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PRE 2010 DOCSCity of Fridley, Mian.. BUILDING PERMIT N° C493i7) Date: d. Owner: ...__°:---� ._.��'1 .�+_ .:.�...-,�:�" �:.�:�.... Builder Address j�,•�%- t'+� .-r!!''�.a Address _.._..._ :..;.Z�....._.._.- ...................... _ _ LO TIT�F BUILDING Part IA .. No. Street r ._ ":.t_......._ - -.... i _. — Lot..... �, Block ......,.. ........,.. Addition or Sub -Division ...f,..:. y'.. -....`._..... Corner Lot ----- ------------------ _........ Inside Lot ..----.._ ............ Setback ...._.�1e . _.._......... Sideyard ... i---------,e�f----__........-----••--- Sewer Elevation....._............._......._...._.._........._......._...._......._....-............_....._. Foundation Elevation DESCRIPTION OF BUILDING To bUs as: ..... ... "� p . •• g Sq. Ft.tM1.iP..,�t Cu. Ft. a��, Front ........./. Depth Height , ......... � . a0_('_jn___9tructlon Front ....: Ga:.._.. Depth ... Height .�.�� ..:.__ Sq. Ft. ..a_.. cu. Ft. 36,4�� .::...:4.,. s.G tom'...:,.... 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 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 $ k. f ° ., 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 of any of the provisions of said ordinances. , ,< ° Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing,, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUIIDING PERMIT CITY OF FRIDIEY, MINNESOTA Owner's Name � � h N tf' A'Builder Jd �► /� �, - - Address 7//7 — LvGs [. �f7s rit dress 7/.#—/ — w CS PP ©©LOCATION OF BUILDING No. ;t,3 ¢ Street to 121 - Part of Lot - AORIK Lot ? Block Addition or Subdivision let �"-�°/A7-.9 � Corner Lot Inside Lot Setback 3.5- / Side -Yard /0 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. iJDESCRIPTION OFBU�IIDING F /'! q�Oj-- � S'IaL J�J, To be used as: ?e -.s i OLM, C- Front r 2 9 -2z / Sq. Ft. /1 7 Cu. Ft. G 1Y'0��} ¢ Front 1 Depth Height __ -L0 Sq. Ft. 3 S�W- Cu. Ft. Type of Construction f t- A m e- Estimated Cost 1 S® To be Completed De -c-. I S- I 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. DAA 3,1 d a SIGNATURE (A Schedule of Fee Costs can be found on the Reverse S de.) City of Fridley Application for Plumbing and Gas Fitting Permit DepL of Bldgs. Phone SII 4.7470, DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location— Number. Cel I z RATE TOTAL Number Fixtures ...................... x $1.50 2 y xn' x °QL Z T<� Z O �� WU' Z �p •• R N WATER HTR. GAS ELEG ZX 2.00 1 12 ? 3� o GAS FITTING FEES: NO. U <3 x $1.50 $ '6 C/ 1st 3 Fixtures ....................... .. Additional Fixtures .................... Base OR $ I i i $ a' 1st 2nd _ 3rd _ 4th • Future Connection Openings I Connected with Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ Future Fixture Opening x 1.20 $ Z New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ xx3.25 $ Water Heater (Up to 200,000 BTU) ...... ZX 2.00 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL x $1.50 $ '6 C/ 1st 3 Fixtures ....................... .. Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........... $ TOTAL FEE $ ��• �� 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. Owner of Building Used as To be completed about — Estimated Cost, $ Old—New. Building Permit ROUGH FINAL a z 2M 7-59 19Ad Application for Power Plants and'.Heating, Cooling, Ventilation, .Re#rigeralion and Air Conditioning Systems and Devices 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 $ ,y each add. 60,000 BTU ........................ 2.00 $ _ Replacement of Furnace ............................. §.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. EDR 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 BTT) ....................... 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 $� ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 FA 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. Owner _ Kind of Used as To be co Fri�l�eyl Minn 18 Bing Estimated Cost, $ Old New. uilding Permit No. oZ— Permit NO. / DESCRIPTION OF WORK HEATING or PO R PLANTS -steam, Hot Water Warm Air o l Trade Name Size No Capacity Sq. Ft. E.D.R_ 6 -d BTU H.P. Total Connected Load `Z - -f—o Kind of Fuel BURNER —Trade Name Size No Capacity (REMARKS -OVER) 4z 2M 7-s9 Sq. Ft. E.D.R BTU H.P. RAY N. WELTER H EATI N G Co Signed 4637 CHICAGO AV€- BMINNEAPOLIS 7. MINNESOTA y Business Phone No- as J—' Z a G 4 2 53-81-5-915.51 1111...—....vvv /z -,D_ '? s City of Fridley iwlIEGT ?AT THE TOP OR THE TWINS r I PLUMBING PERMIT APPLICATION rt,'---•--- COMMUNITY pEVEL.OPMENT DIV. I i PROTECTIVR 0109CYOM NW r---� i CITY HALL FRIQLRV $*MR i.....A" .J 444-899-300M Eft RiV. QATE PAGE OF b rvvo Job Address - 0 2115/73 1 1 800 238 N. E. 69th. Ave. Owner Address Phone Jack P. Krichen Contractor MI�GASICO Address y�3 MARQUETTE AVEA one Kind of Building Use Frame Res. Completion Datestimate Cost 12 —2 —712 10.00 Plumbing Fixture Rates: NO. RATE TOTAL I! W —' Number Fixtures x $2.00 $_ I Future Fixtures x $1.50 evo• ! New Fixture -Old Open. x $1.50 ,a I I I I Catch Bastn x $3.25 9r'D ol I I Water Heater -99,000 BTU x $3.00 'O91N I I I ! Ground Run Old Bldg. x $3.25 ■a°, MNMI m Elec. Water Heater x $2.00 1111 9NIsv■I + I I I I w Gas Fitting Fees: lO c 11NMIC I I ! 3 o tlOO1�I a 1st 3 Fixtures x $2.00 _ �0,� I I I Additional Fixtures x $ .75 b '1N0°d1 I I I I ' >,NIaG Gas Range -199,000 BTU 1 x $5.00 5.00 I A � SArtll N9rMI �r I I Repairs be Alterations See IDescription: Code ■N19V■ I I I State Surcharge Gass ®X® S'iar_cliars .50 som V I TOTAL FEE $ 5.50 Niw I I !The undersigned hereby makes application for a permit 11IrNI>tlnl I I I I for the work herein specified, agreeing to do all work 114-29012 _ in strict accordance with the City Ordinances and Tulin Ya1VM of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and correct. oIG 'Sire,�Q g Date 1111...—....vvv /z -,D_ '? s • 53-8Z,-9915051 �'1��•�'; i�(c•�� Future Fixture Opening .. • • • • • • • • • ---- A. plic-callon for plu �• • • Catch Basin .................. a . x $3.25 $ Dopt. of Bides. phono S' -*-34W x $3.00 S DESC?IPTIOli 0: V10i,i — x :1:25 S._------ , LaaU' ' 238 LE �� s 'It 2•W 5 NumSr:. Y.i:d dnd Lecr=loz of Fixtures KO. FiisTr TOTAL 15t3Fix:cres ••••••••••••••••'•---,•----xS2.03 3 AddiU;aal fixtures ............... ----- x + .75 S City of Mdley:. Z M Is z o e ti �1z z Cf u z �U - 7 7 - r N wAtt4 "Tit. Pas WC. The undersigned hereby makes application for a Permit for thr vorY her Cit? O.CJ�" c 1< i ' o 3 s o o • to specified, aZzeein to do all wcrk !n strict accor+da^.ce with trt specii c E i ' i S MIs _ o _ - ., a^.d ruling of the Department of Buil :.'nom, and hereby declares that a:I L4e f: East II 1 • , and npresertations stated in this app:icatson are true and co:-reti-t' II ' st all gr 11 5-12-76 Ridley. b:iaa 19, 2nd —"- Jack Krich®n Owner 3rd frame Kind of Building • - • Fc`s:o Cea Cc:..::::.d �ifb :ecs.ea �j;.zr.:.res. S=Yaaz ❑ Used as t Raw F!: -tura. old Crpnzins Cc:.puol ❑ To be completed about - X)_7 PARTIAL RATE SCHEDULE L 01HC rlXTU?z RATES: KO. RATE TOTAL Number Fixtures .... • - x $2.0.0. S Future Fixture Opening .. • • • • • • • • • ---- x $1.50 S • -• 1ew Fixture Old Oyening......•. • • • -- X $1.50 5--- Catch Basin .................. a . x $3.25 $ water Beater 'Up to 59.000 BTU) .... .------- x $3.00 S • %ew Ground Run Old Bldg....:... • ---- — x :1:25 S._------ E!.ctric Wa:ar H.at•as.....:........ �� s 'It 2•W 5 s!S FITTIIG FEES: KO. FiisTr TOTAL 15t3Fix:cres ••••••••••••••••'•---,•----xS2.03 3 AddiU;aal fixtures ............... ----- x + .75 S C:.s R:: ;e to 193.000 BTU ........... -, x $5.00 5 ------ Estimated Cast, S 10.00 pat�et Old -r. Building Permit NO-- . RCUGH FINAL ' '2- -4- 50 State Su,rchazge • k AL 1: FRATIONS•—Rafor to Code • ��++}f.• • Cha =' h a 5 • TOTAL. i.:c• Urr"._, bP .,�� Signed - �4 Y Busin= Phurie XMIMMr-TAru SUBJECT City of Fridley pr�:6)' AT THE TOP OF THE TWINS BUILDING PERMIT ' ' R `L -------COMMUNITY DEVELOPMENT DIV. s r i PROTECTIVE INSPECTION SEC. OL gj3fC�2 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 10/30/89 JOB ADDRESS 238 - 69th Place N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 8 3 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin/Laurie Kelzenberg 238 - 69th Place N.E. 571-5057 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 JD ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 81 x 22' Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, Provide a hard surface driveway. SEPARATE PERMITS REQUIRED FOR , WIRING, HEATING, F'LUMSiNG AND SIGNS: 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 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 $2, 550 $1.28 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECK FEE TOTALFEE A�a1 $55.28 SIGNATURE OF CONTRACTOR OR AUTHORIZE GENT (DATEI WHEN PROPERLY VALVATED THIS IS YOUR PERMIT SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI BLDG iNSP 0ATE NEW [ ] ADCN l)Q] ALTER [ R-1 AND R-2 Building Permit Application Construction Address: 'a.3cz-j, Lo O� . Legal Descriptiaaz: Effective 5/1/88 Owner Name & Address: \Lg-v, Nr �� o.�i.c\-z�� c Tel. # 5-)\S o S? Contractor: � -\ r"�- Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. �IPPIQN OF IIrlPlmVEI�iP length Width " a."; -;i Height Sq. Ft. GRPJM AMM: EA• Length _ Width Height Sq. Ft. DECK AREA: length Width Hgt/Gmund Sq. Ft. OTfE3t: Corner Lot [ ] Inside lot [-(] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: DATE: Ft. $ Width + 6' _ See Back Page APPLICANT: Tel. Permit Fee $ State Surcharge $ Lap a p SAC Charge $ Driveway Escr w $ Park Fee $ Sewer Main Qkarge $ STIPUTATIMS: CITY USE OILY Fee Schedule on Reverse Side $.50/$1,000 valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Nary [ ] Not Necessary [ ] /07 s - Specifications for proposed garage addition at; 238 69th P1, Fridley, MN 55432 1) 8' X 20" concrete footings 42" below grade. 2) 8" X 16" block foundation to 8" above grade. 3) Treated lumber for bottom plates. 4) 2" X 4" framing for wall studs. 5) Double 2" x 14" for header above garage door. 6) Biltrite sheathing 25/32". 7) Aluminum siding. 8) 2" X 6" rafters- (hand framed). 9) #15 roof felt. 4240 asphalt shingles. j ®1 I/.,, 0 NC tA�-" ��� 6' O'c. AGREEMENT ar ' ',�, ,�, owner of the property located at Lau have no objection to the City allowing the construction of a/an add;,4i qA race, X22 J to be located at 2M 04" Plate U without the required certificate of survey that the City ordinarily requires for all new construction. - ",—Izze� Wit e s • SUBJEtI PE City of Fridley 2 8 8 3 9 AT THE TOP OF THE TWINS ?'Reeerprwa- BUILDING PERMIT 572-3§0QmjmITY DEVELOPMENT DIV. y INSPECTION SEC. r PROTECTIVE NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J ` 612-571-3450 910415 1/14/99 14 / 99 JOB ADDRESS 238 69 Place NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 1 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Kevin Kelzenberg 238 69 Place NE 571-5052 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO LaMere Construction 714 18 1/2 Ave NE M ls. MN 55418 789-8171 3588 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 B DESCRIBE WORK Replace basement sheetrock in rec room 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING 1 1 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 RE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,500 $.75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CH GE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $48. SO Fir SC $1.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTA FEE License$5 0 $ .75 5 GNA TUBE OF CON -RACTOR OR AUTHORIZED ;-FE N T (DATE, N OP ALIDAT IS IS Y E� `r����`r////////���� / IZ� SIGNATURE OF OW NER�iF OWNER BUILDER, tDATEs BLO iNSP -039. OATt NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ^)13j 6 T t y 10/66e. /j Legal Description: Owner Name & Address: �(�,�, w )K e`er e ,,A Tel. # 5 -1 � - 15615 ;Z Contractor: L.4 M e. ? C,3 1< V " MN LICENSE # --b G V � Address: 17 V;Z 19-u 2. PS--, �2 q1 Tel. # -7 yj? - Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. 1 Estimated Cost: $ / S7-0 O " (5'0 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: l j/ Ll APPLICANT: Tel. # STIPULATIONS: —[�-e- -ia-� CITY USE ONLY 'Q- Permit Fee $ -S� Fee Schedule on Reverse Side Fire Surcharge $ /. .001 of Permit Valuation (1/10th%) State Surcharge $ %� $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $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 STIPULATIONS: —[�-e- -ia-� l SUBJECT P City of Fridley 29150 AT THE TOP OF THE TWINS BUILDING PERMIT RECE T 700. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �lJ8® •!/ r PROTECTIVE 1 � NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEV 55432 612-571-3450 910-FlS 4/6/99 JOB ADDRESS 238 69 Place NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DEscR. g 3 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin Kelzenberg 238 69 Place NE 530-4374 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing & Siding 18979 Gladstone Blvd, Maple Grove, MN 55311 416-4804 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20010277 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 0 ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (28 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 $1.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,399 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- $74.75 Fire S $2.40 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION22 41 PLAN CHECK FEE TOTAL F 4C;00000)! �/ Is L &A/License $5.00 3.35 9 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATLro EN7�P,O IDAT S Y U PER IT I v BLOC IN Oa I SIGNATURE OF OWNERSIF OWNER BU4DERi iDATEI l NEW ADDN ALTER [l ConstructionAddress: Legal Description: — Owner Name & Address: Contractor: M1 Cku Address: ! l®I lct i CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Z (0 q -q`` P( r-\ VQI-?(=nhp r-ri Effective 1/1/99 lb- Tel. #S,=�o-( -)H MN LICENSE #Din 9-1 RJUA Attach to this application, a Certificate of Survey o OLP, rn n lot, with the propgsed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: 1r- C'� 9PJ1 11�t 1P11 ZCi Construction Type: Driveway Curb Cut Width Needed: DATE:- t4` Lp APPLICANT: Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ _ $ jja (� l Tel. # —L'gQL4 STIPULATIONS: CITY USE ONLY Permit Fee $ ��' , % Fee Schedule on Reverse Side Fire Surcharge $ a .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ O $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 $ J-,-34` STIPULATIONS: Building V $ BUILDING See Back Page for Fee Schedule Permit No.: 0 i7 Inspections 571 (y 0 RESIDENTIAL APPLICATION Surcharge Received By: (W 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY $ I DIMAPT 2 12008 DATE —) 50 a 01'� YOUR E-MAIL ADDRESS kAJ5gSnaA0 9 0421-r C, SITE ADDRESS Aft,938 ! La" % 14 THIS APPLICANT IS: ❑ OWNER )LCONTRACTOR PROPERTY OWNER/ NAM $ TENANT ADDRESS: CITY STATE ZIP $ $ // -- PHONE: lis -� $� 01 - Q (aa NAME: Fee Determined by Engineering CONTRACTOR $ Renewal By Andersen Agreement necessary ( ) Non Necessary ( ) SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West (o YOUR STATE LICENSE WITH APPLICATION ADDRESS: Roseville, MN 55113 r STATE ZIP PHONE License #20130983 13 SINGLE FAMILY/NF PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ — ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: t f Q SIZE IMPROVEMENT LENGTH WIDTH N ROOFING HEIGHT . Ft. NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT* GARAGES PROPOSED SIZE: ❑ ATTACHED GARAGE ❑ DETACHED GARAGE I. 2• Existing Floor Plan Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used 13 Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Other 13 Trim ❑ Fascia ADDITIONS 1. HE & PORCHES SUBMIT: Site Plan/Survey showing the existing structure 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 ALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION � `7, Serf') -- C.. -.,l M • sTf l Permit Fee $ 1a5. a5' See Back Page for Fee Schedule Plan Review Fire Surcharge $ $ 571 (y 0 65% of Building Permit Fee Surcharge $ 00 .001 times the total job valuation License Surcharge $ o?. 5 W .0005 x Permit Valuation Minimum $.50 SAC Charge $ $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ $1550 per SAC Unit (Plans to MWCC for determination) Erosion Control $ ft + 6 i{ = ft x $21 =$ $450 Conservation Plan Review Park Fee Sewer Main Charge $ $ Fee Determined by Engineering Total Due $ A. " Agreement necessary ( ) Non Necessary ( ) (o Make checks payable to: City of Fridley Attach Stioulationc 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not 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 approves plan in the case of all work wh'h requires r view and approval of plans. SIGNATURE OF APPLICANT Gr�`� PRINT NAME QtCj, QyAgp h� DqT 13�cm Building BUILDING Permit No.. /®�� Inspectio6S RESIDENTIAL APPLICATION Received By: 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY Da EFFECTIVE 1-1-2010 DATE Gti D YOUR E-MAIL ADDRESS lkelzenLe VaA0O.C6VVJ SITE ADDRESS Z 3 C 5 THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: ie Ir—e n 10 e r - TENANT ADDRESS: Z 3 a (,,114A I Ce CITY i le STATE_LJ�) ZIP S� PHONE:H -7i0 7> r x'11 — S 0,5 C" CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY _ STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE i�SINGLE FAMII Y/NEW CONSTRUCTION SIZE (77�-TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE )(DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION DITION ❑ MAINTENANCE/REPAIR '❑ REMODELING DESCRIBE WORK BEING DONE: c , : A YIP 1A) Z 4i Q rE d OI 2 C SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING` FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit® I ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia 9 3Z `� and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: =IS THE 1997 U.B.0 FEE SCHEDULE) JOB VALUATION $ slOCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks Davable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all ork whic s review and approval of plans. SIGNATURE OF APPLICANT - PRINT NAME 2 /' DATE i� u- I� I !JL l=-�I lilt 1 t t{ � i i •pr��7 ! - l i I � i �( I I , ! SA- mm It ! i l J_ P i l i _� ! � ► l i w i4. u- ks z 14. tic V4 1110 :56 PI, VI Al IA ME HZI A- 9 1 — I 7. -t � C, -4— I'll -I - A-, , 1 Ar BUILDING PERMIT APPLICANT: PROPERTY OWNER I, ;3V6 L- ge- I Z t k Le'- Yunderstand that the State of Minnesota requires that all residential buil ing contract, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. This license requirement applies to owners of residential real estate who build or improve such property for purposes of speculation or resale. By signing this document, I attest to the fact that I am improving this house for my own use and am not building or improving this house for the purpose of reselling it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and Xhat thhouse for which I am applying for this permit, located at Z -z,,S (f.)R f ace , is the only residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. §514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to $10,000. I further state that I understand that the filing of a false statement with The City of Fridley may also result in criminal prosecution and/or civil penalties to applicable city ordinances and/or state statutes. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to The City of Fridley for compli pee will all applicable building codes and city ordinances witl the work being py f rryfed on this property. NZA, iP�,wW 0 Date For questions or information on contractor licensing, or to check the licensing status and enforcement history of a particular contractor, call the Minnesota Department of Labor and Industry, Construction Codes and Licensing Division, at (651) 284-5069. The web site is: http://www.dli.mn.gov/Ccid.asn 4 Land Planning 6875 -Hl#vy #45 N.E. minlvvpoll� 24 Land Surveying Soils Teshmq ENGINEERING, INC. Civil & milmapal 4-0,66 Engineering Enyineers Surveyors f.c r: - certificate of surve i o g zv