PRE 2010 DOCS•
City of Fridley, Minn.
BUILDING PERMIT
Date: Sept. 17, 1988
owner: _ Robert E Silseth Bider —__$am _
Address 2105 30th Ave. S. Address Same
LOCATION OF BUILDING
N9
No. .—.. 24 — Street _ 67th Way N. E, _. Part of Lot
Lot _ 3 Block 3 _ Addition or Sub -Division .____Edgewater Gardens
Corner Lot — Inside Lot — x Setback _.V_ Sideyard _.10' & 5'
Sewer Elevation 836.78 _ 839.78
Top of Footing
DESCRIPTION OF BUILDING
4 q-9_9 Y
9939
To be Used as:
Dwelling Front _26 � Depth 48' Height _ 20 L Sq. Ft. 1248_ Cu. Ft 24Jb-0
Garage Front 34' Depth 26 ' Height __10' Sq. Ft .___.._K9 Cu. Ft 86 00
Type of Construction _ Frame —Est Cost A 21, 000.00 ___ To be Completed
• SEWER LOCATION - 5' East of Manhole
CJ
WATER LOCATION - 5' West of Manhole
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 pce wi 21 provisions of
ordinances of the city of Fridley.
$100.00 Sewer Connection Charge
In consideration of the payment of a fee of $ 5 0. 00 , permit is hereby granted to Robert
S i 1 s e t h to construct the building or addition as described above. This permit is granted upon
the eFress condition that the person to whom it is granted and his agents, employees and workmen, in all work
doneFridlMinnesota regarding location, construction, alteration, maintenance, repair and moving of buil
within the city limits and this permit may be revoked at any time upon violation of ate► of the provisions of d
ordinances.
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, Bas heeling, Sewer or water. Be sora to See
the Building Inspector for Separate permits for thm Meme.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER o S NAMEQ�ILD—ER <-W 17-1%
ADDRESS,/g<' 30 4 04- S ADDRESS
LOCATION OF BUILDING
a
NO. STREET
LOT BLOCK ADDITION
COR -NM LOT INSIDE LOT
SEWER ELEVATION
SUBDIVISIO!gjg.'�(%,g�.��
SETBACKSIDEYARD
TOP OF FOOTING
Applicant attach to this form T-;�Yo Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
P
Front r _�i ,, Depth q � Height
,quare feet -�� rdl Cubic Feet
Depth 2 C Height 1 Ll
'- Lek ---
Square feet (, 0 Cubic Feet'y F -
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 c C O SIGNATUREa-e���ryj—,Zi�
(Schedule of Fee Costs can be found on the Reverse Side.)
J
City of Fridley
Application for Plumbing and Gas Ming Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK L�_
Z s
Number, Kind and Location of Fixtures Locate" /
pp
c
3
Number Fixtures ....... ..............
�� a $200
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
N
$
Catch Basin ...... .....................
x $3.25
$
Z
�p
•
F
•
N
WATER HTR.
GAS
ELEG
Base
a $2,00
$
GAS FITTING FEES:
%
� v
1st 3 Fixtures ..........................
x $2.00
$'
Additional Fixtures ....................
x $ .75
$
1st
/
2nd
3rd
EE—
4th
• Future Connection Openings
• New Fixture, Old Openings I
Connected with Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ....... ..............
�� a $200
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ...... .....................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
D�
$ �-
New Ground Run Old Bldg. ............
x $3.25
$
Electric Water Heater
a $2,00
$
GAS FITTING FEES:
NO. RATE TOTAL
� v
1st 3 Fixtures ..........................
x $2.00
$'
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU .............. x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are trued correct.
Fridley. Nrnn. .1969
Owner ,
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old �ew-uilding Permit No ' �� Permit No.
Signe
By
Business one
ROUGH
FINAL
Description ................................................$ 0 0
TOTAL FEE $ A 42
�VarL4- * ao(o -czozaz!,
City of Fridley
6431 University Ave NE
Fridley MN 55432
(763) 572-3602 or Fax (763) 502-4977
-_: Water and Sewer Permit Application
❑ New Connection
tg.Existing
Date: --C2 — 0 6
Job Address: A 14
DUtility Line Repair/Relocation
OWater and Sewer Connection
V
Name of Applicant (Plumber): g Z-�V� 1140)
Name of Property Owner:
Existing Structure Permit #
Permit Type: Sewer Fee:
Water Fee:
Meter Fee:
Repair Fee:
Relocation:
State Surcharge:
SAC Charge:
Special Assessment Fee:
Total: $ v
Applicant Signature;
Inspector approval:
Water Meter Repair — Weekend & Holidays
$125/hour
Water Connections Permit
$50
Sewer Connections Permit
$50
Inspection Fee for Water/Sewer Line Repair
$40
Special Assessments
See Engineering
Cost of Water Meter
See Utility Billing
SAC Charge
$1550
State Surcharge
$ .50
Water Tap
See Engineering
04/04/05
3uilding
BUILDING
Permit No.11,137
,
In spections
RESIDENTIAL APPLICATION
Received By:
-
763-572-3604
CITY OF FRIDLEY
S�
Date Rec'd: �-q
)ATE SFS YOUR E-MAIL ADDRESS
iITE ADDRESS 7 W
i7IIS APPLICANT IS: OWNER CTOR
PROPERTY OWNER/
NAME; PAC) V"
TENANT
ADDRESS: c
CITY i�Z� STATEM—alP '
PHONE: 2' a0 -D2 037-15
CONTRACTOR
NAME: WDWbA POOR"(51
STATE LICENSE # %Gn ( 0777 EXP DATE
SUBMIT A COPY OF
STATE LICENSE
ADDRESS: 12 S t
IS STATE��LiPYOUR
WITH APPLICATION
PHONE 7 �42"1�'l(vr9 FAX
PROPERTY TYPE
❑ SINGLE FAMILYINEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANC AUTAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING❑ HOUSE ONLY
NUMBER OF SQUARES — ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES ❑ ATTACHED GARAGE
1. Existing Floor Plan
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
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ "�(o?5. ' OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ .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 $21= $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ 10'l ,`l 2�_ Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I
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�itwcrk is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all w r ich rend approval of plans.
SIGNATURE OF