PRE 2010 DOCSVillage of Fridley, Minn.
I II it . IiiX U15.111 D! 1k
N® 2 1 Office of INSPECTOR OF BUILDINGS
112 L If
.r
s1� �� y
Fraley, Minn.,
/� III
LOCATION OF BUILDING
C3 / D it a+, m+ (moi (e� (d �r el/�✓c�e.C�
Front � T
Del
To be used a.
Block :!L-+" Addition or Sub -Division
of
A. DESCRIPTION OF BUILDING
eight Stories_ Manner of Construction
'6000
To be.,�ompleted
'DEstimated Cost
9e
6
I
Permit is hereby ted to to
the buildinLr described in the above statement. This permit is granted
upon the express cothat the 6rson to whom it is granted, and his agents, employees and workmen, in all
the work done in, arnund and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, 1inn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city 11mit§, and this permit may be revoked at any time upo,,n violation of any of the provisions of said
ordinances.
kit Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to
the above permit° I hereby agree to do the pro
above set forth and according to the provisions
sworn, I hereby s4te and say that the facts sta
true as therein stated.
Subscribedand "sworn to before me at Fridley,
day of + A.D. 191 1 .
I
f
tie by the Inwpector of Buildings of Fridley of
ps ed work in accordance with the description
if the ordinances of Fridley, and, being first duly
ed` by me and contained in the above permit are
Mage of
No 5
{F
'
OIF B INN
t. 4`
Architect
; _ Fricu
, 19
Builder`?
`
No.
reet art of iJo+
Lot,
dock Addition or b-Diuigd "
D +' QTUP��hT
fQ
Front De
Height_ Stories 1 Dlant�er Of Conettction,
To he used,
To be coaiapleie « , + Estimated Cosy 1y*�
II
Permit hereby
ted 1rfl to-
r -` L
the MFa7t{d�il �.i•FmSs �, aWv®} t ent illi.'permit to gi�,rnted
U the eOress c ,*ton That the, 'to wl#oin itis rented; and. ixfs sante, employees ' and worknµea,• W an
,the work done in, d and u�Ooa said; building, or ami part thereof, shall conPort m aII xespects to the ordi-
nances, of Fridley, Minn., regarding the conittruuction, atetation, maintenance, repa5r and moviIIg of buildings
within t1�e City is, and >this permit m$}( 'be revoked a t any tlmu npoa viola#on of :any of ttie provisions of said
¢ TnRtleet0 of .Staildiats.
r—
A_N,W
7Eia cbaslde tion,bf the,issaae Atli dettveryto
of
ane by tie Inspeejor of buil o 'dley of
>.
the"above pe Y hereby agree to do the pro
nosed Work ; in aecorfnce e d crigation
�,
above set ;forth d according to the provisions
bf the>ordinanees of in; t duly
sworn= Z hereby state and say that,the facts stall
by ane above, rnoit are
true tfiea�eia ted: I,
Subscrlbed WOO tabefore tae at Fridley= anneaota,
day
Y
'J ���"' } i i✓•x 1R # ���i yY4S �4 Y L'3
"6} ^f c'"4 LMA4
.. a+c ,Y`i�.S'rA'"
Village of Fridley, Minn.
BUILDING. PERMIT
Date: 'f... / .........
Owner.n ... .. ...
Address .? "`". ................
Builder ......... ,I .. .... .... ........
Address
LOCATION OF BUILDING
No. .ef. ,0 ... Street .................... Part of Lot ...... ............. .
Lot ..../! ....... Block .. ............ Addition or Sub -Division .
Corner Lot ........... Inside Lot ........... Setback ... S deyar�d.............................
..............
DESCRIPTION OF BUILDING
To be Used as:
.Front
Depth Height
1� p /.. f.. g ........
S Ft.
q. 02/G/
Cu. Ft. ....... .
...................... Front
Type of Construction
........ Depth ........ Height ........
..... Est. Cost .`......
Sq. Ft. ........
To be Completed
Cu. Ft. ........
&--
In consideration of the issuance to me of a permit to construct
the proposed work in accordance with the description above set fpr
ordinances of the village of Fridley.
In consideration of the payment of a fee of $.... �....., permit is
above, I agree to do
*ith all provisions of
granted to 49.
......................... to construct the building or addition as described above. This permit is grar*e'd 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.
-b �..vj...v
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbs , eating,
sewer or water. Be sure to see the Building Inspector for separate permits for these it
E
! 0
City of Fridley, Minn.
BUILDING PERMIT N° 6777
• , ��..; / :: r kALMBuilder
wauw�..
Address Address
&C.PON F BUILDING
No. _ Street -- PartAt Lot
Lot Block _____ Addition or Sub -Division
Corner Lot . _ Inside Lot �� Setback _ _ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To Ur as: _
Front tl �1 _ _ Depth ,�_ Height J-9— Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction �_ Est. Colic m_`=__ 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 all provisions of
ordinaaces of the city of Fridley.
t'
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
'�y location,ota regarding construction,
maintenance, fproof bwithin the dtlimits andpermit may be revoked at any akp�ofany
/ fthe vision
ordinance& � of
• NOTICE:
ihb permit does mot cover the comstrucNom, hataliatiom for whits, Plumbing, on heating, sewer or water. Be sure to see
the Buildles Imspeeter for separate permits for these Nems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S ITME I Uto de r BUILDER
ADDRESS �7®s I.fl iro " /I�e L . ADDRESS
LOCATION OF BUILDING
No. , 32n — Street Part of Lot
Lot_ Block Addition or Subdivision
Corner Lot Inside Lot _L,� etback Side -Yard
SEWER ELEVATION
FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
a . otian., Front 16 Depth Height
Sq. Ft. ®2- Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost ®®,9
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.
(Sebedule of Fee Costs can be found on the Revevse�S$de).
SUBJECT
PERMIT N -
City of Fridley
14289
AT THE TOP OF THE TWINS
•
�
BUILDING
PERMIT
CEIPT NO.
• ______ COMMUNITY DEVELOPMENT DIV.
r v PROTECTIVE INSPECTION SEC.
a
F}7/
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
812-580-3450
910-F15
8/15/77
JOB ADDRESS 370 - 66th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
Rice Creek Terrace Plat 2 SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Sylvester Klaus 370 - 66th Avenue N.E.
571-1096
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 j7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install a metal abestos Chimney
9 CHANGE OF USE FROM TO
STIPULATIONS ICBO Report #2073 given to owner for recommendations.
SEPEfrATE PERMITS REQURED FOR
WIRING.
HEATING, PLUMBING AND SIGNS.
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 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
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,
$400
r rJO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
Y
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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$8.00
SIGNATURE OFCONTRACTOR AUTHORIZED AGENT (DATE)
WHEN PROP
LY VALIDATED THIS IS YOUR PERMIT
aO�R
�/'1 9aowsZ`..+ ^^'d
—
!fid'
Q- 14 -17
SIGNATURE OF OWNER I IF OWNER BUILDER) IDATEI
BLDG INSP
DATE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER:���...� y„✓J �4 uw BUILDER:
Address: 32o -Wei, Im NE Address:
. Tel. No.'s(- fQ��
No.: 3 e ) Street: (0 (n
LOT: % ( BLOCK: 3 ADDITION: Ce��(S, l UX- fl- R
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach "to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates..
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: I�� �� l �� A, }- S Estimated Cost: .$ 14 a o
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: g = I S - SIGNATURE:,
Stipulations:
7b 0 (Do
011
SUBJECT
PER
City of Fridley
9657
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_
a
i
`y ------COMMUNITY DEVELOPMENT DIV.®�
INSPECTION SEC.
r PROTECTIVE
l
�
i I CITY HALL FRIDLEY 55432
NUMBERREV.
DATE
PAGE OF
APPROVED BY
•---�
L 612-571-3450
910-F15
9/2/88
JOB ADDRESS 370 - 66th Aenue N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
1 3 1
Rice Creek Terrace Plat
2 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dale and Susan Klous same
574-7526
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
self
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.,
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
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 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
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
$1,250.00
1j$33 $.65
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$31.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$3jZ3Tj $31.65
SIGNATU�OF�COiN1/i TRACTOR OR AUTHORIZED AGENT w/y IDATEIf��WHENER
(DATE HIS IS Y U P R I (A��'' / ySIGNATURE
OVATE �•J
OF OWNER IIF OWNER BUILDER) IDATEI
011
MR [ ]
ADDN I I
ALTER I I
ODnstruction Address
Legal Descripticn:J
Owner Name & Address
Oontractor:
Address:
City of Fridley Effective 5/1/88
R-1 AMID R-2
Building Permit Application
�% — (o%Y-' A U E A
Ln -J, 1 l ;mor , Ula _ (1" E-Ln9- -12-
Da Je R- C�- S.( S a lel A - K / 0 1,(-s Tel. # Y77 V- -7S-2
Tel. #
Attach to this applications, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
,� `. w. • e • ,.. • �
LIVING AREA: Length Width Height Sg. Ft.
GARAGE AREA: Length Width Height Sg. Ft.
DECK AREA: Length Width Hgt/Ground Sg. Ft.
Oorner Lot I I Inside Lot I I Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ 1 d2�
Approx. Completion Date:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
Width + 6' See Back Page
DATE: - 2 -moo APPLICANT: SVS.,. r l- Tel. 7
CITY USE OILY
Permit Flee $
State Surcharge S •
SAC Charge $
Driveway Escrow $
Park Free $
Sewer Main Charge $
$3z=
81ZHJLAti ICIRS:
Free Schedule on Reverse Side
$.50/$1,000 Valuation
$550 per SAC Unit
Alt. 'A' or Alt. 'B° Above
Fee Determined by Engineering
Agreement Necessary [ I Not Necessary I I
. . .
SUBJECT
P
City of Fridley
3 i 979
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
� `
RECEIP NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
572�r J 6®4
x®46-3
r I � PROTECTIVE
1 = �
I 0 ...I CITY HALL FRIDLEY 55432
�'�
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
7/11/01
JOB ADDRESS 370 66 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DEscR.
11
3
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jan Lindstrom 370 66 Avenue NE 763-574-1074
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
K-Designers 3810 W Hwy 13, Burnsville, MN 55337 952-894-3600
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
20138685
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REOUIREO 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
1 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 4E COMPLIED
@@
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,570
$3.28
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-
$139.25
Fire SC $6.57
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
LicenseC $5.00
of
154.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT "DATEi
ENP THIS IS YOUR PERMIT
AALIDATE
G
BLDG JNSF' r ATE
S-GNATURE OF OWNER IIF OWNER 13UILDERI IDATEI
NEW [ ] Effective 1/1/2001
ADDN [ J CITY OF FRIDLE:Y (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 2;-1N� �� .
Legal Description:
Owner Name & Address:3avi Lod orn 310 ld_o�-L Tel. #-102 -5-10 �()1
Contractor: - MN LICENSE ## 2b (oE5
Addres [ Tel. -
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type. z n Estimated Cost: $ Ld—ilD ""
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: �� l l� ' APPLIC T: Tel.
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application
s
Permit Fee $ 139,2S Fee Schedule on Reverse Side
Fire Surcharge $ - _ .001 of Permit Valuation (1/10th%)
State Surcharge $ 3- -2F1 $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ D $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 $ /5 --/ -u
STIPULATIONS:
DESIGNERS
HOME OWNER INFORMATION
NAME
BUILDING PERMIT
MN LICENSE # 20138685
WI LICENSE # 242382
k\
CITY, STATE, ZiP_
TELEPHONE < < �
IN / WINDOWS
(CIRCLE ONE)
VALUATION:t ,
PERMIT COST: I��--l_�O
PICK UP PERMIT AT:
TEAROFF: YES / O
WINDOWS: REPLACEMENT /NEW OPENING
I
PRE INSPECTION: YES/ NO FINAL: YES / NO
CALL FOR FINAL: YES /NO PHONE #:
INSPECTORS NAME:
NOTE
�Sy.ID
HAVE A GREAT DAY!!
3810 West Hwy. 13 • B,rnsville, Minnesota 55337 • MN Lir. 0,20138685 • (952)89+36000 FAX(9S2)89+09000 (800)530-S932* www_k-designemcOm
SUBJECT
P O.
City of Fridley
33981
AT THE TOP OF THE TWINS
BUILDING PERMIT
F •_ COMMUNITY DEVELOPMENT DIV.
V-----�.{�'
PROTECTIVE INSPECTION SEC.
r I
NUMBER
REV
DATE
PAGE OF
AVPROVED BY
CITY HALL FRIDLEY 55432
L J ` 763-571-3450
910415
10/20/03
JOB ADDRESS 370 66 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
3
Rice Creek Terrace Plat 2
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Jan Lindstrom 370 66 Avenue NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
McCloud Construction 1635 Merrimac Lane, Plymouth, MN 55447
763-475-8250
A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20396131
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS Of WORK
❑ NEW O ADDITION ❑ ALTERATION REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK
REplace all windows - three new openings; bath sheetrock; remove
basement paneling
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
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.
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 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
$8,000
$9.00
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 OTHE STATE OR LOCAL LAW REGULATING CON-
Fire SC $18.00
STR CT O OR TMk PERFOW ANCE OFC NSTRUCTION
$2(3.25
PLAN FEE
TOTAL FEE
6CHECK
ffw-jce
a SC $5.00
$325.25
SIGNn URE O CO +TRACTOR kAUyHORIZEO AGENT IDATE,
H N PROPERLY VALIDATED
B G 'NSP
THIS IS YO R PE MIT
IAf
S'GNATURE OF OWNERoF OWNER BUILDER. IDATEI
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 3z - (Oo-h &UE �3-L
Legal Description:
Owner Name & Address: AAU Tel. #
Contractor: Mdopcj c, tier, )A-V- l MN LICENSE # Zo'39 131
Address: I (o36 C1\3- Tel. # '163- 475 - S am
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: Le[�ngthj Width Hgt/Ground Sq. Ft.
`\G�I�CC p L + `
OTHER: tt�- (�1 ;uc.+J c7Perv�S fJ7ee+�cc,�
�rouE E w�c ni
Construction Type: L.Lx ri._Estimated Cos : $
=4F -F o o�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 1 b Ct I v� APPLICANT: ��` Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
$ Q� 00 .001 of Permit Valuation (1 /10th%)
$ 00 $.50/$1,000 Valuation
$ $1275 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 [ ]
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NI IMRFR (lF FIXTl1RFS TO RE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2003
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas`*
Gas Range**
NO. RATE TOTAL JOB ADDRESS 3-7() (,p(.ot\ FkQ -_ 0 Z
Gas Dryer*" _
Back Flow Preventer Required ( )Yes () No
1
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
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
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Building Used
Estimated Cost
PERMIT NO. / 3 9r� I
20 G
PLUMBING COMPANY
�(`n
t`� e t�
1�► cti.� nCi►
SIGNED BY
TEL NO.COKI
Approved By Rough -In Date Final Date
State Surcharge $ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $_20, PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
;ITY OF FRIDLEY INSPECTION DIV.
431 University Ave NE
Adley, MN 55432
763) 572-3604, FAX (763) 571-1287
Effective April' 1, 2004 �a�
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 2.v v
MARK NUMBER OF FIXTURES TO BF INSTAI I Fn nN FAr.N FI nnR
ILUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS .0-S a w Aj w -
Jew Fixtures
$10.00
)Id Opening, New Fixture
$10.00
leer Dispenser
$10.00
flow Off Basin
$1.0.00
;atch Basin
$10.00
lain Water Leader
$10.00
;ump/Receiving Tank
$10.00
Vater Treating Appliance
$35.00
Vater Heater -Electric
$35.00
Vater Heater - Gas**
�, $35.00
gas Range"*
$10.00
21as Dryer"
$10.00
lack Flow Preventer Required ( )Yes ( ) No
Type $15.00
teinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
).00
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
and rulings of the Building Division, and hereby declares that all the fads
and representations stated in this application are true and correct.
LINDSTROM, JAN
370 66TH AVENUE NORTHEAST 200S)
FRIDLEY, MN 55432
OWNER (763) 574-1074
BUILDING USED AS �.e,51 d eiit�
ESTIMATED COST q6 () PERMIT NO.
PLUMBING COMPANY NO (_ Yom` aVVX UAA' r
SIGNED BY TEL N0. &12) $27-clo33
Approved By
Rough -In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
$ �S• OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
'VOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. '"PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () 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 existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to Install a new combustion air. ft will be sized and installed
to meet the current codes and manufacturer's specifications. Yes ( ) No ( )
When Installing a new venting system, the undersigned hereby verifies that
it 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( )
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 Type and Size/Common Vent and Vent Connector Information
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 93 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE I' It Q (P 1� YOUR E-MAIL ADDRESS
SITE ADDRESS 37 D �o�c At&' 7 �+' E-
THIS APPLICANT IS: ❑ OWNER O.CQNTRACTOR
Permit No.:
Received B
Date Rec'd:
PROPERTY OWNER/
NAME: - tAN
L n��s�-f c��
Plan Review
ADDRESS: 3'%O
&&o A07 t� t:.
tt
CITY t STATE NWIP
TENANT
.001 times the total job valuation
PHONE: '?6'3 - 4) 3 - IeO d
$ 6-0
CONTRACTOR
NAME: 1111, U'
1
0,rd Gj,J zy,
$5.00 (State Licensed Residential Contractors)
STATE LICENSE #
403
k�
Z04431_3 Z— EXP
DATE
CITY a�E S TATILW-ZIP 547
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
i���d s`��-• rte!
v�
WITH APPLICATION
PHONE (2 •foo FAX
❑ SINGLE FAMILY/NEW CONSTRUCTION
SIZE
PROPERTY TYPE
Sewer Main Charge
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION
❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH ULROOF
❑ DRAIN TILE
❑ DECK
❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW
❑ ADDITION
❑ MAINTENANCE/ REPAIRREMODELING
DESCRIBE WORK BEING DONE:
—
-.
SIZE OF IMPROVEMENT
LENGTH
WIDTH HEIGHT Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES 7Z3
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
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
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.
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
AT T VWIWQ ARF. RAQVIN nN VST
T—Tn _ T.TmTN('� THF COST
OF LABOR
AND MATERIALS:
TOTAL JOB VALVA'
THE 1997 .0 FEE SCHEDULE)
C3 OCCUPANCY
Permit Fee
$ c
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 4Z, dr-lJ
.001 times the total job valuation
Surcharge
$ 6-0
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ 26)-
Make checks payable to: City of Fridley Attach Stipulations
TION 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 f�eq
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 whices 7rei 0,,da�oval of plans. 1/ p
SIGNATURE OF APPLICANT PRINT NAME Vt� l AC -C[ 0` DATE