PRE2010 DOCS SUBJECT PE NO.
City of Fridley 20077
r '
AT THE TOP OF THE TWINS BUILDING PERMIT
' RE
_____ COMMUNITY DEVELOPMENT DIV.
-
r � PROTECTIVE INSPECTION SEC.
1 � �
1
CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
612-571-3450 910-F15 8/23/89
JOB ADDRESS 401 - 53rd Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED
DESCR. 16,17 15 Hamilton's Addition to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rev. Donald Berry 401 - 53rd Avenue N.E. 571-8845
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Home Improvement, Inc. 7401 Central Avenue N.E. 784-7543
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential Parsonage
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION S] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (23 Squares)-
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.
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 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 $1(1550 $J5. 8
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- $29,00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTALFEE
$29.58
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
"WHEN PROPERLY VA ATED THIS IS YOUR PERMIT
_ r
SIGNATURE OF OWNER IF OWNER BUILDERI (DATE) BLDG WSP
0AT
NEW [ ] City of Fridley Effective 5/1/88
AMN [ ] R-1 AND R-2
ALTER t ] Building Permit Application
Construction Address:_
Legal Description: _J
Owner Name & Address:_ E'(.�fE'��Yot
aP1�l�� Tel. # -7�_ 5`-
Contractor: Z/el)�'e�'- 1J_ ��_ Tel
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
EESCRIPPION OF IMPROVMT
LIVING AREA! Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height sq. Ft.
DECK AREAL: Length Width Hgt/Ground Sq. Ft.
OTHERi
ODrner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Cly eK I /'9�& Estimated Cost:
Approx. Completion Date:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
Width + 6" See Back Page
DATE: 497,23- S7. APPLICANT: my '
Tel. #
CITY USE ONLY
Permit Fee 5 -29,06 Flee Schedule on Reverse Side
State Surcharge $.50/$1,000 Valuation
SAC Charge $ $550 per SAC Unit
Driveway Escrow 5 Alt. "A" or Alt. "B" Above
Park Fee 5 Fee Determined by Engineering
Sewer Main Charge 5 Agreement Necessary [ ] Not Necessary [ ]
TOTAL
SPIPU MIONS: