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PRE 2010 DOCS• 0 6 It-ty ®f Fridley, Minn. BUILDING PERMIT N? 6587 0::;,2'& X107 wli O F U DING No. Street P f Lot Lot _ Block ! Addition or Sub -Division . �. Corner Lot , Inside Lot _ _ _ _ Setback �- -- Sideyard �Z Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T Usadi ` Front' Depth s Height , Sq. FtI;1, 0 Cu. Ftgf. 4W Depth Height _ -Sq. Ft. . _ Cu. Ft. Type of Construction' Fast. C 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 act orth and in ce with all provisions of ur8inanoes of the city of Fridley. / fi ,; Q %/ In consideration of the payment of a fee of $tea �_ , 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 withi neer. city limits and this permit may be revoked at any t�'m� upon, W o— of any of the provisions of said ordin Building Inspector NOTICE: ills porno does not cover the eoaatruction, hrsaWen fot,whing, phnebing, gas heating, sewer or wafer. Be sore to see the Building hupeetor for separate permits for these hum OWNER'S APPLICATION FOR BUILDING PERMIT. CITY OF,FRIDLEY, MINNESOTA. ADDRESS ADDRESS LOCATION OF BUILDING No. ,5^(� Street�Part of Lot Lot_ Block �.. Addition.or Subdivision Corner Lot Inside Lot Setback Side -Yard. SEWER ELEVATION FOUNDATION RLEVATION Applicant attach to this .form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; Front Depth�Height z.,01 _ Sq. Ft../ Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft Type of Construction Estimated Cos y 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 RIGNATURE / (Schedule of Fee Costs can be.found on the Reverse Side). City oFridley Fidle Y Application for Plumbing and Csas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK '01 Number, Kind and Location of Fixtures Location — +� 3 3 in � C� rnz�� u� pZ OuJ.O <3Z V 3 <� (�9 •� �Sn 0 Z �� 00 • F • N WATER HTR. GAS ELEG Base Ist 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 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 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL ca 1st 3 Fixtures .......................... �' x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do 411 work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn- s ° 190 Owner s ' ''a Kind of Building _ Used as To be completed about -1 ` I C Estimated Cost, $�� Old—New. Building Permit No VI-% Permit No. Signed ,'- . - l BY- Business Phone No - ,,7 -6-3 o ,,7 ROUGH !— FINAL it REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ az aM SUBJECT P City of Fridley 210 91 AT THE TOP OF THE TWINS BUILDING PERMIT i REC N0. COMMUNITY DEVELOPMENT DIV. _ PROTECTIVE INSPECTION SEC. 4f I CITY HALL FRIDLEY 55432 NUMBER REV910 GATE PAGE OF APPROVED BY "'j 612-571-3450 910415 10/1/91 JOB ADDRESS 450-475 75th Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 & 2 1 D=11 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Holmquist 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Creative Construction 12375 Oak Park Blvd Blaine 55434 755-7405 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Apartment 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 5 stall garage 9 CHANGE OF USE FROM TO STIPULATIONS Garage to be 8 feet from west and south.property lines. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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 $22,291 $11.15 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- $234.00 Fire SC $22.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE . 0 9.5 SIGNATOR FCONT CTOROR TMORIZEDAGENT IDATEI WHEN PR PERLY ALIDA I OUR PERMIT SIGNATURE OF OWNER of OWNER BUILDERI iDATEi 1511A -it MATE Prepaid Plan Check $ Estimated Cost $ QTY Cr FRMEY Reoeipt # R-3, emomam i nwUSMR33kL Baildbq Permit 7lpplioaticn u. M 0w.04 . • i Effective 1/1/91 Architect & Address Reg. # Dgineer & Address TYPE OF WCI2K (a New [ ] Addition [ ] Alteratim gibe l/uE � � / / BUnDM DIMMMCM Length4A Width 5�� Height Sq. Ft. l �� G of Stories t OFC. AREA: Length Width MM AREA: Length Width Height Sq. Ft. Height Sq. Ft. Width Height Sq. Ft. a291-, �2 o Sq. Ft. x $ Cbst/Sq. Ft. = valuation $ ) Sq. Ft. x $ Oost/Sq. Ft. = Valuatim $ ) _ $ � U, OD O Sq. Ft. x $ Cost/Sq. Ft. = valuation S ) SAL VAIIJE Building Use Omwtnicfiicn Type Ooc4ancy QrcuP Air Ccnditioni;.y i]:c- []No Fire Protection Provided []Yes []No Perfononoe Board Amount $. See Reverse for Schedule Received [ ]Yes [ ]No Permit Fee $ "),34,06 See Fee Schedule an Reverse Side Plan Check $ 9 -). i O In Dooess of Prepaid Amcxmt - See Reverse Side Fire Stmlm*ge $ .2-2.30 .001 x Permit Valuation (1/10th %) State Surdharge $ 11.1S- $.50/$1,000 Valuation (See Sched. for > $1 Million) SAC Charge $ $650 per SAC Unit Park Fee $ —' Fee Determined Bys Spec. Arse +�"'=*+*� S Agree Necessary [ ] Tot Necessary [ ] Driveway Escrow $ feet x $13.50/foot 7072L $ou JIMMMaL )C;9zm Gv/ r� Gj�� -OF h[oe � O.amvt M �� 1. 0 a " a7x �4 00 Rre.a w�7xl'',a'4 oD $+Vra%,e Are a Ii 30 c ��III r 18Xd4 OD aX'�I s I fol Id►�.I I I i� I IAX 0,4 OD r 18xo2* op IR)eo?4 oD Ii 30 c tor; oKm�u�;i��ner�rla�s 8 Gaaragea � �ra[S e. q 8' %roma 4so,- 476 UlkArve Al. E. �L 41NIJ e�3innese'Ti 94 r -sea�e Ir X,e4 on c , r T P c interior w41:6 tiaxf 5+a K' L� ogeres ®VI& $+fie P�ywoar' d�ieeT,n cxTBPiOr, watri 094 S�ttdmt 1��oG Cohered tvforlpr 41^0615f1 ��1dM eB48r p J o a 9 ��III I�X�q op 18Xd4 OD aX'�I I fol Id►�.I I I i� I IAX 0,4 OD r 18xo2* op IR)eo?4 oD tor; oKm�u�;i��ner�rla�s 8 Gaaragea � �ra[S e. q 8' %roma 4so,- 476 UlkArve Al. E. �L 41NIJ e�3innese'Ti 94 r -sea�e Ir X,e4 on c , r T P c interior w41:6 tiaxf 5+a K' L� ogeres ®VI& $+fie P�ywoar' d�ieeT,n cxTBPiOr, watri 094 S�ttdmt 1��oG Cohered tvforlpr 41^0615f1 ��1dM eB48r p J o a 9 TITLE INSURANCE COMPANY OF MINNESOTA ANOKA TITLE DIVISION -20 E. MAIN STREET N ANOKA, MINNESOTA 55303 N 612/421-2550 CONDOMINIUM NUMBER 5 UNITY VIEW CONDOMINIUMS SLOOA 470 I 1 ul � I 1 1 , 1 1 BLDG.. 460 I I i I . I Aced a. V'Awimcc-,• INDEX f T NO. woe. ..... .... a .... APT. NO. NIOO. NO. SNCST NO. .__ .— _50 A4 -T jiO } 56 _4S �s_ J 4_.L— —1--- _ - Is—Jr- y TT .- -�I—fit T 9 SITEL� "RAG: MAN uP�/1c c 6C D �J 614� ptgea _Yard3P, d e tjle' �-aY'a e i 10"6SE1n, i- ALbc, 4E,s,E-mgAJ7 IE st !� tb v � ® . 0. e� 4A �. c k 0 Y'` e i i o � tb v � ® . 0. e� 4A �. c /.20 4aA( 177" f "XI A 01� V 0 /-Z,' _f-.j$X All' -inch smle: -��'D Beet CERTIFICATE OF LOCATION OF, BUILDING CERTIFICATE OF SURVEY I hereby certify that or.- 1 hereby certify that on I made a stirvcy of the liwation of the building(s) on the above I surveyed the property described above and that the above plai described property and that the location of said btvilding(s) is is a correct representation of said survey. correctly shun n on the abovc plat. vt N.S,M. 7:5"/ d' ROY J. HANSEN, REGISjERM -*URVEYOR NO. 6274 2-7 b Jt JL u, -a of 11,L10ract TiVe Guaranty, inc. ROY J. l-4A,%11G!:'N' 13S*7 Spring Leke Land '-14irwyer "A 'V� Alp ;i5'1Hopkins. Minn. :�51. A. tj C) L. h NX Telcohone 95S-5,,,7 3 Civil E. -rig R8b est L. 477d WrIC" -T hO I rhgl(,: St and wd I 1 6-, OF PROPERTY c) r. 466-#74 7SM 4vevu,--Mertheast, Fridley, Minne504. LOCATION_ B) OESCRISED AS F01 -L01 71--5V57 /.20 4aA( 177" f "XI A 01� V 0 /-Z,' _f-.j$X All' -inch smle: -��'D Beet CERTIFICATE OF LOCATION OF, BUILDING CERTIFICATE OF SURVEY I hereby certify that or.- 1 hereby certify that on I made a stirvcy of the liwation of the building(s) on the above I surveyed the property described above and that the above plai described property and that the location of said btvilding(s) is is a correct representation of said survey. correctly shun n on the abovc plat. vt N.S,M. 7:5"/ d' ROY J. HANSEN, REGISjERM -*URVEYOR NO. 6274 2-7 b Jt JL t;i i Y OF rKIULtr INSPLU i IUN DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR LI1C(.U�c; ,.)i: .1i.a11 i, —%JU- PLUMBING FIXTURE RATES NO. RATE TOTAL JOB ADDRESS O5V �-5`PdAf?UG . /ll &_ New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 30 p4 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 �� - 23 , 20o -P Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner IfIA f, Water Heater -Electric $ 7.00 Water Heater - Gas" $10.00 Building Used As4,VI412-ls?Cw��' Gas Range" $10.00 1-3 Gas Dryer"" $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMP Y�%`af�J4•�i�J� o�/��i- C�O/t��`-/lc�J Reinspection Fee $47.00/Hr SIGNED BY TEL N0.1.51-111 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance 3Z Approved By Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE F ANY PLUMBINGIGAS PERMIT IS $20.00 TOTAL FEE $ �� PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 1 SUBJECT P City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 33530 r COMMUNITY DEVELOPMENT DIV. r E PROTECTIVE INSPECTION SEC. i -_-• _ '��,'� CITY HALL FRIDLEY 55432 L f \ 763-571-3450 1 RECEIPT NO. NUMBER 910-F15 REV DATE 5/20/03 PAGE OF APPROVED BY JOB ADDRESS 450 & 476 75 Avenue NE 1 LEGALLOT DESCR. NO. 1 & 2 I BLO 1 I TRACTOR ADDITION Melody Manor SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE RAS Properties 3647 McKinley St NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO BWE Construction 476 Hawthorn Rd Lino Lakes MN 55014 651-484-7427 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Apartment Buildings 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT CU FT 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $33,000 SURTAX $16.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON.$472.05 STRUC THE PERF ANCE OF CONSTRUCTION Fire SC $33.00 PLAN CHECK FEE TOTAL FEE $521.55 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE, WHEN PROPERLY VALIDATED THIS IS UR P RMIT SIGNATURE OF OWNERiIF OWNER BU4DERi iDATE, bLbG INE OA E 1 CITY OF FRIDLEY Effective 1/1/2003 6431 University Ave NE R-3, COMMERCIAL & INDUSTRIAL Fridley, MN 55432 BUILDING PERMIT APPLICATION (763) 572.3604 FAX (763) 571.1287 CONSTRUCTION ADDRESS LI SO /Y? 6 %S vc ly C, Zoning Legal Owner & AddressR-AS. 36Y7 t Tel# ( ) CONTRACTOR & ADDRESS K W •� . G+lnrs��c f' .. Tel# (6iL) t12?'•/• 7NL7 .q26 RL 4:•o L c L r Ay, SSU / y Architect ___ Reg.# Engineer Reg.# BUILDING CONSTRUCTION 1 TYPE OF WORK [] New [] Addition K Alteration -Describe bii^ C�1w 9C=P c.-e..►-.,+'� nt,w SiSTi.-sr w•n OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height , Sq. Ft. OTHER AREA: Length Width Height Sq, Ft. APPLICANT &L-6- 6&ea^ Tel Date VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ 33.06) °'� Sq, Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Air Conditioning []Yes []No Fire Performance Bond Amount $ Permit Fee $ C121, c T_ Plan Check $ Fire Surcharge 21 State Surcharge $ SAC Charge $ Erosion Contro� $� Park Fee $ Spec. Assessments $ Curb Cut Escrow $ TOTAL t?0/20•d LZOLOBOTS9 0i Type Occupancy Group Protection Provided []Yes []No See Reverse for Schedule Received []Yes []No PERMIT FEES See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side ,C01 x Permit Valuation (1/10th t) $.50!$1,000 Valuation (See Sched. for > $1 Million) $1275 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $17.00/foot ATTACH STIPULATIONS A31G I dd d0 AIM W06J 9Z:60 Z00c.-10-add CITY OF FRIDLEY PERMIT NO.: 2004-00067 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/20/2004 571-36U4 YAX: (763) 571-12137 ADDRESS : 450 75TH AVE NE PIN : 113024240112 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE MULTI DWELL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. FIVE KITCHEN CIRCUITS IN APARTMENT #9 # INSPECTIONS 2 # 0-100 AMP CIRCUITS 0 # 101+ AMP CIRCUITS 0 APPLICANT MERIT ELECTRIC COMPANY 751 PAYNE AVE ST PAUL, MN 55 10 1- (651) 774-9671 OWNER GRANNING LAURINE A 450 75TH AVE NE #5 FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl 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 provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (NON-RESI) 50.00 ELEC AMP SERVICE FEE 0.00 ELEC CIRCUIT FEE (0-100 AMPS) 0.00 ELEC CIRCUIT FEE (101+ AMPS) 0.00 ELEC PERMIT FEE - MAX (APT) 0.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 50.50 PAID WITH CHECK # 18415 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 YAX: (763) 571-1287 ADDRESS 450 75TH AVE NE PIN 113024240112 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE : MULTI DWELL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00274 R % l s" DATE ISSUED: 02/26/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. CONVERT OVERHEAD SERVICE TO UNDERGROUND (400 AMP) # INSPECTIONS 2 # 0-100 AMP CIRCUITS # 101+ AMP CIRCUITS 0 APPLICANT MERIT ELECTRIC COMPANY 751 PAYNE AVE ST PAUL, MN 55101- (651)774-9671 Is Awl 19 GRANNING LAURINE A 450 75TH AVE NE #5 FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (NON-RESI) ELEC CIRCUIT FEE (07100 AMPS) ELEC CIRCUIT FEE (101+ AMPS) ELEC PERMIT FEE - MAX (APT) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 18627 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort 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 provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 50.00 0.00 0.00 0.00 0.50 50.50 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57L -36U4 YAX: (703) 571-1L87 PERMIT NO.: 2004-00275 K DATE ISSUED: 02/26/2004 ADDRESS 450 75TH AVE NE PIN 113024240112 LEGAL DESC UNAVAILABLE : LOT BLOCK PERMIT TYPE ELECTRICAL PROPERTY TYPE : MULTI DWELL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. KITCHEN REMODEL APT #6 # INSPECTIONS 2 # 0-100 AMP CIRCUITS 0 # 101+ AMP CIRCUITS 0 APPLICANT MERIT ELECTRIC COMPANY 751 PAYNE AVE ST PAUL, MN 55 101- (651) 774-9671 OWNER GRANNING LAURINE A 450 75TH AVE NE #5 FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (NON-RESI) 50.00 ELEC CIRCUIT FEE (0-100 AMPS) 0.00 ELEC CIRCUIT FEE (101+ AMPS) 0.00 ELEC PERMIT FEE - MAX (APT) 0.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 50.50 PAID WITH CHECK # 18627 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building BUILDING Permit No.: Inspections COMMERCIAL/INDUSTRIAL Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd:00 DATE 0'v-13—'06" YOUR E-MAIL ADDRESS SITE ADDRESS 5T-0 _ 7,S 141-e It lg TENANT Suite No. PROPERTY OWNER NAME: �_ r ® �� <7 16i, ADDRESS: R LF7 4- Al c 1',, %f)e �'r r%I- CITY 04p (s STATE ZIP5.5c(2f Srosion Control $ PHONE:—&(2 (^ ARCHITECT NAME: ADDRESS: CITY STATE ZIP Special Assessments CONTRACTOR n NAME:-nv g ems, <• ADDRESS: 1iy cj-) *iy /lKaQ _CITY If -(--,ZIP S'-rC $ ft + 6 ft = ft x $21 =$ PHONE:'- tF%& FAX $ f 17)3_ S *NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS PROPERTY TYPE ❑ TOWNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ INSTITUTIONAL ❑ MULTI -FAMILY PERMIT TYPE ❑ ADDITION ❑ WW CONSTRUCTION ❑ OTHER ❑ REMODEL RrROOF ❑ SWIMMING POOL PLEASE SUBMIT: 1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE 3. LANDSCAPE PLANS 7. PERFORMANCE BOND 4. ENERGY CALCS AMOUNT $ BUILDING TO BE USED AS: OFFICE sF WHS SF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION (Y/N) AC(Y/N) DETAILED DESCRIPTION OF WORK 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 re uires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME -DATE AL ES ARE BASED ON VALUATION �J^ 6 � Sq. ft. x $ Cost/sq. ft. = Valuation $_ Sq. ft. x $ Cost/sq. ft. = Valuation $_ Sq. ft. x $ Cost/sq. ft. = Valuation $_ TOTAL JOB VALUATION: $ 11 .op USE OCCUPANCY TYPE Permit Fee $ I a�'e See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ ;2. 7 to .0005 x Permit Valuation Minimum $.50 SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Srosion Control $ $450 Conservation Plan Review ?ark Fee $ Fee Determined by Engineering Special Assessments $ Agreement necessary ( ) Non Necessary ( ) -urb Cut Escrow $ ft + 6 ft = ft x $21 =$ Total Due $ f 17)3_ S Make checks payable to: City of Fridley Attach Stipulations