PRE 2010 DOCSDate
Owner i l
Address ...
BUILDING PERMIT
Village of Fridley, Minn. N? 2168
............................
h4& Builder . w. ' 'Y rt„ .........................
4�j ...... Address .........................................
V -
�� VL OCATION OF ` BUILDING
No.
3.... J.. Street .i�......'elole................. Part of Lot .......................
Lot Block ................ Addition or Sub -Division /.c -.v ..
Corner Lot ..... .... Inside Lot ............ Setback . a!li%"' Sideyard .................
To be Used as:
b&41 �
..
Type of
DESCRIPTION OF BUILDING
Front , ... Depth .4y... Height Sq. Ft......... Cu. Ft. ........ .
.. Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft...:... .
AW
in .. Est. Cost ..... F,700..� .... To be Completed !!R .........,
V
In consideratid of the issuance to me of a permit to construct the building described above, I agree to do
the proposed workaccordance with the description above set forth and in compliance with all provisions of
ordinances of the in IP age of Fridley. --+ %
1.
In c 'derati of the payment of a fee of $.. w+; permit is h by granted to r'x .. .... .
.... to construct the building or addition as .described above. This • �t is granted upon
the express condid n that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around ani upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limit, and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
f'•:.," Building Inspector
NOTICE:
This permitldoes not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Item`.
City of Fridley, Minn. A,,-# 'q .5aw
BUILDING PERMIT N® 7159
• -
Date:
Owner: �_ .� Builder
Address Address
•
�L� 1 OF UILDING
No. Street Part of Lot
Lot ---- ...r.__ Block Addi* or Sub -Division
Corner Lot _. Inside Lot _ _ Setback :� ' Sideyard
Sewer Elevation — — Foundation Elevation
DESCRIPTION OF BUILDING
T. V as:
-d Front _._� Depth Height _ Sq. Chi. Ftt_s�
Fro Depth Height— Sq. Ft. Cu. Ft.
Type of Constructio � Est.. ! _ To be Completed
In consideration of the issuance to me of a permit to "'building building described above I agree to do
the proposed work in accordance with the description above set rth and in Hance with ail provisions of
ordinances of the city of Fridley.
r
In consideration of the payment of a fee of $ 7 , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
tress condition that the person to whom it is granted and his agents, employees and workmen, in all work
d, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
7di7ytyL Minnesthe cices
Building Inspector
• NOTICE:
this permit dost not cover the eonstructhm, hataiiation for wirb& phmibtng, gas hedbg, sewer or water. Be ams to see
the Building impecwr for separate perm6s for these items.
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dap:. of Bldgs. Phone SII 4-�a�o /
GRAVITY WARM AIR: RATE TOTAL T-~nfl..w /� �/� /�
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
8.00
$
5.00
$
5.00
$
2.50
$
MECH. WARM AIR ,., goo
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ........................ 2.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $
Furnace Shell & Line—to 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 $_ 1
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 $
City of Fridley: V
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance ys#th the City Ordinances
and ruling of the Department of Buildings, and hereby eclares that all the facts
and representations stated in this application are tru and correct.
Fridley, Aann 19
Owner
Kind of Building
Used as
To be completed about A�00
d
Estimated Cost, $ ��d
Building Permit No,
195-
195—
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Ste of Water arm Air—No—',�
Trade Nam S�i
jze No-
Capacity.
o
Capacity Sq. Ft. E.D.R- A02e' o BTU H.P.
Total Connected Load _ ! / Kind of Fuer ®�
BURNER — Trade Name Size No
- -Capacity Sq. Ft- E D.R.-
FRANK'S HEATING
AND SHEET METAL
Signed 2505 MARSHALL STA F-
.40-11 posr 1M-12-58 Business Phone No�J��
Al
D., ` #9
ONS ��•
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS `
� �p _$'f
A.;�—
Weatherstrips S.H.V.E, Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How.
Yes o I., Yes— 19'—
Fl.1 �' Room l Length Width Height Fl.� • Room Length Width
Windows and Doors—Crac'kage and Area Windows and Doors—Crackage and Area
Width Height No. o Lineal f . Area Width Height No. of Lineal ft. Area
No. of pane of pane light of crack sq. ft. No of pane of pane lights of crack eq. ft.
Coef.I Btu
Infiltration
,fj
.-
Class
c
a
Exp. wall
Coef. Btu
Infiltration
Net exp. wall
Glass
Int. wall
Net exp. wall
Ceiling
%
Floor
Floor
Total Btu.
4
Required sq. ft. E.D.R. or sq. ins.', W.A. Leader area
Fl.1
Room I Length ,I- Width Height
Windows and Doors—Crackage and Area
Width
No. of pane
Height No. of Lineal ft. Area
of pane lights) of crack sq. ft.
Ar � d p ®r
Coef. L Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor i
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length 0 Width '
Windows and Doors—Crackage and Area
Width Helght No. of Lineal ft. Area
No. of Wane of Wane lights of crack ea. ft.
'-Zo Infiltration
:O
Glass
Exp. wall y
Net exp. wall e
Int. wall
Ceiling
Floor J I
_ Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1Room ( Length Width
Windows and Doors—Crackage and Area
Width Height No. of Lial ft. Area
No. ne
of pane of pan lights of crack 4• ft.
Coef. Btu
4 Infiltration 10
Glass 0
Exp. wall %t4LeoNet exp. wall
Int. wall
Ceiling
Floor
Btu
0
Infiltration i
Glass
Exp. wall �-
Net exp. wall 6 67
Int. wall
Ceiling M. lJ
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
m I Rnnm I i.enoth Width Heistht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of.pame lights of crack e4• tt.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Cit of Fridle
City y
SUBJECT
PERMIT NO
®i2228
AT THE TOP OF THE TWINS
BUILDING PERMIT
•
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION
r 1 PROTECTIVE SEC.
,J (NC)
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
7/12/73
JOB ADDRESS 115 - 712 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
31
Aud. Sub. #77 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Mr. Donald Nielsen 115 - 712 Way N.E.
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
X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct 22' x 22' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Provide 42 inch frost footings. Provide a hard surface driveway.
SEPERATE PERMITS REQUIRED FOR WIRING -0
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood
ZONING
SQ. FT.
CU. FT.
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
484
4840
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
$211,192
10
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. -
STRUC O OR, THE P RFORMANA OF CONSTRUCTION.
$9.00
PLAN CHECK FEE
TOTALFEE
'd ���
. 10.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VACDATED THIS. IS YOUR PERMIT
�� ���P
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
BLDG INSP DA E
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS: ZZJ ADDRESS:
NO:-. STREET:
LOT:- BLOCK:11
ADDITION•
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: w Depth: Height:
Square Feet: Cubic Feet:__
Front: —Depth: Height:
Type of Construct
To Be Completed:
Square FAPY-
^--U' Feet
timated Cost; $
The undersigned hereby makes application for a permit for the work herein
specified# agreeing to do all work in stfict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct,
s
DATE: SIGNATURE•
(See eve a Side For Additional Information.)
1 � A
1
u
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING P E R M
.12369„
t
ECEIPT NO.
1 • COMMUNITY DEVELOPMENT DIV.
�1: ------
PROTECTIVE INSPECTION SEC.
96 3 le
'
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�4 �'--1 CITY HALL FRIDLEY 55432
".J 612-560-3450
910-F15
110/19/73
JOB ADDRESS 115 - 712 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
3
1 Au,d. Sub. #177 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Donald Nielsen 115 - 712 Way N.E.
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 l ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBEWORK Install Franklin: Fireplace
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERATE PERMITS. REQUIRED FOR WIRING,
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
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
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PE MIT FEE SACC RGE
PROVISIO F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCT N O THE PERFORMANCE OF CONSTRUCTION.
$5.00
PLAN CHECK FEE TOTAL FEE
5.50 10
ATURE OF CC NTRACTORO AU ORIZED AGENT -RMT
W N PR PEF V IDAT D THIS IS YOUR PERMI-�
Lp�/��
�% -23
'- SIGN) RE OF OWNER IIF OWNER BUILDER) (DATE)
- INSP DATE
u
OWNER'S
ADDRESS:
0
APPLICATION FOR RESIDENTIAL, ALTERATfON,
OR ADDITION BUILDING PERMIT
CITY OF 1-RILILLY, \1JNNESOTA
NO:. S STREET:
R:
S:
LOT :61 6^BLOCK : �/'L AD19ION :�/ 7
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buildixig location drawn on these Certificates,
DESCRIPTION OF BUILDING
To Be Used As:
—Front: Dep Height•
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction, r Estimated Cost:
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that -i11 the facts and representations stated in this application
are true and c orrt-c t .
VimF Wd _. I
(See Reverse Side For Additional Information.)
R E L E A S E
The undersigned requests the City of Fridley to provide for a double driveway
access which would surround an existing cottonwood tree located in front of
the garage.
The requested provision would be made contrary to the City Engineering and
Naturalist's recommendations and that the undersigned for themselves, their
heirs, administrators and assigns, do hereby release, acquit, and discharge the
City of Fridley, its successors and assigns, and all officers, agents, and
employees of each, from all liability and damages consequent upon, resulting
from, growing out of, or in any manner connected with any construction,
occupation, or use of the driveway of the undersigned, by any and all parties,
including specifically, any and all damage incurred to the existing cottonwood
tree and its root system as a result'of the excavation of material surrounding
the tree.
Description of owners property: THE EAST 100 FEET OF LOT 31, REVISED AUDITOR'S
SUBDIVISION NO. 77, all lying in the City of Fridley, County of Anoka, State
of Minnesota.
The undersigned represents and warrants that they are the owners of said
property.
IN WITNESS THEREOF, the owners hereto have set their hands and seals this
'A6day of , 1976.
4es
fitness
Wi ess
Witness
- Husband
Fee Owner - Wife
a
Contract for Deed Holder - Husband
Contract for Deed Holder - Wife
SUB EC
City of Fridley
� 13976
AT THE TOP OF THE TWINS
BUILDING
PERMIT
'
s LCEIPT
NO.,,,,7
` _______ COMMUNITY DEVELOPMENT DIV.
L
_ j�
tI � PROTECTIVE INSPECTION SEC.
1 �
i CITY HALL FRIDLEY 55432
"t
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L"" 612-560-3450
910-F15
4/1177
JOB ADDRESS 115 - 7111 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
pt.i 31
Aud. Sub. #77
SHEET
2 PROPERTYOWNER i MAIL ADDRESS
ZIP PHONE
Donald Nielsen 115 - 7112 Way N.E.
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
Repla e 3 window units
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for rough -in inspection before sheetrocking.
SEPERATE PERMITS REQUIRED FOR
HEATI. PLUMBING AND SIGN&
NG
i
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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.
$1000
$.5O
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
RE OF CONT C ORO A HORI EDAGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
2AT7
,-
,SIGNATURE OF OWNER (IF O E BUILDER) (DATE)
BLDG INSP
DATE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER -
Address:/
No.: �j Street:
LOT: BLOCK: A
CORNER LOT: INSIDE IAT: �
BUILDER:
Address:
Tel. No.:
SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: Height:
Sctuare Feet: Cubic Feet:
Front:
Depth:
Height:
Square Feet: Cubic Feet:
Type of Construction: e.ma ed Cost: $
To Be Completed: 6
/Alt. A Alt. B
Proposed Driveway Width If ew 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 true and correct. See reverse side fer,,additional informat'on.
DATE: " / SIGNATURE: J
Stipulations:
SUBJECT
P IT NO.
City of Fridley
13991
AT THE TOP OF THE TWINS
PERMIT
BUILDING
R PT NO.
ltr _ COMMUNITY DEVELOPMENT DIV.
� INSPECTION
r � PROTECTIVE SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
ILCITY HALL FRIDLEY 55432
�
L---'' ,`� 612-560-3450
910-F15
4/8/77
JOB ADDRESS 115 - 713� Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt. 31
Aud. Sub.
#77 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Donald Nielsen 115 - 7131 Way N.E.
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 [j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construct a fireplace
9 CHANGE OF USE FROM
TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING,
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
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
$875.00
$.5O
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
TOTAL FEE
$8.00
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
S NA URE OF CONT ORORA lRIZ AGENT (DATE)
a•-.
v`7
BLDG INSP DATE d
SleNA LRE OF OWNER IIF OWI ER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER:: Z BUILDER:
Address: �� Z , Address:
Tel. No.
No. :_4
LOT: �1 j
CORNER LOT:
Street:
BLOCK: ADDITION:
INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:
To Be Completed: f
,a 1
Estimated Cost: $ 1�71 -If
Alt. A Alt. B
Proposed Driveway Width If 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 true and correct. See reverse side for additional information.
DATE: SIGNATURE:
Stipulations:
City of Fridley
SUBJECT
,
P
9 5 213
AT THE TOP OF THE TWINS
BUILDING
PERM
ER
IT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
6
a Al
r PROTECTIVE INSPECTION SEC.
S
1 i � CITY HALL FRIDLEY 55432
".j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
JOB ADDRESS a /_ a (�
I
I I
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
r�S�
I Revised Auditor's
Sub. #77
SHEET
2 PROPERTY OWNER a MAILADDRESS
ZIP
PHONE
3 CONTRACTORMAIL ADDRESS
ZIP
PHONE LICENSE NO.
SA-•oa//qq//�� c-
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
por" I CourLrL-
7 CLASS OF WORK
V7fLAvvNFL-_ ❑ ANEW I ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE El REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS
mus) rj�c &r L-1coisf
25;
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
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
Qp®u
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.
V
PLAN CHECK FEE
TOTALFEE
�y
�9` . ®®
SIG ATURE OF NTRACTORO AUTHORIZED AGENT (DATE)
EN PRO R L
AT THIS IS YOUR PERMIT
S Z3 -rid
4
BLDG iNSP_
5-'ZS- 99
DATE
SIGNATUREOFOWWRIIF�OWN.11.111LDERI IDATEI
CITY OF FRIDLEY
• APPLICATION f"OR RESIDENTIAL BUILDING PEIVAIT,
NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
MILDER:
APOWNER: /
Address:
✓�—��
. Addr. ess : ���� z/ 9 -Jam l
Tel. No.: <C--? Z—
No.:J� Street: 1
LOT: _ I BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: rl SETBACK: SIDEYARDS:
Applicant attach to this form rlVo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Us As:
1 / s
Front: Depth: Height:
Square Feet: Cubic Feet:
'Front: Depth: Height:
Square Feet: Cub'c Feet:
Type of Construction-. Estimat d Cost: $ S00
To Be Completed: / _. Alt. A Alt. B
Proposed Driveway Width I dew 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 true and correct. 'See reverse side for additional information.
DATE:
Stipulations:
SIGNATURE:
suedEcr
PE
City of Fridley
15869
AT THE TOP OF THE TWINS
BUILDING PERMIT
�
r
RECEIPT NO
' COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/12/80
JOB ADDRESS
115-711-2 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
Aud. Sub. #77 SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Donald Nielsen 115-7131 Way N.E. Fridley 55432 571-5148
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
OIomer
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW 51 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' % 20' carport.
9 CHANGE QF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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
$800.00
$• 50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT -PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$7.50
PLAN CHECK FEE -
TOTAL FEE
$1.
$9.88
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)HISIS
YOUR PERMIT
-IL-k®
BLDG INSP DATE
SIGNATURE OF OWNER 0F OWNER BUILDERi (DATE)
CITY OF FRIDLEY -
APPLICATION FOR RESIDENTIAL_ BUILDING PERMITS
(Nm, Alterations, Additions, or Repairs)
OWNER: J
ADDRESS:
F:L IVO :
STRJMT NO: 1 / `jSTREET:
LOT: ! BLOCK: _
BUILDER:swz--
ADDRESS:
TEL NO:
Construction Location
I ),L- — 7f
Corner Lot: Inside Lot:
_/ ADDITION: _
Setback:
52
•Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
propos building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front:
Depth:
Height:
Squane. Feet: 0-ibic Feet:
Front: Depth: Height:
Square. Feet: Cubic Feet:
Type of Construction: Estimated Cost: $ 'v_
To Be Completed: �C%J
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 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 true and correct.
Stipulations:
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SUBJECT
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City of Fridley
=16i74
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
16
RECEIPT NO.
• ____ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
17/13/82
JOB ADDRESS 1155 - 71�x Way N.E.
1 LEGAL
LOT NO.BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 31
Auditor's Sub. #77 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Donald Nielsen 115 - 71h Way N.E. 571-5140
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 28' x 12' Deck off Front of Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Variance approved by City Council on 7/12/82.
Idw Itwee ark *21 ul Rift,
SEPERATE PERMITS REQUIREo 1 W#jtW TELEPHONE -U00" W fits:
HEATtIMIC4 RLtlMeimO p( ► R QUIRED gY LAW
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
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
$1,250 $.63
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-
$22.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTALFEE
22.63
IGNA URE OFCONTR CTORORAUTHORIZEDAGENT IDATEI
WHEN PROPS L V I A D IS IS YOUR PERMIT
VILDERI
III,BLDGN DATE
E OF OWNER IF tDATE)
h
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIGN FOR RESIDENTIAL BUILDING PERMITS
(New. Alterations, Additions', or Repairs)
OWNER:
ADDRESS: %
TEL NO: 7
BUILDER:
ADDRESS: l
TEL NO: k
Construction Location
• STREET NO: STREET:
IAT: BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards: t�
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: --
Square.Feet.- Cubic Feet:
Height: d /
Front: Depth: Height:
Square -Feet: Cubic feet: la 6V
��PX`a I`
Type of Construction: C �) Estimated Cost: $
4b Be Obnpleted: J"::Z� - z- ------
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SID£ 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/eTq true and correct.
T_ v \
DATE, SIGNATUFE
Stipulations -
■'Imli.■I
.'I,0II.lS;
IINMIIMMIIMM
ll�llmmllmm
ll�i•If�i•II��
11�1•N�t•tl�l♦
11�1i�i•li��
EMISSION
limlimmilms
illmilmmilms
.t.11.I ! ml
■m> lu H
IMMIMMI
II ■ ■ ■■1■
ii■ ■� ■ ■■I■
�VX6 COMP,`
�y"rte S P"�P, COMMUNITY CREDIT CO.
EXECUTIVE OFFICE
3101 West 69th Street
Edina, Minnesota 55435
Phone: 920-9270
February 7, 1986
City of Fridley
Attention: Mr. James Robinson
Re: The East 100 feet of Lot 31 and
the West 10 feet of Lot 32,
Revised Auditor's Subdivision
No. 77
Dear Mr. Robinson:
This letter confirms our request and agreement that the east 100
feet of Lot 31 and the west 10 feet of Lot 32 of Revised Auditor's
Subdivision No. 77 be combined and regarded as a single parcel, not-
withstanding that we received title to each parcel by separate
conveyance.
BJH:cp
1
Very truly yo)urs,r
f a
Brian J. Hurd
Vice President
General Counsel
ANOKA COUNTY MINNESOTA TAXPAYER'S COPY
DONALD C. BAILEY, TREASURER
325 E MAIN STREET
ANOKA, MINNESOTA 55303
PIN NUMBER: R10 30 24 42 0057 0829385
PLAT 6 PARCEL NO.:
CONTRACT PURCHASER: NIELSEN DONALD L & MABEL V
PROPERTY DESCRIPTION:
STATEMENT OF PROPERTY TAX PAYABLE IN 1986
PROPERTY DESCRIPTION FOR TAX PURPOSES ONLY
RHE LEGAL DESCRIPTION OF YOUR PROPERTY MAY OIFFERI
PK461137 461119 E 100 FT OF LOT 31 TOG/W
WLY 10 FT OF LOT 32 REVISEDAUD SUB NO 77 SUBJ TO EASE
OF REC
TAXPAYER -AGENT OWNER -CONTRACT PURCHASER
NIELSEN DONALD L & MABEL
5 %MINN FED 131001031 115 71 1/2 WAY NE
355 MN ST FRIDLEY MN 55432
ST PAUL MN 55101
SEC/LOT
TWP/BLk
RG
ACRES
GA
SCHOOL DIST.
WS
HST
FISCAL DISP.RATIO
NEW IMPROVEMENTS
EST. MARKET VALUE
A/NA
ASSESSED VALUE
10
30
�24
.1
14---
•E
H
65500
�NA
11955
ARE YOU ELIGIBLE FOR A REFUND?
YOUR ITEMIZED
STATEMENT
MILL RATE
AMOUNT
TO FIND OUT IF YOU ARE ELIGIBLE FOR
S. STATE'
THE MINNESOTA PROPERTY TAX REFUND
..COUNTY 28.73800
343.565.
FILL OUT FORM M•1 PR USING THESE AMOUNTS
TOWNSHIP OR CITY 14.33000
171.31
6. SCHOOL DISTRICT 60.91900
728.28
1. Fill in this amount on line 10
7. OTHER TAXING DISTRICTS 4.69400
56.1 1
1299.26
A. AREA WIDE TAX 107.55300
2. Fill In this amount on line 12
700.00 e. TAX BEFORE CREDITS 1299.26
S. CREDITS WHICH REDUCE YOUR TAX-
A. STATE SCHOOL AGRICULTURE CREDIT
& STATE PAID HOMESTEAD CREDIT 700.00
NEED A FORM M-1 PR? READ THE BACK OF THIS FORM. C. WETLANDS CREDIT
D. 30CMITLE II CREDIT
E AGRICULTURE PRESERVE
to. TAX AFTER CREDITS 1 599.26
A. 240.26
THE STATE OF MINNESOTA DOES NOT RECEIVE ANY PROPERTY TAX
REVENUES. THE STATE OF MNRN IESOTA REDUCES YOUR PROPERTY 12. TOTAL TAX 839.52
TAX BY PAYING CREDITS AND REIMBURSEMENTS TO LOCAL UNITS
OF GOVERNMENT.
REAL ESTATE TAXES C.:>'r'?'•#:::�"ALSl'A'1AXs%`':3:::#`;
SECOND HALF TAX PAYABLE 1886 2TA FAYA9iE 3986
RETURN THIS STUB WITH PAYMENT RET1'115 S 1 LIftTFiAYMIfiiT
TO AVOID PENALTY, PAY ON OR BEFORE OCT. 15 TO AVOID PENALTY, PAY ON OR BEFORE MAY. 15
PLEASE INCLUDE PIN NUMBER ON CHECK 123388 PLEASE INCLUDE PIN NUMBER ON CHECK
PIN: 123388
"'R10 30 24 42 0057 H2O 00829385 �N R10 30 24 42 0057 H2O 00829385
MAKE CHECKS PAYABLE TO: DONALD c. smEY. ANOKA TREASURER— EY, ANOKA COU TREASURER
325 E. MAIN STL ANOKA. MN 55393 MAKE CHECKS PAYABLE TO: 325 E. MAIN STUONALD C. L ANOKA. MN 55303
PAY THISAMOUNT PAY THIS AMOUNT
419.76 419.76
TAXPAYER -AGENT TAXPAYER -AGENT
%MINN FED 131001031 5 %MINN FED 131001031 5
355 MN ST 355 MN ST
ST PAUL MN 55101 ST PAUL MN 55101
08293852000041976 08293851000041976
0829385FOOD083952
INDICATE ADDRESS CORRECTIONS ON BACK INDICATE ADDRESS CORRECTIONS ON BACK
Building
$
BUILDING
License Surcharge
Permit rTo.:;?cx)7 Ca�F 3
Inspections
SAC Charge
RESIDENTIAL APPLICATION
Received ,
763-572-3604
$
CITY OF FRIDLEY
Dat 'd -
DATE
YOUR E-MAIL ADDRESS
Park Fee
sITE ADD s
� �✓�
Sewer Main Charge
THIS APPLICANT IS:
,� OWNER ❑CONTRACTOR
Total Due _
PROPERTY OWNER/
NAME: lr ,4d ZC 1' S, //"'L 1-114
ADDRESS: I /S % I / l.�`°a Y
CITY �/��!% L ��% STATI�AGGI Sy 0-r.Z
TENANT
PHONE: 7G '%
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
Of SINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ 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 ❑ ADDITION
ANCE/REPAM ❑ REMODELING
DESCRIBE WORK BEING DONE: TL"'#'P 0/r/` C''1D Sfl/yCLL S
Ile CTi/ F4,
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT -zC' Sq. Ft.
ROOFING❑ HOUSE ONLY
NUMBER OF SQUARES
JEHOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING 997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ .�51, OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$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
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due _
$
R 7 , /� �% Make checks payable to: City of Fridley 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; that the work will be in accordance with the approved
plan in the case of all work w ch requires7re�ew'apd a
pproval of plans. J�D
SIGNATURE OF APPLICANT�,1"°V2�/� PRINT NAMEL/f��%Ll���� �7��%��% DATE %ZI13 D
Building MECHANICAL Permit No 4 - 1
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 2-19-09
DATE®' /y ^ C��/ YOURE-MAIL ADDRESS
SITE
THIS APPLICANT IS: ❑OWNER CONTRACTOR
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERbIIT TYPE
TYPE OF WORK:
NAME: 1--L 0 A rjO 0
ADDRESS:/'"a LAJ 14!j CITY TATE"V ZIP Ss 43--
PHONE: CIE a- 14 SI - 3'1 q
COMPANY NAME:
CONTACT PERSON:
,1
STATE LICENSE # EXP DATE
ADDRESS: Il Gelb tl o4 w s t- NL' CITY _f `j� STATE MN ZIPS `Sy3 L
PHONE 1-"6 7y-4 a) (i 5 FAX
13 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
❑ NEW 42' REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK __5-.J 11 t_ I=uR,C1ACS
Q eitt a - IA c6A(IL ALttA UA1, Ith�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FM URES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: 3,TSG A V 04 O f � SIZE/BTU Y d ,)i, L'
MFG: �(j n �n MODEL: / a q 4 W -A 0 Z0 SIZE/BTU—ate. fF,
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans. n
SIGNATURE OF APPLICANT 6 n� f' �-i��O PRINT NAME—Lk �1 I C , Vim' f- in _ DATE (i) �11 .
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
MFG: MODEL:
SIZE/BTUJ_A/C
$25.00
40_F EPLACE (GAS) $15.00
GAS RANGE/OVEN $10.00
TO AIR EXCHANGEER $15
(WOOD) $35.00
NEW GAS GRILL $10.00
_AIR
$35.00
_FIREPLACE
FURNACE $35.00
_GAS UNIT HTR $10.00
_BOILER
LINER $10.00
GAS DRYER $10.00
POOL HEATER $35.00
_CHIMNEY
DUCT WORK $10.00
GAS PIPING $10.00
_VENTILATOR $15.00
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans. n
SIGNATURE OF APPLICANT 6 n� f' �-i��O PRINT NAME—Lk �1 I C , Vim' f- in _ DATE (i) �11 .
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977