PRE 2010 PERMITS•
fity of Fridley, Minn.
BUILDING PERMIT No 7338
Date: 4_1�._ _�."__.�.. __.._._..._.......
74
Owner: _. _. _ __ _ ._..r.:.___.._..__ _ Builder .... _ _...y,--......._..._......._...._...__.
Address ..... ......... ......
._...... _._......... ........... .._..._._....... ................. _..._......._..... Address ..... .......... __ .....-------------------------------------------------
------
LOCA NF BUILDING
No. _S(2 _l, _.. Street.. -� ._...... �� ........_.�}...�r............. PLot......... ........
..._......_.... ._...._... _.
Lot.... Block ....._...._......... ............. Addition or Sub -Division PMI
.sir
Corner Lot .....-............. -........ Inside Lot ------.................................. Setback .."J.......---! ............ Sideyard ........_ �_.._..�o. �......_.._._.. _..�._
Sewer Elevation ... .......................... -�F. tion Elevation ..... SS .1.. ._: .. . __...____.._.. ..
10- e t1 C1 F�
DESCRIPTION OF BUILDING
_. ... Front C1•._. Depth u...._ Height ..._.. Sq. Ft o i_ . _4K_ Cu. 70;400
t __.___...._.__ Depth _...__._.. He' ht ....._..... .. Sq. Ft. _.._...__...._. Cu. Ft.
.
Type of Construction Est. C st /$11-7_V.......• .. To be Completed _..._.._.._.�_.._ —__—
U
C�
In consideration of the issuance to me of a permit to construct the building d above, I to
the proposed work accordanwith the description above ,set--fart�i and in co P7
ordinances of the cityof Fridley. ( j
In consideration of the payment of a fee of $,Zz�_.............. _... permit is hereby granted to._.._-..._...�_
_. _..._...._.-.......:. __....._........_. to construct the building or addition as described above. This permit is granted upon
the 'e'
xpress 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 viol atipn of any of the provisions of said
ordinances. - / 1
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sower or water. Be sun to sae
the Building inspector for separate permhs for these hems.
Y
SUBJECT
PERMIT
City of Fridley
° 2406
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i
i
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
12/3/73
JOB ADDRESS 650 Ely Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
34,35)36
V
I
Riverview Heights Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
William E. Erickson 650 Ely Street 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 Construct a 24' x 30' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway.
PERMITS REQUIRED FOP, _��►;►• �.
SEPERATE
HF TING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Frame
VENTILATING OR AIR CONDITIONING.
Wood
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
R_1
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
$3,261
1.63
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-
$13.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$15.13
ST NA°F EDF CONTRACTOPORAUT RIZEDAGENT (DATE)
EN OP L VAL ATED THIS IS YOUR PERMIT
1)3
SiGNATUREOF OWNERIIF OWNERBUILDER) (DATE)
BLDG INSP DATE
Y
WAYNE C. RIDGE
Land Surveyor
1825 Second Avenue
AmQ4k L 0 T-5, 34,13 (-,l 13 L 0 C K -k V
HF--LC)4-FS
LY
tha"t this "surrey;' plan"',' -or
FM, -3,r -,,J by ma or up,,Ur i-ny di!r�ct
a C!:11Y
ot
Fileg.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR DDITION BUILDING PERMIT
CI'T'Y OF FRIDLL-Y, MINNESOTA
OWNER'S NAME : �J re • BUILDER:
ADDRESS: ADDRESS
f
NO ; . l� 3 G� STREET-
LOT:
TREET:LQT: 34/, BLOCK, � ADDITION: A�i ttie�d2�'w
CORNER LOT: INSIDE LOT:— SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buildirig location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
�111iLi� Front:
Square Feet:
Front:
Square Feet;
Depth: 3
Cubic Feet:
Depth •
Cubic Feet:
Height:—
Height:
eight:Height:
Type of Construction: V0C'� ( , e"R_ Estimated Cost: $ j
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 -ill the facts and representations stated in this application
are true and correct.
DATE: ���: _ �� % S S IGNATURE:�''�
(See Reverse Side For Additional Information.)
sJ ,.
BUI LDINC P1:1,011 T I EE SCIIEDULI
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or strLiCture, or for any addition to any existing
building or structure, or for ..iny .+lterati.on or repairs to any existing
building or structure, upon :appl.icati.on LhereLore, require the payment by the
applicant for such permit of fee's to thy- amount herein below set forth and in
the manner herein provided to -edit:
UNIFORM BUILDING CODE: Type 1, 2 & 4 -• $2.15 for each one: thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL tNFORMATION
For the purpose Of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights ,)F the upper surface or to the average,
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
irate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE; Permits for construction will be issued a minimum of 24 hours from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
City of Fridley
SuBjECT
PERMIT N'0,_
22 0 0
)�
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
R NO.
• ______ COMMUNITY DEVELOPMENT DIV.
I ti.
INSPECTION SEC.
�1
V
r PROTECTIVE
CITY HALL FRIDLEY 55432
NUMBERREV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/28/93
JOB ADDRESS 650 Ely Street NE
1 LEGAL
LOT NO.
ADDITION SEE ATTACHED
DESCR.
34 ,35
VLOCKTRACTOR
V
Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Wm Erickson 650 Ely Street NE 786-4228
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 X{] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (11 Squares) 2nd Layer
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide adequate attic ventilation. Provide smoke detectors as per UBC
1210 adjacent to all sleeping areas and in basement.
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
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
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
$900_
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$23.00
Fire SC $.90
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$24.40
CONTRACTOR IDATEI S
WHEN LY (DATED THIS ISS/YOUR
h1l.NERBUiLDERi
�r(PERMIT
BLD iNSP DATE
I Si NATURE OF WN DATE(
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: lC> L
22L�
Effective 5/26/93
Legal Description:
Owner Name & Address: _��/�-j7i��`'� , �f�� Tel. #
Contractor: 42y� 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. F .
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Leri lk
Width Hgt/Ground Sq. Ft.
OTHER: �k da // 5A2- ' 1 -o2y 0 �_.A--/
Corner Lot [ ] Inside Lot f j -
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed:
Ft. Yd Setback
Side Yard Setbacks
Estimated Cost: $ -- -
(Cost on Back)
Ft. + 6 Ft = Ft x $ _ $
DATE: Tel. #
CITY USE ONLY
Permit Fee $ :> Fee Schedule on Reverse Side
Fire Surcharge $ qC) .001 of Permit Valuation (1 / 10th %)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $750 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ Conservation Plan Review $450.00
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ Z- �, STIPULATIONS:
'.I I Y OF FRIXEY INSPECTION DIViSION Effective On 3anuary 1, 2000
543: University Ave NE
=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, CODLING, VENTILATION,
763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
;OB ADORES-----�/. —
RATE SCHEDVLESC�E��LE —
OWNERZ21k �����`� L
tesidential Rate TOTAL �
Furnace Shelf and Ouct Work, Burner • BUILDING USED AS_ e-- C��!
? _�
Also Replacement Furnace $ 30.00
(Side dent Fill Out Back)ESTIMATED COST ���' �. _ PERMITNO. ----__--..
Gas Piping (Needee with new furnace,
but no" replacement) l)CRIPTION Of FURNACE bND OR BURS
Baas kange
No. of Heating units.____.__ Given: One (Siezrr,) (fiat b"dater).(Zfdarrr_? A,ir'
Gas Dryer 10.00 �_.w_ _ TradeNarsre�.Jn_('_.____- Sizefva..�_-T —
BTU- -2� L _ iiP _ __.. _ EDR. _..._. ___ — -----
"Air Conditioning At; Sizcs $ 25.00 J `v uei_-�__....__--_-..T.otal Connected
All Others/Repairs & Alteration ,,,JST ON BACK) Bvmer Trade Narre_____. Size No•___.__�.._ _�_ ___ _ _.
' 0 of Value of Appliance or Work 5... ___.__ BTU _.._._. _ __ _ HP
.ommercial/Industrial
s.25% of Value of Applianc,; or Work �.._.__._-_ The undersigned ,gereby n� akes application, `or a peern7 l for re work Herein
specified agreeing to do all work ir• strict accordance wit,' the City Codes an
State Surcharge i_�9 ruilings of the Duilding Division, and hereby declares that aif the facts and
_ representations
ted it, :his applM,,ation are "rue and coir ,rt.
T 01AL. FEE�`�_,`�
DAT('
VENT i"� . G
it�TIN
uli IYj fU r3 FEE F_c�i�' HEAitNG/CUO�IiVGJ ir,ilt�At �� - —
tEl�'RIGER/1TlON/AIRCOdDi�'tQNING PERMIT i� 25.00 � l
�t,U� THE 5.50 STATE SU` CHAq�'E Signe�b -COX-
!EINSPECTION
TEL_
FEE $47.00/Hr
Air Conditioners can not be placed in a side yard without
mitten permission from adjoining property owner.
i?�'d Zt1LC�l
COMMON VENTy'►/ -N't CCtVNECOR ANO COM15USTION AIR VERIFICATION
When relacing an exi9tin-9--furance. the undersigned hereby verifies inat the
venting has been examined and is free from rust, deterioration, obstructions.
and is securely supported and firestopped where required.
Yes (4 -No ( )
The venting system is plasbcJPVC and meets ail current codes and manufacturer
specifications Including sizing, iength, number of elbows and terminatio,'s.
Yes (el- No( )
The undersigned also verifies that the replacement unit is a listed assent ,bly
and meets the current codes and manufacturees specifications. ThIs d. es
include AGA-GAMA Category i Central Furnace Venting Tables for far,
assisted and natural draft appliances.
Yes ('"o ( )
The existing combustion air isy sized and ins+ailed to meet the current, -/ales
and manufacturer's specifications.
Yes (,'No ( j
When required to Install a new combustion Ajit will be sized and installed
To meet the current codes and manufacturees specifications.
Yes (-)'-No ( )
When Installin a new venting pystem, the undersigned hereby veriii�z that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category i Central Furn :.e
venting Tables for fan draft
Yes
assisted and natural appliances.
(-J'NO ( )
Is the common vent and veint connectors sized and installed correctly �ar
an appliance has been removed fro n the ;.3mmon vent and vented
separately as per current codes.
Yes (-1-14-0 ( )
APIP—han0e-Typ!k and Size/Cornmon Vent and Vent Connector Inears ation
Appliance #1 Type BTU input, Fan ksslsted or Nat
Appliance #2 Type STU InputFan assisted or Nat
Appliance #3 Type BTU Input _ Fan assisted or Nat
Total Appliances _ Total Btu input
Common Vent Type ',lentHeight.._._r ___.�.Diameter inches
Appliance #1 Vent Connector Kight ft Length _-- ft [diameter ----in Type
Appliance #2 Vent Connector sleight ___—ft Length _—ft Diameter --_ in Type
Appliance #3 Vent Connector Height__ ft Length.ff Diameter,- in Type ,
ALTERATIONS: (Descnbe
HEATING CO: L�ti `` �/ C.`
Signed By: _.__..._.. _ _.._. Date: _....
ze/eo•d se9s6sz OU.: �ara-A :10 Axa w08=1 8s:zt 000e-to-noN
SuBjECT
PERMIT NO.
City of Fridley
330
AT THE TOP OF THE TWINS
BUILDING
PERMIT
R
P.• COMMUNITY DEVELOPMENT DIV.
V------
r � PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
12/31/02
JOB ADDRESS 650 Ely Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1 34,35,36
V
I
Riverview Heights
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bill & Mary Erickson 650 Ely Street NE
763-786-4228
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Home Update Co LLC 4517 Minnetonka Blvd, St Louis Park,
MN 55416 952-920-6592
l ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20272209
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
Reside House; soffit & fascia; window trim
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions for this provision would be if sheathing is an approved weatherproof
panel or when the siding is an approved weather barrier.
Vinyl siding is not
a weatherproof covering unless the manufacturer states
this in their application
guidelines. Call for inspection of wrap before covering. Caulk and flash all
exterior openings.
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
ZONING
S0. 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 T TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GO ER IN HIS TYPE OF WORK WILL BE COMPLIED
$5,500
$2.75
WITH WHETHER SPEC IED HE IN OR NOT THE GRANTING OF A PERMIT
00 OT PRESUM TO IV UTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
OV ISI S OF AN OTH R S ATE OR LOCAL LA REGULATING CON-
$125.25
Fire SC $5.50
R/fHE PERF R NCE OF CONSTRUC I N
NPLAN
n
CHECK FEE
TOTEE
Licens
$5.0
.50
TVffFvATTPE .T OR 6A AUTHORIZED AGENT DATE,
EN ROP
VALIDA THIS IS YOUR RMIT
SIGNATURE OFOwNER��t pwNER Bu��OERi 1DATE�
BLD 14SR
oAT
NE'VV [ j CITY OF FRIDLEY Effective 1/1/2002
ADON - [ 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 Name & A(
Contractor.
Address: "{ C� I 1
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft
GARAGE AREA: Length Width
DECK AREA: Length Width
OTHER: j r ` I I�Q � V 1 t'\� d
Construction Type:
Height Sq. Ft
Hgt/Ground Sq. Ft
d' t' L, -j
:-) 1' 1/'1 cm
Estimated Cost: $ --`� (—rDd
Driveway Curb Cut Width Needed: + 6 Ft ,= t x = $
DATE: t -� �2 APPLICANT: Te#
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.
CITY USE ONLY -
i ��� °�
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ S
.001 of Permit Valuation (1/10th%)
State Surcharge
$ a 7J^
$.50/$1,000 Valuation
SAC Charge
$
$1200 per SAC Unit
License Surcharge
$ � , CU (_.
$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 [ J
TOTAL
$ l 0 �V
STIPULATIONS:
v
m
CITY OF FRIDLEY PERMIT NO.:
2004-00687
6431 UNIVERSITY AVENUE NE '
- -
FRIDLEY, MN 55432 DATE ISSUED:
05/12/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS 650 ELY ST NE
PIN 033024320186
LEGAL DESC UNAVAILABLE
LOT BLOCK
PERMIT TYPE BUILDING
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADDITION/ALTERATION
VALUATION $ 10,000.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE
2000 INTERNATIONAL RESIDENTIAL CODE. ROOF REPAIR (ROOFING, RAFTERS) SIDING REPAIR
STATE LICENSED CONTRACTOR I
APPLICANT
BUILDING PERMIT FEE
FIRE SURCHARGE
181.25
10.00
GALLAGHER CONSTRUCTION INC (5600)
24 7 AVE NE
STATE SURCHARGE, VALUE
5.00
OSSEO, MN 55369
LICENSE SURCHARGE
5.00
TOTAL
201.25
PAID WITH CHECK # 9695
OWNER
ERICKSON WILLIAM E
650 ELY ST NE
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 no esume to give authority to
violate or ca el the rovi io of any other state or local law
regulating c ns 1 ct' n or perf rmance of constructio .
Applicant Date 7.
Bldg Ins
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW [ ] CITY OF FRIDLEY �Eff five 4/1/2004
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
.y j D
oo Cove
Construction Address: �. �-
Legal Description:
Owner Name & (Address: W 1� �-� ``� 0.4 LY_, `� n Tel.
1- #_
Contractor: OA � 4 y ��5 J' c- MN LICENSE #.
Tel.# -1(o5- A2-1 .'4Si0
Address: a2q -1 1-.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
"oo
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 Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground i Sq. Ft.
Construction Type: 5�0. ►� �� 1P Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Ftx $
j p , b0
DATE: (� 2 APPLICANT: o�� aq � �� �� S T . T n c Tel. # I �0 3 Z�� `� S 0
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 18, o? Fee Schedule on Reverse Side
$ — 65% of Permit Fee
$ l0.00 .001 of Permit Valuation (1/10th%)
$ .,00 $.50/$1,000 Valuation
$ $1350 per SAC Unit
$ Oa $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 [ ]
$ C�0/ ,;? STIPULATIONS:
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE 2 i. f a
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT COPY OF
YOUR STATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
PERMIT TYPE
PLUMBING Permit No: 10.0 I
RESIDENTIAL APPLICATION R d
CITY OF FRIDLEY D,lJU
EFFECTIVE 2-19-09
YOUR E-MAIL ADDRESS
)WONTRACTOR
NAME.
ADDRESS: C[TY STATE ZIP
PHONE:
NAME:
STATE LICEN: Terry Overacker Plumbing Inc
STATE BOND
502 E Main St EXP DATE
ADDRESS:_ Anoka, MN 55303 EXP DATE
PHONE (763) 572-8880 STATE Zip
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUst:
TYPE OF WORK: I ❑ NEW
,1 REPLACEMENT
DETAILED DESCRIPTIQN OF WORK
V�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED.
535.50.
FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW).
— BATH SINK/LAV DRAINS
MINIMUM FEE
_FLOOR
— BATHTUB GAS PIPING (NEED CITY LIC)
— CLOTHES WASHER — KITCHEN SINK
SHOWER
i_ SWIMMING POOL
— WATER PIPING
—WATER SOFT-NER($35)
— DISHWASHER —LAUNDRY TRAY
—
— WATER CLOSET
HEATER ($35)
—BACKFLOW PREY. (515)
—WATER
WATER METER
FOR IRRIGATION
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—
OTHER
`4tk
IS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 on site., that the work will be in accordance
with the approved plan in the case of all work which requires review and approval of pians.
SIGNATURE`1 OF APPL ICANT PRINT NAME A 6 k. l is k4 -14t
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
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