PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: c
Owner: -4. ja At'C Builder
e
Address _ Address
Z�'
999',
�T'LDING
No.Street -— Part f Lot
Lot _ _ .__ Block ____ _ _ Addition or Sub -Division les
Corner Lot .__— Inside Lot Setback _ ! Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING,
Tope Used
Ar, Front Depth Height Sq. Ft. ArA6 Cu. Ft -11/20
Front Depth Height Sq. Ft. Cu. Ft. _
Type of Construction Est. Cost ..---4�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.
In consideration of the payment of a fee of A J 1 , , 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
within the city limits and this permit may be revoked at any time upon violation., f any of the provisions of said
ordinances. t 9
Building Inspector
NOTICE:
This permit dons not cover the construction, Installation for whing, plumbing, Bas heating, sower or water. Be sure to as
the Building Inspector for separate permits for these Nems.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, mINNESOTA
Owners Name �- Builder
Address ..�� �%� t /�. Address_
LOCATION OF BUILDING
No. i. ''� ���Stree�i / �42� r "r"s ^Part of Lot ~'1
/
- Lot... � Block �-- Addition or 5ub.Div.,.
j
v j _
Corner Lot_ .,,,_Inside LotZ.L Set Backj Side -Yard %�
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used ass
�Z- Front � Depth Height
Sq. Ft. 0 -5- K Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction_ -mac _ Estimated Cost_� �l� .
To be
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 representa-
tions stated in
in this application are true and correct.
DATE ��'•� (,-"e:7 SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
0 is t
City of Fridley U
Application for Plumbing and Gas Fitting Pennit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures -77x $1.50 1, a
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ —1.
New Ground Run Old Bldg. ............ x 3.25 $
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 $
REPAIRS & ALTERATIONS—Refer to Code
Dept. of Bldgs. Phone SU 4-7470 c�
Location
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 applicationoFe true and correct.
Fridley, Minn �� 1
Owner '• �%��'�''�
Kind of Building��
Used as
To be completed about /
Estimated Cost, $ E � fc�
Old ew Building Permit No Permit No.
d Signe '0 �-V'..r
By
Business Phone No `�'€' ✓ �� `S
ROUGH / L � 15 - �O 0
FINAL
Description ................................................
TOTAL . as 2M 7-59
12
I
E
��
<3
�U°d
�O
P
N
WATER HTR.
GAS
ELEG
E'�
(�9a4
Base
1st
2nd
_
3rd
4th
• Future Connection Openings
Connected with Sewer �
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures -77x $1.50 1, a
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ —1.
New Ground Run Old Bldg. ............ x 3.25 $
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 $
REPAIRS & ALTERATIONS—Refer to Code
Dept. of Bldgs. Phone SU 4-7470 c�
Location
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 applicationoFe true and correct.
Fridley, Minn �� 1
Owner '• �%��'�''�
Kind of Building��
Used as
To be completed about /
Estimated Cost, $ E � fc�
Old ew Building Permit No Permit No.
d Signe '0 �-V'..r
By
Business Phone No `�'€' ✓ �� `S
ROUGH / L � 15 - �O 0
FINAL
Description ................................................
TOTAL . as 2M 7-59
Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ................ .
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $
2.00
$
5.00
$
5.00
$
2.50
$
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 RATE TOT L
1st 3 Fixtures ......................
x $1.50
$
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
ViNTILATING SYSTEM
ALTERATIONS & REPAIRS
$
TOTAL FEE
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
Locatton��
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.
NOV 2 3 196®
�jxidley, 1V,[inn 195—
Owner f .
Kind of Building
Used as
To be completed about
195-
195—
_ ov
Estimated Cost, $
Permit No.
DESCRIPTION OF WORK
HEATING o Warm Air—No
Trade Name Size No -1-57-4-7 - ®_7_
Capacity Sq. Ft. E.DA BTU H.P.
Total Connected Load Kind of rue
BURNER — Trade Nam - Size NonIZ
Capacity Sq. Ft. E.D.R '-TU H.P.
GEO. SEDG ICK HTG. & AIR -GOND. CO
1001 Xenia Av. S.
_ Minneapolis 16, Minn.
11 POST IM -12-58 Business Phone
e Cir s 4r®, ®/R,
nss 79 s lied 3t(" RYA
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
, ' Bows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
es No es No 19—
/ F1.1 P -.,O Room I Length // _ Width i Height XF Room I 1
Windows and Doors—Crackage and Area
�—
�`ry
VV
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
)19
2
Net exp. wall 3
Coef.
Btu
Infiltration 3
Infiltration
7(o
Glass
Glass
Exp. wall
3 g
Exp. wall
Net exp. wall
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Exp. wall
Int. wall
/95'
i
Ceiling r
Int. wall
Floor
Ceiling
Total Btu. (e�
Required sq. ft. E.D.R. or sq. ins.' W.A. Leader area
F1.1 Room I Length Width 0 Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration -7' r
Glass f 0
Exp. wall v
Net exp. wall SY 5 1 SA/v
Int. wall
Ceiling o LG
Floor Ed
Total Btu. 11,0
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
r FU 1 f Qif.— Room l Length )A Width log Height
Windows and Doors—Crackage and Area
�—
Width Height No. of Lineal ft. Area
No. .;I)Elne of ane lights of crack sq. ft.
F7 2
14 El I1
2
Net exp. wall 3
Coef.1
Btu
Infiltration
Infiltration
7(o
Glass
Glass
3 g
Exp. wall
2- Z
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Exp. wall
Net exp. wall
/95'
i
7 S-
Int. wall
Ceiling
'I
l `
29511
Floor
Ceiling
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .
.,
MINNEAPOLIS. MINN.
Insulation
How. Applied
,.`Width V 4a Height
Windows and Doors—Crackage and Area
,d"
Width Height No. of Lineal ft. Area
No. pane o f pane lights of crack sq. ft.
soot
Exp. wall X a
2
Net exp. wall 3
Int. wall
Coef.
Btu
Infiltration
7(o
Total rtu.
Glass
F1.1 Room I Length /0 Width /0
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Exp. wall
) jZ
Net exp. wall
Int. wall
Ceiling
Floor 77
Total ]Ttu. Z -b 0
Required sq. ft.'t.D.R. or sq. ins. W.A. Leader area
Fl Room I Length Width S— Height
Windows and Doors—Crackage and Area
Width Height No. o! Lineal tt. Area
No. of pane of pane lights of crack eq. ft.
Infiltration
,d"
Glass
Exp. wall X a
Net exp. wall 3
Int. wall
Ceiling
Al
Floor
Total rtu.
Required sq. ft,j E.D.R. or sq. his. W.A. Leader area
F1.1 Room I Length /0 Width /0
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
�^
Infiltration I q.1 of A �,r
Glass O
Exp. wall
Net exp. wall
Int. wall
Ceiling b %( `®
Floor
Total Stu.
Required sq. ft E.D.R. or sq. ins. W.A. Leader area
City
Uty of Fridley, Minn.
BUILDING PERMIT 3h� 487
Date:
Buil
Owner:
Address Address
UILDING
NO. street �A664W�Tlolw
Block Addition or Sub. -Division d % .4—�!7`�- f
At
'W
Corner Lot M Inside Lot Atf Setback sib\Sla� 7A4
Sewer Elevation — Foundation Elevation
DESCRIPTION OP BUILDING'
as:
4ftA&1#M*fftMt Depth Height Sq. Ft.' Cu. Ft.
t Depth eight Sq. Ft. Cu. Ft.
Type of Constr iction - -Est. To be Completed
In consideration of the Issuance to meof a permit to construct the building described I agree to do
the proposed work in accordance with the description above' set forth provisions of
ordinances oY the city of Fridley.
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, o
cc== thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location,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.
NOTICE:
Ub peroft don not cover 04 construction, hisfaMon for wkln&phanblov, on hendo& sewer or water. Be core to no
the ftfldlog hu"mr for separate permits for dmee hmm
APPLICATION FOR BUILDING PERMIT.
CITY OF FRIDLEY, MINNESOTA
- A ��
OWNER'S 1*]AP4E UILDER
ADDRESS ����/AnnRyss
LOCATION OF BUILDING
No. z Street , ' ,�v� A'` -Part of Lot
s
Lot Block Addition or Subdivision
Corner.Lot Inside Lot�Setback 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
4Frrjnt J � Depth Height d
Sq. Ft.° ° Cu. Ft.�
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Cons truct ion\A/0 0 Estimated Cost e
J
To be Completed ��,�.-A C
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 declAFes that all the facts and
representations stated in this application arq"t a °correct.
DATE ¢� SIGNAWME
(schedule of Fee Costs can be found on the Reverse Side).
M ^ s ~ 0 40/
M . v,^,
F0
SUBJECT
PER�_
of Fridley
15 717
AT THE TOP OF THE TWINS
BUILDING PERMIT
rpCity
R UIPTNO.
• _____ COMMUNITY DEVELOPMENT DIV.
1 i V _
r t � PROTECTIVE INSPECTION SEC.
9? 5- %
/
t . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
5/12/80
JOB ADDRESS 234 -69th Ave. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
2
2
1 Rice Creek Plaza N. Add. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Steven J. Olson 234 -69th Ave. N.E. Fridley Mn 55432 574-9936
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner
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 C:k ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof with asphalt shingles
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd roof but not 3rd. Install ridged galvanized valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Asphalt
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
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
$1000
$.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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTA FEE
r
8.00
SIGNATURE OF TRACTOR OR O (DATE)
Vy OPERLY V LID ED THIS IS YOUR PERMIT
:IZEDAGENT
BLDG INSP DATE r�
SIG RE OF OWNER 01JOWNIRBUILDER) (DATE)
F0
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OW14ER: 7-,,C-� -.
ADDRESS: �� ��— 6 Trp /Vs- '
TEL NO: S?`t— q^3�
BUILDER: - (qk"Z'�
ADDRESS:
TEL NO:
Construction Location ��®®
STREET NO: 5 STREET: / ?H
LOT: � BLOCK: � ADDITION:
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.
oc.F.'
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Squane.Feet: Cubic Feet:
Front: Depth: Height:
Square- Feet: Cubic Feet:
Type of Construction: ���p��®t Estimated Cost: $
To Be Completed:
—� Alt. A Alt. B
Proposed Driveway Width I£ 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 tr�-e and corrg'4.
DATE: SIGNATURE:
Stipulations: ^--
ro
0r
City of Fridley
SUBJECT
P
9 6 2 6 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.
1 � PROTECTIVE INSPECTION SEC.
1 i �
CITY HALL FRIDLEY 55432
1.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/30/81
JOB ADDRESS 234 - 69th. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
2
Rice Creek. Plaza North SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Steven J. Olson 234 - 69th. Avenue N.E. 574-9936
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 j] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 91.x 14' and an 8' x 15' Deck.
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS- REQUFREQ `-FOR WtRM.
HEATING, PLUMBING AiVQ SIGNS'.'
WARNING
Before digging call local utilities
TELEPHONE • ELECTRIC - GAS Etc.
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Wood
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
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
$BQO
�.� 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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$8.00
SIGNATURE TRACTOROR UT RIZEDAGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YYOODUR. PERMIT
Jul
/
BLDG INSP DATE
SIGWATURE OF OW ER IIF OWNER BUIL DERI IDA jl
%_Oo� %.�' I
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: T ®� 7!' BUILDER: C� .
ADDRESS: ��`� 6-2 IV ADDRESS:
TEL H0: `�' TEL NO:
Construction Location '
STRMT NO: JAY STREET: �• 7'�
16
LOT: 2-- BLOCK: -2- ADDITION:
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
Front: K Depth: Height:
Squane.Feet: Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
Type of Construction: Estimated Cost: $ GAG
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired:
SEE REVERSE SIDE OF SHEET
Mie undersigned hereby makes application for a permit for the tvrk'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 al.30, the facts and
representations stated in this application are true d correct.
DATE: SIGNATUM : r^= -
Stipulations:
I
WO
Cho
`F' I�'lifl'dl1�/ilifll/I/I/I.
0,
93
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERMIT
P .
_ 17816
r
• COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
L j\ 612-571-3450
RE
t a1, f
NUMBER
910-F15
REV.
DATE
11/21/84
PAGE OF
APPROVED BY
JOB ADDRESS 234 _ 69th. Avenue N.E.
1 LEGAL
DESCR.
LOT NO.
2
BLOCK
2
TRACT OR ADDITION SEE ATTACHED
Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAILADDRES$
ZIP PHONE
Steven J. Olson 234 - 69th. Avenue N.E.
574-9936
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 20' Storage Shed in Rear
Yard
9 CHANGEOFUSEFROM
TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE OF CONST.
Wood Frame
OCCUPANCY GROUP
OCCUPANCY LOAD
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ZONING
SO. FT.
240
CU. FT.
2400
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION SURTAX
$1,500 $•75
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.
$25.00
PLAN CHECK FEE TOT$LFAE75
LL
SIGNAT HORIZEDAGENT (DATE)
WHE PROPE LY ALI T D T ISIS YOUR PERMIT
F - INS BATE
SIGNATURE OF OWNCR (IF Q ER BUILDER) IDATEI
E
NEW (�]
City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: 0sq es-Vr1-Y An' ��� -
Legal Description: 474 Z 9 Z �""�` 'e� N
Owner Name & Address: -rT �' Tel. #
Contractor: Tel. #
Address:
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: e� -Z-4 /Z x Z yp
C" U "
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction:Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: _ $ $
See Back Page for Explanation
DATE:
APPLICANT: Tel.
CITY USE 0
iLYIF
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
$ e '7j—
$
$
$
$ Z`s'7Sr
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
'.?N/ `9NIN33NIM3 /Yt g 7m
Ap!q paAar:y Psi P.�� u •��i' s���„�oarzv isaueai
/9.. /l'oPLO .P1h4 Uo uo�o�oj,�o
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Effective Aug. 1, 1991
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
aa
03q- � ®'
RESIDENTIAL
RATE
TOTAL
Jab Address
Furnace Shell and Duct Work,
(Alen replacement furnace) $
20.00
_>
$ ��
Department Buildings, 6471 University Ave. N.E., Fridley, MN 55472
Burner
City of Fridley ey
Gas Piping $
10.00
$
Tel. 1571-3450
(piping needed with new furnace)
$
10.00
S
The undersigned hereby make! application for s permit for the work herein
Gas Range
specified agreeing to do all work in strict accordance with the City Codes
Gas Dryer $
10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this applicatio are true and correct.
• Air Conditioning (all sizes) $
10.00
S
Fridley. Minn. 5 1�
01,50/)
All Others/Repairs and Alterations
E. ,SteVt
It of Value of Appliance or Work
S
- .
KIND OF BUILDING
COMMERCIALANDUSTRIAL
USED AS
7 -3
`dC"
It of Value of Appliance or Work
S
TO BE COMPLETED ABOUT
fC
06
ESTIMATED COST / `-
State Surcharge
S .50
OLD - NEW BUILDING PERMIT N0. PERMIT NO.
TOTAL FEE
$
Reinspection Fee ($15.00)
$
DESCRIPTION OF FURNACE/BURNER
Rough Inep.
Date
Final Inep. / -I'Z- � 15-y
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCHARGE
Attach stack verification form with replacement furnace permits
*Air Conditioners can not lne placed in side- yard without
written permission from adjoining neighbor.
HEATING or POWER PLANTS, Steam, Not Mater. Marro Air No.
/ °/
Trade Name /A,�1C' � of Slsa No. � 8(e ® Q Ca'�
Capacity dO16,l Sq. Ft. CDR STU up
Total Connected Load Kind of Fuel 4• N�
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company )0!&aw6 1�/SX-
Signed By 43?10
�p
Tel. N /
o. / C /- 0 -7 7�
SUBJECT
P
City of Fridley
2 6 5 0 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i �
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
ll(
I®��
NUMBER
REV
DATE
7-9-98
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
ti.__.J`.' '•�
612-571-3450
910 -FIS
JOB ADDRESS 234 69TH AVENUE NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
2
2
Rice Creek Plaza, North Addition SHEET
DESCR.
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Lonnie Le Clair
572-1471
M IL D RES
3 CONT VON'
�ON Roofing 11506 g (SONalfe Rd, Minnetonka, 55305
P PHONE LICENSE NO.
9 8-8150 PHONE
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 House & Garage (25 Sq) - Tear Off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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 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
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2,085
$1.04
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-
STRUCT ORT FORIIIANCE F CONSTRUCTION.
74.75
File SC $2.08
��
PbbLicenseF
TO l(L FEE
$5
•
$82.87
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN RO
VALI THIS IS YOUR PERMIT
G IN
ryATE
S,GNATURE OF OWNERUF OWNER BUILDERI IDATEI
EW [ ] Effective 1/1/98
'ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION S� LSD
ConstructionAddress: AaIE N�
Legal Description: , /
Owner Name & Address: t.oy3N L 1 Ct, i " e237 "�% Tel. # 572--N-71
Contractor:4-- " � MN LICENSE # Zo!�� s 30
Address:. 115-00 5 ocKVAt-'_--ie��Jc�o G��1/C�% & el. # 238 - I ( SZ-)
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF DIPROVEMENT
LIVING AREA:
Length
Width Height Sq. Ft.
GARAGE AREA:
Length
Width Height Sq. Ft.
DECK AREA:n
Width Hgt/Ground Sq. Ft. _
OTHER:
�eS
Construction Type:
i R -SD
7�?_eP_oo1= Estimated Cost: $�^
:.,
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: -7 - q -7
APPLICANT:
�'1 -� 5 � Tel. #
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ 01
.001 of Permit Valuation (1/10th%)
State Surcharge
$ • C Cf
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$� ,�3�'
$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
.$ q 212
STIPULATIONS:
SUBJECT
.32496
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�EIPT
NO.
w�_____ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
�'[/
,A��
r PROTECTIVE
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I "'1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
4/9/02
JOB ADDRESS 234 69 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DEscR.
2
2
Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
V',4
C iv i= G . L e C1,A1& 2 3 4 to 1 VC- vr, y3 7e, 3-57II—/f7/
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Lonnie L. Leclair 234 69 Avenue NE
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
O NEW J] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct an 8' x 12' Addition to Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Permit issued subject to SP 402-02 approval
stipulations. 1) Petitoner shall obtain all necessary permits prior to construction.
2) The structure shall not be used for a home occupation or living area. 3) Total
square footage of all accessory structures must not exceed 1400 sq ft. 4) Garage shall
be architecturally compatible with existing home and finished with a complementary
side and color scheme.
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 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
$500
$
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.50
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
TOTAL FEE
$24.50
SIGN A TUBE OF CONTRAC TOR OR AUTHORIZED AGENT [DATE,
WH P P RLY VA ATED THIS IS YO
/�
fPERMIT
S-GNATURT 0F ER,iFg.NERSUILDE-41 IDATEI
ALOG -N4P OATS
NEW I l CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
14 -
Construction Address: \ d 3 q— !!D '/I:—
Legal Description:
Owner Name & Address: L v ov ✓v/ i' _ L C L 4 Tel. #
Contractor. t44 V j= t --I_ MN LICENSE#
Address: 9`314- 6a 9 14v&- d(/. j- Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LMNG AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: 51+1-S-6 'i -� 12` 7 l- S a_
_
ice/
Construction Type: Estimated Cost: $�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 2-/2-02,_ APPLICANT: .-N— .,G rte, , Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application or 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
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
lifelL•L
$0,3,6-0
$ ,S
$ ,5
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
STIPULATIONS:
GiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
CITY COUNCIL
ACTION TAKEN NOTICE
April 10, 2002
Lonnie LeClair
234 69' Avenue NE
Fridley, MN 55432
Dear Mr. LeClair:
On April 8, 2002, the Fridley City Council officially approved your request for a Special Use
Permit, SP #02-02, to allow the construction of a 96 square foot addition to the existing 240
square foot shed, legally described as Lot 2, Block 2, Rice Creek Plaza North Addition,
generally located at 234 69`h Avenue.
Approval of this special use permit is contingent upon the following stipulations:
1. Petitioner shall obtain all necessary permits prior to construction.
2. The structure shall not be used for a home occupation or living area.
3. Total square footage of all accessory structures must not exceed 1,400 square feet.
4. Garage shall be architecturally compatible with existing home and finished with a
complementary side and color scheme.
You have one year from the date of City Council action to initiate construction. If you cannot
begin construction in time, you must submit a letter requesting an extension at least three
weeks prior to the expiration date.
If you have any questions regarding the above action, please call me at 763-572-3590.
Sincer ,
" 1 SUS
Scott 'li kok 1
Community Development Director
SH/jt
cc: Special Use Permit File
Address File
Mary Hintz
Action Taken Letter -LeClair
Page 2
April 10, 2002
Please review the above, sign the statement below and return one copy to the City of Fridley
Planning Department by April 22, 2002.
Concur with action taken.
C-02-39
gouT v4LL
ae oar
'D-01/ 0>%
T
41 t .L V 0
M
•
Wr
o�
Q
t� T
o �
Y
0
Building
$
BUILDING
Permit
Plan Review
$
65% of Building Permit Fee
Inspections
$
RESIDENTIAL APPLICATION
Received By-
763-572-3604
$
CITY OF FRIDLEY
DK°At1 0 2007
�%�`
$
, CD
DATE
YOUR E-MAIL ADDRESS
$
SITE ADDRESS 23
517W SJG
Curb Cut Escrow
THIS APPLICANT IS:
❑ OWNER . B ONTRACTOR
ft + 6 ft = ft x $21 = $
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: A/GCITY
$
A'5
PHONE: 7,C3 4- 57 ' 36v`?_
Sewer Main Charge
CONTRACTOR
NAME: 12ae"Or `Ca
Agreement necessary ( ) Non Necessary ( )
STATE LICENSE # -2 1l7 �� EXP DATE
$
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:� STATE± 5; O
WITH APPLICATION
PHONE 7G�'l5S` ® eoYY FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH fiMOOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ®'REMODELING
DESCRIBE WORK BEING DONE: —JLoO� &fc'
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING 91 HOUSE ONLY
NUMBER OF SQUARES 7 ❑ 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 BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
3, 3
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
, CD
$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
Pmtfze I 1J V. FEE
$
A'5
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
0 14, qq
Make checks payable to: City of Fridley 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 at the work will be in accordance with the approved
plan in the case of all work which requires rev
ie pproval o
SIGNATURE OF APPLICANT ` PRINT NAME L!! le' DATES -36 ,cf) / 7
08/28:2007 02:39 FU 7638715620 Comfort Homes 191001
Co ot°t Homes, I.I.C. 7161 Hwy 86 LLo FPldleyo Minnesota 66482
(798) U71.88si8 • tax (768) 671-6620
oIK.Ort SERVICES TO BE PERFORME®
o m ems,,. �" / �J ice✓ ������
Customer Name: �� S 200..1
Phone #:( ) (or) ( ) ---
Salesperson. '-
20 5
Manufacturer: Model#
Size: U -- New
Address:
Date to 200-q
I
Phone #:(-J—)
Date of Closing: / 200-7
- - Z�:)ht'j
1. ) S�0,0(_6�4
Delivered to Lot
Blocked`tom
Anchored
Skirting Type: OMorizontal OVertical
Skirting Color-Cwhite ®Brown
Skirting Labor A - --
Gas & Pressure Test
Steps: OMetal OConcrete
Utilities Notified of Change
Gas Company
Electric Company
TRADE-IN
Tear down 31e I :
OFiberglass
been noted above.
d&_)
r
elves 149 x
PWe understand thet unless the Items
Date---J---J 200—
Date
ate/ 1200—
Date_1/ 200—
�
Building
$
BUILDING
See Back Page for Fee Schedule
Permit No.:—01
inspections
RESIDENTIAL APPLICATION
Received By: D
763-572-3604
/ L 1
CITY OF FRIDLEY
Date Rec'd: a 5L
DATE P I OP, YOUR E-MAIL ADDRESS Xo
d 15 CN N
SITE ADDRESS R's
/
5 R �n Aye. IVF FF
$
ITIS APPLICANT IS:
❑ OWNER CONTRACTOR
.AC Charge
PROPERTY OWNER/
NAME: D A it 1 ,C 0 1 r
$1450 per SAC Unit (Plans to MWCC for determination)
TENANT
ADDRESS: v"Z 3 LI (s R It, � /� "!`yL &C—CITY Fri Cl /C l/ STATE zIP 65' y3 D
PHONE - __7 G'31 '5? A- f Y 71
rosion Control
CONTRACTOR
NAME:_ The Home Depot A.H.S. Inc.
I., nit 5Q /V
SUBMIT A COPY OF
STATE LIC 3200 Cobb Galleria Pkwy.
Q SP 1 3 4 F • G 0 Y 77
YOUR STATE LICENSE
ADDRESS: Atlanta, GA 30339
CITY STATE ZIP
WITH APPLICATION
PHONE 763-542-8826
SINGLE License #20268257
:E
PROPERTY TYPE
t 0 '? . o cl
❑ TWO FA
.ORIES
PERMIT TYPE
❑TADDITION ❑ GARAGEISHED
WS
❑ BASEMENT FINISH ❑ ROOF
DRAW TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWRvIIvIING POOL
TYPE OF WORK:
❑ NEW roPPlgk ❑ ADDITION
ANCE/REPAIR ❑ REMODELING
)ESCRIBE WORK BEING DONE: 3 tai ndpw O oIA 0 M (nes
(D l rl s -f l04 ODa n l A !!� S
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
:OOFING
❑ HOUSE ONLY
DUMBER OF SQUARES
O HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
>ARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
ROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
ROPOSED HEIGHT:
WING
FOR NEW CONSTRUCTION INCLUDING DECKS,
I Vinyl
❑soffit
ADDITIONS. & PORCHES SUBMIT:
I Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
I Other
❑ Fascia
and proposed project
PINDOWS
2. Two sets of construction plans
4 EXISTING OPENINGS N es ❑No LOCATION OF WINDOWS
3. Energy Calculations
)R FOR NEW OPENINGS -DESCRIBE SIZE OF L 1 u t n o f au fn
)PENING CHANGES &
YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE IA7 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 322-0 OCCUPANCY TYPE
ermit Fee
$
4 7, it 'i
See Back Page for Fee Schedule
Ian Review
$
65% of Building Permit Fee
urcharge
$
/ L 1
(.0005) times the total job valuation — Minimum $.50
ire Surcharge
$
3.23
.001 x Permit Valuation (1/10%)
icense Surcharge
$
of ,y V
$5.00 (State Licensed Residential Contractors)
.AC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
'.urb Cut Escrow
$
ft + 6 ft = ft x $20 = $
rosion Control
$
$450 Conservation Plan Review
ark Fee
$
Fee Determined by Engineering
ewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
otal Due
$
t 0 '? . o cl
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
mformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
;rmit but only an application for a permit anA work is not to start without a permit; that the work will be in accordance with the approved
.an in the case of all work which re u' s rev w Pd. approval of plans. % p
GNATURE OF APPLICANT v PRINT NAME ` ' m 5 e p �� DATE
3uilding
$
BUILDING
See Back Page for Fee Schedule
'tan Review
Permit No.: BMW 13L
_nspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
$
Received By
-/ 63-572-3604
ire Surcharge
CITY OF FRIDLEY
,2. 3 t4
Dat �:
ATEb 9 YOUR E-MAIL ADDRESS Joy
/ 5 & i I d('f
%l7 A i S. t O�
—2131
.ITE ADDRESS
a 3 g V (. _ Iv
$
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
$
PROPERTY OWNER/
NAME: bllfltL C t i
$
TENANT
ADDRESS: .93q &V AV'L MF— CITY FP1 d1L STA E AZIP'5-6 Y3-?
$
PHONE: 7L31 612 ., 14 7 l
Fee Determined by Engineering
ewer Main Charge
CONTRACTOR
NAME: fHD At- Home Services, Inc.
Agreement necessary ( ) Non Necessary ( )
p in
$
STATE LIC 2690 Cumberland Pkwy, Ste 300
G S�
g y $ -Gob -7YOUR
SUBMIT A COPY OF
Cumberland Office Park
STATE LICENSE
ADDRESS
CITY
STATE—ZIP—
TATEZIPWITH
WITHAPPLICATION
PHONE Atlanta, GA 30339-3913
lI�IGLE Lic# 20268257 Ph. 763/542-8826
=E
PROPERTY TYPE
TWO FA
.DRIES
PERMIT TYPE
QADDITION ❑ GARAGE/SHEDWINDOWS
❑ BASEMENT FINISH El ROOF
DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
.
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
>ESCRIBE WORK BEING DONE: 31itAdraiii1
S
>IZE OF IMPROVEMENT LENGTH
WIDTH
AIGHT Sq. Ft.
DOPING
❑ HOUSE ONLY
DUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
rA RAGES❑ATTACHED
GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
'ROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
ROPOSED HEIGHT:
:rDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
7 Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
I Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
7 Other
❑ Fascia
and proposed project
;IINDOWS
2.
Two sets of construction plans
7 EXISTING OPENINGS Plles ❑No LOC,A�TTI�ON QF WINDOWS
3.
Energy Calculations
l
,R FOR NEW OPENINGS -DESCRIBE SIZE OF o in t I'�/ f6t. In • tr r Aj 2
t
PENING CHANGES &
'YPE
3
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 $ A 3L .? OCCUPANCY TYPE
'ermit Fee
$
3. S
See Back Page for Fee Schedule
'tan Review
$
65% of Building Permit Fee
urcharge
$
77/--2 -2
(.0005) times the total job valuation — Minimum $.50
ire Surcharge
$
,2. 3 t4
.001 x Permit Valuation (1/10%)
icense Surcharge
$
6.0 O
$5.00 (State Licensed Residential Contractors)
AC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
' urb Cut Escrow
$
ft + 6 ft = ft x $20 = $
,rosion Control
$
$450 Conservation Plan Review
ark Fee
$
Fee Determined by Engineering
ewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
otal Due
$
[. 7 L
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
Dnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
:xmit but only an application for a permit an4 wcy7k is not to start without a permit; that the work will be in accordance with the approved
ian in the case of all work which re uires ev' w d approval of plans. D�
GNATURE OF APPLIC L1 PRINT NAME T' S c ha lc DATE 0? r 8 b
3uilding
$
BUILDING
See Back Page for Fee Schedule
Permit No.
nspections
RESIDENTIAL APPLICATION
surcharge
Received By -
763 -572-3604
(.0005) times the total job valuation — Minimum $.50
CITY OF FRIDLEY
$
DatRnq dAP9 0 3 W9
)ATE *3 (--31 t D -1YOURAE--MAIL ADDRESS fF`� ��! u
if`0 %�� S_ P 0
ITE ADDRESS p2 s
lf 697"1 A -y t / V E
$5.00 (State Licensed Residential Contractors)
HIS APPLICANT IS:
❑ OWNER AeONTRACTOR
PROPERTY OWNER/
NAME: >1 @ C I
$
TENANT
ADDRESS: 2 q t. q ' A V & IV E CITY Ff 1
STATE-ZIP�� 3 a
$
PHONE: 7 L 3 1 1-72 - W7 i
$450 Conservation Plan Review
CONTRACTOR
NAME:_ fHD At- Home Services, Inc. Jodi eD
F(d c t J 0 04 S
Fee Determined by Engineering
STATE LIC 2690 Cumberland Pkwy, Ste 300 q S A t 3
YS _ G 0.14 7
SUBMIT A COPY OF
Cumberland Office Park
Iotal Due
YOUR STATE LICENSE
ADDREss CITY
STATE ZIP
WITH APPLICATION
PHONE Atlanta, GA 30339-3913
PROPERTY TYPE
INGLE Lic# 20268257 Ph. 763/542-8826 �E
O FA
PERMIT TYPE
QADDrrION ❑ GARAGE/SHED EQVINDOWS
❑ BASEMENT FINISH ❑ ROOF 0 DRAIN TILE
0 DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
0 NEW ❑ ADDITION
HIAA ITE/NANCE/REPAIR ❑ REMODELING
WORK BEING DONE: L w
6 QUM/
-)ESCRIBE
/
IZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
' OOFING
0 HOUSE ONLY
DUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
;ARAGES
0 ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
'ROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
'ROPOSED HEIGHT:
;IDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
7 Vinyl
0soffit
ADDITIONS. & PORCHES SUBMIT:
3 Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
3 Other
❑ Fascia
and proposed project
WINDOWS
2.
Two sets of construction plans
,1 EXISTING OPENINCiS�es ON, �AT�O OF WS
3.
Energy Calculations
!R FOR NEW OPENINGS -DESCRIBE SIZE OF �jOM ^ � !� V /7i S
)PENING CHANGES &
"YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINq ME 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ ';I 'I OCCUPANCY TYPE
'ermit Fee
$
/ S
See Back Page for Fee Schedule
'Ian Review
$
65% of Building Permit Fee
surcharge
$
(
(.0005) times the total job valuation — Minimum $.50
'ire Surcharge
$
4,33
.001 x Permit Valuation (1/10%)
icense Surcharge
$
!S.0 0
$5.00 (State Licensed Residential Contractors)
AC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
:urb Cut Escrow
$
ft + 6 ft = ft x $20 = $
;rosion Control
$
$450 Conservation Plan Review
ark Fee
$
Fee Determined by Engineering
ewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Iotal Due
$
-7 q
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
-)nformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
2n -nit but only an application for a permitpni work is not to start without a permit; that the work will be in accordance with the approved
an in the case of all work which/re ' s v w and- approval o€plans.
IGNATURE OF APPLICAN ./�� PRINT NAME DATE 3� O