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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PEBMW N� 929 Ofce of INSPEUrOR OF BUMDINGS Owner rN Architect Fridley,. Minn.,r-x"� !� 19 Builder LOCATION OF BUILDING No. 12,52 Street w n t -'j wu� Part of Lot , Lot ' ° Block Addition or Sub-Division�,� DESCRIPTION OF BUILDING s � ' Front ° Depth C-2 Height Stories .'-'- `—Manner of Construction To be used as = xs' ;.,p, To be completed T's' "� x Estimated Cost n f G. ! ?; t�"'a �� ? � d`i Z.� 4. e° .moi' a i� � !A .r #, d* ,s:,•,r.. T -_� Permit is hereby granted to 4" -z to, 1� the building ' ✓' -~ described in the above statement. This permit is 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, 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. b '`,• rnsuector of Buildings. AGREEMENT 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 duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. r Subscribed and sworn to before me at Fridley, Minnesota, this day of;� .�.v A.D. 19_. 0 Village of Fridley, Minn. BUILDING PERMIT Date:. ..................... Owner / t/ Address ,1. �.v� .�. . (� ........ .. n U No SO%_L-._/ -ee-i-2-"' r Builder) .. Address ........� . �.�.......... ...... . / O ATION OF BUILDING No. /�.�_ ..4 . Street . d .� ......................... Part of Lot .................. ... . Lot .... �r..... Block .................. Addition or Sub -Division ..... Corner Lot ........... Inside Lot ........... Setback ........... Sideyard ............................. DESCRIPTION OF BUILDING To be Used as: o ...... ..... Front /!..... Depth/407... Height ........ Sq. Ft. 4 ..... Cu. Ft. ........ ..................... Front ........ Depth ........ Heights Sq. Ft. Cu. Ft. ........ Type of Construction .................. Est. Cost ...."��To be Completed .................. C a--0 l � yG fKicesof PR?,d n of the issuance to me of a permit to construct the building described above, I agree to do ��in accordance with the description above set forth and in compliance with all provisions of r llage of Fridley. ............................................... ... In nsideration of th yment of a fee of $.. rmit is hereby granted to........ ......................... to construct the building or addition as described above. This permit is gr ed 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. .. .... din actor NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. SUBJECT PEJR City of Fridley 2 8 5 AT THE TOP OF THE TWINS BUILDING PERMIT q a0 COMMUNITY DEVELOPMENT DIV. EC. r PROE�y It_�l(%lnG� I vv �� ,[CITY NUMBER AEv DATE PAGE OF APPROVED By N FRIOLE�132 612-571-3450 910-F15 9/18/98 JOB ADDRESS 1351 66th Ave 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 Dennis Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Grittner 571-7892 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing & Siding 18979 Gladstone Blvd Ma le Grove 55311 416-4804 20010277 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE N0, 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 (22SQ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS vNiffy Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 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 $.94 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,885.00 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 FEET AL FEE Licen SC $5 0 $67.32 SIGNATURE OF CON'RACTOR OR AUTMOR,2EO AGENT ,DATE, E FPR P ALI D THIS IS9 P RMIT �O S,GNATU RE OF OWNER, IF OWNER BUILDER, IDATE, INSo DATE Hur t—iy lro=04 FROM CITY OF FRIDLEY m 4164M P.014M mm Ve X/l/98 ADDN ALIM [ ] SDM= FAULT AM DIt-1 AM R-2 BUdDINO PERMU AWLICATION S 5 $ r,. -AS -60 id"m ® dd1 ---� �N o NO*) [ O*) n i o . QA"Gll i Sq. Ft. , SQ. FL so. FL - Pam& FM J • So Sim ge s A4 SAC Oar& $- LIMM Smcbna $ Demeway Emow S Erases comal Pwc FM $ - Sewer MAIM te TOTAL si � 1, 3 Sdadule an Revem Side .001 Of Pcmk'Vahadan (1/10th%) v I " - Building ' • - BUILDING ,o_r See Back Page for Fee Schedule Permit $ 65% of Building Permit Fee Fire Surcharge $ �;k, .001 times the total job valuation InspectionsRESIDENTIAL $ APPLICATION License Surcharge Received By: 763-572-36040014, 63-572-3604 SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) DAJVAY • 4 2W1 $ ft + 6 ft = ft x $21 =$. CITY OF FRIDLEY $ $450 Conservation Plan Review DATE 5,4 `Z)-7 YOUR E-MAIL ADDRESS 414A ///LO/(+'4IlF{1 Ad �Yei4rsAm SITE ADDRESS I;5 1 4� ,I A VG N E Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: OWNER ❑CONTRACTOR Make checks vavable to: Citv of Fridlev Attach Stipulations PROPERTY OWNER/ p NAME: t. R 61 e'-0 TENANT ADDRESS: , k10 Ayc- A16 CITYf7pDWI STAT IP PHONE::W 1;D2, V 2-3 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE_ZIP WITH APPLICATION PHO FAX PROPERTY TYPE 1NGLE FAMIL EW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE )R DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 13l/1 t p Ncw MK /h/ 154LK oEF of Dl delI Q, RoD M SIZE OF IMPROVEMENT LENGTH Joh WIDTH /-I HEIGHT Sq. Ft1le, ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan 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. 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 B D ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: _' ©Z 119, S (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ I.200. J O OCCUPANCY TYPE Permit Fee $ ,o_r See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ �;k, .001 times the total job valuation Surcharge $ 0005 x Permit Valuation Minimum $.50 License Surcharge $ $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 $ Make checks vavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which re fires review and approval of plans. t SIGNATURE OF APPLICANT 1 PRINT NAME GEE' /Z FI 69,54 J DATE 5 —4-0-7 cw