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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N° CH522J0 Date: Owner: Builder Address Address O1: UILDING No. it! Street ,F .4 _ P Lo Lot _ _ _ .__ Block Addition or Sub-Divis�ion�e y Corner Lot Inside Lot —:��- Setback �� _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used _. Front Depth ' Height aW Sq • Ft. Cu. Ft. A7A cz Fraii Deptb H t Sq. 1:'t 0 Cu. Ft.of Instruction – f Est. Cost _ _ o e Com lxe0z Type ����f-� TbPleted 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 ordinances of 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 theexpress conditt�'pn that the person to whom it is granted and his agents, employees and workmen, m all work done in, around ax d upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, A2innesoto!, regarding location, construction, alteration, maintenance, re and moving of buildings within the city limits and this permit may be revoked at any time n violationf any of the provisions of said Qrdinances../i r Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to am the Building Inspector for separate permits for thus items. APPLICATION FOR BUILDING PERINIIT CITY OF FRIDLEY, MINNESOTA O;dner Is Name Jy �! I� 84 Builder _/.x A/ Address dress 77//2„��- LOCATION OF BUILDING No. Street ; ��} e.. A) k _ Part of Lot Lot Block Al Addition or Subdivision C ­v -c ObIZA Corner Lot Inside Lot Setback Side -Yard SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING -mom �-�� /,.� 2 �G P���. a�d_el z 1 To be used as: R iA 1 d c-, FronDepth__Height Sq. Ft. Z, 0 Cu. Ft. Front �-� Depth 2y Height /P Sq. FtFt. Type of Construction Estimated Cost X fpa 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 Bdi.ldings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE YZ/7 Y/7SIGNATURE (A Schedule of Fee Costs can be found on the Revers Side.) 0 0 ®I Application for Power Plants and Heating. Cooling. Ventflation..Re igeraand Air Conditioning Systems and Devices �.►o PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, 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 ............................. C.00 $ Repairs & Alterations—up to $500.00 ...:e ............ 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR 4Steam....... 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 TOTAL 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 VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE ,L ✓c_�� ROUGH- OUGH FINAL- FINAL Dept. Dept. of Bldgs. Phone SU. 4-7470 ' 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. /7 Fridles1Minn- '1-� 19 Owner _ Kind of Used as To be completed about Estimated Cost, DESCRIPTION OF WORK j HEATING or PVER PLANTS --S am, Hot Wa , Warm Air—No r Trade Name L /C�Y�C/i-Q .� _ Size No G Capacity Sq. Ft. E.D.R� BTU H.P. Total Connected Load T r a%^© Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. EXI R BTU H.P. (REMARKS -OVER) SignedRAY N_ W E I TF' R H EATING f"� E By 4637 CHICAGO AVE. MINNL.AP0+IS 7. MINNESOTA 42 2M 7.59 Business Phone No- o �`' 4--'e City of Fridley Application for Plumbing and Gas Firming Pem* DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLIIMBING FIXTURE RATES: NO. RATE TO ,'AL Number Fixtures ...................... x $1.50 Future Fixture Opening ......... x 1.20 $� New Fixture Old Opening .............. x 1.00 $ REPAIRS & ALTERATIONS—Refer to Code Dept. of Bldgs. Phone SII 4-7470 , —.— J/, I — — z op dzl�'52ze'� 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 true and correct. �, Fridle Minn 19� Owner ?7 of Building Used as &Z449-1 To be completed about — Estimated Cost, $ Old—New. Building Permit ROUGH FINAL Description .............................................. a TOTAL FEE U a2 2M By Business Phone refid, N In W W �4n ? �U' R'N + WATER HTR. GAS ELEG +�'' U3 3 in 3� O0�end O Base 1st 2nd 3rd _ 4th • Future Coaaec3ioa Openings Connected with Sewer [� I New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLIIMBING FIXTURE RATES: NO. RATE TO ,'AL Number Fixtures ...................... x $1.50 Future Fixture Opening ......... x 1.20 $� New Fixture Old Opening .............. x 1.00 $ REPAIRS & ALTERATIONS—Refer to Code Dept. of Bldgs. Phone SII 4-7470 , —.— J/, I — — z op dzl�'52ze'� 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 true and correct. �, Fridle Minn 19� Owner ?7 of Building Used as &Z449-1 To be completed about — Estimated Cost, $ Old—New. Building Permit ROUGH FINAL Description .............................................. a TOTAL FEE U a2 2M By Business Phone 01 SUBJECT PE City of Fridley 12067 AT THE TOP OF THE TWINS PERMIT BUILDING REC T NO. � ` COMMUNITY DEVELOPMENT DIV. L _ � INSPECTION r � PROTECTIVE SEC. 1 i NUMBER REV. DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-560-3450 910-F15 3/19/73 JOB ADDRESS 215 - 69th Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Rice Creek Plaza North Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE William G. Doljq 215 - 69th Place N.E. 55432 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. 6 USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW ❑ ADDITION ® ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS PERMITS REQUIRED FOR WIRING, SEPERATE 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 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 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 $500.00 .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. $5.00 PLAN CHECK FEE TOTALFEE $5.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED (DATE) WHEN PROPERLY VALIDATE I IS YOUR PERMIT BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 01 APPLICATION FOR RESIDENTIAL, ALTEMTIGN, OR ADDITION BUILDING PEMIT CITY OF FRIDLEY, MINN9SOTA ONNER, $ : LiLZ-4�id/ol G - �o� G BUYLDER ADDRESS: �` /S"- Gi �` . G .AD S S ; LOT; BLOCK; ADDITION s OORKBR LOT: IN -ME LOT./i ^ 3ETBACKi SIDEYARD:, AfftivAnt attach to djU € _„o Certificates of Survey of Lot and proposed Wldftg location 4vWR ou t#e" Certificates, Va Be UmW As: DESCRIPTION OF BUILDING Depth : $eight Square Feet; Cubit Beet, Front: Depth; Height; Square Feet; Cubic Feet; Tyfe of Constructions Estimated Cost: $ - 0-001 ! we Be l et+td a -3 The un4arpigned hereby s application fora permit for the work herein #peaif fed„ agreeing, to do all toric in sttl.ct accordance with the City of ftWay Or4l*ances and icut to of the Department of Buildings, aud hereby larea dat all the facts and representations stated to this application exe tri an$ correct. DATE -9 3Zz -3 SIGNATURE: (0" Ravwoe Sldo For Additional Inforcwtisn. ) SUBJECT PER0. -- City of Fridley C AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. I6 �sa� n "1CITY HALL FRIDLEY 55432 ,j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/5/90 JOB ADDRESS 215 - 69th. Place N.E. 1 LEGAL. LOT N0. BLOCK TRACTOR ADDITION SEE TACHED DESCR 9 2 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Doig 215 R 69th. 'lace N.E. 574-9533`- 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Amre Inc, 370.G Annapolis Lane, Plymouth, MN 55447 553-0020 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 Reside. 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 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 Z 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 $4,700 $2.35 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $72.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $74.35 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PROP L A I T THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEW [ ] Effective 5/1/88 ADCN [ ] R-1 AND R-2 ALTER [ ] //BWId ng Permit Application construction Address: Ui � l� �'e Legal Description: Owner Name & Contractor: ��Ae 0,'9x- Teel. Adder: Attach to this application, a Certificate of Survey of the lot, with the prcposed construction drawn on it to scale. RIPPION of REM= LIVIM AREA: length Width Height Sq. Ft. QRRAM AREA: length _ Width Height Sq. Ft. DECK AREA: length Width Hgt/Ground Sq. Ft. Off• Corner Lot [ ] Inside [ ] Ft. Side Yard Se acks Type of Constn�ction: ,�e /) Estimated Cost: $ L� Approx. Cmpletion Date: ®-8, Proposed Driveway Width If New Opening Is Desired: Ft. $ $ .CL��C Width + 6' See Back Page DAA Tel. # U APPLICANT. Permit Fee $ / e eo State Surcharge $_ SAC C large $ Driveway Escrow $ Park Fee $ Sewer Main 0=W $ TOTAL STIPULATIONS: wil .riyi• J ' MY USE ONLY Free Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by; Agreement Nay [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 19% 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS — Plau RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace S30.00 S U representations stated in this application are true and correct. (Side Vent — Fill Out Back)�S— % t O. Gas Piping (Needed with new furnace) S10.00 S OWNER Gas Range S10.00 S . BUILDING USED AS Gas Dryer $10.00 S Y _ ESTIMATED COST 70 PERMIT N0. /_-,N ,_) 7T *Air Conditioning — All Sizes S25.00 _ $ �5•� DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (UST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water)arm Ai Trade Name Size No6111C-6ge)'q 4) Commercial/Industrial BTU �&a)O HP EOR 1.25% of Value of Appliance or Work S Fuel J)Aj, g:i/4l Total Connected Load State Surcharge S .50 Burner Trade Name Size No. TOTAL FEE S • 5� BTU HP EOR SUBURBAN AIR HATING COMPANY8419 CENTER DRIVE MW 5_4432 MINIMUM FEE FOR ANY HEATING/CO0LING/VENTILATION ' REFRIGERATION/AIR CONDITIONING PERMIT 1S $25.00 Signed BTel No. O D 4_&Idd PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE S42.00/Hr Approved By Rough—In Date Final Date l _f7 "Air Conditioners can not be placed in a side yard without FILL OUT BACK SID= F R S i ACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE SUBURBAN AIR Post -it * Www Fax Transmittal Memo 7672 T. wcalma JJ Fax 571— AU Tewww#::5��- Comments 6127544694 P.01 10 NmafPages� Today'sDale///-�� Tuna From D Company ai►L� L//��, locegon Dept charge Fax # / 0 �J ` /�/ 9,J Telephone 8 Odgtnat ❑Y(up ( ❑Retum OOCagtorplew n�..�. emm !2/27/96 SUBURBAN AIR WORK ORDER JOB 14041 8419 CENTER DR., SPRING LAKE PARK, MN 55432 PHONE - 784-6100 ------- ____ _ ------------------ Builder Name: System changeout - - - Lock box: Customer: Bill 574-9533 Job Address: 215 69th Place NE Fridley Job Descript :ir _��" "�" �"�"a furnace & A/C ------------ ------------------- ----------- ------------ JOB SPECIFICATIONS Complete SYSTEM 1 SYSTEM 2 Furnace: AMANA GUIC09OA30 80% Air conditioner: AMANA RCC24A2A G It Ado l .r 5d" Thermostat: SWITCH SURBAS$ FOR GOLD CONDENSATE PUMP Zone system: Zone system desc: -- Flues: VENTING FURNACE & WATER HTR EXHAUST Supplies first: NEW LOWER PLENUM — Gas pipe: CONNECT FURNACE & DO ORSAT TEST Electrical: CONNECT FURNACE &'A/C Other: SENIOR DISCOUNT Other 2: REMOVE OLD SYSTEM ***************** ORSAT TEST AND SERIAL NUMBER INFORMATION *******************&* ** SEE EQUIPMENT MAKE AND MODELS ABOVE ** Furnace Serial Number: Air Conditioner Serial Number: ORSAT Information: CO2 I - .. 0.2 CO Alc; i-acC CFH INPUT 7D PRESS ?.moi " STACK EMP y S_�. Gas Valve Ignition Make Ignition type Filter size �(�X _ Vent size ,fit' Heat anticipator setting Limit setting - fixed '' Fan on setting - timed VERIFIED BY: DATE: I CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES Tn RF INSTOI I En nm cerria m nna f Effective On January 1, 1997 ��' I r���v, PLUMBING FIXTURE RATES: . NO. RATE TOTAL JOB ADDRESS_ X45- 407p' P1,4CC ME New Fixtures Old Opening, New Facture -Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 The undersigned hereby makes application for a permit for the work herein $ 4.00 speed agreeing to do all work in strict accordance with the city codes $ 5.00 and rulings of the Building Division, and hereby declares that all the fads $ 7.00 and representations stated in this application are true and correct. $ 7.00 $ 7.00 Aj r $ 7.00 .1998 $10.00 owner 0616• W141/1,461 a7Y-215-.33 $ 7.00 $10.00 pp �^ Building Used As X' $10.00 $10.00 Estimated Cost �4J— eje PERMIT NO. $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance p p® State Surcharge $ .50 TOTAL FEE D9O PLUMBING COMPANY�/%R. /�OQ%��,P e:c SIGNED BY _f �6L�lA'L TEL N0. Approved By Rough—In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.5o STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. SUBJECT PE City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT/<27809 r COMMUNITY DEVELOPMENT DIV. r �1 PROTECTIVE INSPECTION SEC. �D L F EY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 0 s1aF15 9/16/98 10B ADDRESS 215 69th Place NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 9 2 1 Rice Creek Plaza, North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Doig 574-9533 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Peak Roofing 11506 S Oakvale Minnetonka 55305 938-8150 20045301 d 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 O ALTERATION k7 REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK gxxgx Reroof house & garage (24SQ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 $2.056.00 $1.03 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCALjLAW REGULATING CON- SVUCTION OR TH ERFORMANCE O' Q1J UCTION $74.75 Fire SC $2.06 PLAN CHECK FEE TOT FEE C $5./0 82.84 SIGNATURE OF CON'R TOA OR AUTHORIZED AGENT IOATE, EN RO VALID T�THIS I R PERMIT - f� ' 61 G ,NSP 0ArE S-GNATURE OF OWNER OF OWNER BUILDER, IDAiE, NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY 0 C\ ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Ca ConstructionAddress: e')\ e, \o ff ��� U_ Legal Description: Owner Name & Address: `� '��', a ,,� \ �, Tel. # �� �— I S 30 Contractor: ���,� ',<.�o�cir,oc MNLICENSE# ')ooL1S3o( Address: �) A-4 AN Tel. # 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 Hg Ground Sq. Ft. OTHER: (� l� i Construction Type: ��� �� Estimated Cost: $ ass (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: \ S - j,& APPLICANT: Tel. # xls� CITY USE ONLY Permit Fee $ '77. 9r Fee Schedule on Reverse Side Fire Surcharge $ o2.6 ( .001 of Permit Valuation (1/10th%) State Surcharge $ 163 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S_,00 $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 $ �� y STIPULATIONS: u sua�ECT P IT NO. City of Fridley 335-1-2 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. -------- COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 0V9 r I CITY HALL FRIDLEY 55432 NUMBER REV OATE PAGE OF APPROVED BY 763-571-3450 910-F15 5/13/03 JOB ADDRESS 215 69 Place NE i LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Eleanor Doig 215 69 Place NE 763-574-9533 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rum River Lumber Co 10141 Woodcrest Dr, Coon Rapids, MN 55433 763-862-7300 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20036086 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION p REPAIR O MOVE O REMOVE XX 8 DESCRIBE WORK Reside house & garage 9 CHANGE OF USE FROM 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 or take pictures. Caulk and flash all exterior openings. Permit Inspection Cards Will Be Mailed To Homeowner To Post 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 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 $17,301 $8.65 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. $293.25 Fire SC $17.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Li nse SC $5.00 $324.20 SIGNATURE OFCON 'RACTORORAUTHOR iZED AGENT iDArE, WHEN PROPERLY VALIDATED THIS IS YOPR PE MIT S,GNATURE OF OWNEA.IF OWNERBUILDE A MATES -NSA --�' r)A Tt u MAY -06-2003 09:10 FROM CITY OF FRIDLEY TO 8626015 P.04/05 NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ j 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, its CO+h- Place � Legal Desccription: Owner Name & Address: O e( �,r 06 !� � aIS (D9 th PI ace - N . I✓,) Te 1. 574-953 3 ContractorjuM V-wu LAP01he r 6MN LICENSE# 000?�(nQ90 Address:__ Q141 �cck-re Sk- D riyc: TeI. # 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 HgUGround Sq. Ft. Construction Type: Si f u nQ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: (0 '03 APPLICANT: Tel. # -70-' - FADD -1,5 W Call (763) 572.3604 for Permit Fees if mailing in application. Fax to 763-5714287 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 CIN USE ONLY - TOTAL $ 3A 4, ?. Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.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 [ j