PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 5 3 01
Date: :— J. �./, _.
Owner: Builder
r
Address _ Address
LOC TIO BUILDING
No.Streetlie - F Part of Lot
.t,,.-
ot. Block Addition r Sub -Division _
Corner Lot --- Inside Lot _� Setback = SideYard-�•�---_--------
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth R Height Sq. Ft. Cu. Ft�r
Depth ei t Sq. Ft. Cu. Ft.
of nstruction Est. Cost "'i'o be Completed
Type`
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 $,, 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
NOTICE
This permit don not cover the construction, installation for wiring, plumbing, .gas heating, sewei or water. Be sure to see
the Building inspector for separate permits for these Nems.
0 .46Pi4 0
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
43 4.... Street ,6-�, AZ, A-aas < of Lot
Lot / / Block 3 Addition or Subdivision
Corner Lot Inside Lot Y Setback �� Side -Yard /o
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
Sq. Ft. Cu. Ft.
Front /-2- Depth_xaV Height / 0
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
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 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 ��� SIGNATURE Oct 0-1�
y
(A Schedule of Fee Costs can be found on the Reverse Side.)
Application for Power Plants and: Heating. Cooling. Ventilation, .Reh igeralion tind
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARPF AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 8'00
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. ............. 5.00 $
Repairs & Alterations each add. $500.00 ....... :...... 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam.......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 5*00
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$ 1,50
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$
ROUGH Plan #R-1 to File
FINAL
Dept. of Bldgs. Phone SU. 4-7470
Location 195 - 63rd Way
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn 5-25-61 19
Owner FaU-1 0Gn8t10aQU0R COI&PMY --
Kind of Building -
Res.
Used as
To be completed about 6-2
Estimated Cost, $— 450 *00
Old --Mew. Building Permit No. Q Permit No./ �0�
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, Hot Wates, Wa—L air Nol
Weezatinghouse GO -100
Trade Name Size No
Capacity Sq. Ft. E.D.R 100BTU H.P.
Total Connected Load 45,631 Kind of Fuel Ga s
BURNER — Trade Name Size No
Capacity.
(REMARKS -OVER)
Sq. Ft. E.D.R BTU H.P.
By FRED VOLT & Co
_59 BusinesseWe
Tt� 8 AIR CONDITIONING
42 zM rat Lake St. x WE. 9-6767
St. Louis Park, Minnesota
V'
Application for Power Plains and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ........................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .....
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..... ...........
2.50
$
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ..... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ........................ x $1.50 $ 1"1-5®
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING a $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ —SIX)
ROUGH
FINAL
Dept. of Bldgs. Phone SM -3450
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application Ore true and correct.
0
Owner
Kind of Building 4Z—
Used as
To be completed about40/
Estimated Cost, $
Building Permit No. . 4-3 b/ Permit No. I L
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
194�
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name Size No
Capacity. Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
42
01
SUBJECT
City of Fridley
18022
F
AT THE TOP OF THE TWINS
BUILDING PERMIT
f
RE T NO.
Y_�___. COMMUNITY DEVELOPMENT DIV.
r 1 PROTECTIVE INSPECTION SEC.
1 �
`
1 "1 CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/3/85
JOB ADDRESS 195 - 63rd Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
] ]
3.
Eva Erickson River Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Earl Ransom 195 - 63rd Way N.E.
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Richard Hastings Contr. 6331 Riverview Terrace NE
574-9966
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 KJ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof 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.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$1, 600
$'80
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-
$26.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
GA PS
$27.30
SIGNATURE OF CONTRACTOR OR A1#HOR17ED AGENT (DATE)
WHEN PROPERLY VA
ATED THIS IS YOUR PERMIT
BLDG INS P
Z� .3
TE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
01
NEW
[
]
City of Fridley Effective 4/1/84
ADDN.
[
]
R-1 AND R-2
ALTER.
[
]
Building Permit Application
Construction Address: lC�` 6 ,3 �.s Al
Legal Description: Co°t /% ��k 3 JFyA Ef,ckSon/ k►04�4 AAA�vo&
Owner Name a Address: A AL 'RAN Sd Nf ) 9S 639D w A� Tel. f
Contractor: i c� A 2.) k�o s ?cr` Rt GS' -Tel. i
Address: 633 ( Ric yE90C".J ?1-Z
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:
Corner Lot [ ] Inside
Lot
[ ]
Ft. Yd.
Setback Side Yard Setback
Type of Construction: 7 -EA?,
o"�'F
too Estimated Cost: 8
Approx. Completion Date:
Alt. A
Alt B
Proposed Driveway Width
If New Opening Is
Desired: $
8
See Back Page for Explanation
DATE: �Z3,L,?S APPLICANT:
w
Tel.
f S? If 99�
CITY
USE ONLY
Permit Fee
$
�2 6
Fee Schedule on Reverse Side
Plan Check
$
25% of Building Permit Fee
State Surcharge
$
$ D
=.50/$1,000 Valuation
SAC Charge
$
$425 per SAC Unit
Park Fee
$
Fee Determined by Engineering
Seiner Main Charge
$
Agreement Necessary [ ] No; Necessary [ ]
TOTAL
_
U
STIPULATIONS•
SUBJECT
PER
City of Fridley
24920
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
' '
RECEIPT Nq.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
1 � i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
�....
612-571-3450
910-F15
3/24/97
JOB ADDRESS 195 63 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
11
3
Eva Erickson River Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Lyman Ransom 195 63 Way NE
574-9734
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Same
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 O ALTERATION REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage (Vinyl)
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and have inspection of same unless
manufacturer's specifications state it is not required.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,100
$.55
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
$39.15
SIGNATURE OF CONTRACTOR Ofy9►UTMORI2ED AGENT IOATEI
WHEN PROPERLY LIDATED THIS ISYOUR PERMIT
SI�.TU.E01..NEF10FOW NER BUILDERI IOATEI'
BL INSP
OA7E
NEW l
ADDN
ALTER [ ]
ConstructionAddress:
Legal Description:
CITY OF FRMLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
195--63 E--
P2 i u n T RG: S' DE-.JGE
Effective 1/1/97
Owner Name & Address: L y ofg � , t=,-. pz.AM -5 o rr Tel: # s' 7 I73 yG
Contractor: S <F L r MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Grou7tT�
q. Ft.
s� a , �Sib
A
If
RDa 3/4 y
R�PL�tcC 5�P�`NG
Driveway Curb Cut Width Needed Ft., + 6 Ft = _
Estimated Cost: $ //0 o e
(Fee Schedule on Back)
Ft x
DATE: 34 4 117 APPLICANT: Tel. # 5.7 73 y�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
6,r�=
,79 7
CITY USE ONLY
$
Fee Schedule on Reverse Side
$ %. /Q
.001 of Permit Valuation (1/10th%)
$
$.50/$1,000 Valuation
$
$950 per SAC Unit
$
$5.00 (State Licensed Residential Contractors)
$
Alt. "A" or Alt. "B" Above
$
$450.00 Conservation Plan Review
$
Fee Determined by Engineering
$
Agreement Necessary j. ] Not Necessary j
STIPULATIONS:
6,r�=
,79 7
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 5543.2 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572.3604 REFRIGERATION AND AIR CONDITIONING'SYSTEMS AND DEVICES -
RATE SCHEDULE
Residential
Rate
TOTAL
Furnace Shell and Duct Work,: Burner -
Also Replacement Furnace
$30.00
$
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
$ 10.00
$
but not replacemdht)
Gas Range
$ 10.00
$
Gas Dryer
$ 10.00
$ i
*Air Conditioning All Sizes
$ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge $ .50
TOTAL _FEE $
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATIONZAIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not•be placed in a side yard without
written permission from adjoining property owner..
JOB ADDR
3
Effective On January 1, 2002
BUILDING USED AS (1�St041!414-r/
ESTIMATED COST 3��d PERMIT NQ; 1, /
DESCRIPTION OF FURNACE AND OR EWRNER
1.
No. of Heating Units Circle One (Steam)'. (Hot�Water) (Warm Air)
Trade Name Size No.:
BTU HP EDR
Fuel Total Connected Load_
t.
Burner Trade Name Size No.
BTU HP
EDR
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 an
rulings of the Building Division, and hereby declares that'all;the facts and
representations stated in this application are true and correct
STANDARD HEATING & AIR CONDMM CO.
410 WEST LAKE .;TREET DATE 71
MINNEAPOLIS, MN 55408-2998
612-824-2656
HEATING CO
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMnN VENT}VENT .nNN .Tl7R AND.C)MI3 ISTInN A1R yaipcAmN
When _re In acing ars tmfingfurance, the undersigned hereby verifies that the
venting has been e)(omined and; is free from W" st, detoratiort "obstructions,
and is securely supported -.and f restopped where required. Yes O No (:)'
The venting system is plastic(PVC and meets all current codes and manufacturer"
specifications including sizing; length, number of elbows and termination. Yes () No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes() No ( )
The oxesting nnmhtjsr1nn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to install a new g;nmhustinn airs it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When jne alling a new venting syr,,, the undersigned hereby verifies that
itis a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fdtnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented:
separately as per current codes. Yes ( )No(
)
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat.
Appliance #3 Type
BTU Input
Fan Assisted or Nat ,
Total Appliances
Total Btu `Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
HEATING CO:
Signed By:
Date
SuBjECT
ITN`
City of Fridley
3 309
AT THE TOP OF THE TWINS
BUILDING PERM
I T
1-11
r
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
�a
r E PROTECTIVE
(®3
1 ; i
NUMBED
REV
DATE
PAGE Of
APPROVED BY
CITY HALL FRIDLEY 55132
763-571-3450
910-F15
9/18/02
JOB ADDRESS 195 63 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
3
Eva Erickson River Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Janet Ransom 195 63 Way NE
763-574-9734
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Window -Lite Home Imp 8400 89 Ave N STE 460 Brooklyn Park
MN 55445 763-391-8334
e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20039258
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW 0 ADDITION 0 ALTERATION REPAIR
0 MOVE 0 REMOVE
8 DESCRIBE WORK
Replace 9 windows within existing openings
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.
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 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
$9,400
$4.70
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$181.25
Fire SC $9.40
K THE PERFO OF CONSTRUCTION
PLAN CHECK F
TOTAL FEE
�'/�
Lic e C $5.
200.35
SIGNATURE OfCON'RACTORORAUTHORIZED AGENT iDATE,
PROP R VALIDAT THIS IS UR PERMIT,
OG �NSo
A
DArE
S-GNATURE Of OWNERiif OWNER BUILDER, iDATE,
Pan X01 Z,3o?3 3- JOO- 10Lj
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �Q�� &-)Lq W
Legal Description:
Owner Name & Address`�ge4 iean, Spm % /q5-/y3r,:4' Tel. # 22V 7
Contractorp: n /V�0tj - 1-N6m e Ziv MN LICENSE #-ibL1 9 5�
Address:' qoo - f?qib tom! of- A,),)• '-�f ° 7 '/[ Tel. #.-Z M - S33
Attach to Ithis 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: 9' 14J; n c/vci )& jQh2 j 2W1 a 4P Cost: $ 9, 446 • ®®
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: 9130 69 APPLICANT: 4 -d -o', P 6—l�L ® `—Tel? ,,g J&;g-39/-f23y/'
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 Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $q. 7o $.50/$1,000 Valuation
SAC Charge $ $1200 per SAC Unit
License Surcharge $5.60 $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 $ C:266 • '35- STIPULATIONS:
3uilding BUILDING Permit No.: n��(
Inspections RESIDENTIAL APPLICATION Received By:
163-572-3604 CITY OF FRIDLEY Date Rec'd:
)ATE MA Le 3T—L4 R O O YOUR E-MAIL ADDRESS
,ITE ADDRESS
'HIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
S o�
ADDRESS:
W A(
CITY Eg t 1- Li- STATE
TENANT
PHONE: -)(,.3-S-77'4
` 01 a3 q
CONTRACTOR
NAME: C -H
BOMS S
STATE LICENSE # 2® a 7
O 01 // 4, EXP DATE O a C5
W. D STAA"ZIPJ�f
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: -S S3 3 -2 B
N ,
CITY --A /`%
WITH APPLICATION
PHONE -71,3 - S.3 �6 b� FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION
SIZE -H G A"-6 9
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION
GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH
❑ ROOF
❑ DRAIN TILE
❑ DECK
❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW
❑ ADDITION
❑ MAINTENANCE/REPAIR
REMODELING
DESCRIBE WORK BEING DONE: Lr yT�4',j A .2 c4X 2 q 6AAq6Z
SIZE OF IMPROVEMENT i Z X 2 y LENGTH ZLf WIDTH % HEIGHT a 1-r Sq. Fag
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED �
PROPOSED HEIGHT:
SID G
inyI
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yeso
OR FOR NEW OPENINGS -DESA E SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
ALL F ES ACRE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
9.3 -7, (USING VIE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
❑ HOUSE ONLY
❑ HOUSE & GARAGE
ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
WINDOWS
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
Permit Fee
Plan Review
Fire Surcharge
Surcharge
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$20=$
$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 PERMrf-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; that the work will be in accordance with the approved
plan in the case of all work which r ' es revim and appro 1 of plans.
SIGNATURE OF APPLICANTL—L.PRINT NAME Jrl= -J ° ' U4KAl DATE I-) ` 6. 060
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MIN NEA POl.19 20. MINNESOTA
TUXEDO 0.2100
HARRY S. JOHNSON
ROBERT B. MEREDITH
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HARRY S. JOHNSON r....0 a• z 100 '
ROBERT B. MEREDITH
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lic#20270966
5533-210'x' Ave NW
Burns, MN 55303
763/753-6081 612/6854918
May 5, 2006
City of Fridley / building dept.
Re: Permit request for 12x24 attached garage addition
Homeowner Janet Ransom, 195-63`d Way, Fridley, Mn. 763-574-9734
Yurich Construction Inc, a division of Yurich Enterprises, Inc., is requesting a building
permit on the above property for Janet Ransom. Enclosed is a drawing of the proposed
12x24 garage. Any questions or contacts please call 612-6854918.
Thank You,/J
a' ( I. 4 --4
Jeff J Yurich / Yurich construction
Building
q7 . q �'
BUILDING
$
Permit No.: �j
Inspections
$
RESIDENTIAL APPLICATION
.001 times the total job valuation
Received By:
763-572-3604
.0005 x Permit Valuation Minimum $.50
CITY OF FRIDLEY
.00
Date Rec'd: S I�
DATE --_L--3 - U YOUR E-MAIL ADDRESS
SITE ADDRESS Cgrel/Pry N
$
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
$
PROPERTY OWNER/
NAME: `S
$
TENANT
/
ADDRESS: f �r Vis. �� CITY 47
STATFA MP
PHONE:
$
CONTRACTOR
NAME: v1 /V • 4Azc,lento% %� X
STATE LICENSE # O 2 %Q 1 E DATE
-7W
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: I 1,2A/ CITY
STATE ZIP
—
WITH APPLICATION
PHONE �G �- �-r-3 it FAx y
PROPERTY TYPE
SINGLE FAMILYMEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH Q_RROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:ke- -Iwdl
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING�.�.
27
OUSE ONLY
NUMBER OF SQUARES
OUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
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:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 11 A . OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
q7 . q �'
See Back Page for Fee Schedule
$
65% of Building Permit Fee
$
.001 times the total job valuation
$
1 , (,�
.0005 x Permit Valuation Minimum $.50
$
.00
$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 ( )
$
in I
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 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 of all work which requires review and approval of plans.
SIGNATURE OF APPLICAN PRINT NAME��/.�DATE