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PRE 2010 DOCSI� • Village of Fridley, Minn. BUILDING PERBM NO 859 Office of INSPECTOR OF BUIIMINGS Owner a° Architect it Fridley, f Builder ii LOCATION OF BUILDING No. Street �"/ .�0„a Part of Lot Lot._ Block Addition or Sub -Division i ! DESCRIPTION OF BUILDING Front -!,L4— Depth �'- Height " Stories n' --'Manner of Construction_ ,f To be used as ' c* r- n{°� To be completed"' £'<1' y` ` Estimated Cost FFF T �I Permit is hereby granted the building described in the above statement. This permit to granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, :Around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, ji Minn., regarding the 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. .e,r�•.z.�-��"b.a. inspector of Buildings. it AGREEHFNT AND SWORN'`STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance. with the description above set forth ",and according to the provisions of the ordinances of Fridley, and, being first duty sworn, I hereby] state and say that the facts stated by me and contained in the above permit are true as therein stated. !i Subscribed and sworn to before me at Fridley, Minnesota, this- day his day of A.D. 19_..���r ti.-��-•-Y._� �. for Power Plants and Heating. Cooling, Ventilation, ReMgwatlon and 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 ............................. 0.00 $ 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 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ i� AIR CONDITIONING �, 2,-1 s 62 FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ � ROUGH FINAL U, RYSTUMS ana WOVIG s Dept. of Bldgs. Phone SSU'_ 4-7470 Location t4. 7 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 19 /j Owner G� t) a"' Kind of Used as To be completed about Estimated Cost, $ (0:ld>ew. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --.Steam, Hot Water, Warm Air—No 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) Signed By. .�VZ°42 2M 7.59 Business Phone No 4 Date Wmrw•v Owner +� /S/. Address � Address ..... ......... ... LOCATION OF BUILDING No... �Or� . Street . • • . , .. Part of Lot ....................... Lot .............. Block ....... `. .•. Addition'or, Sub -Division ...... ........................... Corner Lot ;.... .... Inside Lot ...... Setbajck ............. Sideyard ...... DESCRIPTION OF BUILDING Td be Used as: ...... 0"W .Fro � r . nt . depth .". ..Height �.�« .. Sq. Ft.. �ly, Cu. Ft........ . 17 ... FrontDepth ... .. Leight ......... Sq. Ft......... Cu. Ft......... Type of Constructi . Fat. Cost . or........... To be Completed ... . i it . In consideratior of the issuance to me of a permit to construct the building described above, I agree to do the. proposed ;work I i accordance with the description above set, forth and in compliance with all provisions of ordinances of: the vi age of rridtey. ...,.. ......... • •'' In consideration • . it the ' pa�ryment of a fee of $.. ... , permit is hereby granted to ........... :. to ' construct the building 6r ad dation as described above. This permit N granted upon the express diti "hst the person toVhom it is granted and his agents, employees and workmen, in all work done in, around and said building, or' any part thereof, shall conform in all respects to the ordinances of Fridley, Whu=esota " arding location, construction, alteration, maintenance, repair and moving of buildings with - In the village limits d.this permit may be revoked at any time upon .violation of any of the provisions of wid ordinances. .. Building inspector K. NOTICE: This per It not cover the construction, Installation or alteration for Wiring, plumbing, gas heating, sewer or r. 'a sure to see the Building Inspector for separate permits for these Items. ,Ik V' App�hcation for Power Plants and: Heating, Coding, 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 ............................. §.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. 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 $ GAS, FITTING FEES: NO RAii TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 DTU ........... x 2.00 $ - AIR CONDITIONING -_ _ $ FAN HEATING SYSTEM Se® Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH Dept. of Bldgs. Phone SU. 4-7470 Location o .3 / - 43 coir ✓ `� p 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 19 Owner Kind of Building Used as iQ� To be completed about Estimated Cost, $ 'ZrO� Ol New. Building Permit No. Permit No.� HEATING or POWER 15 Trade Name Capa ' �ffI Total Connected Load, ;WORK Nater, Varm. Air—No Size NolIMNd 1 -If a 7� Ft. E.D.R BTU H.P. 71 'A /`A . h '– Kin BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. TM 7-59 (REMAR4`OVER) l iii►`..r.—•wi �� Business Business 'hone No i® 01 SUBJECT PE RMIT City of Fridley o 9909 AT THE TOP OF THE TWINS BUILDING PERMIT _ r REC O. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 3 y3 r PROTECTIVE 1 � ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/22/89 JOB ADDRESS 1039 - 64th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Woodrow Colby 1039 - 64th Avenue N.E. 571-6263 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Niznik Construction 203 Main Street N.E„ Minneapolis, MN 55413 536-5933 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 Ij REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (14 Squares) 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. On all new roofs oP tear -offs and rept^c^^±ent roofs, State Code requires that 2 layers of 15 10. tett, mopped together, be installed to a point 24 incbn up from exterior 'fall lige, or *the use of oft approved underlayment membrane. 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 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 1 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 $700 $.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 SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 4 ng .50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH PROPE LY A I T T I IS YOUR PERMIT G INSP qi SIGNATURE OF OWNER IIF OWNERR BIiI L DE RI IDATEI 01 NEW [ ] ADDN [ J AL'I'T [ J Construction Address: Legal Description: _ Owner Name & Address: Contractor: Al P ,, Address: si ® i R-1 AND R-2 Building Permit Application Effective 5/1/88 Tel. # W- a2o.� Tel. # 51.fy" -,5-Y,7,3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: --'"7 o 0 Approx. Completion Date Proposed Driveway Width If New Is Desired: Ft. $ $ qWidth + 6' See Back Page DATE: �/ �l�l APPLSCANT: ( J. Tel. # Permit Fee State Surcharge $�Zj SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary L J Not Necessary L J CITY OF FRIDLEY INSPECTION DIV,- Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS I 0-1�V I Lk� 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 Fumace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and eplacement Fumac $ 20.00 Zs7PIping $ D ®v representations stated in this application are true and co t 1993 (Needed with new furnace) $ 10.00 OWNER Aloffyoll Co I Gas Range $ 10.00 $ BUILDING USED AS V1 bA Gas Dryer $ 10,00 $ ESTIMATED COST* (�� PERMIT NO. *Air Conditioning — All Sizes $10.00 $ ' j)ESCRIPTIQN OF FURNACE AND OR BURNER All Others/Repairs•& Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No, of Heating Units ( Circle One (Steam) (Hot Water) arm Air) Commercial/Industrial Trade Name Size No. 2 BTU -J HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. TOTAL FEE D „a BTU HP EDR Richmond & Sons Elec.. Inc. dba.' HEATING COMPANY Golden Valley Htg. & Air Cd. MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION 5152 West Broadway REFRIGERATION/AIR CONDITIONING PERMIT IS X15.00 Signed By Crystal, PSN 5, No. n AU PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By Rough—in Date Final Date /. *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (/f No ( ) 2. Is free from rust or deterioration Yes (� No ( ) 3. Has no foreign objects lodged within Yes (,� No ( ) 4. Is securely supported Yes / No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (/S No ( ) 6. Has total heating BTU's of All other BTU's `— TOTAL BTU's i Remarks List Alterations Being Done: 5ii Crystal; �J�N HEATING COMPANY PhDn® 535-200® Signed By A --A Y 00 Date SUBJECT PE City of Fridley 26405 AT THE TOP OF THE TWINS BUILDING PERMIT ' , REC , COMMUNITY DEVELOPMENT DIV. _ �' PROTECTIVE INSPECTION SEC. r ; ��� NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 "'' 612-571-3450 910415 6/22/98 JOB ADDRESS 1039 64 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Woodrow Colby 1039 64 Avenue NE 571-6263 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Mon -Ray Inc 8224 Olson Memorial Hwy, Golden Valley, MN 55427 546-8625 5111 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION _[] REPAIR ❑ MOVE ❑ REMOVE X B DESCRIBE WORK RAtAttl$kAkAj Replace Windows 9 CHANGE OF USE FROM TO STIPULATIONS X>h�fb.��/��.�.f��.%�/�bfb.�/byid/kb.ff/fbf/�.f.b�bkbf�b�i/16kfbfles/Eb,bbf�>t4�1 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 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 $2'000 $1.00 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 PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $70.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLYVALIDATED THIS IS YOURPERMIT aLfG INSP .r GATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW ! 1 Effective 8/1/95 ADDN ► ► CITY OF FRIDLEY ---------- ,,ALTER (I SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application W Construction Address: 1039 4th Avow -A NF - Legal Description: — Owner Name & Address: WOODROW COLBY Tel. # 571-6263 Contractor: MON-RAy TNr, _ MN LICENSE # Address: 8224 Olson Memorial Hwy Golden Valley, MST 55427 Tel. # 546-8625 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. I 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 [ ] Type of Construction: Approx. Completion Date: _ Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 2.000.00 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ _ $ _ DATE: &-ajar qg _ APPLICANT.- �Q Tel. # _ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY_ $ 25 Fee Schedule on Reverse Side $_200.001 of Permit Valuation (1/10th%) $ 1. nn $.50/$1,000 Valuation $ $850 per SAC Unit $ 5.00 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined bry Engineering $ Agreement Necessary [ecessary [ ] a' r suB.IEcr(J*2 T NO -0 City of Fridley 6 1 6 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 1039 64th Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 Moore Lake Highlands SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Woodrow Colby 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Gates Roofing 4640 Ximines LN Plymouth, MN 55442550-0043 6793 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 X7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and arae 14 s tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 $1167.00 .58 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- STRUCTI OR THE PERFO MANCE OF raNSTRUCTION. $40.25 Fire SC $1.16 C� PLAN CHECK FEE TOT FEE Lice .00 4 .99 t.GNATUkE O CONTRACTOR OR HORIZED AGENT IDATEIEN ROP BL INSP VALIDAT D HIS IS YOUR PPERMIT 0-22 r�ATE URE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: )0 3 " l 6 `tom pv r P • C& - Legal Description: 7 o,• - 02 -C -F l -e- Q - Owner Name & Address: Woo bxo- 3 �o•-.T Tel. # Contractor: 6;av-N-e-5 MN LICENSE # �7 R Address: C4G''W K( M ew-c s L Tel. # S3' a Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EIAPROVEMENT 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:- Estimated Cost: �l 67.66 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: % - " Ft x $ = $ APPLICANT: Tel. # e' cZ y4 STIPULATIONS: r CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /i .001 of Permit Valuation (1/10th%) State Surcharge $_ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ , d O $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 $ STIPULATIONS: r City of Fridley=733 SUB�ECi _7" 5 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. fr COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � 1 ; I NUMBER JiFV DATE FPAGE OF APPROVED BY 1 "'1 CITY HALL FRIDLEY 55432 763-571-3450 910-F15 10/20/03 / 1OB ADDRESS 1039 64 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charles Shields 1039 64 Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8826 20268257 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace one patio door within existing opening 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. Caulk and flash all exterior openings. Inv C"fian cards WN L2 To ger To Post 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 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 1 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 $4,164 $2.08 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- $111.25 Fire SC $4.16 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CNE KFEE TOTALFEE Licen a SC $5.00 $122.49 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IDATEIW EN PROPERLY VALIDATED THIS IS YO R PER IT S.GNATURE OF OWNER IIF OWNEABUILDEA, IDATEI O INSP QATE NEW( ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER L ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: L�b n Legal Description: Owner Name & Address: l ,�� �,QS �����1 Tel. #-IMfj1 k moi Contractor:. RMA HOME SERVICES INC. MN INCENSE # Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. # Atlanta, GA 30339 A 763-542-8826 urvey. of the k BC -20268257 .. in it to scale. DES .CRI -- ON OF IM.PROVENIENT 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: C�, {� l Estimated Cost: $ 4, Driveway Curb Cut Width Needed: F 6 Ft =t x $ _ $ DATE: _(Q . Com' f �():ZSA11LICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ W -95 - CITY USE ONLY ID,4 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] Not Necessary [ ]