations --up to $500.00 6.00 $ _
Repairs & Alterations each add. $800.00 3.00_--
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU.
..$10.00
$ �� . Gv
each add. 60,000 BTU ............. ....
. 3.00
=
Replacement of Furnace
6.00
$
Repairs & Alterations—up to $500.00
6.00
$
Repairs & Alterations each add. $500.00
&W
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
$. —
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00
Each add. 200 sq. ft. EDR Steam
3.(I(1
-.-.--
Each add. 320 sq. ft. EDR Hot Water
3.00
$
OIL BURNER—to 3 gal. per hour
0.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) ....
.. 5.00
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures _X$100
$ U J
Additional Fixtures
x .75
$
Gas Range to 199,000
x$ 500
$
AIR C014DMONENG
FAN HEATING SYSTEM
VIIITILATING SYSTEM
ALTERATIONS S REPAIRS
ROUGH
FiN1II, '7-
$
see Foe Schodub
TOTAL FEE
(SURCHARGE $_.50)
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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.
Owner
Kind of Building __ V/l v
Used asTo be completed about _ "1 -1 Z
Estimated Cost,
Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or PO7R PLANTS—Steam, Hot Water, V � No_ CI Z.Q
Trade Namei�,a4za�
Size Ne-g�'L
Capacity Sq. Ft. E.D.R
BTU H,p
Total Connected Load
�qof Fue
BURNER — Trade Name
Size No
Capaci Sq. Ft. E.D.R
BTU >�P
0 (REMARKS—OVtR)
SUBJECT
PERMI O.
City of Fridley
o " 17442
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R E C>9440r'
------- COMMUNITY DEVELOPMENT DIV.
i
4 a �®
r 1 PROTECTIVE INSPECTION SEC.
X
I� �(J
1 I �
CITY HALL FRIDLEY 55432
,.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
445 IQA
JOB ADDRESS 668 63rd Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
9
63rd Ave. N.E. SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Myron Stickley 668 63rd Avenue N.E. 571-3265
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
soffit and trim, replace picture wilhdow
9 CHANGE OF USE FROM TO
STIPULATIONS
T VF --OCCUPANCY
GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
um
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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$4,000.00
2.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMAN E OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
- =�
46.50
SI ATUREOFCON' A ORORA N RIZ�'v`J"" (DATE)
��"�yp�'
SY URPERMIT
PROPERLY VALIDATED THIS IOft
' �
BLDG INSP
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
CITY OF FRIDLEY Effective Aug. 1, 1961
APPLICATION FOR RESIDENTIAL BUILDIIJG PERMITS
(News Alterations. Additions, or Repairs)
OWNER:. Ar� �7'r K q_ BUILDER:
ADDRESS: & AV, f'�,�__ ADDRESS: CZ0--)'Fe-iqL AU,
TEL M0: TEL N0:
Construction location
STPJ= NO BTM=: �Z5 f� r ® 1Li -1 lf� ! i
LOT: 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 certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square Facts Cubic Feet:
Fronts Depth: Height:
Y Square Feat: Cubic Feet:
Type of Construction: sS FPly' ICIVb-° Estimated Cost: S ' ! ogp
QiMpe
Tb Be Cbrapleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired:
SEE REVERSE SIDE OF SHEET
The undersigned hereby makes application fox a •
'' pp permit for the vnork herein specified,
agreeing to do ,all work Its strict accordance with the City of Fridley Ordinances and
rulings of the Delkirtme nt of Buildings, and hereby declares that all the facts and
representations stated In this application are true and correct. .
UNTEs #-- Z6,f SIGNATUME:
Stipulations:
CITY OF FRIDLEY INSPECTION DIV.
Effective On March 1, 1996 p�
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, %� `n �.6
572-3604 REFRIGERATION AND AIR CONDITIONING
SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
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 $ 30.00
S-46P�
representations stated in this application are true and correct.
(Side Vent – Fill Out Back)
Gas Piping (Needed with new furnace) $10.00
S
C2 ,1996
OWNER
Gas Range $ 10.00
$
BUILDING USED AS
Gas Dryer $ 10.00
S
*Air Conditioning
GO
ESTIMATED COST PERMIT NO.
– All Sizes $ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs $ Alterations (LIST ON BACK)
I% of Value of Appliance or Work
$
No. of Heating Units % Circle One (Steam) (Hot Wate (Warm Air
Trade Name �e� Size No. —
Commercial/Industrial
BTU HP EDP
1.25% of Value of Appliance or Work
$
Fuel r%A- S Total Connected Load
State Surcharge
S .50
Burner Trade Name Size No.
BTU HP EDP
TOTAL FEE
HEATING COMPANY'<,</�1����
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
/
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signed By - Tel No.—Z�7_ XV
PLUS THE S.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
xAir Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Approved By
FILL OUT BACK SIDE
Rough–in Date
STACK VERIFICATION ON
Final Date
�� IREP A k mURNA C1 l�s'P
City of Fridley
SUBJECT
-")
•-
70;-
AT THE TOP OF THE TWINS
BUILDING
PERMI"':'
2758 ,
r
______ COMMUNITY DEVELOPMENT DIV.
1 v .. PROTECTIVE INSPECTION SEC.
-
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9398
JOB ADDRESS 668 63rd Avenue NE
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
9
Christie Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Myron Stickley
571-3266
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Great Northern Resources Inc. 10026 University Ave Con RaRids 784-0162
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 fEk REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 14 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
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 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
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
$1199
.60
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION R THE RFORMANCE OF CONSTRUCTION.
$40.25
Fire SC $1.20
PLAN CHECK FEE
TOTAL E
Licen a
5.00 .05
SIGNATU E OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN OP
BLQf NSP
Y ALIDA HIS IS U E
rIAiE
SIGNATURE OF OWNERoF OWNER BUILDERI IDATEi
JUL-06-1948 15:24 FROM CITY OF FRIDLEY TO 7888864 P.01/02
AUDF4 '(] CITY OF FMLEY
ALTER (] MGM FAMMY -AND DUPLEXES It -1 AND R-2
BUILDING PERMIT APPLUCATION
av M 4 Nis rim
Ugal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
r
Attach to this koplication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
;. DESCRItP'I'ION OF IMP'ROVENIENT
Length
Length
Width
Height
Width
Height
Width
Hgt(Ground
Estimated Cost: $
Sq. Ft.
Sq. Ft.
Sq. Ft.
(Fee Schedule on Back)
99
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ m $
DATE:
APP.C.
0 a, 1, Tel. #
CITY USE ONLY_
Permit Fee
$
Fee Schedule on Reverse Side -t,o
Fire Surcharge
$
.001 of Permit Valuation (1/10th%) 1'
State Surcharge
$ fnfi
$.$o/$1,OOQ Valuation.i4
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Cont raators)
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 $ r,
STIPULATIONS:
l
SUBJECT
RAULhQ
City of Fridley
33085
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECIETINT NO.
COMMUNITY DEVELOPMENT DIV. >r ------
; PROTECTIVE INSPECTION SEC,
572-3604
511)
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED Br
� CITY HALL FRIDLEY 55432
763-571-3450
910-F15
9/13/02
JOB ADDRESS 668 63 Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
g
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Myron Stickley 668 63 Avenue NE
763-571-3266
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 651-786-0550
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
Install interior basement drain tile system
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping
rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code.
erll Ins�o�lion
arils
WillBe oil
811
®o®Wner to Post
SEPARATE PERMITS ARE REOUIgEO 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
$3,860
$1.93
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
City ense
$1 .04
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
ENP OPE 'LIDATED HIS IS R P/ERMIT/xJ
_
/
INSp FSA TE
$,GNATURE OF OWNER,F OWNER BUILDER- (DATE,
l
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER C] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�3
Construction Address: (o (a X G 3 —#` Ai_�.c • ��
Legal Description: M DraAn -VEL, Sus�c
Owner Name & Address: LIUYon &+� tkl� Tel. # 1(e3 - S? 1-3op(i(o
Contractor. Rite -Way Waterproofinci MN LICENSE#
Address: 448 Lilac Street, Lino Lakes MN 55014 Tel.# 651-786-0550
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: rntPrinr RaspmPnt Drain Tile- SjEatPm
Construction Type: Estimated Cost: $ 3 $(9 0.00
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: q-// APPLICANT: Tel. #
Call (763) 572-3604 for Permit Fees If mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
$ 00- a S
Fee Schedule on Reverse Side
Fire Surcharge
$ 3-14
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 1 • g3
$.50/$1,000 Valuation
SAC Charge
$
$1200 per SAC Unit
License Surcharge
$ IN X
$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
$ l a -S- VLI
STIPULATIONS:
Building
Permit Fee
BUILDING
PermitNo.: aav i D
Inspections
$
RESIDENTIAL APPLICATION
Received By:
763-572-3604
.001 times the total job valuation
CITY OF FRIDLEY
Datt&:MA 1Z
763-502-4977 FAX
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
EFFECTIVE 1-1-09
$2000 per SAC Unit (Plans to MWCC for determination)
DATE ®
YOUR E-MAIL ADDRESS X--C®0,ker A -04 v Cp;%? 1
SITE ADDRESS �f'
✓� S£
THIS APPLICANT IS:
❑ OWNER (CONTRACTOR
PROPERTY OWNER/
NAME: �%A"i f Oe Sfi Wcle y
TENANT
2y,,v
ADDRESS: 6d e rr CITY TATE ^11-'1ZIP S$Of /
$
PHONE: %d 3 57-7/
CONTRACTOR
NAME:
SUBMIT A COPY OF
STATE LICENSE # EXP DATE
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS: �!�/ Z®(t /i £. CITY r4grA {%( STATli ?-VIP SSB
INSURANCE
PHONE `763-300-,o 3yo FAX '163 w 3 - 5c/ S 2.
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED 11 WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: `h serol./
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FORNEW CONSTRUCTION INCLUDING DECKS,
11 Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
IN EXISTING OPENINGS Aftes ON. LOCATION OF WINDOWS
3. Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED rl ✓ NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ U, OCCUPANCY TYPE
Permit Fee
$
L5- See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
ni �— .0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
y n L Make checks savable to: City of Fridlev Attach Stipulations
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 a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all,,w��ork which requires review and approval of plans.
SIGNATURE OF APPLICANT adO V e";t PRINT NAMEAdeLU I, C°Oat DATE S-// -169
I PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK I