Loading...
PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT Date:y Owner: ,i�,,''-�+` Builder Address Address �� LO WIZ. BUILDING No.Street __ __ _Part ,, Lot _ Block ____ Addition or Sub -Division Corner Lot Inside Lot Setback Side Sewer Elevation Foundation` Elevation DESCRIPTION OF BUILDING T r Front Depth Height Sq. Ft. Cu. Ft. / I zwoo 4 of Fro t !°- 0i:e Depth Height Sq, Ft. Cu. Ft. Type o Construction Est. 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 OA 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 the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done is 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. — � .r `—'\ Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to as the Building Inspector for separate permits for these trams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name ,Builder Address Address LOCATION OF BUILDING No. Street IPart of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard :EWER ELEVATION FOUNDATION ELEVATION 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 Sq. Ft. Cu. Ft., Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City 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. DATE � � !� � � � SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). y s r March 23, 1962 Fridley City Hall Fridley, Minnesota Attention: Mr. Allen Jensen Dear Mr. Jensen: I have no objection to Mr. Kowalke facing his home toward 73rd Street; thereby, giving him twenty --J- feet back lawn. oSincerely yours, Ors . Opal Schipansky 7316 Able Street, N.E. Minneapolis, Minnesota Application for Power Plants and Heating, Cooling, Ventilation, .Rehigeration and Air Conditioning Systenms 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 $ 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 ©�_ $f Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ Ok BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule �a GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ d 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 SII. 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 Cite Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application arp/true and correct. f id eY, Minn. ��./f% e�� 18 4-a0✓ Owner Kind of Used as To be completed about Estimated Cost, Old ew. uilding Permit No. �` ® Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Ste of Wa Warm Air—No Trade Nam Size No Capacity0 e7 19 Sq. Ft. E.D.R BTU H.P. Total Connected Loader Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU A.P. (REMARKS—OVER) r Signe A'.ZA.1 /�. �J�f►'//Jr / 4 2 2M 7-59 Business Phone No. /. AME ,•H T G. C 0 N T R DDRESS i 11 N BTU. COEF. I _ OP DATE /— NAM ', B [ADDRESS 1 -,x/ PL. FL. ROOM LENGTH WIDTH HEIGHT FL. z if ROOM LENGTH � WIDTH HEIGHT N OWS AND DORS-CRACKAGE AND AREA WINDOWS AN WINDOWS AND ORS-CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF LINEAL FT. LIGHTS OF CRACK AREA SO. FT WINDOWS AND NO. WIDTH HEIGHT No. OF LINEAL FT AREA LIGHTS OF CRACK SO. FT FLOOR I / I NO. WIDTH HEIGHT NO. OF LINEAL FT. AREA N0. COEF. BTU HEIGHT NO. OF LINEAL FT. AREA COEF. BTU INFILTRATION LIGHTS OF CRACK S0. FT. ROOM LENGTH 4 WIDTH HEIGHT INFILTRATION SQ. FT. •I GLASS FLOOR J GLASS EXP. WALL NET EXP. WALL / EXP. WALL NET EXP.,WALL IL CEILING --� --P. 1 _3 TOTAL BTU. CEILING TOTAL BTU. HEAT LOSS f ® HEATING UNIT I FLOOR E.D.R. STEAM Q TOTAL SO. FT. H.W. FLOOR TOTAL BTU. COEF. I 9 dTOTAL INFILTRATION BTU. 440c -,x/ CA6 C) FL. c*(,✓ ROOM LENGTH C WIDTH HEIGHT FL. z if DOM LENGTH / WIDTH / HEIGHT WINDOWS AN DOORS-CRACKAGE AND AREA I WINDOWS AND ORS-CRACKAGE AND AREA FLOOR EXP. WALL NO. WIDTH HEIGHT NO. OF LINEAL FT. AREA N0. WIDTH HEIGHT NO. OF LINEAL FT. AREA CEILING FL. LIGHTS OF CRACK S0. FT. ROOM LENGTH 4 WIDTH HEIGHT LIGHTS OF CRACK SQ. FT. •I 3 FLOOR J / / TOTAL BTU. --� --P. 1 _3 TOTAL BTU. COEF. I BTU. INFILTRATION / 440c -,x/ GLASS c*(,✓ / ®0 ERP. WALL 1440 z if NET EXP. WALL 0 � d CEILING EXP. WALL FLOOR EXP. WALL pZ, NET 6XP. WALL Al:/ TOTAL BTU. CEILING FL. OOM LENGTH WIDTH DOORS-CRACKAGE AD AREA HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRAC SQ.FT. // I *- 1 141 p ROOM LENGTH 4 WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA N0. I WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK S0. FT. 1 -- / % 1 .0, 1 1 _�3 FLOOR COEF. BTU. INFILTRATION S13 440c -,x/ GLASS G' 1- JAI6 EXP. WALL 1440 GLASS NET EXP. WALL 0 � d CEILING EXP. WALL FLOOR EXP. WALL pZ, NET 6XP. WALL Al:/ TOTAL BTU. CEILING % FL. WINDAS AND NO. WIDTH OOM LENGTH WIDTH DOORS-CRACKAGE AD AREA HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRAC SQ.FT. // I *- 1 141 p HEIGHT COE F.1 BTU. COEF. BTU. INFILTRATION I .INFILTRATION 14- 1440 GLASS 62 GLASS EXP. WALL EXP. WALL pZ, NET 6XP. WALL Al:/ NET EXP. WALL CEILING CEILING FLOOR FLOOR TOTAL BTU. / TOTAL BTU. TOTAL BTU. HEAT LOSS f ® HEATING UNIT I TOTAL E.D.R. STEAM Q TOTAL SO. FT. H.W. i 36S DATE NAME EXP. WALL ,.HTG. CONTR. [NAME NET EXP. WALL J 013 [ADDRESS LIGHTS OF CRACK CEILING S� DDRESS NET EXP. WALL FLOOR EXP. WALL / FL. ROOM LENGTH Jig WIDTH HEIGHT FL. ROOM LENGTH WIDTH HEIGHT if WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH I HEIGHT No. OF LINEAL FT AREA NO. WIDTH HEIGHT NO. OF LINEAL FT. AREA FLOOR LIGHTS OF CRACK SO. FT LIGHTS OF CRACK S0. FT 3 / .5' 3e) -a J /, I p aP I `l. ------ ----- NFILTRATION��� .► GLASS 36S I I I 6-6 EXP. WALL / N0, I WIDTH I INFILTRATION NET EXP. WALL �^ EXP. WALL LIGHTS OF CRACK CEILING S� —3�� NET EXP. WALL FLOOR EXP. WALL / CEILING 0 NET EXP. WALL FL. I Qe& 0QROOMILENGTH r WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA NO. WIDTH I HEIGHT NO. OF LINEAL FT. AREA LIGGHTS OF CR CK SO. FT. INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR INFILTRATION BTU. I I I ICOEF. BTU. GLASS N0, I WIDTH I INFILTRATION / / 3 �^ EXP. WALL LIGHTS OF CRACK GLASS S� —3�� NET EXP. WALL ,. EXP. WALL / CEILING 0 NET EXP. WALL FLOOR FLOOR CEILING TOTAL BTU. FLOOR TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK SO. FT. /� 112, 1 /-1 - COEF. BTU. I I I ICOEF. BTU. WINDOWS AND DOORS•CRACKAGE AND AREA N0, I WIDTH I INFILTRATION / / 3 �^ LIGHTS OF CRACK GLASS S� —3�� ,. EXP. WALL / / ® 0 NET EXP. WALL FLOOR CEILING TOTAL BTU. FLOOR TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT TOTAL BTU. FL .IROOM LENGTH WIDTH HEIGHT X FL.1 ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA N0, I WIDTH I HEIGHT N0. OF LINEAL FT. AREA N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA LIGHTS OF CRACK S0. FT. LIGHTS OF CRACK -3.2 ,. CEILING COEF.1 BTU. I COEF.1 BTU. INFILTRATION ® INFILTRATION GLASS EXP. WALL GLASS EXP. WALL NET EXP. WALL /17 NET EXP. WALL CEILING / CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT • BTU. COEF. DATE NAME .H T G. [NAME C O N T R. y GLASS O B [ADDRESS ADDRESS `� •,FL. NET EXP. WALL OM LENGTH '3WIDTH J/ HEIGHT FL. ROOM LENGTH WIDTH HEIGHT WIN 0WS AND DOORS.CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA NO. WIDTH HE GIT N0. OF LINEAL FT. AREA NO. WIDTH HEIGHT No. OFILINFALFT4 AREA ,7 v LIGHHTS OF� CRRACK SO. FT LIGHTS OF CRACK SO. FT vvz cs ,r— OM LENGTH WIDTH HEI WINDOWS AND DOORS•CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF LINEAL FT.1 AREA LIGHTS OF CRACK ISO. F / i / INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR 13:7 17L I I I I I I COEF.I BTU INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS•CRACKAGE AND AREA N0. I WIDTH I HEIGHT NO.uOF LINEAL FT. c!REA COEF BTU. COEF. BTU INFILTRATION INFILTRATION �® �0 0 GLASS EXP. WALL NET EXP. WALL NET EXP. WALL CEILING CEILING FLOOR ,7 v If io ,r— OM LENGTH WIDTH HEI WINDOWS AND DOORS•CRACKAGE AND AREA NO. WIDTH HEIGHT NO. OF LINEAL FT.1 AREA LIGHTS OF CRACK ISO. F / i / INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR 13:7 17L I I I I I I COEF.I BTU INFILTRATION GLASS EXP. WALL NET EXP. WALL CEILING FLOOR TOTAL BTU. FL. ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS•CRACKAGE AND AREA N0. I WIDTH I HEIGHT NO.uOF LINEAL FT. c!REA COEF BTU. I I I I I COEF.1 BTU. ® INFILTRATION �® �0 0 GLASS EXP. WALL /0 NET EXP. WALL CEILING FLOOR TOTAL BTU. FL.I ROOM LENGTH WIDTH HEIGHT FL.1 ROOM LENGTH WIDTH HEIGHT WINDOWS AND DOORS•CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA N0. I WIDTH I HEIGHT I I!GHTS OF RACK FT AREA30. FT. N0. WIDTH HEIGHT LOIGHTF, OF CRACK S0. FT. COEF.1 BTU. I I I I I COEF.1 BTU. INFILTRATION INFILTRATION GLASS GLASS EXP. WALL EXP. WALL NET EXP. WALL NET EXP. WALL CEILING CEILING FLOOR FLOOR TOTAL BTU. TOTAL BTU. TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SO. FT. H.W. HEATING UNIT City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE YOTAL Number Fixtures ...................... x $1.50 �^ Z Z x 1.20 °� Z Z O , j wU' Z $ Water Heater (Up to 200,000 BTU) WATER HTR. $ • O Q New Ground Run Old Bldg . ............ ;.. $ GAS FITTING FEES: in 3� o� $ Additional Fixtures .................... S� < C�9 °d �U' eg (�90 F N GAS ELEC. Base I I 1st I t 0 2nd r I 3rd 4th ' Future Connection Openings Connected with I Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE YOTAL Number Fixtures ...................... x $1.50 $� " g Future Fixture Opening ................ x 1.20 $ •� New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ • O Q New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE , 16 DepL of Bldgs. Phone SII 4-7470 r-.&:_ 995" r y3 City of Fridley: The undersigned hereby makes application for a permit for the work heret 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 applica on are true and correct. Fridlev. ,nn. 1942— Owner 9 4L Owner / ' ' Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No CI Permit No. Signe fn° By Business Phone No„ ROUGH FINAL • 0 City ®f Fridley, Minn.. BUILDING PERMIT Date: _ June 71 1965 N° '7'766 K6 3 owner: Seymore Nelson Builder United Diversified RW�e ers & BldIrs. Address 73d: Avenue N. E.AddressR, R. 2 SamMex LOCATION OF BUILDING No. $95 Street 73rd Avenue N. E. Part of Iat Lot _ 15 _ Block 5 Addition or Sub -Division Shaflers Add. 1 Corner Lot — Inside Lot Setback — Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Att . Garage Front Depth Height Sq. Ft Cu. Ft Front Depth Height Sq. Ft Cu. Ft. Type of Construction Frame F.st. Cost To be Completed Storm damage Repair 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 compliance with 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $20---00—, permit is hereby granted to United Divers. Rem. & BldIrs. to construct the building or addition as described above. This permit is granted upon the express condition that the peon 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 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. NOTICE: ills penah don not cover the construction, hutaWan for whing, plumbing, gas heating, ewer or water. Be sora to see the Building kqw for for epsrate Wmalft for thea Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S • NAME ` i� r> r �i� ` 1� �< 1 `, etA BUILDER L) k, , _ _4 ADDRESS - .� % l J (f_ �� ADDRESS (r rte LOCATION OF BUILDING No. Street Part of Lots LOT BLOCK ADDITION OR SUBDIVISION Corner Lot Inside LOT..�'Setback Side -Yard SEWER ELEVATION FOUNDATIONELEVATION Applicant attach to this form Two Certificates of Survey of Lot, and.proposed building•location drawn on the96• Certificates. DESCRIPTION OF BUILDING To ge�'tm • ,R -A Front Depth (DHeight Sq. Ft. Cu. Ft. Front Depth `Height Sq. Ft. Cu. Ft. _ Type of Construction_ Estimated Cost To be completed The undersigned hereby makes application for apermit for the.work herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and riilings:of the Department of Buildings, and hereby declares that all the facts and represen�ati.ons stated i:i this application are -true and correct. s 'SIGNATJ .. LURE.( (Schedule of Fee Costs.cen be'found on the.Reverse Side). APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME 6e- y K'-' ADDRESS (� C} -7 LOCATION OF BUILDING /� f® !' . Nom ,b�.� Street -Part of Lo/tv LOT BLOCK ADDITION OR SUBDIVISION Corner Lot Inside LOT Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATI01j 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 /(0- �' Height (V 6 °l Sq. Ft. Cu. Ft. Front Depth THeight Sq. Ft. Cu. Ft Type of ConstructionFy�j'� N� 2 Estimated Cost __ 0o 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 all the facts and representations stated in this application are true and correct. DATE�G' C _SIGNATUREL 2�Cn, L.. �. (Schedule of Fee Costs can be found on the Reverse Side). • ._r_ !- • SUSJECT PERWI City of Fridley "3 2 7 7 8 AT THE TOP OF THE TWINS BUILDING PERMIT r ` v __���_ COMMUNITY DEVELOPMENT DIV. _. RECEIPT . r - PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DAT 712/02 PAGE OF APPROVED 911 612-571-3450 910415 JOB ADDRESS 895 73rd Ave NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 4 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Judith Lawrence, 895 73rd Ave NE, Fridley, MN 55432 763-784-9067 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Judith Lawrence (same as above) 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof (tear-off) H & G - 28 squares 9 CHANGE OF USE FROM TO STIPULATIONS Underlaymert must comply with State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING 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 BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,001.00 $1.50 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 $97.25 Fire SC $3.00 PLAN CHECK FEE T Al FEE $101.75 S.GATUREOFCONTRACT ORAUTHOA1FEDAGENT (DATE, E PR -Y VA ED THIS IS YOUR PERMIT URE OF O Rii N R U4DERi IDATE���j Bl G iNSp NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Narr Contractor. MN LICENSE # Address: 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 Hgt/Ground Sq. Ft. OTHER: Construction Type: Estimated Cost: $ �® l Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: -/o2 - v oZ APPLICANTt--�,bi'7?/- �2�'fl �� Tel. # Call (763) 5723604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side $ S-00 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1200 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by'Engineenng $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 101.15 STIPULATIONS: W . , Building MECHANICAL PermitNo:aa-C "ID, Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY d- I DATE 1 LU B YOUR E-MAIL ADDRESS (�(�fY1�ri � nhS 6--c i Q00A C .CO►tiL THIS APPLICANT IS: DOWNER =NTRACTOR PROPERTY OWNER/ NAME: i f'f % Agth CITY /li�alS STATH ZLP TENANT ADDRESS: h 9/ � - 712 -7- 9' 70 D PHONE: CONTRACTOR COMPANY NAME: be `s �� i h 4 Ate-, 17r^ c CONTACTPERSON: Prom SUBMIT A COPY OF YOUR STATE STATE LICENSE II EXPDATE LICENSE WITH ADDRESS: 4081 - 30-1 `r`-'` L -.s N Int CITY STATEJA�ZLP ESM APPLICATION PHONE JUD -yLU -361-7 FAX j U 3 - q 4 q PERIVIIT TYPE IXSINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW WREPLACEMENT 0 ALTFRATIONAUIMODEL DETAILED DEscit ITON OF WORK 62 a lad 2 X i 5 i� ✓t 4 f, A Vrl LJ h �a'� ' n g, eW o i amen4 ati o( - G lIr Cpnd. 4_ oner PER MS I GB.665 the permit fee is a mh>imu m of $15.00 or 50/e of the total cost up to $5W.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, exchldMg the fixtures. (This should reflect orly the cost of labor ) Labor cost under $300 = $15.00. Labor Dost betweco $300 to $500 = cost of labor X.05 = FORPROJECTS WHERE LABOR EXCEEDS S5ft FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: MUNCATE TOTAL NUMBER OF EACH BELOW) �1- Equomat Io uBcd MFG: l(Rffi C (r MODEL: 559 u e PVxey 11,4 SnEffTU (A0,coo MFG: MODEL: ;Z_ps- Id, uZA4 SIZFJBTU 13 xcr LTvn MFG: MODEL: SIZE1BTU ✓ AIC $25.00 (GAS) $15.00 GAS RANGE/OVEN $10.00 _FIItEPI-hCE Ant TO ALR EXCIIANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 —BOILER FURNACE $35.00 GAS UNIT HTR $10.00 $35.00 LINER $10.00 GAS DRYER $10.00 POOL HEATER $3500 DUCE WORK $10.00 GAS PIPING $10.00 VENTILATOR $1500 FQR $Si J OTt 1 PERNIIT1 PRPermit eeOJECTS Number of10 00 X$10.00=$ 1Geo Stege $ .50 Number of fixtures @ $15.00 x $15.00 = $ fixtures $25.00 / x $25.00 = $ TOTAL DUE $ Number of @ Number of fixtures @ $35.00_[ _ x $35.00 = $mss o e State Surcharge = $ .50 Total = $ 10 . D THIS IS AN APPLICATION FOR APERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accauate; that the work will be m conformance with the oWmances and codes of the City of Fridley and with the Minnesota Construction Coles; 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 01 work which req review and approval of P". O DATE -7 a �19. JOY SIGNATURE OF APPLICANT ( PRINT NAME PT P A cF 1%TnTF• q PAR ATF PFRMITS ARE REOUI32M FOR BUILDING. ELECTRICAL AND MECHA CAL RK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977