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. � � sue�ecr � � � P NO. .-
City of Fridley _ 16 4 3 4
"TT"ET°P°FT"ET�'"5 6UILDI�JC PERMIT
F� .
i �-� � . . .. R NO. �
� � COMMUNITY DEVEIOPMENT.DIV. � � . . . � . p� � .
% . � V -''i . PROTEC�IVE 1NSPECT16N SE0. � , . � .. � �% 7�� � � .
� �
�, _--. ��� �'�`, � � CITY HALL FRIDLEY � .S$d32 . Nl1MBER FE4 OATE ' PAGE OF . pPPROVED BY �
z � '' 612-571-3450 910-Ft5 10/20�6/81 � �
�as aDO»ess 6434 Ashton Avenue N.E.
�� � .�E�� � lOTNO. � BIOCK - TRACTORADDITION � � � � SEHATTACHED �
� : DESCp.. :� Br�Q . . �.Z� � FY'1[Il9jr PdISE�. . . . . . SHEET
. . ��4�.PROPEPTYOWNER. � . . MAILAODRESS . . . � ZIP � �. -PNONE . . . . .
' Onella Lee 6434 Ashtan Avenue N.E. 574-1895
3 CONiRACTOR. MAILADDRESS � � Z�P � PMONE� � LICENSEN0. � � �
6�an's Alwni.iwm Service 10933 Beard Avenue Sputh 888-7614
iw
4� ARCtfITE6TOR DESIGNER � MAIL ppDRESS . � ZIP . � PHONE IICENSE NO.
� . 5 ENf31NEER . .. MAILAODqESS � . � . �ZIP � PHONE LICENSENO. � .
�.. 8 li$E�OfBU1LDING ' � �. - � � �� � � � ' �
.. � � �.2@31(�@IItldl � . � . . . . .� . .
- 7 CUSSOFWqRK � � � � � �
� (7 N€W q ADDITION �: ALTERATiON � ❑ REPAIR ❑ MOVE ❑ REMOVE ' � � �
. ' 8 DESCRIBE WOPK ' � . � � � . � . . �
inst,all steel;siding;and trim
9 OHANOE RF USF� FROM' � � � TO � � - � � � � � .
. � � . . � . � . � . .. . � . . � � . ,. :a
` 'fi'iPULRTIilP1S` .. . . . .. . . . . �. � . . . . . ,
. . . . . . . . � � � . ,
. . . .. . . � . .
TVPEOFCONSL �� OCCUPANCVGflOUP .. OCCUPANGVLOAD
� . S�RARATE PERMITS ARE REOUIRED fOR��"fRIGAL, PLUMBINO, HEATING: . . .
� '� � Y@NTILqTiNG�AR AIP COND�i1DNIN4: � � � � ' . . ' �
' TMIS PfFMIT BECOMES MULI AkD� VOFA iF �WORK OR.CONSTRUCTION� ZONMG �. 3Q. FL. CU. FL �
.�� AUiHORRED IS NOT COMMENCEG'W4FtAfN�60 DAVS, OR IF WNSTRUCTION � � � .. . .�
OR WORK9S SFISGENDED OR pBpNDY/NE0 FOR A PERIOD OF.17@�DAYS AT ��
ANV TIME. APTER� WQRK IS COMM�NCEO. � . � � � --NO. 'DWLCa. UNt�$ . OFFSiAEET PARKING �
��.� I.MEFEBY CERTIFV THAT 1 MAVS 41EAD AN9 EXAMlNEO� THIS APPLICATION �. 1 ���. � STAi1S � � � GARAGES � �
' . � 'AM�KNQWTME9AMETOBETp4fEANDCORRECT.AL4PROVISIONSOFLAWS yq�UATION� � - � � �� �SURTAX� ' �
AND-0RDINANCES GOV£PNIMf3 TH�S� TVPE 4F WORK WIiL BE COMPLIED "�•3 � 5�iS �� ��•1. 77 �
. W)TH'WHETHEN SPEC4PIED HEREIN QA NOT. THFGRANTIpG-0f A PERM�T � � �
: �OE4,NIIT�PRESWME�Tp CakyE.kUTMQRITY.70 VIOtATE qA��GANCEI TME pERMITFEE. � �� SACCHARGE �� �
,PROY.�BIONS OF ANY OTNER ASE OR l¢GAL, LAIN PEGULATING CON- y�•4Q� SD .
� 67RUGT! R THE PEiiF ANCE OF CpN$i. � T7�'M/,-� . �� - �
t / � � PLAN CF1f I(€Efi' -TOTALf E � �
I� / B-1G � �/ ,s' �46.27
�� �. S�ktirqqEOFCan;A�Cr� C HoaiZED�cENF'- � �onrEi W N� p LY VAiiDATEDTHI5IS�VOUR`�PERMIT'
' � � ' � � � � �f +q. �� �� � � � � . � .
51 NAiUR OFQWNERJFpN[NERBW�pER� T ATEi qLOG M k � ' D4 �
, . ' fi . �., , . . � .
. . . s.es- '� ,. . _ . - . . _ - .
'i` � '... � � .
CITY OF fRIDLEY
Effective Aug. 1, 1981
APPLICATIO;V FOf; R[SID[i4TIR� DU1LDIilG PEiU�iITS
(Ne�•r, Alterations, Additions, or Repairs)
Oklt�ER: �/��� �rl�2..
ADDRESS: ���y �,,, ✓�j, �
TEL rt0: �-7�i� 4s
ST]tGCsT NO: (� y� STREET:
6UILDER: ,��p�� �a�I/,o��i
no�a�ss:169�� ��i.�J- �
TE� r�o: ,���— 7�/'-�
n
G(°�i�-' � //. G- r
�z�: 9-,o 8��: �a ��T�oN: �",e�o P�-
Corner Lot: Inside Lot: Setback: Sideyards:
Ap�licant attach to this £orm two Certi£icates of SUrvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOtJ OF COt•JSTRUCTION
Front:
Square Feet:
Front:
Depth :
Qibic Fcet:
Height:
�P�� �_ Height:
Squar.e FePt: Q�bic Peet:
Type of Construction: E��� �� /�� 8stimated Cost:
Zb Be O�r,�pleted: g'f�,f/ j �f���
Alt. A
��� °d
Alt. B
Proposed Drive«ay Width Yf New Opening Is Desised: $ g
. . SE� Re^,VER;E SIDE OF SHEET
liie undersianed hereby makes application for a persnit fcr the r�orR herein specified,
agreeing to Zo;all work iti strict accordance with the City of Pridley Ordinances and
rulings of the Department of IIuildings, and hereby declares that all the facts and
rc�resentations stated in this applicatio e tr e d wr�
DA7'E: �� o�p �� SIGNATURE: �
Stipnlat-ions:
/
�/�• ��' 1�.�
/, r� r/ ��ta� r�
(
� / (O'� 7 !-� -s�
o�cS- �
� O.� •0�7
�� �
BiIILDLNG PERMIT FEE SCHEDULE
The Inspector of buildings shall, before issuing permits for the
erection of any buildinq or structure, or for any addition to any
9xisting building or structure, or for any alteration or repairs
to any existing buildinq or structure, upon application therefore,
require the payment by the applicant for such permit of iees to the
amount herein below set forth and in the manner herein provided to-wit:
TOTAL VAI�IATI�I
$1.00 to $500.00
$501 to $2.000
$2,001 to $25,000
$25,001 to $50,000
PEES
$10.00 Minimum Fee $15.00 plus surcharge
$10.00 £or the first $500 plus $1.50 £or each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the first $2,000 plus $6.00 for each
additional $�,000 or fraction th.ereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$50,001 to 5100,000 $283.00 for the first $50,000 plus 53.00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100.001 and up $443.00 iar the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN Cf�CK: 25 percent of bui.lding permit fee :
DdtiVPtrIAY �PRESSION BSCROW: Concrete Qub Streets �ly
Alternate "A": Removeal and replac�ent of wrb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "8": Renoval and replacement of curb end qutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 feet x$15.75
VERIFICATION OF FOUNDATION
Permite for constsuction will be issued a minimum of 24 hours fran the time of
applioation 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 foundatton once it
has been constructed rvill be required before proceeding with.the £raming.
�......� � s
1 � '�
�
INTEROFFICE MEMORANDUM
��Q��
U
To: Barb Dacy
NYom: Ra1ph Messer1"" t _
�r
Date: June 24, 1999
Subject: 6434 Ashtoa Avenue, N.E.
Here is the copy of the Correction Order for 6434 Ashton Avenue, N.E. as promised.
There dces not appear to be any signiiicant items with the exception of the electrical cord situation and
the cause and repair of the ceiling deterioration in the rear entry/laundry area.
If you have any questions, please calL
Thank you.
__ _ _
__. _ _ _ _ __ _ __
INS.�".ECC�'IfIN R�PVt�T.A,�I�' Ct1�GT ��JJ�v vRAE� '
7une 24,1999
Diane Miller
D & J Properties
953 Ivlississippi St NE
Fridley MN 55432
Property Address: 6434 Ashton Avenue, N.E.
Date Of Inspection: June 16, 1999
This is to advise you of our inspection findings at the above address. T'he condirions listed below were noted and must be
correc0e�1 in accordance with the City of Fridley's Rental Property Inspection and Maintenance Code. A follow up inspection will
be made on ihe date and time speci&ed below in order to confirm that the ordered corrections have been completed: Please uote
t6at if a third inspection is required due to uncorrected couditioos, a$60.00 fee may be assessed for that inspection, and
for each subsequent inspection until the coodition is corrected. Please cootact our office if you have any questions.
Thank you:
1. Iustall deadbolts with quick releases on front and rear entry doors
2. Repair or replace inoperative LF burner on stove
3. Remove eatension cords supplying the refrigerator in garage, freezer in kitchea and garage door opener. Relocate
appliances to eliminate need for eztension cords; OR install approved ouUets to adequately service the appiiaoces
without the use of extension cords
4. Investigate cause of ceiling which is d.eteriorating iu rear entryflaundry area �nd repair
5. Repair or replace ceiling io rear entryflauudry area and refinish
INSPECTOR: John Berg
CLEARED: For FSre Dept Use Ooiy
�.,,,.
Building
Inspections
763-572-3604
STfE ADDRESS _
77iIS APPLICANT IS:
TENANT
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAII, ADDRESS �
❑ OWNER �7CONTRACTOR
STATE LICENSE tl
ADDRESS: 6 33 �
PHONE S� ��'y
SSINOLE FAMII,Y/Nl
TWO FAMII,Y/NEW
❑ ADDI110N
❑ BASEMENf FIMSH
❑ DECK
w
❑SIDING
DESCRIBE WORK BEING DONE: '%E'f1 �Z Q F�F � i2 e zofl �
OF
NUMBER OF SQUARES �_
GARAGFS
PROPOSED SIZE:
PROPOSID HEZGHT:
SmIlVG
❑ Vviyl
❑ Aluminum
❑ Othc
❑ HOUSE & GARAGE
❑ ATfACHED GARAGE
❑ DETACHED GARAGE
OSoffit
O Trim
❑ Fascia
WIIVDOWS
IN EXISTING OPENINGS OYa �No IACATTON OF WfNDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TOTAL
Plan Review
Surcharge
Fire Surcharge
License Surchsrge
SAC Charge
Curb Cut Escrow
Erosion Contrnl
Pazk Fee
Sewer Main Charge
Total Due
BASED ON
([JSING
S 5.(fD
$
$
$
$
LUDING THE COST OF
U.B.0 FEE SCHEDULE)
O DRAA1 TII,E
❑ 01IiER
Permit
Received ByU�
Da�d" 2�0%
SS �(3Z-
Ft
BASEMENTRFMODF�.i1.r. BMI7'•
1. Existing Floor Plan
2. Proposed floor pinn
3. List of strucmra] members w be used
FOR NEW CONSTRUCfION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMTf: �
I. Site PIarJSurvey showing t}ie existing structures
and proposed prqect
2. Two sets of conswction plans
3. Encrgy Calculetions
AND
S� Back Page for Fee Schedute
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
55.00 (State Licensed Residential Contractors)
51450 per SAC Unit (Pians to MWCC for determinatlon)
R+6ft= ftx$20=$
$450 Conserva6on Plan Review
Fee Determined by Engineering
Agreemeut necessary ( ) Non Necessary ( )
THLS IS AN APPLICATtON FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge 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 ConsWction Codes; that I uuderstand this is not a
pemut but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNANREOFAPPLICANP�� vuTniTUenrtc��iv�.snw LZ►�!.._ _,,.,� 7 �c�...�
Page 2- Building Residential Application
� ' '"''' BUILDING PERMTT FEE SCHEDULE
The Chief Building O�cial sha11, before issuing pemuts for the erection of any building or
structure, or for any addition to any �isting building or structure, or for any alteration or repair
to any existing building or siructure, upon application therefore, require the payment by the
applicant for such perxnit of fees to the amount herein below set forth and in the manner herein
provided to-wit
VERIFICATION OF FOUNBATION
Permits for construction will be issued a minimum of 24 hours from the time of application to
allow 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 &azning. New Houses Onlv
City of Fridley
Building Inspecdons Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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sueaecr � � � . � P NO.�
� City of Fridley „ . 16434
"TT"ET°P°FT"ET"""S gUILDING PERMIT
3' , : ,, a No.
� ��L �� COMMUNITY DEVELOPMENT DIV. . � �
. % � � � . PROTECTIVE INSPECTION SEC. �� � � �% ��
^_ .i �. ; �. � . .
(.--. y� °t'J CITY HALL FRIDLEY � 55432 NUMBEP REV OATE "� VAGE OF� � qPPROVEO BY : �
i J� . 612-57�1-3459 910-Fi5 � � ... ..
l0/20�6/81 � �
iGeaooaess 6434 Ashton Avenue N.E.
� � 1 LEGAL � L6TNQ � BLOCK � TRACTORAODITION � � � SEEATTACNED
� � DESCii�. 9ta:O� . � �-Z � � . FT1CIlHY PdY�C��. . � � � SHEET .
� . '='.PflOPEPTYOWMER.. � . . � MAILADDRESS � � � ZIP -PHONE � � �
On811a Lee 6434 Ashton Ave=rue N.E. 574-1895
ru
3-CONiPACTOR . MAILADDRESS � � � � ZIP PHONE � LICENS6NQ �
5tan's Al�i.mim Service 10933 Beard Avenue South 888-7614
1 ARCHITECTORDESIGNER. � MAILAQDRESS � ZIP PHONE UCENSENO. � �
� 5 .ENG�NEER � . MAILADOFlESS � .. �. . ZIP PHONE � LICENSENQ.� .
� �. 5 U$EOFBWLDING � - . � � ' � � .
Ete3]Sl@rit].d1
� .7'��GLASSOFWORK� � � � � � . .
� . � � � ❑ NEW q � ADDITION � ALTERATION ., ❑ REPAIR G MOVE ❑ REMOVE � �
. . B DESCR78E WOHK '. .. .. . � . . � . .
7si�tall steel siding,and trim
9 CHAN6EQFUS@.FFOM �� � TO� . � � . I
� 9?Ei'ULATION9 . . . . . . . � .
SERAAA'fE PERMITS ARE REOUIRED"FOR ELECTRICAL, PLUM9ING, HEATING, T�PE OF GQNSL ��. OCCUPANCY
'� Y@NTILATMG-OR AIR CONDITi6NING. � � . �
'�� TMIS�PERMiT 9ECOMES NUCL AND VOID IF�WORK OR�:CaNSTRUCTION� ZONING����� �� �$Q�.Ft.. ��
.� AUtHOPIZED IS NOT COMMENCED� WITHIN 80 DAVS. OR IF COFN}TRUCTION � � � � �
. OP WORK]S $IJSPENDED OR �pBANDONEO FOR A PERIpD QF�.136�DAYS AT
�� ' ANV TIME. AFTER� WORK IS COMMENCEO. . .� y0 DWLG�..uNtF$,. �
� �.l NEREBY DERTIPY THAT I HAVf hiEAD AND EXAMINED� THIS�-APPLICATION �� �$Tqi1S r
' . 'ANDKNOINTHE9AMETOBETpUEANOCORRECT.AL[PROVISIONSOFlAWS VALUATION ��
. . AND ORDINANCES 60V£RNING TMfS TYPE OF�WORK WI�L 8E COMPLIED ' ,�{`j�S�S
. WITH. WHETHER.SPEC4FIED NEREIN OR NOT. THE�QRANTiN6 OF A PERMIT � � ��
� DOE;.AOT PRE3LLME:TO GtYE AUTMpRITY TO' VIOIATE OR�CANCEI THE pERMITFEE.. �
� PFOVI610N5 OF ANM OTHER AEE OR LpCAL LAW REGULATWG CON- ,�•4��50
. STRVCTI R THE PEFF ANCE OP COFI$i �� TiON,- � �
* pLAN HE KFEE'
��� i�-�_�/
�: dtGN6iUHEpfCON�N�CT HOHiZEDAGENf �DATEi WHEN P P LY YALIDAI
. e�+� .
. A AiUR tlFQWNERtlFpV1NfRBNI�ER� ., ipATE� �-BL�G M��C'� �
¢g���'°ar �
.. . .. ..�.>- .��.��. ...r� ., �.
I THIS IS
OCCUPA�NCY.
CU. FL
e
�
I
CITY OF FRIDLEY Effective Aug. l, 1981
APPLIC/1TI0'J FOR RlSIDGiVTIAL f3UILD1iiG PERtfITS
{Hee�, Alterations, AddiLions, or Repairs)
% /� �
� �.t/ �i.i I �
* f
� �� i � i��.�>..,<r '�
� � �
I3UILDER: �g,,.i,�ie�'CCcm� �//,�e.�.
n��c�ss: �69�� .��i�.�. �,
TEL f�0: �e��— �lof �
Construction Location
STRL'GT NO: CP %� STREET: (�E� CG✓�— �� L.
LOT: � - !O BIAQC: ia ADDITI0I3: �,e,.�.� �/j-
Corner Lot: Inside Lot: SetbacY.: Sideyards:
Applicant attach to this £orm two Certi£icates of S� rvey of lot and
pzoposed builcling location drawn on certificates to scale.
DESCRIPTIOIJ OF COt•JSTRUCTIOPJ
Front:
Square Feet:
Front;
Depth:
Qibic Fcet:
�P�=
Square Feet: Gvbic Peet:
7ype of Con�truction: l��� � � !].cw.�
Rb $e Oos�pleted: g'/�/ f �Q��
Height:
Height:
Estimated Cost: $ �Y� °b
Alt. A Alt, 8
Proposed Drivecvay Width Tf New Opening Is Desired: $' $
. SEE I�VER;E SIDE OF SHEET
Ziie undersigned hereby make:, application for a permit £or the �aork herein specified,
agreeing to do,all work in strict accordance with the City of Pridley Ordinances aiid
rulings of the Dep,.�rt�nent of Buildings, and hereby declares that all the fact> and
representations stated in this applicatio e tr d correct,
D.9T�: ��Q�� SIGNnTUItE:
Stipulations:
J
t��i, sZ I t,e�" . �
�, � � �i� �
� �� _ � ��5�
a� /
-.sr p.� '.
. _, b...
BUILDING PERMIT FEE SCAEDULE
The Inspector of buildinqs shall, before issuing permits foz the
erection of any building or structure, or for any addition to any
Axisting buildinq or structure, or foz any alieration or repairs
to any existing buildinq or structure, upon application therefore,
require the payment by the applicant for such permit of iees to the
amount herein beloa set forth and in the manner herein provided to-wit:
TO'PAL VAIxIATI�1
$1.00 to $500.00
$501 Uo $2.000
$2,001 to $25,000
$25.001 to $SOr000
PEES
$10.00 Minimum Fee $15.00 plus surcharge
$10.00 for the first 5500 plus 51.50 for each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the fisst $2,000 plus $6.00 for each
additional $�,000 or fraction th.ereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 ior
each additional $1.000 or fraction thereoi, to
and including $50,000
$50,001 to 5100,000 $283.00 for the firsi $50,000 plus $3,00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 arKl up 5443.00 far the firat $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN CHECK: 25 percent o£ builfling permit fee
DRIVIIVAY D�PRESSI�1 ESCROW: Concrete G1irb Streets �ly
Alternate "A": Removeal and replac�es�t of curb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "8": Removal and replacement oi curb and gutter and install a 3 foot
wide a�roach with 6 inch depth
Driveway width plus 6 feet x$15.75
VERIFICATION OF FOUNIIATION
Permits for construction will be issued a minimum of 24 hours fram the time of
application to allow for proper review of the proposed atructure and of the
construct3on site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedirg with.the framing.
«,,.. <3=
r
1 _.: ��
���'
To:
From:
Date:
Subject:
INTEROFFICE MEMORANDUM
Sarb Dacy
Ralph MesserJ�`�/�
�����
June 24,1999
6434 Ashton Avenue, N.E.
i� � �
/
�
Here is the copy of the Correction Order for 6434 Ashton Avenue, N.E. as promised.
There dces not appear to be any significant items with the exception of the electrical cord situation and
the cause and repair of the ceiling deterioration in the rear entry/laundry area.
If you have any questions, please call.
Thank you.
June 24, 1999
Diane Miller
D & J Properties
953 Mississippi St NE
Fridley MN 55432
Property Address: 6434 Ashton Avenue, N.E.
Date Of Inspection: June 16, 1999
This is to advise you of our inspection findings at the above address. The conditions listed below were noted and must be
corr�ted in accordance wikh the City of Fridiey's Rental Property Inspecbon and Maintenance Code. A follow up inspection will
be made on the date and time specified below in order to confum that the ordered correcrions have been completed. Please note
t6at if a third inspeciion is reqwred due to uncorrected conditious, a S60.Of1 fee may be assessed far t6at inspectiou, and
for each subsequent inspeetion until the condition is corrected. Please contact our office if you have any questions.
Thank you:
1. Install deadbolts with quick releases on front and rear entry doors
2, Repair or replace iuoperative LF burner on stove
3. Remove eztension cords supplying the refrigerator in garage, freezer in kitchen and garage door opener. Relocate
appliaaces to eliminate need for eztension cords; OR install approved outlets to adequately service the appliances
without the use of eatension cords
4. Investigate cause of ceiling w6ich is deterioratiug in rear entryflaundry area and repair
5. Repair or replace ceiling in rear entryflaundry area aud refinish
INSPECTOR: John Berg
tien as showa.
[:i.FARED: For Fire Dept Use Unly �
Building
Inspections
763-572-3604
DATE / � J /
SITE ADDRESS �
THIS APPLICANT I5:
TENANT
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
BUILDING
l9��-3
Pemrit No.:,
RESIDENTIAL APPLICATION R�'°� By��
CITY OF FRIDLEY Dat�'� Z00%
� YOUR E-MAIL ADDRESS �
❑ OWNER ,�CONTRACTOR
STATE LICENSE N L�O SI £XP DA'.
nn�xESS: 6 33 1 tZ�vEizV�r w [ E R
) v-996
❑ BASEMQJT FINISH $f.ROOF
❑ DECK ❑ SIDING
❑ SWA�A9
n
DESCRIBE WORKBEINGDONE: '%EflR Q FF �} tZctZ60 F
SQUARES�_
GARAGES
PROPOSED SIZE: �
PROPOSEDE�lGHT:
SIDWG
❑ Vinyl
❑ Aluminum
❑ Otliv
❑ HOUSE & GARAGE
❑ ATfACf�D GARAGE
❑ DETACf�D GARAGE
OSoffrt
❑ Trim
O Fsscia
wnvnows
IN EXISTING OPENINGS OYes ONo LACATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
ALL
Permit Fee
Plan Review
Surcharge
Fire S�uchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Contrnl
Pazk Fee
Sewer Main Charge
3ASED ON VALUATION, INCLUDING THE COST OF
(USING'I'fE�997 U.B.0 FEE SCHEDULE)
VALUATION S � () nrrrmsrer�
$
� �S�(3Z-
❑ DRAA1 TII,E
❑ OTI�R
BASEMENT �MODEI,ING SUBMIT•
1. ExistingFloorPlan
� 2. Proposed floor plan
.3. List of strucdual members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
AADfftONS. & PORCHES SUBMIT�
1. Siu Plen/Survey showing fhe existing structures
sod proposed project.
2. 7wo sets of consW ction plens
. 3. Energy Calculations
TERIALS:
See Back Page for Fee Sc6edule
65% of Building Pemut Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
55.00 (Sffite Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservadon Plan Review
Fee Detertnined by Engineering
Agreement necessary ( ) Non Necessary ( )
THLS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
Attach
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the wo�k will he in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota ConsWcrion Codes; that I understand this is not a
peanit but only an applicafion for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work /wh�ich re/� uues �rev'iefw �and approval of plans. j /
SIGNATUREOF APPLICANTj�,�(/ /�y(�GLv�;s pg]NTNpMg R��A72A �CTi cDATE_ 7/ S/ D%
�
Page 2- Building Residential Application
.��y:
� ` " 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 payxnent by the
applicant far such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
VERIFICA'I'ION OF FOUNDATION
Permits for construcrion will be issued a minimum of 24 hours from the time of application to
allow 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 franung. New Houses Onlv
City of Fridley
Building Inspections Department
5431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977