AF - 35632/
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Village oi Fridley, Minn.
BUILDING PERMIT
Date: �. ... ..................
Owner .. ...... .. .. ... ............ Builder .
Address . . . �.4�^� . . . . . . . . . .�. F . . !!' -• [✓ "-if ' 1�cTCiress
/i/I I c1 _�� � o _ v
CC
?�° 1790
LOCATION OF BUILDING
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No. . . . (c.?�C� �. . . Street . . . . . . `: �!�� . rs': `' : . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . .
% ,�,�l /,
Lots.�. . ° .?. . .��Block . . � . . .. . . . . . . . . . Addition or Sub-Division ��. . . .�'.""`?2.. !.. . .
Corner Lot ........... Inside Lot ........... Setback ........... Sideyard ........................ ..
DESCRIPT(ON OF BUILD[NG
To be tised as:
� . . . . . '. . . . , . . Front .� �%. . . Depth .v� p. . . Height . ��
. . . . . . . . . . . . Front . .�.�. . Depth . e�, �. . Height . . . . . . . .
Type of Construction . . . . . . . . .. .. . Est. Cost . . �►.?t.rl.Y.'v . . . . . . .
s---
Sq. Ft. ....... . Cu. Ft. ........
Sq. Ft. ........ Cu. Ft. ........
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 co ia ce with all provisions of
ordinances of the viilage of Fridley. , <:::::_.__
Tn consideration of the payment of a fee of $. ��a�. .,1 nkrmit is hereby granted '� . . . . . . . . . . . . . .
V
. to construct the building or addition as described above. This rmit is granted upon
the xpre�ss condition that the person to whom it is granted and his agents, employe�es and worlrnien, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
�ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revo at any timz upon vialation of any of the provisions of said
ordinances.
.............. .. ..... ... Building Inspector
�_ �
NOTICE:
This permit does not cover the construction, installa,tion or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate Permits for these items.
sue.,ecT PERMIT NO.
Cit✓Y of Fridle �� �
AT THE TOP OF THE TWINSy g U I L D I N G P E R M I T ?���' �
r
� . —
� �
� COMMUNITY DEVELOPMENT DIV.
' 1 L'�'���-, �./���
r � � PROTECTIVE INSPECTION SEC.
� . � _
1 � �'��1 � CITY HALL fRIDLE� 55432 NUMBER FlEV DATE PAGE OF APPRO�ED BV
�'""�� ,�� 612-571-3450 910-F15 9/6/94 � �
JOB ADDRESS 6301 Able Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. S�j 20 2 Moore Lake Highlands sHEET
2 PROPERTY OWNER MAIL A�DRESS ZIP PHONE
Joseph Stanek 6301 Able Street NE 571-3054
3 CON7RACTOFi MAIL ADORESS ZIP PMONE LICENSE NO
Same
4 AFCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE N0.
5 ENGINEER MAI� ADDRESS ZIP PHONE UCENSE NO.
6 USE OP BUILDING
Residential
7 CLASS OF WOHK
O NEW ❑ AODITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Reroof House (22 Sq) Tear-off
9 CHANGE Of USE FROM TO
STIPULA710NS
Underlayment must comply with the State Building Code.
Provide smoke detectors adjacent to all sleeping areas and in basement.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVIOAD
SEPARATE PERMITS ARE RE�UIRED 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 DAVS, 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 OFFSTFEET PARKING
I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STAL�S 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 �1,650 �.H3
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI AW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTR r�on,. $39.00 Fire SC �1.CS
PLAN CHECKFEE TOTALFEE
�'"� `� 41•48
NAIUFlEOF NrRACTORORAUTHORiZEDAGEN IDATE� HEN PqOPER VALIOATED THIS IS �OUii PERMIT
� �e 9-��y
�-S�GNATUF7EOFOWNEAi�FOWNEABUILDEF�1 10ATE1 BLOC INSP �14TE
NEW
ADDN
ALTER
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Appiication
ConstructionAddress: � 3 Q I - �. �; � � . �� -�- - � �
Legal Description:
Effective 1 / i /94
�"���
Owner Name & Address: �os �� +-� • ��'�} N �... � -- S � ^'� � � '� S • f?-f3 o U � Tel. # S �7 / � 3 � S `�
Contractor: �' �, L �' MN LICENSE #
Address: S'�}�s r�}-� ,¢�3 0�� Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed consizvction drawn on it to scale.
DESCRIPTiON OF IMPROVEMBNT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. F�
DECK AItEA: Length Width Hgt/Qround Sq. Ft.
oTHER: �� � a cs .� .— c���� l� �"� �- � T� �2 o f�'�
G c-D
Corner I.ot [ ] Inside Lc�t [ ]
Type of Construcdon:
Approx. Completion Date: _
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ �"tfi'a"�""'
� � �`�� �='
(Cost on �ackj
Driveway Curb Cut Width Ne�ed: Ft, + 6 Ft = Ft x$ = S
DATE: -- � APPLICANT: Tel. #� � I-- 3 d��
�,iSE ONLY
Permit Fee $ 3°� �� Fee Schedute on Reverse Side
Fire Surcharge $ � � ros^` .001 of Permit Valuation (1110th%)
Stat� Surcharge $ �,�j �.50/$1,000 valuation
SAC Charge $ $8i10 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow
Erosion Co�troi
Park Fee
Sewer Main Charge
TOTAL.
STIPULATIONS:
$
$
$
$
$
�J,'
Alt. "A" or Alt. "B" Above
$450.00 Conservation Ptan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Ne�essary ( ]
I �+—f.e,u-� �� ��.�,�!'.�� �, �'�`�-,�y"�.Q'
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13UtLD[[�IG ['GRMIT FEE SCIfEDULE
"i�hc Cl�ief 13uilding OfYicial stia(!, before issuing �ermits for the er�ction of any building or structure,
or f�or any additior� tc� any existing buiidinfi or structure, or for any alteration or repair to any existing
buildirig or su�ucture, uPon a�p(ication t�licrefo�e, require the paymenC by the a��plicant for suctti �ermit
t�f t-ecs to the �iinount herein below set tz�rth and in the manner herein pcovideci to-wit
"t'OTAL. VALUE
$1 to $soo
$501 to $2,000
$2,001 to $25,000
$25;001 to $50,000 �
$50,001 to $100,000
$100,401 to $�00,000
$500,()Ol to $1,000,000 -
$I,004,001 and up
r-rF�s
$15 (Miniu�um ree is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fractioa thereof, to and including $2,000
$45 for fiist $2,ppp pivs $9 far each additionai $1;000
or fraction thereof, to and including $25,OOp �
$252 for first $25,Opp pl�s $6.Sp for each additional $1;OOQ
or fraction theroof, to. and including $50,000 -
$414_SO for first $SO,OOU plus $4.50 for each additional
$1,000 or fractioa thereof, to _and including $100,000
$639.50 for f�rst -$100,000 plus �$3_50 for each addifional �
$1,400 or fraction d�eof, to and includi�g -$SOf3,000
$2039_S0 for die first $SOO,ppp plus $3 for each addit[onal
$1,U00 or fraction thereof, to and iuciuding $1,000,000
$3539.50 for the fust $1,000,p00 plus $2� for each additiouai
$1,000 or fraction thereof -
DRIVEWAY DEPRESSION ESCROW
{Concrete Ctir1� Straets Only)
Alternate "A": Remova( and re{�lacement af curt� and gut�er only - Driveway width plus b feet times
$13.50_
Alternate "B"= Removal and rep(acement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15_75_
VER,iF[CATION Or FOUNDAT[ON
Permits for constzuction wit! be issued a minimum of 24 hours from the time of appiication to a(low
For pr�per review or t�ie pro�seei structure and of thc construction site_
A Certifcate of Sucvcy of the lot, showing the iocation of the foanclation once it hae it has hecr�
constructeci wilt be re;yuirc;ci before proeeedsng with tlie framing_
�,
,...
3uilding
nspections
163-572-3604
�A� � �7 G�
.ITE ADDRESS �
'HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
7/ a`�c'��' �";�
❑ OWNER `�i:�]
NAME: �� �G
a.DDxFSS:� ��1 �
PHONE: �%�o�• �%%'
xaME: � " �i.
STAT'E LICENSE # �
ADllRES� '
PHONE '
❑ SINGLE FAMILY/NEW C
❑ TVJO FAMILY/NEW COT
❑ ADDITION
O $ASEMENT FINISH
❑ DECK
DESCRIBE WORK BEING DONE:
SIZE OF IIv1PROVEMENT
ROOFING
NUMBER OF SQUARES _%�_
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
Permit N
Received By:
Date Rec' d:
AIL�a DDRESS
/-/L� �� � _
❑ ROOF
�DING
❑ SWIMMINC
O ADDITION
O REMODEL;
LENGTH
o xovsE orrryY
�i'iOUSE & GARAGE
� � ATTACHED GAR.AGE
❑ DETACHED GARAGE
� !G� S� L c%d"TL�.�f/� /t/ .
CP DATE �
CITY STAT$� IP
X �$/ ` ��.> -- �,.�� �i
SIZE
s'1'ox�s
[ED O WINDOWS
❑ DRAIN TILE
❑ OTHER
POOL
1G
WIDTH HEIGHT S . Ft.
BASEMENT REMODELING SUBMTT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
ING FOR NEW CONSTRUCTION INCLUDING DECKS,
�Soffit ADDITIONS & PORCHES SUBMIT�
O Aluminu - �I'rim 1. Site Plan/Survey showing the existing structures
��� �ascia and proposed project�
W�NDOWS 2• Two sets of construction ptans
3. Energy Calculaaons
IN EXISTING OPENINGS ❑Yes �No LACATION OF VJINDOWS
OR FOR NEW OPENWGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING TH �1�, 97 U.B� FEE SCHEDULE)
TOTAL JOB VALUATION S�C �'i/� �� ��" OCCUPANCY TYPE
Perrnit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
G�rb C�t Escrow
Erosion Control
Pazk Fee
Sewer Main Chazge
Total Due
�
$
$ °7.
$ ��—
$ S.�
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$ I550 per SAC Unit (Plans to MWCC for @etemiination)
�t+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Deterrnined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED
I hereby apply for a building pemrit 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 Conshvction Codes; that I understand this is not a
permit but only an applicati ;for a permit and work is not to start without a permit; that the work will be in accordance with the approved
lan in the case of all wo w ch quire.�r ew approval of plans. ,
• /%%�"'% ,
• �,rL..s%ll��/�%�!. ._. , . .
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minixnum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,OO1 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fracrion to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,040
$1,000,001 andup $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to
a11ow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977