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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N?s32K Date: ZI Cwner: Builder Address CATION OF BUILDING No.F Street Partof Lot _ ___ Block Z Tm or Sub -Division -+ �'►f /I i Corner Lot Inside Lot — l Setbackiii..---'0 _ Sideyard Sewer Elevation _____ Foundation Elevation DESCRIPTION OF BUILDING To jq Used Front Depth ti4LA Height Sq. Ft Cu. Ft rant Deptht Sq. Ft Cu. Ft Type of Construction �`+�� Est. Co 'ter To be Completed In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with aft provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $L.�"" , 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 heat permit may be revoked at anq time upon violation of aay of the Pomona of said ordinances. .rl) Building Inspector NOTICE: fhb pariah don not cover the cendructton, indaW= for Ufa. plumbing, gn hsathm aver or wrier. Be sun to as the Buthiing lespeetar for separate permits for thus home. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder Address Address LOCATION OF BUILDING No. Street .3 C®ll� Part of Lot Lot Block, / Addition or Subdivision Corner Lot ---.Inside Lot Setback -fd Side -Yard AD / SEM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used ass DESCRIPTION OF BUILDING Sq. Ft. Cu. Ft. Front Depth Height 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. /2 (A Schedule of Fee Costs can be found on the Reverse Side.) Aarril surveyerls eertinecte sso�j;ez ,s� jeq 90,t ps i� _ __ I -,pm n} 1 0 6 2 1 f H A N C E A V E a .(J�J�j(��/UfA'JW Co.` M I N N E A P n L 1 9 20. T U XE C) O B- 2 1 6 0 HARRY S. JOHNSON ROBERT B. MEREDITH cql f r; Prop^" o0 io U L 4 , C N � ��N iT/Llr� EASE -- J,01 -- ti - - 3 I I e• •I • I 5 I� 0130 9 herby c o t q that t i& ice. a tome and correct 4ep„se, tAtjort of a 4oty" of the b o&vida . i.pi.� of .eot S, Block 2, F U A F R 9 C K S 0 N R 9 V F R M A N d R, Anoka Co&wty, Minnesota. sota. 94 does. #tot p#4,vot t to dhow 4Aptioveme-rzta o -t a z&oacAme� U, 4 anq. k& awed b y ire ,brie. b � clay of G ' Vii% f� f k� , 196,x. P 4u�ty S/. {�rr�cert, M..irt . k'eq. No. 5065 City of Fridley Application for Plumbing and Cas Fitting Perndt DepL of Bldgs. Phone SII 4.7470 ® DESCRIPTION OF WORK 158 — 632 Way Number, Kind and Location of Fixtures Location m ai rc iLR s in RATE °cZ � aaz p�j,PI J 0 (7 z • F • N WATER HTR. GAS ELEC. 2 2.40 Future Fixture Opening ................ x 1.20 $ New Fixture Old _ Opening .............. x 1.00 $ O Catch Basin ............................ x 3.25 $ 2.00 Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: l RATE 1 1 1 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x 1 $ Base Gas Range to 200,000 BTU .............. x 2.00 $ 1st 11 91anos 1 2nd _ 3rd _ 4th • Future Connection Openings Connected with Sewer New .Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 7 10.50 Number Fixtures ...................... x $1.50 $ 2 2.40 Future Fixture Opening ................ x 1.20 $ New Fixture Old _ Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ 2.00 Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1,50 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ 16.40 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, Mnn December 12 is 62 Owner. Paul Schwartz Const. Ccs• Kind of Building Frame Used as Dwelling To be completed about March 191963 Estimated Cost, $ 800.00 Old—New. Building Permit No Permit No. SignedSTAi BARD PLUMBING A APPLIANCE CO. By - Busin s Phone No We 8 35 9 ROUGH FINAL 42 2M 7-59 Application for Power Plants and Heating, Coding, Ventilation, .Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 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 $ 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 NO RATE TOTAL 1st 3 Fixtures ...................... Furnace Shell & Lines—to 400 sq. ft. IDR 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 $ 14-50 ROUGH FINAL Location 158 — 63J way N. E. 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, r ;nn 12-1 1962 Owner Paul Schwartz Constraotion Company Kind of Building FZ Used as flee. To be completed about 1"19-63 Estimated Cost, $ 450,00 Old—New. Building Permit No. %P & c;'-' 6 permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Wa— Air—No 1 Trade Name Westinghouse Size No„jT ,_1 nA . Capacity. Sq. Ft. E.D.R 100M BTU H.P. Total Connected Load 45 631 Rind of FueL Gas BURNER — Trade Name Size No Capacity. (REMARKS—OVER) Sq. Ft. E.D.R BTU H.P. Signed FRED VOGT & CO. HEATING & AIR CONDITIONING By6530 West Lake St. E. 9-6767 C_ -¢w 4e zM 7.59 Business Phj3 lis Park, Minnesota Land planning Stir 171 4t 1 6875 Highway No.65 N.E. Land Surveying • • Minneapolis, Soils Testing r'�1 tll�f�I �d•�3i�Ir. Minn. 55432 Civil Engineering Telephone 7846066 Municipal Engineering Engineers & Surveyors _ Area Code 612 Mortgage Loan Survey for Mr. Ur--'OUGUN'; F -P15 �r � 2. SCa1e:10feet L------ ----- '7S.? 2 ►ttioYe UY IeSs• LOT 5 BLOW- 2 EVA ER)C Vc1SoN RIVER M NIOP no a co" This is o true and correct representation of a survey of the boundaries of the land above described and of the location of all buildingst if any, thereon and all visible encroachments, if any, from or an said land. This survey is mode only in connection with a mortgage too" now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. it is understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary corners. Doted this,_LLL—doy of--JjUaja_LA. D. 19]1. SUBURBAN ENGINEERING, INC_ Engineg.rs •panssz uaaq sett rCausdna30 30 City of Fridley SUBJECT 13241 THE TOP OF THE TWINS BUILDING PERMIT rAT fEC:EIPTN O. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i I 1 "1 CITY HALL FRIDLEY 55432 L---- A., NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 I I 10/6/75 JOB ADDRESS 158 6331 Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward sky 158 - 6311 Way N.E. 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 RBsidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. Aumm Before digging call local utilities TELEPHONE - ELECTRIC - GAS Etc. SEPERATE PERMITS REQUIRED FOR WIRING, REQUIRED BY LAN,,.,` 1-117ATING., PLUMBING AND SIGNS. 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-1 572 5720 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION j 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, 232 2.12 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- $11.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $13.12 SIGNATURE OF CONTRACTOR O AUTHORIZE GENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT "/) ' A cia'AV /()Z / 1 9'e I'► IG ATURE OF OWNER I IF OWNER B ILDERI r1 ATE) ( A i L SLOG INSP I DA E APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: ---Z_ l,; z BUILDER:- 20- J-4 UILDER:2CJl ADDRESS: ADDRESS: 'S NO:. % S STREET: 2 - LOT: LOT: BLOCK : �-- ADDITION L� 11 cP a2 CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and propose building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: od/A/te;L_&�) Front: z Depth: Height: �U Square Feet: Cubic Feet: 1;5 - Front: Front: Depth: -Height: Square / Feet; —Cubic Feet: 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 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: 10 - (g) -vTS SIGNATURE-:. (See Reverse Side For Additional Information.) Land Planning ,land Surveying Soils Testing Civil Engineering Municipal Engineering Mortgage Nrle(' rrkA' n• 6875 Highway No.65 N.E. n ` (f, Minneapolis, r; jl�%�1T"�« . 2f�f PJ'a2C. Minn. SS432 (, Telephone 784-6066 Engineers & Surveyors. Area Code 612 Loan Survey for mr. D0UGLAS FQ15�E wrY -15,0 n Scale: i RA=-30Veet _.•-;.- '` ". '-r X5.32 - Cy�U,U'r�� }F110E vri �lY1F rtiUre Or `e SS• LOT 5 BLOW 2 This is a true and correct representation of a survey of the boundaries of the land above described and of the location of at[ buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary corners. Dated this__J-�_day of June A. D. 19]1. SUBURBAN ENGINEERING, INC, Engines `� Sur a rs„ by (.� 4'I oz m MIT 14'72'7 SUBJECT P City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO • COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. 1 � � �'•'1 CITY HALL FRIDLEY 55432 �••'• ,'� NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 5/30/78 JOB ADDRESS 158 - 63�i Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Epsky 158 - 63h Way N.E. 560-4320 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ElNEW p ADDITION ❑ ALTERATION 13REPAIR ❑ MOVE F1REMOVE 8 DESCRIBE WORK Construct a 14' x 16' deck 9 CHANGE OF USE FROM TO STIPULATIONS Provide frost footings SEMAlM PERMITS REQUIRED FOR WIRIffut HEA1W.4, KUMING Arra SQN& I 'ARNWG Before digging Cap 1 u TELEPHONE. RECTRlC.� �S Ete Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 ] 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. $400 $.50 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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 MATURE OF CONTRAC OR OR AUTHORIZEDAGENT (DATE) HEN PROPER Y VALIDATED THIS IS YOUR PERMIT &ak ,g_ !� - SIGNATUREO OWNER II OW ER LDER) (DATE) LDG.(NSP OATE m MIT 14'72'7 • CITY OF FRIDLEY , APPLICh'rIm FOR RESIDENTIAL BUILDING PERMITS NEW, ALTLRATIONs, ADDITI011s, oii REPAIRS) 01111ER: T3UILUI;R: Address: ! - �,�' L Q/ f Address: Tel. No. No.: Street: � y LOT: I3I,OCY.: ADDIT I0; ] : _ _-s�� (Lc, CORNER LOT: INSIDE I/JT: SET13ACK: SIDEYARDS: Applicant attach 'to this form lVo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Lkc'. ILI Front: Iq Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: • �QB G7? Type of Construction: Estimated Cost: $ To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opcning Is Desired $ $ (SEE REVERSE SIDE OF SKEET) 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 Ordinancgs and rulings of the Departmcnt of buildings, and hereby - declares that all the facts and representations stated in this application . are true and correct. See reverse sidef'62�7 foreadditional infornlation. DATE: �'p — 7 SIGNATURE:: Stipulations• o .19 .. v SUBJECT RMIT NO. City of Fridley 21111 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV.a- r PROTECTIVE INSPECTION SEC. i = CITY HALL FRIDLEY 55432 APPROVED BY NUMBER REV DATE PAGE OF 612-571-3450 910-F15 10/9/91 JOB ADDRESS 158 - 631g Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Epsky 158 - 6A Way NE 571-2911 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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16t x 221 Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. SEPARATE PERMHTS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS, ASG Before digging Call for sit Efftlity Weations -OOOZ .K QUIRE3 BY LAW 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 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 $5,450 $2.73 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 $5.45 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLA CK FEE TC64L FEE 9.18 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI E LY E HIS I$ YOUR P MIT IJ a-7_-r AWHP W 17 INSP r)ATE $IGNATURE OF WNER IIF OWN BUILDER IDATEI NEW [ ] Effective 1/1/91 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: y Tel. # -571—cls' Contractor: Tel. # Address: 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. 15S OL DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: SSIX 15'*Aer- S14 to Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: _ Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ 151 Ft x $ tce m as*) = S DATE: — APPLICANT: Tel. # Permit Fee $. Fire Surcharge $ �. 1 State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS:lc,—Y-q/ air Application for a Certificate of 0cr.upancy shall be made ten (10)dermitys prior to the use or occupanany stnottUe`used orfor j4�olccupiedluntilingpa Certificate issued; and said structure sued. H mo of- - P- #.!n ad ailb ail' J o a oa a e•xo pawns a s! -atllgo.1 ou puo �taJadoJd aya uo pa�old 6uleq Mou uool 060644ow o yalM uol42auuo2 ul Aluo apeuw sl A*Ajns s141 •puel plus UO JO wOJ', 0/IuO )I'sauew43"00 ua elq!slw 110 puo auoeJaya #Aue I! h6ulpllnq Ila Io uolaoaol 044 p pun paq!Jasap awogo puol 044 Io s01Jo unoq 044 }o �taeJns o ;o uo!aoauesOJdaJ aaaJJoa puo onJ+ a 41 s141 V -fM 'Scia1.40 �J101�A LAI :81 -DOS) u aW .Xoa AeAJng UVOU e2'eRtAoPq 919 apo oaJd sjoAeA.iriGS v s.IeeuT2xi j 6ulJaaul6u3 lodulunw 99o9 -08L 0uoydalal - �J 6ulwouleuj 11^13 1*UUw Ltodoauu!w ��ZC 1d � / • . !a1 1! Bu sa s oS 6ul�taeJnS puol '3'N 99 'ON AO -461H S189 ) �1 •' �=/� [•{•//y% '�/ /�l� 6uluuold Puol - SUBJE& P City of Fridley 2 9255` AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. Cl / 1 1 ; NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 1'' 612-571-3450 910 -FIS 4/20/99 JOB ADDRESS 158 63 1/2 Way NE T LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Epsky 158 63 1%2 Way NE 571-2911 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO American Building Contractor 12233 Nicollet Ave S, Burnsville, MN 55337 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 707-6959 20141480 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (29 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 $2,485 $1.24 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL AW REGULATING CON. $74.75 Fire SC $2.48 NOR THE PERFOR AN € OF CONST CTION VA,l PLAN CHECK FEE TOTAL FEE License SC $5.,PO $83.47 N URE OF CON'RACi R AUTMOR�ZEO AGENT iDATE� WHEN PROPE VALIDATED THIS IS YOUR PERMIT A SIGNATURE OF OW NER dF OWNER BU4DER� iDATEi rBL NSP gAiE 01, r+w-44-1V= UV; lb I-KUM U1IY OF FRIDLEY TO 7079925 P. 011M •. y .. L , raecave !� l�ltf ADDN [) CITY OF FRIDLEY / ALTER S'NGLE FAMILY AND DUPLEXES R 1 AND R 2 6 BUILDING PERMU APPLICATION ConstsvctIoaAddreSs:JS 9, 3/.t 1,-,,t.4v� Alk LegW Description: • . Owner Name & Address: F A W4 Counselor: _A /f% e e : e -- t, c �L , .. y C d �-? rA s T� MN LICENSE fl a o d Address- Z 2 3 3 l I ;c �(t qyc. S/3[c.� 14,%- Tel. # 07-69S 7 Attach to this application, a Certificate of Survey of thIS53 3 7 lot. with the proposed construction drawn on it to scale. DESCRIPTION OF MPROVEMENT LI MG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height_ Sq. Ft. DECK AREA: Lsn c Width �j WGround _� Sq. Ft. v L U - Construction Type: At PtaGc. Estimated Cost: S (Fee Schedule on Back) Driveway Curb Cut Width Needed: . + 6 F ffi Ft x $ _ $ DATE:6 APPT.IC Tel. # CITY USE -ONLY Permit Fee $—.9V Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 1-.;2 f $,5O/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ �. Qy $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 j ) TOTAL $-A3. Z STIPULATIONS: Building AND MATERIALS: BUILDING s �� (USING THE 1997 U.B.0 FEE SCHEDULE) PermitNo.: '^® Inspections OCCUPANCY TYPE RESIDENTIAL APPLICATION $ �% , Received BZ 763-572-3604 $ 3c ® ;Q, CITY OF FRIDLEY Fire Surcharge -7 Date Recd DATE Ji//y f a ® 7 YOUR ADDRESS Surcharge SITE ADDRESS 15-8, Z. 3 z i a o, 1/V9W License Surcharge THIS APPLICANT IS: ❑ OWNER ®CONTRA R SAC Charge PROPERTY OWNER/ NAME: Gc4w 91111'P Ch Curb Cut Escrow TENANT LLC ADDRESS: /S8 (e3-6 ��i o.T CITY '�Ci' ,e STAT&47,9IP $ PHONE: 743 S-7/ 019// Park Fee CONTRACTOR NAME: Ca ( .moi ox o u1l Sewer Main Charge STATE LICENSE # o100 64410 EXP DATE Agreement necessary ( ) Non Necessary ( ) SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: :)03 CZ ® OCG CI gc J-' . i 9 ✓ers STATEINZIP—j�!373 f 2. WITH APPLICATION PHONE (ol 3. a / FAX 3 ZO A7 (i4C3 PROPERTY TYPE 10 SINGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE MADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW 90 ADDITION ❑ MAINTENANCE/REPAIR M REMODELING DESCRIBE WORK BEING DONE: - Z1 -- -6--� Yx8 — 4 .Jry SIZE OF IMPROVEMENT LENGTH oZ/- (o WIDTH /`1 HEIGHT Sq. Ft 3 ROOFING ❑ HOUSE ONLY Fr y NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELIASUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: 13 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DWKS, ❑ Vinyl 0Soffit3 33 7179 ADDITIONS. & PORCHES SUBMIT: El Aluminum ❑Trim ` I. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project. WMOWS 2. Two sets of construction plans Yes No LOCATION OF WS ,---� IN EXISTING OPENINGS ❑❑ 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL ARE BASE ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: JES s �� (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ �% , See Back Page for Fee Schedule Plan Review $ 3c ® ;Q, 65% of Building Permit Fee Fire Surcharge $ 31 , q od .001 times the total job valuation Surcharge $ 15 t 74J .0005 x Permit Valuation Minimum $.50 License Surcharge $ co $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ R 14 o � Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMITNOT 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 quires re h approval of plans. SIGNATURE OF APPLICANT PRINT NAME i V ATE li �b 3 V f- Building MECHANICAL FD rmit No.: c�7 - Ilispection777 SIDENTIAL APPLICATIONceived By:7.63-572-3CITY OF FRIDLEY a� 'd-200 YOUR E-MAIL ADDRESSu fSo. SITE ADDRESS THIS APPLICANT IS: O OWNER ACONTRACTOR PROPERTY NAME: yr ejc Sk OWNER/ ADDRESS: / f i� 6' 3 %7 i . 1 CITY TENANT PHONE: , CONTRACTOR COMPANY NAME: o x- a • �� L–aC IAC SUBMIT A COPY OF CONTACT PERSON: L176 13 5 / 6 0'7 EXP DATE YOUR STATE STATE LICENSE d !Zc34 _ CITY �. c� STA7ErZIP S?/3 LICENSE WITH APPLICATION ADDRESS: 7Q6 �� !?22 FAX PHONE /`�–'�– SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE PERNIIT TYPE O NEW 0 REPLACEMENT �{ALTEItATIONMEMODEL TYPE OF WORK: DETAILED DE-^SCRIPTIOp/N OF WORK Q `i is EJ, Ir.. PERMS 16B.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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) ys SIZEBTU Q eLciz*-rkv Equipment Installed MFG: S °� S C O MODEL: SIZEBTU MFG: MODEL: MFG: MODEL: STZEBTU AIC $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 — A/C TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER 535.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER 15.S35 00 i DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00x $10. _ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00=$ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 j_x $35.00 = $ 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 application for a permit and w is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wo w 'c it eview and approval of plans. SIGNATURE OF APPLIC PRINT NAMEL ^n L_ V kir DATE OL City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or propanelIFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new const cation IMC 1346.0312 5. Ventilation . a. per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 6-19-2007 DATE OF PLANS: 05-08-07 TITLE: JAS -KO BUILERS COMPLIANCE: PASSES Required UA = 123 Your Home = 110 10.7% Better Than Code Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS: Raised Truss 312 44.0 0.0 7 WALLS: Wood Frame, 16" O.C. 536 19.0 2.0 30 GLAZING: Windows or Doors, Above Grade 72 0.350 25 FLOORS: Over Outside Air 32 30.0 0.0 1 SLAB FLOORS: Unheated, �48.0" insul. 69 10.0 47 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. Builder/Designer Date Building' BUILDING Permit No.: Inspections RESIDENTIAL A]P]PLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date 763-502-4977 FAX EFFECTIVE I -I-08 DATE .3 O YOUR E-MAIL ADDRESS SITE ADDRESS /S.R,, !,-- THIS APPLICANT IS: ❑ OWNER WCONT &TOR PROPERTY OWNER/ NAME:yio' s 44-(( TENANT ADDRESS: lS-R G 3-S3 (AJ CI-,_ 4Y STATE/"X-ZIP PHONE: 76 ,S-7 a / / S NAME: ADDRESS: 2 G 3�ro i2fi� CITY -�i ,!! G2I uPs� STAT)y ZIP S2 CONTRACTOR SUBMIT A COPY OF PHONE �o /� l 9 O � FAX YOUR STATE LICENSE STATE LICENSE # loo 666 CU EXP DATE /lame./— PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PQ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT 2YI 30 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl offit ❑Ssoffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ t. and proposed project ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 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 TETE COST OF LABOR AND MATERIALS: THE 1997 UBC FEE SCHEDULE) AL JOB VALUATION $ In t 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 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) $1825 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 a permit and work is not to start without a permit on site; that the work will be in accordan wi the app in the case of all work which requires review and approval of plans. SIGNATURE OF AP CANS PRINT NAME cam,, P J v-Sl�cw cc DATE/�L�� 7 Cj o I e 8y 62r, a kq ! (� --------------- Ly Naw S.S ,/y P THIS SHPLL EE AVAILASLE CIN SITE Fs. R i f •r_ FBF,. Ptc,,tio-, AND FINAL INSPE{JTfV,PdJ goo Su 13k0�1 a�J 1� EVIEWED )R CODE Building PLUMBING PermitNo.: `® 4 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat 'd 763-502-4977 FAX EFFECTIVE 1-1-08 DATE 13 0? YOUR E-MAIL ADDRESS SITE ADDRESS 0 Y w �- THIS APPLICANT IS: ❑ OWNER 000NTRACT R PROPERTY NAME: A w r OWNER/ 1 ADDRESS: l p LD ��a Is�J �i CITY �i� Ale �X STATEjj:ZZIP TENANT PHONE: r - o� CONTRACTOR NAME: STATE LICENSE #e "> 1 EXP DATE SUBMIT A COPY OF YOUR STATE DATE LICENSE, BOND AND CERTIFICATE OF STATE BOND # a 12 EXP ZIP_,� ADDRESS: �sr�,%- ,�STATE,04�-', INSURANCE PHONE FAX --7 PERNIIT TYPE 4SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW AREPLACEMENT DETAILED DESCRIPTION OF WORK e M e/\. — /U eG%.) doer,. g<o' n! IaLV✓^ PER MS 16B.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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. i BATH SINKILAV FLOOR DRAINS SHOWER _ WATER PIPING GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ DISHWASHER �E LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER Y i �.. _ �f_ Permit Fee $ Number of fixtures @$10.00 Y X$10.00=$ U. G Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00=$ State Surcharge = $ .50 (M)NIMUM $15.50 (MINIMUM $15.50) Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 work which requires review and approval of plans. U Fadjj/ Mc DATE A0 Y 67r SIGNATURE OF APPLICAN Ui PRINT NAME ol-/i t14y� - &j4" APPROVED BY rl DATE AP ED City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 502-4977 REPRINTED ON 7/11/2008 ADDRESS 158 63 1/2 WAY NE PIN 153024420044 LEGAL DESC EVA ERICKSON RIVER MANOR LOT 5 BLOCK 2 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : BASEMENT FINISH VALUATION : $ 10,000.00 NOTE: BATH IN BASEMENT AND FINISH STORAGE AND FAMILY ROOM. STATE LICENSED CONTRACTOR? 1 APPLICANT LARRY JASKOWIAK CONSTRUCTION 203 ALDER RD SOUTH HAVEN, MN 55382 (612) 219-0884 EPSKY EDWARD W & ARLIE G 158 63 1/2 WAY NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date PERMIT NO.: 2008-00629 DATE ISSUED: 05/15/2008 BUILDING PERMIT FEE 181.25 PLAN CHECK FEE 117.81 STATE SURCHARGE, BLDG VALUE 5.00 FIRE SURCHARGE 10.00 LICENSE SURCHARGE 5.00 TOTAL 319.06 PAID WITH CHECK # 11233 I Bldg Insp Date I I SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.