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City of Fridley, Minn. BUILDING PERMIT • Date: July 15, 1968 • • Owner: Address Vernon Larson No Builder Ray Swene on Address 5615 Camden Ave. N. LOCATION OF BUILDING No. _ 1383 Street _ 76th Ave .Ny E, _ Part of Lot Lot 21 Block 3 Addition or Sub -Division . Meadowmoor Terrace Corner Lot ._____..____ Inside Lot — X.-- Setback 35' Sideyard ._._ Sewer Elevation ___ _ _ 891.52 — 895.5 Ton of Fnnting DESCRIPTION OF BUILDING To be Used as:---:-� 0q,gp- 9828 Dwelling Front 42' Depth 24' Height _20' Sq. Ft. 1008 Cu, Ft, 20160 — Front Depth _ _ Height — Sq. Ft. Cu. Ft. 000 Type of Construction _.. Frame Fit. Cost — $15, _..__.. To be Completed SEWER LOCATION - 49.3' East of Manhole in center cul-degsac WATER LOCMON - SBTX 8.7' North of Sewer 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 se�..gorth and �n compliance with 21 provisions of ordinances of the city of Fridley. / 1 �J In consideration of the payment of a fee of 3 0. 00 , permit is hereby granted to Ray Swenson 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 buil within the city limits and this permit may be revoked at any time upon violation of any of the provisions 70a ordinances. Official Building ZNMBMK Breher NOTICE: This permit does not cover the construction, installation for wiring, plumbing, on hooting, sewer or water. Be sire to an the Building inspector for separate permits for thea itenu. •." APPLICATION FOR BUILDING PERMIT CITY PPIDLEY IMUMSOTA.... ADDRESS D.. LOCATION OF BUILDING s.. ... N0. ... STREET. LOT 4- _BLOCK ADDITION OR SUBDIVISION CORIZR LOT INSIDE LOT SETBACK �.S✓ SID YARD SEWER ELEVATION0P'''FOOTING .t .. Applicant kittach to thin 'form, Two. Cert1fi6aVa4..of Sur#ey of Lot and proposed building •lgciition dravni. on tb;e a CerAlff ares . DESCRIPTION OF BbILDiNG To Be' Ud d • s ' Front ._ �� DeptHeight gt o 4' y Square feet„ Cubic Feet 1 �' i #!Yriont ;Height Square feet Cubic Feet 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 4 (Schedule of Fee Costs can be found on the Reverse Side). Land Plowiny cfu*"*M 6875 - #,�r�ay its AlE, cared St#wyoy MIMM)WIli-3z Sol/s Tesmy ENGINEERING, INC. 0"-iola C/w/ 6- AlLompa/ SlImet 44066 EnYineerS Sur veyons certificate of suv*47 fo'lrJULmowsxl "D Owes IVOR TH R-30., 76 T" AVE., N E . 0,01NO7,'CS IRON DZ-N0rZS 07-1117Y 0 DR.WNAGC rASZNENr 3L 0 Cg 3 /*y ,Cor rADowmooe 7R�RAcx- COJINrY Or 4AVKA &Mby ctrbiry mlai #ws a a hue Wd *WMd Ate"$WfdiM ')'d SWWY elk b%M*P;V 4r* door dwvArd 4rd, &d A. 0 d". SUB UjQ 8ANCENC71MERANCI, INC. E Surors SCALE =4O' City of Fridley Application for and CMing Pernut DESCRIPTION OF WORK Dept. of Bldgs. Phone 560-3450 Number, Kind and Location of Fixtures Locatioz< Ci NO. RATE TOTAL Number Fixtures ....... ...... ....... N � $— 1/ y1 Y New Fixture Old Opening .............. 6' Z Z W x $3.25 W U0' Z W �O O F r N WATER HTR. GAS ELEG Base z $2.00 $ GAS FITTING FEES: / 1st 3 Fixtures ...... ................... x $2.00 O@ $ , Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st / 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer ❑ Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... ...... ....... �`P x $200 � $— Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 © Q $— New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 O@ $ , Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description .......................................... ..$� TOTAL FEE $ City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 application are true and correct. Q Fridley, Minn,e - Z2 1940 Kind of Building Used as To be completed about Estimated Cost, $ Old New. uilding Permit No Permit No. ROUGH FINAL 42 Signed By Business Phone No UL Application for Power Plants and Hearing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 6.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR NO RATE /TTAIL 1st 3 Fixtures ...................... Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE /TTAIL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................ x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $� ROUGH FINAL Dept. of Bldgs. Phone 560-3480 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 i�d correct. .In Fridley, Minn �/%�? — 19�� Owner Kind of Building ,),/a��' Used as To be completed about Estimated Cost, $ Old ew Building Permit No. Permit No. T/2 DESCRIPTION OF WORK HEATING or POWE vTS—Steam, Hot Water, 4arm Air No Trade Name ' Size No- s� Capacity Sq. Ft. E.D.R ��A�BTU H.P. Total Connected Loa 1;19 Kind of Fuel- BURNER ue BURNER — Trade Nam �� ��- Size No.. . Capacity Sq. Ft. E.D.R— BTU H.P. RAY N. WELTER HiEATING CG= Signed AA BHICAND "F—. B INNigWoue 7. MINNE80TA C4131104P Business Phone No-® Ile (REMARK< -0;; City of Fridley, Minn. BUILDING PERMIT Date: _July 24 1970 Owner: Vernon R. Larson Bider Same Address 1383 -76th Avenue N.E. Address Same LOCATION OF BUILDING No. 13 83 Street 76th Avenue N.E. _ Part of Lot Lot -21--- Block 3_ Addition or Sub -Division . Meadowmoor Terrace Corner Lot , Inside Lot — X Setback — Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING No0768 To be Used as: Ca_rage Front 20' Depth 22' Height 10' Sq. Ft. 440' Cu. Ft 4,400' Front Depth Height -- Sq. Ft. r Cu. F't. Type of Construction Frame Fes. Cost_ $1, 900.00 _ To be Completed 2 months Provide Hardsurfaced Driveway 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 t forth and in compliance wi _ all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Vernon Larson 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 ordinance& HANK MUH161f Building Inspector NOTICE: 'fids permit doss not Cover the construction, haft en for whine, phunbing, gas heating, sewer or water. Be sours to see the Building Inspector for separate permhs for these items. J APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : ,e f -b )j 9, %Z0/',/BUILDER : 5A M E - ADDRESS : J 3 & 3 - %6-i"j V, N G ADDRESS • Sal " C NO:..13 Fs 3 STREET:_ %� LOT: P BLOCK : -3 ADDITION: "zFAPo Cy NIOo 2 TERGZAC C CORNER LOT: /l%© INSIDE LOT :SETBACK: SIDEYARD: 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 • '20 r Depth • P'�;? Height • IZ) ✓ Square Feet:- Cubic Feet: 14 , ¢ b 0 Cu1C77 Front; Depth: Height: Square Feet; Cubic Feet: Type of Construction: �',�/�sy� Estimated Cost:_$ 1q00 To Be Completed: (9 /u/oS, The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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 : ' - jv L - ;F,*, 770 SIGNATURE (See Reverse Side For Additional Information.) PLO Y i4l 00 3S z l y s 3737 y 0° CERTIFICATE OF SURVEY For: Vernon R._ Larson - 1383 76th Ave. N.E. Fridley9MInnesotare July 239 1970 0 Denotes Iron D"tes Utility and Drai gd,EwLrnrt, -Z '0 4z, 1 OP 'Oe C� A �W, 7 "Oe % N - Id EASEMENT This represents a survey of LOT 219BLOCK 39 MEADOWMOOR TERRAQ: i: ..,,.kap 1,4innesotao I ncieby certify that s by me ,-,r under any direct -4 at I af4 a duly registered --=veyo., inc. the laws of the state of Minnesota. r Reg* "o. 114 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 . gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: s lst 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING FAN HEATING SYSTEMS see Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $ ic. 60 ROUGH INSP. FINAL INSP. REINSPECTION FEE Date ($10.00) L 6= APPROVAL FOR PERMIT MINIMUM FEE FOR ANY HEATING PERMIT IS. $7.50 PLUS $.50 STATE SURCHARGE Job Address !. F-3 7&'61L Age -17 y2ec Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 66 Fridley, Minn. ` / Q . 19� OWNER M �_/_ e- l L a rznc ri KIND OF BUILDING _ / d Fra- r1 E USED AS TO BE COMPLETED ABOUT�o�y� — 7 ESTIMATED COST 4L20 n OLD - NEW BUILDING PERMIT NO. PERMIT NO. 60 DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name' Size No. Capacity Sq. Ft. EDR BTU HP Company ' Signed By Tel. No. 1 SUBJECT P City of Fridley 21647 AT THE TOP OF THE TWINS BUILDING PERMIT r � • ____ COMMUNITY DEVELOPMENT DIV. _ L -I PROTECTIVE INSPECTION SEC. l r i CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED 81 L 612-571-3450 910415 11/10/92 10B ADDRESS 1383 - 76th Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mabel Larson 1383 - 76th Avenue NE Fridley 55432 784-5831 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Leif Hendrickson Build 6434 Riverview Terrace 55432 571-2776 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION �] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replacing 5' under front door & replacing front concrete step. 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED .50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUT ITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER ST EOR LOCA LAW REGULATING CON- $15.00. STRUCTIO R THE P R NCE qF CON R CTION. PLAN CHECK FEE TOTAL FEE C _ ___ _ 1 $15.50 SIGNAT EOF• TRA TOR OR AUTHORIZED AGENT IDATEI WHE ROPER Y VWDATE TT{,1 IS YOUR PEERMIT�T BLDG I GATE S.GNATURr OF OWNERIIF OWNER BUILDERI IDATEI 1 NEW [ ] Effective 3/1192 ADDN [ ] CITY OF FRIDLEY ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 13 10 O � 7 �� A14 Legal Description: Owner Name& dress: Tel. # 78 Contractor: � _9 MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # 71- Z 77,6 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to . scale. DESCRIPTION OF IMPROVEMENT Length Width Length Width Lenj4h Width ge Comer Lot [ ] Inside[ Type of Construction: Approx. Completion Date: Ft. Yd Setback Driveway Curb Cut Width Needed: Ft. + b Ft = 1-07MM APPLICANT: ITY Height Height acv Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ Ft x $ (Cost on Back) = S Tel. # Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ J Not Necessary [ ] TOTAL STIPULATIONS: GNOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287 December 15, 1992 Mr. Rick Hanson Hcme Care Repair Clinic 14441 92nd Ave N Maple Grove MN 55369 Re: Construction In Fridley Without a Building Permit (1383 76th Ave NE) Dear Mr. Hanson: On October 22, 1992 I did a building inspection at 1383 76th Avenue NE for Ms. Mabel Larson. She stated that she had some work done that she was not satisfied with. One of the complaints was that a stool was installed improperly. Glen I returned to the office I could not find a plumbing permit for this work. Doing plumbing work in the City of Fridley without having the required permits is a misdemeanor. It is also a misdemeanor for anyone, besides the homeowner of the property, to do plumbing work in the City of Fridley without someone in their shop carrying a Masters Plumbing License. I have left two messages on your answering machine with no response from you to date: you need to come in and get the proper permit for this work. Please contact me at 572-3603 if you have any questions concerning this matter. 'Thank you, GARY R. FORD Bldg/Mech Inspector GRF/mh OC: Mr Keith Flakne, MN Enforcement Division �Mi�l 1oQ Rso�► �ji.�� ��o�� - v �a �c�-.o,� S�g Lo -0. Ser4,4 work 6 bt-%4 , L ` �, s -�lti c�.-} C5� �� a®l w a.`s � �., s � a l`, � � 1 �� ✓ O'p 'i r1 y �r� ��$�l .i. '1r'�'�.�,r ` Ack:!6t ® c� Z eov.\c� w1 � i � Wk, -Lr> O,+V�, o�1i �o► c� ��t� o mak- a ��u.�...�a`�•..� ���w•� � ao � � .,.�..5=�� ork—lw �;,c F!5 o. jM%tsNEK-.4rL oe- l� lS SOSO 0. iytiiS 4p sc—wl to - tj r C.1 —"! rg3-f f / 1 h 4 l . KA A S-krs - 4 Au S s Caw J s s 5 �-► e.� . c� + Z E � � J yow.'t ®ww�4rl b t �,,� 4 4c� �✓�•yam- 1�JiV2 UJrca QiS`?–�! tra pN ' �0.iA✓ �w'3�_`2P: -•�---��� u1 �,----S+J-"� -N �--'��..P7��o.uc `i �,d�e�__�[O..a: __ 1L1 `��d_—�-_ (, ( �s bR � i •J p.w c1 G►�'�• `N,.2 � t�cyaR✓ f� �,t n.c i�' I� `�i Sy�®� r F S, e, 40a2 Csa, c. ATTENTION: LANDLORDS & HOMEOWNERS HOME • CARE • REPAIR • CLINIC WILL SAVE YOU TIME AND MONEY! WE CAN HELP YOU GET YOUR RENTAL UNITS READY FOR NEW TENNANTS OR YOUR HOME READY FOR A QUICK SALE. SOME OF THE SERVICES WE PROVIDE: ❑ PAINTING — Inside and Outside ❑ DRYWALL — Replace or Repair ❑ ASPHALT — Seal Coat - Repair ❑ GUTTERS — Replaced - Repaired - Cleaned ❑ WINDOWS — Cleaned - Replaced ❑ APPLIANCES — Aemove Old - Install New ❑ COMPLETE CLEAN-UP — Yard - House - Apt. - Fire Damage ❑ CARPENTRY — No Job too small ❑ CEILING TEXTURING — New and Patching ❑ PATIO AND DECKS — Wood - Concrete - Repair - Replace ❑ ODD JOBS AND REPAIRS - No Job too Small CALL FOR FREE ESTIMATE - 420-5457 OLIv - 9; "° Avg : moo. ./y%Ak-lz �' OJ�-, lfiN. 5r536 OUR GUARANTEE: All projects are performed by Experienced and Versatile Professionals who will do the job right 6 HUME CARE REPARI 14441 —92ND AVE.NO. MAPLE GROVE,% MN. 55369 420-5457 n4,94 L. Ll D nJ /3,R3 -- -A, WORK ORDER ORDER DATE ja -L-�2— CUSTOMER - CUSTOMER ORDER NO. ORDER TAKEN BY >ME/LOCATION CUSTOMER PHONE ❑ DAY WORK ❑ CONTRACT ❑ EXTRA v IANIC HELPERS A G: DAT! L WORK ORDERED BY 11 41PTION OF WORK ; . a.^ C° " •. ':. slyly'✓� �l /C��(.�G� p�7.C//ct9ai7'i eiMe,— �L�A t� Q`;� N, t5 �./A Ti�1.! L�.0 Aim!`/. -• ��` TOTAL MATERIALS ( OMPLETED TOTAL LABOR 3I billing to be mailed when job finished il amount due for above work. TAX one home , q TOTAL AMOUNT $ )y acknowledge the satisfactory completion of the above described work. WllsonJones Ca.Doetaaa MADE IN U.S.A. �. S3467CL Duplicate ,999 S3468CL Tap em HOME CARE REPAIR . 14441 =92ND AVE. NO. MAPLE GROVE, MN. 55369 420-5457 BILL TO M,43 f f ZAI 501J Alll>RM ('Ily JOB NAME/LOCATION 108 PHONL WORK ORDER ORDER DATE CUSTOMER ORDER NO. ORDER TAKEN BY Rrc. k 0 . CUSTOMER PHONE 1gq- s1si ❑ DAY WORK ❑ CONTRACT O EXTRA MECHANIC HELPERI STARTING DATE— ' TE—' I WORK ORDERED BY 1-62 DESCRIPTION OF WORK foe NSA Lj,_ IV ec�.. 1, 0 r (—r.{`i— 6-i f-tN6 o 2 7-;ei'hn i,rt/C 105, ------------- t TOTAL MATERIALS DA COM LETED TOTAL LABOR ❑ Tot billing to be ail hen job finished. ❑ Total a r above work. TAX ❑ No one home TOTAL AMOUNT $ 1 hereby acknowledge the satisfactory completion of the above described work. SIGNATURE WilsonJones Ca.eon,esa MADE IN U 5 A S3467CL DUO -16 S34 66CL vvi",e ® wusorj re . 1969 J 9 CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE T Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 1368 '76-r l A V E NE RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) ,199Y Gas Piping (Needed with new furnace) $ 10.00 $ �I OWNER MAREL LARS©i� 79 Y ' S-2 3f Gas Range $10.00 $_ t/ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST y 350, 00 PERMIT NO. r �� *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU: _HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $.50 Burner Trade Name BTU HP tb D°UE R TOTAL FEE �(J -5206 P.O. BOX 1164 HEATING COMPANY MPLS., MN 55440 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE 1k, 4C REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FO STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully 7examined Yes ( ) No ( ) 2. Is free from -mi.- t on deterioration Yes ( ) No ( ) 3. Has fi foreign objects lodged within Yes () No ( ) 4. A _ Is secely supported Yes O No ( ) 5. MeeI current Code requirements for size and t PTU's connected Yes ( ) No ( ) 6 Has, heating BTU's of All TU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done - HEATING CO: Signed By: Date: Yes () No ( ) Yes ( ) No ( ) SUBJECT P City of Fridley 2 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV ~ r PROTECTIVE INSPECTION SEC 077-5 i NUMBER DATE AGE OF PCITY APPROVED BY 1 HALL FRIDLEY 55432 I.J 612-571-3450 910415 771 6/3/97 JOB ADDRESS 1383 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 21 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mabel Larson 1383 76 Avenue NE 784-5831 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Coty Construction Inc 1001 6 St S, Hopkins MN 55343 933-3536 9356 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 Reroof House (18 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 1 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 $1,485 $.74 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- $48.50 Fire SC $1.49 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE LicenseC $ .00 7AL FEE $55.73 �� SIGNATURE OF CONT A CTOR OR AUTHORIZED AGENT IDATEI N R B G INS LY VALI ATED THIS IS YOUR PERMIT Fl •TE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER j ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION a, 75 ConstructionAddress: U U 7 Cn �� Axe---, I`% F Legal Description: �' Owner Name & Address: _ig.�S %6 � Tel. # Contractor: Cp v Ccw - MN LICENSE # Address: [� l0 7`"� S� S ® Ute✓ t y�3Tel. #j��. 7✓" u�y2� 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: �j ��� Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ! 3' APPLICANT: Tel. # P3 J� STIPULATIONS: CITY USE ONLY Permit Fee $ J c9 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $$950 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 [ J Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air ConditioniAll Sizes All Others/RQ6rs i -Alterations (LIST ON BACK) 1% of ValueApplliance or Work Commercial/Industrial 1.25% of Value ofAppliance or Work LL ffective On August 1, 1995 JOB ADDRESS / 3 & "5 .76 4 - A19 7q/, rir Z The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $ representations stated in this application are true and correct. $10.00 $ OWNER C rt $10.00 $ . BUILDING USED AS $10.00 $ ESTIMATED COST 3 5�1�, ®Ca PERMIT NO. $ 25.00 $ DESCRIPTION AF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU:' _HP_ - - - - EDR $ Fuel Total Connected Load State Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEES® S0 MINNEGASCO gin"-Ak-y" 40.00 f Su-N� -e__ ATfN:JIJDI-35282 HEATING COMPANY P.O BOX 111665 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION ' REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough -In Date Final Date *AIr Conditioners can not be placed in a side yar without FILL OUT BACK SIDEtSTACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURN CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been cwfull + examined Yes ( ) No ( ) 2. Is free from;or deterioration Yes ( No ( ) 3. Has no fore objects lodged within Yes () No ( ) 4. Is sectwely tuorted Yes O No ( ) ..fin 5. Meets',�ll Code requirements for size ,,current and toy TU's connected Yes ( ) No ( ) 6 Hu-&- heating BTU's of 4.5 All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: MINNEGASCO N: JUDI - 321 -SM pa W I1ss CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND GDEVICES JOB ADDRESS RATE SCHEDULE OWNER ASL. 1fa 4ZS O �v Residential Rate TOTAL �W-L��--� Furnace Shell and Duct Work, Burner - 0 0 0 BUILDING USED AS N�� Also Replacement Furnace �30. (Side Vent - Fill Out Back) . $ /3 / ` ESTIMATED COST �, C PERMIT NO. / LoC� Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) arm ) Gas Dryer $ 10.00 $ Trade Name lQs��cz Size No. L90-cz �6-oo BTU 1s, Z) 0 � HP '/z EDR *Air Conditioning -All Sizes $ 25.00 $ Fuely J A 7 ofZp- Z Total Connected Load � S� O O rn All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and 5 - representations stated in this application are'true and correct. TOTAL FEE $ MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO v 4r REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 DATE PLUS THE $.50 STATE SURCHARGE Signed REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date written permission from adjoining property owner. Yt0 E,)5 eS LO,L-L CEUNMY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: L Has been carefully examined Yes ) No ( ) 2. Is free from rust or deterioration Yes (V) No ( ) 3. Has no foreign objects lodged within Yes-�- ) No ( ) 4. Is securely supported Yes( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ) No ( ) 6 Has total heating BTU's of All other BTU's % 4 cz) TOTAL BTU's ' O 9 O 7. Has a liner been provided for water heater Yes ) No ( ) 8. Has combustion air been provided for water heater Yes ') No ( ) List ALTERATIONS Being Done: HEATING CO: Signed By: Date: � VAI L (3ML� CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 �C_l1-ac Effective On March 1, 1996 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Reinspection Fee $42.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE R ANY PLUMBING GAS PERMIT IS $20.00 TOTAL FEE $ 2ba50 PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. r ze � �4 � A E PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS of kl� New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 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 $ 7.00 LARSON, MABEL _8 Rain Water Leader 1383 76TH AVENUE NORTHEAST Sump/Receiving Tank $ 7.00 FRIDLEY, MN 55432 Water Treating Appliance $10.00 Owner _ (612) 784-5831 Water Heater —Electric $ 7.00 Water Heater — Gas** _� $10.00 Building Used As xze�s/fjtnAjCA5 Gas Range** $10.00 Estimated Cost PERMIT NO. Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No 2 j� pt�un� Jp� G CO. Type $15.00 PLUMBING COMPANY(�� Reinspection Fee $42.00/Hr SIGNED BY TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE R ANY PLUMBING GAS PERMIT IS $20.00 TOTAL FEE $ 2ba50 PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. w CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 September 11, 2000 Mabel Larson 1383 76 Ave. NE Fridley, MN 55432 Re: Final Inspection 1383 76 Ave. NE Contractor: Norblom Plumbing Co. Dear Ms. Larson: A plumbing permit was issued on June 15, 1999, for the above noted address, to install a gas water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, SUBJECT PE City of Fridley 30819 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO.c-,q COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. /?/ r PROTECTIVE 1 �r---,•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By L 612-571-3450 910415 I _J 4/12/00 % JOB ADDRESS 1383 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon/Mabel Larson 1383 76 Avenue NE 784-5831 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 502-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE N0. 20130983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 11 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Permit Inspection Cards Will Be Mailed To Homeowner To Post 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 VV.ITHIN 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 $3.65 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT $7,300 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- Fire SC $7.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $153.25 PLAN CHECK FEE TOTAL FEE ceps SC $5.00 $169.20 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE, WHAN PROPERLY VALIDATED THIS IS YOUR PERMIT VJ4W67 S-GNATURE Of OWNERow OWNER BUILDER$ iDATE. — —V/,y G -NSR r r'A It NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: 1\� Tel. # (al a- 1$x-1 • SS 3j Contractor: RENEWAL BY ANDERSEN _ MN LICENSE # Address: 350 -73RD AVE. NE Tel. # FRIDLEY, MN 55432 (612) 502-4777 LICENSE #20130983 arvey of the lot, wnn the proposes 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/Groundl ' Sq. Ft. OTHER: ,� .i 4 uzs iran C� 1v1�22K-�S •gym r�Yu t x1 i 4) y- Construction Type: Estimated Cost: $ , ?Jb60 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ° �r�lo�'L� APPLICANT: /Z Tel. #' CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application Permit Fee aS Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (til Oth%) State Surcharge $ $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge fftyr STIPULATIONS: $ $1100 per SAC Unit $•�6 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ ) bq Agreement Necessary [ ] Not Necessary [ ] City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING P E R M I T 33058 r COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 ..-5010 CITY HALL FRIDLEY 55432 ' 763-571-3450 572=36�� RECEIPT NO. NUMBERV 910-F15 RE DATE 9/9/02 PAGE OF APPROVED BY JOB ADDRESS 1383 76 Avenue NE 1 LEGAL DESCR. LOT NO. 21 BLOCK 3 TRACT OR ADDITION Meadowmoor Terrace SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Weiss 1383 76 Avenue NE 763-780-8557 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 JD REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof Garage (7 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION @ $750 SURTAX @ $ .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 $32.65 Fire SC $ .75 PLAN CHECK FEE TOTALFEE 3.90 ,X SIGN RE OF CONWACTORORAUTHOWZEDAGENT (DATE, SSG A U E OF OWNER,,F OWNER BUILDER, IDATE, EN ROPE �IDATEW-AHIS IS YOUR PERMIT L ,NSR OAtE Z 01, NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 q /oz� BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Tel. #_3P7 Contractor. MN LICENSE # Ai JX Address: Tel.#���-iSel-�'�s� 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: Z,)n69dAa_ 9Ay- PC'Ab®t Z®A r,aLIARAM 41" o-f'F wu ock-v►IL- 1 - Construction Type: Estimated Cost: $� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ yy DATE: QZ APPLICANT :1 � Tel. #,L� 7�� ' 55'7 Call (763) 572-3604 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 TOTAL $ '-K? 6s- CITY USE ONLY - Fee Schedule on Reverse Side .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 Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: