AF - 34934SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
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� • COMMUNITY DEVEIOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC.
i-_--� ��'-'1,,� CITY HALL FRIDLE� 55432 NUMBER REV. DATE
i 612-571-3450 9�0-F15 g�22�g�
JOB ADDRESS 5324 Altura Road N. E.
1 LEGAL �OT NO. BLOCK TRACT OR AODITION
DESCR. 3]. 6 Carlson's 5umoai.t Manor Nort
2 PROPERTY OWNER MAI� ADDRESS Z�P
Harold Anderson 5324 Altura Rpad N.E.
3 CONTRACTOR MAIL ADDRESS Z�P
Lloyds Home Improv�nent Inc 1012 - 42� Avenue N.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER MAILADDRESS Z�P
6 USE OF BUILDING
Residenti,al -
PAGE OF
/ /
PER .
15895
R EIPT NO.
�/
APPHOVED BV
SEE ATTACHED
�� � SHEET
PHONE
PHONE UCENSE NO.
788-5602
PHONE LICENSE NO.
PHONE LICENSE NO.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
9 CHANGE QF USE FROM
TO
:3TIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvaniaed valleys.
SEPER�tE F�ER1iAAITS R�QUiRED 1�OR 1�f1R1�lf�„
HEa�n�G, PLU�A61�G AND Si�NS.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR E►.ECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �'].�200
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`9.00
STRUCTION OR THE PERfORMANCE OF CONSTRUCT�ON.
SIGNAT OF CON ACTOR OR UTHOA�Z NT �DATE
r h.,
NER BUILDERI IDATEI
EN
�JI
3 i
STALLS
GROUP OCCUPANCY�OAD
CU. FT.
OFFSTREET PARKING
GAAAGES
SURTAX
$.60
TOTALFEE
$9.60
D THIS IS YC
�
CITY OF FRIDLEY
ARPLICATION FOR RESIDENTIAL BUILDIPJG PERMITS
(New, Alter�tions, Additions, or Repairs)
i . � . �/ � � �
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Construction Location
ST�'sET NO: STREET: CL CiL-s��B✓ ��� —
I,pT: � / BLOQC: !� ADDITION: �h, � a �� � I''! ' 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.
� DESCRIPTIO�� OF CONSTRUCTION
�� ��o�
� �_ Front: Depth: Height:
Squa�e. Feet:_ Gtiibic Feet:
Front: Depth: Height:
Square• Feet: Cubic Feet:
/ (� L �
Type of Construction: Estimated Cost: $'� i G��-
Zb Be Qompleted: ��,�i_
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 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: � SIGNATUi2'E:
Stipulatians:
� g. v�
. �b
� 9-�0
.� .��-
BUILDING PER��IIT FEk SCHEDULE�
SECTION 2. The Inspector of 13uildings shall, before issuing pe�ni�s for the ezec�ion
of any bui].ding or si:ructure, or ior any addition to any existing buildiny or structure,
or for any alteration Qr repairs to•any existing building or structure, upan application
therefore, require the payment by the applican� for. such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit: �
NEVJ CONSTRUCTION: Single ramily iiomes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building pexmit fee.
DRIVE4JAY DEPRESSION: (Concrete,Curb Streets Only) "
' Alternate A: Removal and replac�ment of concrete curb and
gutter only; Driveway width plus 6 feet x Y1S.75
Alternate 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
�:11 � d_ ► �• ` �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
poi.nt 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 existinq 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 shal.l the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge. �
VERIFICATIOiV OF F01N ATION
NOTE: Permits �or construction will be issued a minimimn 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 been constructed will be required before proceeding with the framing.
-► : � � ':►
Application for a Certificate of pceupancy 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.
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sue�ecT ERMIT NO
c�ty of Fridley -17151 '
�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
; � RECEIPT NO
� i y_��___ COMMUfJITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � � y
i � �
i
� � /'�'1 � CITY HALL FRIOLE� 5S4$2 NUMBER REV. DATE PAGE Of APPFOVED BV
�'"'"� � �'� 612-571-3450 9�0-F15 5/19/83 / /
JOB ADDRESS 5324 Altura Road N.E.
1 �EGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 31 6 Carlson's S�mmit Manpr North SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Harold Anderson 5324 Altura Road N.E. 572-9614
3 CONTRACTOF MAIL ADDRESS Z�P PHONE LICENSE NO.
T.C. I. 3959 - 28th Avenue South 722-1217
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LlCENSENO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUILDING
R� S 1t�G'ri't1 AZ
7 CLASS OF WORK
❑ NEW � ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Basement Alterations
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQ�IREQ FOR �If}���
HEATING, PLUMBiNG AND SI�NS,
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4�000 $Z.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
ROVIS S OF ANY OT STA OR LOCAL LAW REGULATING CON-
TRU OR TH PE OR AN OF CONSTRUCTION. $44. SO
PLAN CHECK FEE TOTAL FEE
$46.50
SIGNATUAE FCONTRACT RO AUTHOFlIZEDAGENT IDATEI WHEN PROPERLY VA IDATED THIS IS VOUR PERMIT
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SiGNATUREOFOWNERIIFOWNERBU�LDER1 IDATEI —�° BLDG INSP np
CITY Of iRIDLCY �if�ctive �uq. 1, 19e1
wNPIIUTlai FOR RCSIDENTl/1� oUl101i�G PLRH)TS
(Nc,r. Alteratfons. Additions. or Rcpairs)
ONt�R: �,�ra 1d (� Nderso n� dUILpER; _�C � ' •
ADDP.ESS: _ S'3 Z N /�I�ura- �Zc� ADDRtSS: _ 3G. Sq �$ r�,9 ��S ,
tE� �o: � S� 2-�� 1 y � T� No: ? 2 2 � 2 1�
. — -
. . Constrvction Locetio _
;,
�..
. iTR1ST NOs iTJtEZT:
LOrl': �/ tIACX: ^__� ADDiT�s -�i�SpNtS `l. rr'�rn� i i4,cJUfL
���. rrf
Cornez Lot: � Incide LoL: � i�tbaeks � Sideyards:
J1p�liear�t att�ch to tl�is te� bwo Certificates of bl�rvey of Iot ar�d
pzoposed buildir�9 locatian erawn on eertificates to scale. -
, •
OESCRIPTJOJt OF COIJSTPUCT10f�
� Front: Deptl�: Neigbt:
iquare Faets Q�bic Feet: -
, Front: Depth: Nei9ht:
iquare Feat: Q�bic Peet:
Zype ot O�ratruction: � CIJ� �,�,w+��,�,1 tstia�ated Cost: _�/��� ��
9b '� O�r.,plcted:
711t. 11 I►1 t. 8
tzopesed Drivc�►iay f:idt?� Ii New Opening Is Desized: _' _
.__--_-___ � _
, . 6EL RiVER;E SID% OF SHF�T �
. �
Zi�e undersiQned ?�ereby s�a1;e� applic�►tion ioz a per�it icr the ti�ork I�ezein specified,
•greeinq t� �b ,all vork it, striet accozd�ee r►ith the City of Fridlep Ozdinances tnd
rulin9s oi the Dep�:bnant oi Duildings, ana Aeseby declares t?,�t •11 the facts and
=epresent�►tiers sLated 3r� t?�is applicatio re true d co-zect.
nart: S sicca»►zv�: � .
_____._
Stipulatio�s:
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p
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G� \ �
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;
1VILDING pERMIT !EE SCHEDDLE
The Inspectoz ot bvildir�qs s?�all, �etoze issuing pezmits tos tAe
•r�etion ot •ny builein�.os atzvetvre, oz ios any addition to any
�:iatiAq Duilainq or. stsncture, or toz any alter��.io:n or. ;t.�pai;z��;. ,�
to at►y •:istinq bnildiaq -os �tsuctyze. vpon app2ieatior t?iestf'ose,
z�Quitt the��payssnt by, the applieant tor sueh pe�si, , Qt �ess to Lfie
a�o�at a�s�tia b��l�v ;�et tostA ana in th� sanne� `lfet�ib ��to•ie�ed to-wits
'1'OR'11L V�LtJ11?I�l R . , . ?t�5 ; � . -` - . . 1
�1.00 b iS00.00
15�1 � •2/ ���
=2,001 �c i25,000
=25,001 to =50.000
iS0,001 tc t1�0,000
t100, �01 ar�d up
�
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0
i10.00 �tinias� fee t15.00 plus surcharge
:10.00 !or th� tirst tS00 plus Sl. SO foz each
•dditional =100 oz fraction thereof, to ar�d
inclvding :2,0�0
i32.S0 toz tAe iiz.st 52.000 pius i6.00 foz each
addi tional tl •000 or izaction theseof, to and
t�elvdir�g t25, 000
i170.S0 toz tAe fizst S?5,000 plus ta.50 toz
each .aa�cional s1,000 oz tzaction thereoi, to
and includfng iS0,000
i?63.00 toz the fi:st i50.000 plus 53.00 foz
�ach additional t1,000 oz tzaction t]�eseef, to
ar�a includinq i1�0,OG0
t1a3.00 foz the iisst =lOC,000 plus S2.S0 for
�ach aaditional i1,000 oz tz�ction ihezeof
PI.�W O�C7C: 25 percer�t oi building permit fss
Ditivi3�tAY DEPRESSION ESQt�W: ConCZlt! Q�zb Streets �ly
111ternate 'J►': ReJaav�al u�d zeplaceloer�t of cuzb and gutter oaly
.,, , . Drivevay vidtA plus 6, teet s f13,�0 '
l►Iterna�� •D': Reooval a»d sep2sce�oesit° b�'cvz�'"ir�b guttet'Yria`��ir,stall a 3 toot
vide �ppzo�ch with 6 inch depth
Drivc;ay vidth plus 6 ieet x:15. �S
VERIFICATION OF FOUNDATION
i+era�its ios conststictioa► vill De i::v�a a Ainiln�n of 24 hours fzom the time of
application to aliov foz proper revie.r of the proposed structuze and of the
const� etion sitt.
11 Geztilicate of �rvey of tbe lot, shovin9 the Ioeation of the foundstion once it
bas Deen eonstrvcted vill be sequized betore pzoceed_ ir� vith the iraminq.
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sue�ECr PER
City of Fridley 19 9 3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
' ' RE
� � •
� • COMMUNITY DEVELOPMENT DIV. �7
r� �~ � PROTECTIVE INSPECTION SEC. 2��✓ O
� , �
( � /"'1 � CITY HALL FRIDIEY 55432 NUMBER , REV. DATE PAGE OF AVPqOVEO BV
�""� � �'' 612-571-3450 910-F15 6/7/89 / /
J08 ADDRESS 5324 Altura Road N,E.
t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 31 6 Carlson's Sumnit Manor North Addn. SHEET
2 PROPERTY OWNER MAIL AQDRESS ZIP PHONE
Harold Andexson 5324 Altura R�oad N.E. 572-9614
3 CONTRACTOR MAIL ADDRESS Z�P PHONE C NSE NO.
NLilton L. Johnson Co. 2513 Central Avenue N,E., Mpls., MN 55418 781-9��8
4 ARCHITECT OR DESICaNER MAIL ADOFESS ZIP PHONE UCENSE NO.
5 ENGINEER MAILADDRESS ZIP PMONE UCENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION �] ALTERATION O REPAIR O MOVE ❑ REMOVE
B DESCRIBE WORK
Aluminum siding, sof�it & fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIH CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOHK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHOFIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF; A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIfV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STA�LS GAqAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEFEIN OR NOT. THE GFANTING OF A PERMIT $7 �SOO S3, 7S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- CjC�, OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $
PLAN CH CK FEE TOTAL FEE
$102.75
SIGNATUAEOFCONiHACTOROAAUTMOAIZEOAGENI IDATEi WHEN PROPERLY V DATED THIS IS YOUR PERMIT
�I
R. �
SiGNATUfiE OF OWNER�IF OWNER BUILDER� �DATE� BLOG �NSP TE
� [ �
ADCtJ � �
AI+'I�2 � )
�l AND R-2
A� i 1 d]1XJ �llllt A�11CdtlOTl
Effective 5/1/88
p�nsttvction Addres,s: 5324 Altura Road
,
Iegal Descriptia�: Residential --
Owner Name & Address: Harold Anderson (SamP) Tel.. # 572-9614
�
���r. Milton L. Johnson Company � Tel. � 781-9548
p,�S• 2513 Central Ave N E M�nls 55418
Attac� to this application, a Dextificate of Survey of the
lot, with the prq�o�eci oonstn�ctio� drawn an it to scale.
� rc w• • •�- � i• •�• r i�
LIVING AREA: Le.ngt2i Width Heic�►t Sq. Ft.
C�R�GE AREA: Lengtiz Width Heic�t Sq. Ft.
D�cR AREA: I,�ngth Width Hgt/Grour�d Sci. Ft.
w
OTi�t:
C�orner Lot [] Inside Iot [] Ft. Yd Setback Side Yard Setbacks _
Z�pe of O�nstnlction: Alum sidina, soffit & fasci��� �t� $� 5�� ��
Ap�rox. Oort�letion Date: 6/30/89 .
proposed Driv�way Width If New Is Desired: _ �. $ $
/J ,`� W1 + 6' See Back Page
pA�: 6/7/89 ApPLICAN!': ���/ 'Pel. # 781-�548
P�ermit Fee S �J , c> G
State S�ur.harge $ � � %�
SAC Charge S
Driveway Fscrr�w $
Park Fee S
sewer Main Criarge S
,�1 V.
.�rvJ.raai�► :
T / � r � �
p,�y � �II.Y
�ee Sd�edule ar� Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A�� or Alt. ��g�� Abwe
Fee Detexmined b5' �rticlir�eerirx!
Agreanent Neoessary [. J Not Neoessat�' L]
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: 1 � � � f ' A'. t a: :�:I:n� 1 '
�he Chief Huildiryg Official shall, before issuing permits for the erec.�tion of any
building or stnicture, or for any addition to arYy existinq buildirg or sttvcture, or
for ar�y alteration or re�air to any existinq building or structure, uprn� application
therefore, require the payment by the applicant for sudi pexmit of fees to the ama3nt
herein below set fo2th and fn ti'� �annor ��ix� pL�vider3 tro-wit:
. ,
Zb►I'AL VALIJE
$1 tfl $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
�
$50,001 to $100,000
5100,001 to $500,000
��
$15 (Minimun F�ee is $15 plus surc�az9e)
$15 for first $500 plus $2 for each additior�al $l00 or
fraction theseof, to and includinq $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fractian thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fracticn the,reof, to and including $50,000
$414.50 for fiust $50,000 plus $4.50 for each additional
$l, ��r fractio� ther'eof, to atx] includi,t�g $100, 000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction ther+eof, to and including $500,000
$500,001 to $1,OOA,000 $2039.50 for the first $500,000 plus $3 for each additional
$l, 000 or fracti� the,r+eof, to and inciudir�g $1, 000, 000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1, 000 or fractioa� thereof
atlVF.i�IY �PRESSIQd F.�QiC1W
_ (Oot�tcrete Qa� Streets On1Y)
Alternat� nA��; �val arxi replavenent of cu� and gutter anly - Driveway width plus
6 feet times $13.50.
Alternate "g" : R�emoval arxi replavanent of curi� azri gutter and iRStall a 3 foot wide
eP'P�� w�th 6 itx� de�th - Drivew�ay width plus 6 feet tim�s $15.75.
' -a' �" r- • •1' "� h ���� �.
Permits for' aonstiv�,�tiq� will be is„stled a minim� of 24 hvur5 fram the time of
applicati� to allaw for proper review of the proQosed �re ar�d of the
oonstivcti� site.
A Oertificate of Sluvey of the lot, showir�g the lacatian of the foiu�ciatian �oe it has
it has been �tn�cted will be required before prooeedinq with the framinq. .
� � J
City of Fridley
AT THE TOP OF THE TWINS
r
� �` _��� COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC.
` --.. ,� � "' �,� CITV HAII FRIDIEV SS432
i 612-571-3450
SuBJECT
BU ILDING PERMIT
NUMBER IpEV
s�aF�s
�oe no�Ress 5324 Altura Rd NE
t LECaAI �OT NO. BLOCK TRACT OR ADDITION
DESCR. 31 6 Carlson's Sum
2 PROPERTY OWNER MAIL ADORESS
Harold Anderson 5324 Altura Rd:NE
3 CONTRACTOR MAtL ADDRESS
Milton Johnson Co. 525 Lowry Ave NE Mpls.
4 AfiCHITECT OR DESIGNER MAIL ADDRESS
5
MAIL
DATE
9/8/98
/
27608
N8.
�"���
OF APPROVEO BY
/
SEE ATTACHEO
SHEET
55421 572-9614
ZIP PHONE LICENSE NO.
55418 781-9548 2083
ZIp PMONE IICENSE NO.
ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (23 SQ) Tear-off
Fascia/trim/windows
9 CHANOEOFUSEFROM TO
STIPULATIONS
Reroof - Underlayment must comply with the State Building Code.
Fascia - Install soffit ventilation to meet the State� Building Code.
Windows - Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of house.
TYPE Of
SEPARATE PERMITS ARE REQUIRED FOH ELECTRICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTFUCTION ZpNING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DW
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORiiECT. ALL PROVISIONS OF �AWS ypLUATI
ANO ORDINANCES GOVERNING THIS TYPE Of WORK Wl�l BE COMP�IED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT
PROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGUTATING CON-
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION.
PLAN CI
�' ;�-�; #' Lice
SIGNATUAE OF CON'RA OR OR OA�ZED AGENT IOATEI �
�
�o�re�
a ,y _ �,
SO.
UNITS
STA��S
$1,971.00
$62.25
K FEE
�C $S.OSY
GROUP IOCCUPANCVLOAD
CU. FT.
OfFSTREET PARKING
IGAFAGES
SURTAX
$.98
SAC CHARGE
Fire SC $1.97
TOTA EE
,�� $70.20
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N L�V
ADDN
nLZ Liz
II
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' C[TY OF ERIDLEI'
SINGLL' FAM[,[,y pND DUPLEXFS R-1 AND R-2
BUILD[NG PERMIT APPLICATION
['sffective 1 / 1 /97
6�
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ConstructionAddress: 5 3 2 4 Al tura Rd . N. E. . ��
Legal Description:
Owner Name & Address: xarold Anderson Tel. A� 572-9614
Contractoc: Milton Johnson _� MN LICENSE�i 2dg3
Address: 525 �,owx'y P�ve. N,E�, �p�.s, ��418
Te1.1� 781-9548
Attach to this application, a Certificate of Survey of the
lot, with the proposed conshuction drawn on it to scale.
DESCRIPTION OF IMPROVEAZENT
LIVING AREA: Length ' Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: .
Sq. Ft.
Sq. Ft.
Sq. Ft.
Tear o�� and xerroof � hous a3
CotLStruction and garage; fas.�trim/win. � � ��°'° `°°
Tyne: ��a cosc: � �Q % 9 7 /
� (Fee Schedule on Back)
Driveway C�rb G�t .Width Needed• Ft. + 6 Ft = Ft a$ "-. � _$ �
DATE: 9�' S'� APPLICANT: - � Tel. �{ �� i.. 9 5 4 f�
r
Permit Fee
��ire surcharge
State Surcharge
SAC Charge
�icense Surcharge
�riveway Escrow
:rosion Control
'ark Fee
'ewer Main Chargc
TOTAL
C[('UI./�'('[OVS:
$ �a. �s
$ /. �r �
$
$
$ �vo
$
$
�
$
� ���-�v
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOthi6) �
$.SO/$1,000 Valuation
$950 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 l�iecessary [ ] Not Necessary [ ]
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�cu��.���,vc: rc�t�irr rr:� scEi�����.i�.
'l'h� Chief I3uilding Ofiicial shall. I�efore is.tuing pern�its for the erextion c�l' any building c�r structure, �r li►r
dny addition co any existin� building or stcucturc, or foc any alteration c�r repai� to any cxisting buildin� or
stiucture, upon application tl�erefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manne� heoein provided to-wit: � .
TOTAL VALUE
$1 to $S00
5501 to 52,00p
S2.OU1 [o $25,000
$25,001 to $50,000
$50,001 to $100,000 .
$t00,001 to �SOO,ppp
FEFS
S21 (Miaimum Fee is g21 plus suncharge)
$21 for first $S00 plus $2,75 for each additionat $100 or
fcaction thereof, to and including $2,000
S62.25 for first 52,000 plus $12.50 for each additional $1.000
or fcaction thereof, to and including $25,ppp
$349.75 for first �25,000 plus $9.0p 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 fr�ction thereof, to and including �1p0,000
.�887:25 for 5rst s100,000 plus SS.00. for each addidonal
$1,000 or firacxion tliei,eof,.ro and �including SSOO,ppp .
SS00,001.to $1,000,000 • $2887.25 for the first SS00,000 pius $4:25 for eacli.ad�diao�l
�.�1,Q00 or fraction thereof, to and including 51,000,000 ��
$1,000,001 and�up
$5012.25 for the first $i3Opp,ppp plus 52.75 for each additional
$1,000 or fracrion thereof
DRIVBWAY DEPRF.SSION ESCROW
(co� a� sa� o�y�
ilternace "A"•: Removal and repiac:eu�nt of curb and g��r only =�Driveway width pius 6 feet times $13:50.
1[ernate "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.
VERIF[CATION OF FOUNDATION
;:rmits for construccion will be issued a minimum of 24 hours from the time of applir.ation to atlo� for proPer� �� �
:��ie�a of the �ro�osed structure and of the conswction site.
�(:crtit�icate c�t' tiur��ey cif the lot, sliowin� the lacation of tl�e foundation �+nce it has it has hccn c�n�tr�uctcc!
"�: !�: r���uirc�l h��i�r� ���'�r:�:rdin�; ���iti� thc fr.ttnit�!!_
S K
Building PLUMBING P�t N�.: �'� . ��'
� Inspections R]�SIDENTIAL AP�.'LICATION R��iv� By:
1763-572-3604 D� R�°d: �—�`��
CITY OF FRID�LEY
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
TfIIS APPLICANF 1S: � OWNIIt ' ANDERSON, HAROLD
PROPERTY N�� 5324 ALTURA ROAD NORTHEAST
0�� FRIDLEY, MN 55421
•TENANT ��S: (763) 572-9614 �AT� �
PHONE:
CONTRACTOR -- _____ ,
wv,�: pj(�RRI [� � p� I in�R� ir: �r�. —
SUBMIT A COPY OF '�A� � E7� DATE . .
YOUR STATE ADDRESS: CITY STATE ZIP
LICENSE WTTH pHONE •
APPLICATION
PERNIIT TYPE �GLE FANID..Y ❑ TWO FAMIi.Y ❑ TOWNHOUSE
TYPE OF W.ORK: � � /°� �P��T
DETAII.ED DESCRIPTTON OF WORK Y� P�2C �- �U2`�"� �I�Z�'�
-�-
PER MS 16B.665 t6e permit fiee is a minimum of $I5.00 or 5% of the total cost ap to 5500.00, whichever is gteater, for the
improvement, installation or replacement of a residential fixture, excluding 1i�e fixtures. (This should reflect only the cost of labor )
La.bor cost under 5300 = 515.00. Labor cost between $300 to $SOU = cost of labor - x.OS = -
FOR PROJEGTS WE�RE LABOR EXCF.EDS 5500, FEES ARE BASID ON 510.00 PER-FDCTURE, EXCEPT WHERENOT£D. Ft3CTURES: (INDICATE TOTAL
NUMBER OF EACH BELOR�
BATH SWKH.AV _Fi..00R DRAiNS SHOWER WATFR PffING
BATHiVB GAS PIPING �oCAruc�j SWA�yIDdCi POOL. WATER SOFfNER (S3�
CLOTHES R%ASHER KITCfiEld SINK WATER (1.OSET _BACICf7.OW PREV. (Sl�
_ DI5HWA3F�R _ LAUNDRY TRAY �WATER HEATER (Si5) FOR IRRIGATION
_ WATER MEI'ER _ OTHER
Fr,rmit Fee . S Number of fixt�u�es (a� $10.00 x$I0.00 = S
Surch e .50 Number of fixtnres aQ" $15.00 x$15.00 =$
TOTAL DUE S ,� Number of fnctures (a3 �35.00 � x$35.00 = S ziS �
State Surcharge = $ .50
• Tota1= $ �iS�S't�
TFIIS ]S AN APPLICATTON FOR A PER1rIIT NOT VALID UNTII. PROCFSSED
I hereby apply for a building permit and I acla�owledge that the information above is complete aud accurate; that the work will be in
conformaace with the ordinances and codes of the City of Fridley and with the Minnesota Consh�uction Codes; that I understand this is
not a pennit but only an application for a it and work is not to stait without a permi� that the woric will be in accordance with the
approved plan in the case of all 'c reqti review and approval of plans.
SIGNATURE OF APPL]CANT PRINT NAIv� �� l t I`� � Y u� U w� DA'rE �" O" Q�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604