AF - 34261*
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N° 2'77
Vi�lia�e of Fridley, Minn.
BUILDING PERMIT : ' � : g .
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Oi6ce of INSPECTOR OF BUiLDIN(,�S '
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Architec
Builder
Frid?ey,
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OF BUILDIlVG - ` ° r ;
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No.�._ 8tree . art of Lot. �.�..,.,. ,�.,
, � -
Lot Bloc Addition or Sub-Divfsion
F,II'TIO�N OF BUILDING � } . * .
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�ront �"' � Depth"' -1 Height � / Stories_�_ Manner of Constructio� ��*�'"!�'� t , �.�� .
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To be used as��,ry��-�---� To be complete��� '"� f'� "� ' Estim�at Cost����,.. {
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Permit is heraby granted to ""''�'�`"�`'""""'���"`• �"` J�5""�+'L1J1.t ta �3'�'�� � ,,, F
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the building � described in the above 1�tatement. T'hts permi� �t �,
upon the expresa condition that the rson to whom it ia granted, and his agents, employees and war,�, ;�,a3� ;
the wbrk done in, around and upon sai8 building, or axiy part thereof, shall con4orm' in ail se�pect� �b �ie, 5��.
nances of Fridley, Minn., regarding the conetruction, alteration, ma,intenance, repair and ' mo�+i�i$ . af .�iu{��t ,'
within the city limits, and thia permit may be revoked at any time upon vfolation of axly of tl�e g�ar df`�t=-'',
� . . � . .. . . . ; y rr. ��:
ordinances. � ' � , �
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AGREEMENT AND SWORN STATEMENT
In consideration of tke issue and delivery to me by the: Inspector of .Buildin,� af �8ke� s�f
the above perxnit, I hereby agree to do the proposec� work in accnrdaxice wiib.; the �i °
above set forth and according to the provisions of. the ordinancea of Fridley, a�id, being �i��`
sw`orn, I hereby sta,te and say that the faets stated by me and conta,ined ixi the abc�w�: �t "� -
true as therein at�ted. . ;_ :1
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Subscribed. and sworn to before me at Fridley, Minnesota, this_„ `��.; -
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day of ��-xJ"' p .D. 19 � �. �
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sue�ecr PER O.
City of Fridley 12698
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � RE PT N0.
� COMMUNITY DEVELOPMENT DIV.
' � ti.- -
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� � �"—�l � CITV HALL FRIDLEY 55432 NUMBER � REV. DATE PAGE OF APPROVED BY
� ""�' ��� 612-5603450
910-F15 $ 30 74 � �
JOB ADDRESS '7374 Able Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. IO 4 Schaffers' Subdivision #1 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
J. T. Heffner 7374 Able Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Boisvert Builders 8027 u'nc Str et n
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASSOF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 30` Addition onto Dwelling and a 12' x 16' Porch
9 CHANGEOFUSEFROM TO
STIPULATIONS
Fire separation to all portions of garage that is within 5 feet of
eave of house. Owners signature that garage will not be connected
to dwelling.
SEPERATE PERMITS REQ111RE0 FQR WIRING,
HEATiNG, PLUMBING AND SI�NS.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITSARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCl F2'a.ICI
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 1 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
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT yfi4�4SO 2.2g
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC OR THE PERFORMANCE OF CONSTRUCTION. $21. SO
� r ^ PLAN CHECKFEE TOTALFEE
� $23.78
nTUaEOFCON7anCi0a nu7HOaiz DaG N^ ID TEI ,yt/ N PROPERLY VALIDAT D THIS IS YO� ERMIT
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IGNA7U EOFOWNERIIFO EF�B LDERI (DATEI BLDG �NSP DATE
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APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, 1�1INNESOTA .
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OWNER S NAME : BUILDER : �,._c� ,,�-z�
ADDRESS : � 7� G� �A � ADDRESS : ��b � �� �_.c� �,.,,,,�, �
NO : . �� 7 7' STREET : �`/ r� �'c-v�� �% �
LOT:_�^BLOCK: � ADDITION: ��3L���r�% O--�G- �'I
CORNER LOT: INSIDE ZOT: SETBACK: SIDEYARD:
Applicant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILUING
" To Be Used As : �� i��2� �
��,
! + Front: � Depth: � � ` Height: � �
�
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
ljrpe of Construction: ��v� y._ Estimated Cost: $ 7, �� �� Q�
To Be Completed: .� _�_„�, `�, � ,
The undersigned hereby makes applicatinn for a permit for the work herein
specified, agreeing to do all work in st'rict 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 : �/ � � �� � SIGNAT[JRE •
(See Reverse Side For Additional Information.) r f
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�BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erectio� of any building or structure, or for any addition to any existing
building or structure, or for any alteratian or repairs to any existin�
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 ma.nner herein provided to-wit:
UDTIFORM BUILDING CODE: 2`ype 1, 2& 4-$2.15 for each one thousand cubic
fee�, or fraction thereof, in such cubical contents. Type 3& 5'- $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
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 of 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
rate 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 w ill be issued a minimum of 24 hours from �he
time of application, to a12ow 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 xequired 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 wYiich a building pern►it has been
issued; and said structure shall not be used or occup3.ed until a Certificate -
of Occupanc� has been issuede
.
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sue�ecT PERMIT .
City of Fridley a 5 4 4
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
; � CEIPT NO.
� • COMMUNITV DEVELOPMENT DIV.
� � ti: — .l�
r � � PROTECTIVE INSPECTION SEC. �
�
� 1 /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPFOVEO BY
�'"""��� ,�' 612-571-3450 910-F15 9/11/79 / /
JOB ADDRESS 7374 Able Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. lO 4 Sh.affer's Sul�. #1 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
John Heffken 7374 Able Street N.E. 784-6843
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
Resi.dential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 22' x 16' Garage Addition
9 CHANGEQFUSEFROM TO
STIPULATIONS
Garage can not evex be attached to the house.
SEPER�ITE PERMII'S REQUIRf D FQR 1�{flRil�C,� .9 ; W�RNINC-
NEA?tNG, PLUMBING AND SIG��,
f�sfor� di����g ctft to�t u���s
. 'I�IEPHQNE • ELECTRIC .
R�QUlREU gY ��s�t�
L.A W
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� Frame
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 PERI00 OF 120 DAYS AT
ANV TIME AfTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APP�ICATION �. 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 $2 �%OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1 3S
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- �1a
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. ySs�cFSX� $�.2. HO
PLAN CHECK FEE TOTAL FEE
$14.15
Si�N Tua OFCONTRACT a r ORIZEDAGENT fDA7El yyH�(V PFOPERLY LIDATED THIS IS YOUR PERM17
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�SiG UFEOFOWNER�I OWNE BUILDERI IDATEI BLDG iNSP � E
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CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterati�ons, Aclditions, or Repairs)
f�� '� � /t����fpr� BUILDER: ���•
OWNE R: �,l r.� �7 ���� s �� ru_
ADDRESS: 73'IN �lE ��Ie ��, • RDDRESS: �
TEL N0: %�y-�,�(L{�, TEL N0:
Construction Location
STRE�T NO :%3'I L% STREET: �I�� �� /� S� �
LnT: I d BLOCK: �^ ADDITION :���('r s �� b, d, � I
Corner Lot: Inside Lot: ,� Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOI� OF CONSTRUCTION
. z •
� c« . - _ Front: .� 2 Depth: � Height: �D .
' Squar.e Feet: Ciibic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Cons�ruction: �CD _ �r� m �
eo
Estimated Cost: $�G�O� —
�
Zb Be Qompleted: /�iD �!, 7� .
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET ,
The undersigned hereby makes application for a permit for the w�rk herein specified,
agreeing to cb all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Build�ngs, and hereby deelares that all the facts and
representations stated in this application are true and correct.
DRTE : yl 7�'7� S I GNATU RE :�Gfi� 1'� G'c. (/C �4(P Y�l�"��u
Stipulations:
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BUILDIIJG PCR��iIT FEt SCF�EDULE .
,
5LCTION 2. The Inspector of 13uildings shall, before issuing permiL-s for the erec�ion �
oE any building or structure, or. for any addition to any existing buildiny or structure,
or for any alterai:ion or re��air.s to any existing building or structure, upon application
therefore, require L-tie payment by the applicant for sucli permit o£ fees to tHe zmount
herein below set forth and in the manner herein provided to-wiL: �
N33W CONSTRUCTION: Single Family Fiomes and Garages: $4.00/1,000 cubic ieet.
PLAN CHECK: 25 percent of building nexmit fee. .
DRIV�WAY llEPFtESSION: (Concrete C�zrb Streets Only)
' Alternate A: Removal and replacement of concrete cuxb and
gutter only; Driveway �aidth plus 6 feet x,�1�.75
Alternai:e B: Removal and replacement of concrete curb and
. gutter and install a 3 foot wide approach with �
� � 6 inch depth; Driveway width plus 6 feet x$17.85
:1/ � : 1� �' : �►
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 th��cellar to the
average heights of the upper surface or to the average height of the roof suriace
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars�-($500.00) or fraction thereof in the cost
ot all pzoposed work. �
In�no case shall the fee charged for any permit as set forth iri Section 2 be less
than $7.50 plus $.50 state surcharge. '
' � � � � � 1 � �
NOTE: Permits for construction will be issued a minimtun of 24 hours from the time
af application to allow for�proper review of the proposed structure and of the
construction site.
A Gertificate of Survey of the Zot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
ERTIFICATE 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 builcling permit has been issued; and
said structure shall not be used or occupied until a Certificate of.Occupancy has
been issued. _
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CHIMt�EY AN� STACK VERIFICATION
The undersiqned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (,�
2. Is free from rust or deterioration Yes (�
3. Has no foreign objects lodged within Yes (�
4. Is securely supported Yes (�/�
5.
6.
Meets all current Code requirements for size and
total BTU connected
Has Total heating BTU's of � ���
A11 other BTU's '"' Q �
TOTAL O ) U
Rema rk s �--?i
Yes (�
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Compa ny �,�c� f' '
Signed By
Da te i'�-���%d
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WORK SHEET
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sue�ecr IT NO. '
City of Fridley 2 5 � � 2
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �,�
f
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
' � �.------ � ��J
r � � PROTECTIVE INSPECTION SEC.
`-.--�; ����1,,� CITY HAII FRIDLE� 55432 NUMBER REV DATE PAGE Of APPFOVED BV
i 612-571-3450 910-F15 1/26/98 / /
J06 ADDRESS 7374 Able Street NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
bESCR. lO 4 Shaffer's Subdivision ��1 SHEET
2 PAOPER7Y OWNER MAIL ADDRESS ZIP PHONE
John Heffken 7374 Able Street NE 784-6843
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDHESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION �7 REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Replace window and vinyl siding
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and have inspection of same. Install smoke
detectors in all sleeping rooms and on each level of house.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION ZONING SQ. FT. CU. fT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTqUCT10N
OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS A7
ANY TIME AfTER WORK IS COMMENCED. NO. DWIG. 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 �AWS yq�UATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL 8E COMPLIED @ @
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT y+2 � ZSO y� 1. 13
OOES N07 PRESUME TO GIVE AUTHOFtI7V TO VIOLATE Oli CANCEL THE pERMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �7�F. �S Fire SC �2. ZS
PLAN CHECK FEE TOTAL FEE
$78.13
SIGNAIUAEOfCON'R Ct ORAUTHORIZEDAGENT IDATEi NEN PROPERL ALIDATED THIS IS VOUR PERMIT
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S� TUAEOFOWNEA�ifOWNEABU40ERi IDATEI ..8� iN$P �latE
NEW
ADDN
ALTER
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CITY OF FRIDLEY
5INGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1 / 1 /98
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ConstructionAddress: _t � � � �-� �%� � S �' .��� �
Legal Description: c � ( � i� � � � � �l L �� �� l�t �� �s S �► � � �� � _
Owner Name & Address: �c� v, �.� �c-t 1����^ Tel. # 7 �`-1 ��, �}3
Contractor: � � � �� o ,r MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPR4VEMENT
Length � Width Height
Length Width Height
DECK AREA: Length Width
OTHER: � � � ,� - w � � �i a w �
�'
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =_
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
H„ � � �I � ►� , ! / t/�l
�r%��/�X .S�i'°��'�
Estimated Cost: $ � � -� �
(Fee Schedule on Back)
Ft x $ _ $
DATE: � - �- � � � � APPLICANT: c.l� lV l��,-� Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STiPULATIONS:
� �
� 7 ��
$ �
$ ./
$
$
$
$
$
$
$ ��
CITY U5E ONLY
Fee Schedule on Reverse Side ���%��lG�'���T ��1
.001 of Permit Valuation (1 / l Oth %) `N� S��-r1,o�it.G
$.50/$1,000 Valuation ���
$1000 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 ( ]
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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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $S00 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
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 Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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CHIlVINEY AND STACK VERIFZCATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (�) No ()
F�
�3.
Is free from nist or deterioration
Has no foreign objects lodged within
4. Is securely supported .
5. Meets all current Code requirements for size
and total BTU's connected
6 Has total heating BTiJ's of
All other BTU's
YesONoO
YesONoO
YesONoO
YesONoO
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:
sue�ecr NO.
c�cy of Fridley 30855
�
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
; ` RE EIPT NO.
� • COMMUNITY OEVELOPMENT DIV. � �� �
' �V'_""
r � � PROTECTIVE INSPECTION SEC.
1 �
l----�,��"' �.� CITY NALL FRIOLE� SSIJ2 NUMBER REV O�TE P�GE Of �PVROvEO Br
L 612-571-3450 91Q-F15 4/25/00 / /
JOB AODRESS �374 Able Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. lO 4 Shaffer's Subdivision ��1 SHEET
2 PiiOPEfiTY OWNEFi MAIL ADDRESS Z�F PMONE
John Heffken 7374 Able Street NE 784-6843
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Ja son Lindsa Roofin & Ext Inc 9520 Jackson St NE, Blaine MN 55434
4 ARCMITECT OR OESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
792-1857 2Q172715
5 ENGINEER MAII ADDRESS ZIP PMONE IICENSE NO
6 USE Of BUILOING
Residential
7 CIASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 S) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPE Of CONST. OCCUPANCV GROUP OCCUPANCV �OAO
SEPARATE PEFIMITS ARE FEOUIRED FOR ELECTRICAI, PLUMBING. MEATING,
VENTII,ATING OR AIR CONDITIONING. � � � �
THIS PEiiMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZpNING SO. FT CU FT
AUTHORIZED IS NOT COMMENCEO V�ITHIN 60 DAYS, Op IF CONSTRUCTION
OR WORK IS SUSPENDED OR AgAN00NE0 fOR A PERI00 Of 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OFfSTREET PARKING
I HEfiEBY CERTIFV THAT 1 HAVE REAO ANO EXAMINEO THIS APP�ICATIpN 1 STALL$ GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTA%
ANO ORDINANCES GOVERNING 7MIS TYPE OF WORK WI�L BE COMP�IEO @ @
WITM WMETHER SPECIFIEO HEREIN OR NOT. TME GRANTING OF A PERMIT W2�272 `P1.14
DOES NOT PRESUME TO GIVE AUTMOfi1TV TO VIOLATE OR CANCEL TME pERMIT fEE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGUTATING CON• �83 . 2S F� SC �2 . 2.7
TRUCTION OR TME PERfORMANCE OF CONSTFiUCT10N
P�AN CMECK FEE T A� FEE
����� Licen C $5. 0 $91.66
S�G M7UpE O� CON'AACTOp -AUT i2E0 �GEN* iD�rE� MEN i:OP V VALI AT D TNIS IS V P RMI
��
S�GNaTUAE O� OwtiEA ��� OwHEA Bw�OEA� � �O�TE� BL .�w5� �� � �� E
NEW [ ]
ADDN
ALTER
Effective 5/10/99
� � CITY OF FRIDLEY
(] SINGLE FANIII.Y AND DUPLEXES R-1 AND R-2
BUII,DING PERMIT APPLICATION
Construction Address: '� � � �% ��/e 57�. �, �•
Legal Description:
Owner Name & Address:
Contract�
Address:
q��
�J
� ��
��
�: Tel. # ��� ��Dr�'�
'ENSE #,�{Q / � � �/ �
Tel. # % I�Z—t��S %
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:_
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 Sq. Ft.
..�� _ �� Q''� r' %� �'��->� • /1.:�/�-
Driveway C�xrb C�t Width Needed
,
Estimated Cost: $ �� ��
Ft. + 6 Ft = Ft x$
_$
DATE: y a� -o v APPLICA.��I'T: Tel. #�92 ��� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �'�3 .� S�
$ ��
$ /. /;/
$
$ S• 0�
$
$
$
$
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 [ J
�.-�
BUII.,DING PERivIIT 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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1.00Q
or fraction thereof, to and including $25,000
$391.25 for fust $25,000 plus $10.10 for each addidonal $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof _
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Pernuts 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 Certificate of Survey of the lot, showing the location of the foundadon once it has it has been constructed will
be required before proceeding with the framing.
�►. . . ..