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PRE 2010 DOCS0 City of Fridley, Minn. BUILDING PERMIT N9 3823 Date: ....!..... .....` . '..�............. Owner ....................................... Builder ..... ...... .............................. Address ...................................... Address .......................................... LOCATION OF BUILDING No. .Fa./. .. Street ..... 4� f .0�?........ Part of Lot .............. ............ l Lot .... �p..... Block .... 9 .......... Addition or Sub -Divi on ...... ... ..... : /... . ... Inside Lot Setback -3 .......... Sideyarri .. 6 .:� ..... . Corner Lot ......... ....................... DESCRIPTION OF BUILDING T Us as • �/2 — , i, �' • Z�-(�yDepth 0?4. A Height ../V4 i4 5q. Ft.�� Cu. Ft�� � ... .. .... Front .. . .................... Front ........ Depth ........ Height � 5q. Ft. ........ CuL Ft. ........ Type of Construction .................... Est. Cost..A% . ......... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. A................................................. 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 Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances.' s .. Building Inspector 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. A APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builder CLEM JOHNSON & SON 2500 22ndAVE. N. E. Address __ Address _. MELS. 18, MINN. LOCATION. OF BUILDING No. - Street - Port of Lot. Lot Block Addition .or " Sub. Div,° Corner Lot • Inside Lot ._ Set Back Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as -Fronts._ Depth_�Height 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 a11. the facts and representations stated in this application are true and•..�c Date Signature (A -Schedule of Fee Costs can be found on the Reverse S de) 4 4 L (� City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldd Phone SU 4-7470 DESCRIPTION OF WORK Loon Number, Kind and Location of Fixtures ul C 'a'+ C� to 12 w x} 3 Z O �n K Oz iJi p N tT3z (� W 6 3 V' d W (�'1 4c ? 0 F N WATER HTR. GAS ELEC. Base 1st / l 2nd 3rd 4th • Future Connection Openings I � New Fixture, Old Openings Connected with Sewer Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ............. s $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTL) ...... x 2.00 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ......................... Additional Fixtures .................... Gas Range to 200,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL — x $1.50 $ — x .50 $ x 2.00 $ 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 jLre true and correct. Fridley, Minn J18� Owner i� ` , � S;�, Kind of Building Used as 19— To be completed about Estimated Cost, $ ore O}d—fNew/Building Permit No /�� -1 �Z '!:�: D-// 0 7,9GB -� Business Phone Connection Permit No . ....................................................... JAN 2 8 1960 %/;z - Water FEB 16 1960 raj Description................................................$ TOTAL FEE $ / , --j-0- 11 IM -8-58 Sewer Meter Deposit o � _4 Application for Power Plants and Heating, Cuing, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 t GRAVITY WARM AIR: RATE TOTAL Lilon to / — z y -'�i �L , 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. 80,000 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 Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 840 sq. ft. IDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. IDR 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 $ L� GAS PIPING (Up to 3 Fixtures) ......... (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM )See Fee Schedule VENTILATING SYSTEM ) ALTERATIONS & REPAIRS TOTAL FEE REMARKS: A-7-� d 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 true and correct. Fridley, 19f Owner �'t'� ' 195— Kind of Building 195— Used as f ' To be completed about Estimated Cost, $ O e a Ol�uilding Permit No. DESCRIPTION OF WORK HEATING or PP WER PLANTS—Steam, Hot Wa ,Warm No Trade Name `� p� �-� �� Size No Capacity Sq. Ft. E.D.ft j H.P. Total Connected Load C% Kind of Fuel /W, BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. edRAY N, -WELTER HEATING Ct 4630/ CHICAGO AVE. By. MwNCAR0 .61frr-9--MINNr-= 11 POST IM -8-58 Business Phone No- �` Q J -7 Erb/ ! . City of Fridley, BE BUILDING PERMIT N° 5 5 91 Date:119""4 Owner: Builder Address _ Address L CATION O BUILDING No. — Street � r I" Part of Lot _,,I Lot Block Addition or Sub -iii — Corner Lot _ Inside Lot a Saback Sideyard _ V Sewer Elevation __r _ _ Foundation Elevation DESCRIPTION OF BUILDING To as: " Front Depth Height �_ Sq. Ft. Cu. Ft. Fro n _ __ Depth _ Height Sq. Ft. --- Cu. Ft. Type of Construction ewiixr Est. Cost To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do theproposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. °!1 In consideration of the payment of a fee of q , permit is hereby granted to the to construct the building or addition as described above. This permit is granted upon 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 art Thereof, shall conform in all respects to the ordinances of Fridley, 1ylinnesota regarding location, constru�on, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any upon viola, ' of any of the provisions of said ordinances . w Building Inspector NOTICE: This permit dose not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate pencils for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Address ,Z_f ,Za_ _e V %7� . Address LOCATION OF BUILDING No. Street Part of Lot Block Addition or Subdivisio .� 7l Corner Lot Inside Lot �..�' Setback Side -Yard SEriMR ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To MbeU.831,as Front Depth F7 Height Sq. Ft._Cu. Ft. Front _ --Depth Height, Sq. Ft. Cu. Ft. Type of Construction. Estimated CostZ�6) cc 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE G� r� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY • APPUcATION FOR PLUMBING AND GAS FITTING PERMIT 4 W v� U • U pA a o� a � H �i X M 3 to C 1 .H O c w el 3 oG u g w m � +c+ b ro U W o mg� 6 0 p r w w U a 0 � c� d 0 Water Heater as lec Future Fixture Opening x $2.00 $ Company New Fixture, Old Opening • x $2.000 $ Signed By � � I ' Catch Basin x 1st $ Water Heater - to 99,000 BTC x $5.00 $ Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 . $ 2nd x $5.00 $ ROUGH INSP. Electric Water Heater x $5.00 $ Date 1 GAS FITTING FEES: • 3rd FINAL INSP. �✓ "� � " 1st 3 fixtures x 53.00 $ 3.00 ' Date Additional Fixtures Gas x $1.00 $ e APPROVAL FOR PERMIT ' Range to 199,000 BTC x S10.00 $ REPAIRS $ ALTERATIONS 4 th First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMZT IS $7.50 pLUS $.SO STATE SURCHARGE State Surcharge $ .50 (R) - Future Connection Opening (') - New Fixture, Old Opening Connected with Sewer Water Job Address _C) C;"- I (0 ..A Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct no Fridley, Mn. C -[ (°X ) fz , 1910 OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST PLUMBING FIXTURE RATES: NO. RATE TOTALOLD - W BUILDING PERMIT NO. PERMIT NO. Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ Company New Fixture, Old Opening • x $2.000 $ Signed By � � I ' Catch Basin x $5.00 $ Water Heater - to 99,000 BTC x $5.00 $ Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 . $ New Ground Run Old Building x $5.00 $ ROUGH INSP. Electric Water Heater x $5.00 $ Date 1 GAS FITTING FEES: • FINAL INSP. �✓ "� � " 1st 3 fixtures x 53.00 $ 3.00 ' Date Additional Fixtures Gas x $1.00 $ e APPROVAL FOR PERMIT ' Range to 199,000 BTC x S10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMZT IS $7.50 pLUS $.SO STATE SURCHARGE State Surcharge $ .50 TOTAL FEE $ !3-110) REINSPECTION FEE (510.00) m SUBJECT -PEfiM T N City of Fridleyo AT THE TOP OF THE TWINS BUILDING P E R M 1 r R EIPT NO. i v ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. -1 1 1 � � , CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J\ 612-571-3450 910-F15 6/24/80 JOB ADDRESS 821 - 68th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 1 Brookview Terrace SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE John E. O'Daniel 821 - 68th Avenue N.E. 571-5298 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Satre 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 n x IIIA" Poirch Addition O Rear of Structure 9 CHANGE OF USE FROM TO STIPULATIONS W'ARIiN; Before digging call local utilities SEPERATE PERMITS REQUIRED FOR WIRING TELEPHONE - ELFICT 1C - CAS Etc. HEATING, PLUMBING AND SIGN � diw �Q U I R - �D Pae-'1 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 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 263 5260 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $10,000 $3.00 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. $60.90 NONE PLAN CHECK FEE TOTALFEE 15.00 $78.00 SIGNATURE OF CONTRACTOR OR AUTHOR ENT (DATE) PR�O_PERLY VALIDATED THIS IS YOUR PERMIT i +WHEN t y "IL. r/1 BLDG WSP DAT G ATURE OF OWNER OF OWNER BUILDER) (DATE) m Land Planning(4a&tr6u17L 370MississOpiSt.N.E. Land Surve my Mumma)m/s 2/, Soils Tesliny ENGINEERING, I N c. /ylinnesafo Civil Fr Municipal SUnset4-6066 En ineerin / 9 Engineers Surveff�5 certificate of survey For:- 6LEM JOHNSON `} JONS 75, r7 l /U_ c B;"\WNVl['W TERRACE lbereby cerfiry kd klr is a live and caMd represenfofian o�'a sarrey *'the bor,aOP;es o/'flse abo�r o�escri6ed fand,ond /far lacvtmn o�'o// buildings , /hereon , and o/l risible e�w�ochmenfs , �E'omy. �isrn or ars said larnd As su�veeJed G (me day '!f on � � r A' 0 /$_Ja' SUB UR BAN ENGINEERING, INC. Fn9ineers fr Surreyors ,�" CITY OF FRIDLEY APPLICATION FOR RESIDtNTIAL BUILDING PERMITS (dew, Alterations, Additions, or Repairs) OV114ER: {•� •X BUILDER: A ADDRESS: 7% ��/Y1�DDRESS: TEL NO: 1•40: J Z 9P, Construction Location STREET NO: B2.1 STREET: Ake A/4a LOT: TS BLOCK: _ ADDITION: r4%h n Corner Lot: Inside.Lot:_ Setback: _ Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION 0�"t k) Front: T Depth: 3 1 Height: Square. Feet_ Cubic Feet: 5 Front: Depth: _ Height: Square - Feet: Cubic Feet: Type of Construction: l2e'z f-ejlT l Estimated Cost: $ /®�O® To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET• ahe 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 h' eby declares that all the facts and representations stated in this applicatio are true and correct. SIGNATURE: DATE: Stipulations: 1 oa �Twr-a— CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLU.NSING FIXTURE RATES: NO. RATE TOTAL ::_Wer Fix`ures N aU $ /r cat:re Fixture Opening x $2.00 $ New Fixture, Old Opening b� $2.00 Water Catch Basin x $5.00 $ :cater .eater - to 99,000 BTU u e M m G x 441 $ w � $7.00 Heater .Oi .+ Air x $5.00 $ a x x sh+ 0 l+ .0 C a o 4 -fixtsres 34 1st 3 x p :, C +� :+ t� C V ••� 0 O 041 = 4j 0 0 la Wy� First $100.00 $5.00 $ each add. $100.00 or fraction y 3 v bci w U alp a 3 TOTAL FEE 0 as leo I 3rd j (R) = Future Connection Opening Connected with Sewer (_) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLU.NSING FIXTURE RATES: NO. RATE TOTAL ::_Wer Fix`ures 3 x $3.00 $ /r cat:re Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ :cater .eater - to 99,000 BTU _� x $5.00 $ 5--0 100,000 B.J to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ %ew Ground Ran Old Building x $5.00 $ Flectric Water Heater x $5.00 $ G'S FITTING FEES: -fixtsres 1st 3 x $3.00 $ .x•00 Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS It ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE (S10.CI Job Address jP2,1_ Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. OANE-R v KIND OF BUILDING///I�Td87/D- f% USED AS �-� `� � A- �- TO BE COMPLETED ABOUT ESTIMATED COST B C� OLD <:�ILDING PERMIT NO. PERMIT NO. Company Signed "gtL,� Tel. No. J 7/ '— ROU -3B INSP. Date ' FINAL INSP. Date APPROVAL FOR PERMIT 11INIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE sUr,=RGE CITY OF FRIDLEY • APPLICATION FOR PLUMIBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE % 2 - PLU.\3ING FIXTURE RATES: r0. I RATE ::_tee= Fi�t:res 1 x $3.00 c^1=:re Fixture Opening x $2.00 "yy, d $2.00 Water r L $5.00 Nater Heater - to 99,000 BTU x $5.00 H M,! $10.00 Water Softener m ro Sa p, k' $5.00 Electric Water Heater Heater q� .moi ,s . $ -c+ XJ sei O M .L' C0 S u P0 . M S O I:, C w L C -1V •.� 7 O u -A ++ r-.. JJ W 0I N tro!! ..1 V LC k ."�. Lam'! ti C7 O a5 leC 1 'st _nd 1 � (R) a Fuvare Connection Opening Connected with Sewer (;} = I:ew Fixture, Old Opening Water PARTIAL RATE SCHEDULE % 2 - PLU.\3ING FIXTURE RATES: r0. I RATE ::_tee= Fi�t:res 1 x $3.00 c^1=:re Fixture Opening x $2.00 New : ix:ure, Old Opening x $2.00 Catc.. Basin x $5.00 Nater Heater - to 99,000 BTU x $5.00 '_00,003 B:J to 199,000 BTU x $10.00 Water Softener x $7.00 New Ground �n Old Building x $5.00 Electric Water Heater x $5.00 r,�S FITTING FEES: 1 e c^e Job Address / �� - v J '" • 6 -- Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are Ctrue andGecrrect Fridley, Mn. ✓ EQ l / , 19 O OWNER®� A) ( l i4 RIND OF BUILD9INGUSED AS -5 / I, 6—ti C C-- - 1st 3 fixtures x $3.00 S Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 S RF?AIRS $ ALTERATIONS First $100.00 $5.00 S each add. $100.00 or fraction $2.00 $ State Surcharge S .50�7 � TOTAL FEE $ 0 REEINSPECTION FEE (S10.C•')) FINAL INSP. Z ^ 3 - O Date APPROVAL FOR PERMIT I=m= FEE FOR ANY PLUMBING PERMIT IS $7.50 pLus $.So STATE SURC'tmn-v r'' TO BE COMPLETED ABOUT % 2 - ESTIMATED ESTIMATED COST �y ®, v Z TOTAL OLD - NEW BUILDING PERMIT NO. pp PERMIT NO. O� $ Company , 6 ., $ Signed By $ c� 71 $ Tel. No. - $ $ ROUGH INSP. . Date S 1st 3 fixtures x $3.00 S Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 S RF?AIRS $ ALTERATIONS First $100.00 $5.00 S each add. $100.00 or fraction $2.00 $ State Surcharge S .50�7 � TOTAL FEE $ 0 REEINSPECTION FEE (S10.C•')) FINAL INSP. Z ^ 3 - O Date APPROVAL FOR PERMIT I=m= FEE FOR ANY PLUMBING PERMIT IS $7.50 pLus $.So STATE SURC'tmn-v r'' �� ___I _� ,, �.i �� MIT NO. 8473 SUBJECT P City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. ►y_- COMMUNITY DEVELOPMENT DIV. SEC. � PROTECTIVE INSPECTION E . � ---I CITY HALL FRIDLEY 53132 l NUMBER pEv DATE PAGE OF APPROVED By ----�; L 612-571-3450 910-F15 10/29/98 10B ADDRESS 821 68th Avenue NE 22iX X I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 2 lBrookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steve Wicks 572-1311 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Daco Inc. 14510 45th St N Rogers - 3180 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 9c REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (25 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2142 $1.07 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 Fire SC $2.14 PLAN CHECK FEE TOTAL FEE O PS'' XS2.1N.!§1�0 License SC $5.00 $82.96 CON'RACTORORAUTMORIZEDAGENT IOAT 1 WHEN PROPERLY ATID THIS IS YOUR PERMIT BL G N$P flAfE S,GNATURE OF OWNERoF OWNER BUILOERI 10ATEI MIT NO. 8473 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION G� 1 fi I ConstructionAddress: ct� U -p— . Legal Description: Owner Name & Address: lr�� �` �� r Tel. # 6_72J31/ Contractor: '� Cc c a MN LICENSE # -S / $ 0 Address: y.57/0 yS'j `1 S7' lN. C. Ro7 g rs g7 , 5. 1k� Tel. # 'V f 7 3 906) 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: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: I `e cx�-(` '�' S S Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ ME DATE: %G 2 S APPLICANT:' c � lw ",,.�_ _ _ Tel. # �%3�©c� -- \ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] t/0 7. q/ CITY OF FR I DLEY - �Ye6 Building Inspections 763-572-3604 DATE Q5//,tK /D ,/ c SITE ADDRESS _ 8� / THIS APPLICANT IS: PROPERTY O'PVNERI TENANT SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE TYPE OF IBUMDING RESIDENTIAL APPLICATION CITY OF FRIDLE"Y YOUR E-MAIL ADDRESS = Permit No.: Received, By: DateRec'd. - ADDRESS: CITY STATE ZIP PHONE: % —J STATE LICENSE ' ❑ BASEMENT FINISH � ROOF 0 D 0 SIDING ❑ SWIMM DESCRIBE WORK BEING DONE; SIZE OF IMPROVEMENT SQUARES aq'L �rtACES PROPOSED SIDE: PROPOSED H0014T: SIDING ❑ Vinyl ❑ Aluminium (3 Other WI1VDOwS IN wasTm OPENINGS ❑Yes ❑No OR FOR NEW OPEMNOS-DESCRISF. SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED AL JOB V. Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge ❑ HOUSE & GARAW ❑ ATTACiWD GARAGE 0 DETACHED GARAGE 0SWA ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF Q DRAIN TILE ❑ OTIM ALU.ATION, INCLUDING THE COSI' OF USING THE 1997 U.S.0 FEE SCHEDULE) $ 1.'1 $ S 1� S $ S p-1 .14 BASEMENT RgbLQDZLM SUBMIT: I. Existing Floor Plan 2 Proposed floor plan 3. List of gract iral members to be u%d FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. 1. Sia PlawS>zrvey showing the obling shuchm and proposed projad. 2. Two scts of construction PIAN 3. Energy Calcumons ?"TERIALS: See Back Page for Fee Schedule 65% of Building permit Fee (.0005) times the total job valuation—1Vjntum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) _ft+6ft= ftx$20=$ _ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks navable to: City of FridleY Attar THIS IS AN APPLICATION FOR A PERMrT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge drat the informafion 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 Minitesota 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 cast of aU work wh3c as review and approval of plans. r./." -DATE 5 -_ � SIGNATURE OF APPLICANT_ PRINTNAME �v e