AF - 34951n
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City of Fridley, Minn.
BUILDING PERMIT
nate: dvne 9, 19b5
N° '7'798
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o�: ao� �$ � �c�.0 �a c��
�d� 53� �ltura Dr3v� Id. E. A,� 161$ '�T. I� Street BT. E.
LOCATION OP BUILDING
Na 5� street �].�nra Dr3.ve �T. .E. � ot r�ot
I,o� �5 81ock b Addition or Sub-Div9sia��EbZ'18oF1 � s 8�3.$ I�BA�Ts 11ioT'�h
Coraer 7.ot Inaiale Lot Setback Sideyard
Sewer IIevat4on Fotmdatiaa IIevation
DESCRIPTIOM OF BUILDING
To be Used as:
Front Depth Height Scl. F't. Ca FL
�`rant I�Pth FTeight S�l• Ft. Cu. Ft
Type of Constauct4a� Est. C�t �� 5�• '" To be Completed
Stoi'm dam8�8 Y'epair
In coasdderation oP the is�anc� to ane of a permit to camstruet the builaing d�bed above I a�ee to do
or�dinanees� tbe dty oY Frldley. wlth the d�lPtion above�f ¢��,d� P�� wlth a�l p�aroiafons of
��
In camdderatta� of the �yment of a fee of $��—. P�t is hereby► gi�anted to�c�a�? a*�d C�.
Ik�II i�Iiehtle to c�anatruct the bullBinB' or adaitioa es d�clbed above. This�{ t is �aantred upoa
tke e� condition that theperson to whom it is �►ted aad his agente► �p�y� an� a�rlm�►en, � all w�k
8ane fn, ara�ad aad upon said buildiag, aT AnY thereo$ shall co�aa�n in- ali r�pects tfl the o�a'Nnaaces of
� the� ts a� �'��, ������ atterat�, matatenanoe, sqeP�ir ead anoving � bt�ilain�s
�� permit maY be revalceS at ans► time upon violatioa of a�► o� the P�� of e8td
Ol'�IIBII�.
�.18� den�BII �S �
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'1� p� aen eo� �er t6s �o. t� im �ng. ptambms. en �, a�ra�.or watu. B� w,. to w.
t6� gW�g [� tor � P� tor fMa Hput.
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. .$8 �ltura. Dr 6s�e � . . . ADDRESS :. � ,-,���i - .,��-° Sr�;' ,�,,,,,A : � �'
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.. LOC�Z�ON OF ���i� � ,.
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No.. ;oi ��,,,,.,
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Lot_ .� S Block����^Addit,ib� or: Su�d�.�i�n � '�- �o�
Cor�r Lot Inaide �ot � _���et�k Side :Ya��. �
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S�R . E�`VATIQN � F�INaATiON _ E%�A�I�,,..,w,,,�.,��,.,.... .. . ,r.�.....r. ' . �
Applteaat att�t�h tp ti�.i+l. fo�,4 T�ro .Cert�.fic�te�a► :a% &urveg of .i�o�.; �d pra�Ed.,b�� `
ia� locatit>n sl���an on tbe9e' �8�'tificates ., . .
DE3CRIPTiOAi OI� B�IIT.DING
T'v be used �s: , .
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�T_�_ ont Dmpth . Heigh�
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1�ipe af construction - � � , . l�sti�c�d. �oat - � .�5�•� '
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The undersigned hereby makes applieetion � for a pexauit. �or. t�e �vor1� here�in speci.ffed,
agreeia$ ��o cfo ail work ii� . st7rict accos�dance with the City of .Pridley Ord�i�aances and �
...
xulit�gs i�, .the Departffieat' �wf Buildi,a�s,; �a h�y a�c.�s ��at a�i t�g ��c�. :�nct _...
represe�tatians state`d in t4is`eppl3cation are trus and cortec�.
�hedul,et pf �e Caats csn be fouad on the Reverae Side).
' Roof. G1aa�, scre�n�. PB�ntin�. Qen�ral R�pair.
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B1�DZA1Q PE�T F8E SG`�� w 1. '��
� Se�tion 2. The Inspector �"c�f`°�uildings'.�s��9:�°, 'b�o�ei i's�u�..anp per�i,t fos
, tibe erecCion of eay buildin,� os struGt,nr�., ;a� • for any acld,�t� ts any egiet-
, is� building os struature, Qr'�'�or. �iinq� $�Ce�,afi '��s''::s�epaf� t,� any esi.sting .
. . buildi�pg or structure, upon applicet�'� ��r��or, ��re C6e p�t�st by �
applicant foa suc6 permit of feee �Cl� �t� �amo�t �her�in�•beiow set 'forth._a�d
: � in the mannQ= h�reia p�eovided to-w�C:� .�:
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-�:�_.—._ 2.1. F�r aay �uch permit. �or the �asep��ori-e�E� any fire'JP�# bu�lydlPB� �!Ciier �,
-•��:r-L4� ,a garag�.:�8�ehous�, .factos� -�x�. j�it�ii''�+��ev�lc;,r -� ..�� ��be �� tal,+� --�# �"° ' � z
' '�►Y `�-p�ot addi��on, fot. 8i�$�;a*'�'a�Y� #b: o1�q �xis��i.�g btt�l.l� ' �•:;" - �: �.• m
ahelY %e at the rate �rf $1.40 for �,clt,,.� t�oct��td .�ee�b�� feet. os ��r�
;�.- .. :ther,eof, i� sucb cubical aoat�n�e;:,` - : � � . _ � •
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' `� 2 2 ��..�'or.�sny such'''p�nnit.. f� e..erectiQn.-o# a fYre- �oa�--
� �S► -� 8+��...�:�--
�tasy sr grain elevator,. . or f� • the �r�e�tion •o£ �s - �� � �•,�
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. , fsrr, _sim�,ler_�cc�pan�,Y�, _to an _ e�t3-�b � '
� ft�g �,1�1� sl�i • �b�..�,�, e.;.. - �'
. �. ."�,,.'�o,r--�sa�h �ns thous�d cv�bic .feefiy�. oLaseiiied,.�, nfir�p�o h .. _
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. , ��, ^ . ��; aFciB �iy: eucb permi:t �fo� �fi�� �r.�a�ian � of � �ny adn�£ir�bp��' �ui;ldi,�rg _ _ -
8 itage, �warehouse, �actory �►r. grain el�vat��; � dr ariy� �fi�D��'� - .
addixion, gor aimf�dr oc�up�Y, to sa e�is�t �~ .
�ach �oae �hou� �' . � �'�� - Pe�t $E.� fo� ...:
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�_ For aay such pern�i,t fdr the eiect3cn of any pon-f�repraof $s
warehouee, factory or g�rai�_Ql�xaL�r, ;ot for� the-ereatt�� � o#- �B�e. ._~ .
��,--�or-fe�mila�' occu . 'Q°y. � �i;t�e�o�"�_ . _ _ ..
---- ---�'a�aa=,°, or eddition � �°�, C� aaX euietin$ build�ng br for eso� se�h ,.
� . �,. nine� 'c�a�s���Aas.6j ior-.8ach one thoua�a�d cubfC feet
or _ _. ._. _ �._. caateata theaeof wit3� a minimum �of $4.�• �
t , oo theseof, i.o the cubical� _.- ,
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Fo�r tbe� purpose of�� . . _ . _. _ . - - -. .. _ _ �. _ _ . . .,_ .._ � .._. _. . _
• of any bufZdi ���t� fees for bnilding Ferm�its, .th�. cubical ca�test8- '
ng or add_ .t-ioa to_ .a _u�ni,fora- hei�ht -througbcf�t •'�► � ' �
gro�ail aseei' ra+vered .ftami a point sis (6) iach�� be2�to� the �].oar 1l�.n� a�f_ .�-t�,.-
bas�at o� celler to the- aveea s he :-=��-''°
av�r e he � . _ .- � ��- c� the � ngper - ee�`€a�e -or=to � tba ` _ .
, � i8ht of the rpoi �urface of the mai$ �able o# a.�it�hed roof. �
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����. �`or repairs or aiteratioaa to an eui.at • I•--,. �_ ro .
. , p at the rate of $3. � e r, ,8 � � �r. uc . � . ��� �e she]►1 b�-�:--�`' `t � :
:;, ther P� each Fi�re �uadred Doll�s .(�3������..°r.��;� •
�f_ iri � t1�►e��so�t:.?o��,#1r1_A=��'tao�k � - , _ . , ,, _. - .
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,?,.6 `_ . ta ao ease� :s1�11 � �i��a _ � • ;.. `� .i�i�h itt 1 ' °` '�,
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SuBJECT
City of Fridley
AT THE TOP Of TNE TWINS g U I L D I N G P E R M I T
r
� �
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� • COMMUNIri DEVELOPMENT DIV.
� ; �. ------�
r � � PROTECTIVE INSPECTION SEC.
� . �
� S �"'1 � CITY MALL FRIDLEV SS432 NuMeER
�""� � �'' 612-571-3460 910-F1 S
�oe nooRess
5388 Altura Rd
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. �� ti C M _
2 PROPERTY OWNER
Richard Tistle;
3 CONTRACTOR
L J ltoof ing
4 ARCNITECT OR DESIG
5 ENGINEER
8 USE OF BUILDINfi
Residential
7 CLASS OF WORK
8 DESCRIBE WOpK
MAIL
MAIL
ADORES$
REV OATE PA6E OF
7/31198 / /
�lson's S�mit Ma.nor Nort
rh Additio�n.
6926
�/7�/�
APPROVEO BY
SEEAT7ACNE0
SMEET
ADDRESS Z�P PFIONE LICENSE NO.
vd Coon Ra�ids 55448 767-1587 9076
ADDRESS ZIP PHONE LICENSE NO.
ennnFaA ZIP PNONE LICENSE NO.
O NEW � ADDITION 0 ALTERATION $7 REPAIR � MOVE O REMOVE
9 CHANtiE OF USE FROM
TO
I STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PEFiMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, NEATING,
VENTILATING OR AIR CONOITIONIN(i.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTF�UCTION 20i�
AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOFi A PERIOO OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO.
I HEREBY CERTIfY THAT t NAVE READ AND EXAMINED THIS APPLICATION
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ VAL
ANO ORDINANCES GOVERNING TFIIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEFiE1N OR NOT. THE GRANTING OF A PERMIT ]
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pEF
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REtiULATIN(i CON-
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. SE
PLI
c
SiGNAT OL CON � RACTOR OR AUTHORIZED AGENT �DATEI
. �
S�GNnTURE OF OWNER dc OWNER BU�lOERi �DATE�
DCCUPANCY(iROUP OCCUPANC
S0. FT. CU. FT.
OFFSTFiEET PARKING
STALLS (iAiiAGES
SURTAX
f . 87
SAC CHARGE
�"ire SC $1. 75
TQTALFEE
.37
i�LIDA TNIS IS.�U�PEFj�
/ /
1�TE�V
ADDN
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R 1 AND R-2
BUII,DING PERNIIT APPLICATION
Effective 1/1/98
�(�a�� 3
d�, �� �
ConstructionAddress: �
I.egal Description: �j 3 � � �-i � �
• t e
Owner Name & Address: J�ccl�.Q�,l Tctf1� .�a� Tel. #
Contractor: �c^ MN LiCENSE # qo? �
Address: l� 1 s� �� I�� t�l .� %�- S-� `��� Tel. # 7 6 Z— �.J-�7
LIVING AREA:
GARAGE AREA:
DECB AREA:
OZ'HER:
Attach to this application, a Certificate of Survey of the
lot, with the pmposed construction drawn on.it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width � Hgt/Ground Sq. Ft.
Z
Construction Type: Estimated Cost: $ ` j`%� ��
-�� � (Fee Schedule on Back)
Driveway Curb Cut Width Ne,eded: Ft. + 6 Ft = Ft x$ _$ �
DATE: 1 �t �' APPLICANT: _ � � `�� Tel. #
,
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
:
$ ��°'��
$ , �.�
$ d C�'�
$
$ ��� ��
$
$
$
$
$ � ��
CITY USE ONLY
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuadon
$1000 per SAC Unit �
$5.00 (State Licensed Residenrial Contractors)
Alt. "A" or Alt. "B" Above �
$450.00 Conservation Plan Review
Fe� Determined by Engineering
Agreement Necessary [] Not Necessary [ 1
�.a � �
.
BUII,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing pertnits for the erection of aay 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 $2,0�
$2,001 to $25,000
$25,001 to $50,� .
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,�0,000
$1,0�,(�1 and up
FEFS
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $5� plus $2.75 for each additional $100 or
fraction thereof, to and including $2,� �
$62.25 for first $2,000 plus $12.50 for each additional $1,0�
or fraction thereof, to and including $25,0�
$349.75 for first $25,� plus $9.00 for°each additional $1,000
or fraction thereof, to and including $50,�
$574.75 for first $50,� plus $6.25 for each additional
$1,000 or fraction thereof, to and including $1�,0�
$887.25 for first $1�,000 plus �$5.� 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 addidonal
$1,000 or fraction thereof, to and including $1,000,0�
$5012.25 for the first $1,�,� plus $2.75 for each additional
$1,000 or fracdon thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "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.
.,� ,�