AF - 36131City of Fridley, Minn. %� •� aS=? �SL
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Coiaer I.ot _�..___ L
3ewar Elevatlm .._.__.._
�ek .�7�.�......_�_ Sideyard ......__..,L�S......—+�.1--�•-----
Foundatlon Elevatl� ��P�.�_.__________.�—.--.—
DESCRIPTION OF BUILDING
T Uoed- � �� J�
: PYnnt �� DeP� -�'`'-�-- He1H1�t .,E_�.._.. Sq. Ft �v1.[� Cu. Ft�l+El1
—� ._ Fsan _� Death r ' t_._...� $q. Ft. _._.._.._. Cw. FG —.—.-
Type of Caash�letlon� `E�� ��_ Fst ������ ._..._.. To be� ComPleted .._...._.._..._.�...��
OUTSIDE APPEARANCE OF THIS BUILDING MUST BE OF
APPROYED VARIANCE WITH OTH€R BUILDINGS IN TH1S
BLOCN.
In conatderntlon oP the iseuance W me of a permit to ec
the� piropoted work in accordance wit6 the dpscrlpt[on above .
ordinaacee ot the dty of FMdiey.
pro�i�Is�iona oP
��
7a emalderati� ot the �yment of a Yee o! 5�---, D�'�t is hereby granted to�..----
to omsttivet the buiiding or addition as c
the expren candiHaai that theperson to whom� it is 8+'ented end !ua
�done in, asound and upon said buildtn6� �' 8RY P� thereof, shall
P'rldleY� Minnenota regarding locatl�. c�nstntetloq alteratl� ma
w1� dty limiffi and thia pernut may be revoked at at�v hme �
. above. Thia permit is granted up�
employees and worlan�, in all work
. in alt resP�s W the ordinanc�ea ot
e, repair and moving of buildinas
latioa oP a� of the prov3sioos oP seld
Bufldin8 �POCtor
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City of Fridley, Minn.
BUILDING PERMIT
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Owffir: _1`ir. James T�. McLaughlin Buitder S� —_..---_..-----
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Addroes �fi$2._8E4Pa..II��e_._N,E• _.__.._ Addme Same ._.__.�_._..—
LOCATION OF BUILDING
Na 7689 g� _Bacon Drive N.E. _.__._. Part ot Lot — __...._.
Lot ___1Z___ Block —_1 A._.-- Additloa or 3ub-Mvidoa ..._M�d°wm°or Terrace
Cm�na' I.ot _ 7ndde Lot —X-- Setback _—.._...---.- Sideyar8 ----��.._.._�
3ewar Elavatlm -----.___..--- -- Famdatia� Elevation .._.-- ---.--
1b be Used as:
Remod�l. Dinine 800m �t
DESCRIPTION OF BUILDING
DeP� �ight ..---._.._.. 3q. Ft Cu. Ft _._^
— .` Front --� Depth _— Height _...__ 9q. Fk �__ G�t. Ft
qyyp,� (�yl�� _ Frame pyt, � _�500.00 _.._ � be �p�� _,,._.,Ju1y 15, 1970
�---
bs candderatlon of the iaw�ance to me of a perm[t to conatruct the building
tha P�D�d work in accoordance wit6 the descriPtion above eet forth and in w
a�'dloenoes at tLe dty of FYidley. /��
l 1l1 /l�r1i /� � �A � _
to do
ns d
7n camdderat[on of the payment ot a fee oP;._S..AQ.—_._.., permit is hereby gi�ented to�'i'Ks . McLauahlin
the exBrees �tlan ihat t�pe���on�t �whom it�is 6+�tadh� hfa � 8s�tnPloYees a� wn'Imien.�in all w k
�dane ln, arastnd azd uPan eeld 1wi1din6� a' �1Y P� thereof� ahall ohBOtoam in all ieapecfs to t6e orc8neness aR
F+'»Y� ffitaneaola l6gacdit� lomtlon. cons4vett�. Slteratloo, �. regsit 8od moYinq ai
w�;w� oiq' �ts aod Uus permtt m�q be xevoked at aRYRY �e t�m v�7atlon oP aay a! the provSeims�
NOTK'�S
n4 p«Ne aa. we cerw th. ee.wsd.�, fw.WM. i« wYYa r�a ri �a wrn. «.rM.r. w.w. a,..
14 MMip I�yMer far rpvah padb fae fMe pNR .
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OiiNER' S ,
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ADl�SSS
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
NQ::' „< 6 9 STRSET• .CJ -�i CD'yC ` // Y'
M/ �
LOT:—� �—SLOCK: � ADDITION:,/ I �PGO� u� t,..> �, -�.. �� �-y� ` �
CORNEB IAT: INSIDE LOT: �/ SETBACR: SIDE7CARD;
Applicant attach to thia form lfao Certificatee of Survev of Lot and propoeed
bullding �ocation drawn on theee Certificates.
HESCRIPTION OF BUILDING
o Be Ucgd As:
e»t Odp��`'s2 J .
s.�1�1 �cs�rant: � Depth: ,--__. Height:
�� JG��"+ �`Ai�r5 /��
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet•
1j•pe of Construction: �"�'��( �'I � gstimated Cost:_ $ L7 �'�'
To Be Coipleted: �/ U ��/ �-y —�9%(j '
- Tha uaderai�ed heraby makee applicativn for a pesait for the work herein
apaei�ied, agieeiag'Co do all work in attict accordaacs wi[h ths City of
Pridley Ordinancet aad sulings of the Depar�ent of Buildings, aad heraby
daclases that all tha facts and represeatatione statad ln thia application
ar� trua snd correct.
L1ATS :
(SM ltsvesse Side Por Addition
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inepector of Buildings shall, before �seui.ng pexmite fox the
erection of any building or atructure, or for any additiaa to any existing
building or atructure, or for any alteration or repairs to any existing
buildiag or sCructure, upon application therefore, require the payment"by the
applicant for such permit of feea to the amount herein below set forth and in
the manner herein prwided to-wit:
UNlFORM BUILDING CODB: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. lype 3� 5-$1.85 for
each one thoueaad cubic feet.
ADDITIONAL INFORMATION
For the purpose of camputing fees for buildiag panoits, th� cubical content�
of any building or additioa� ia determined by multiplying the ground asaa
eovered from a point eix (6) inches below the floor line of the ba�ae�nt
ax ti+e cellar to the avarag� haights of the upper surfacs or !o th� averags.
height of the roof surfaee of the main gabla of a pieeired roof.
For repaira or alterations to an existing structura. the fee ahall be at the
rate of $3.00 per each five hundred dollara ($500.00) or fraction thereof in
the coet of all propoeed pork. ,
In no casa shall the fee charged for any pesmit as eet forth in Saction 2 be
le�� than $5.00.
VARIFICAT�ON OF FOUNDATION
NDTE: .Peseite for aonrtruction will be iseund a minimffi of 24 hour� fsam tha
tf1� of tpplication, to allow for proper reviaw of the proposed �tructurs and
of ths eonrtructioa siee.
A Certifi�d Susvey of th� lot, �howing the locatioa of the fouadation, onca it
}w,•been conetzuctad, vill be sequired before oloceadiaa vith eha framiag.
CERTIFICATE OF OCCUPANCY
Applioation for a Certificate of Oceupaacy Ahall bs made ten (10) dayt prior
to th� use or occupancy of any structura for which a building p��it ho basa
�t�uad; and �aid �tsuceura shall not be u�nd ar occupind until a Certific�ta
of bccb�taay La� b�en issued.
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�e�.:� .�::T£F44 � ��.,.��i=PPMENT QN. : . ��. �,.
� PRiSXEe�t�aN3kE(ii�tli:�C. ' � � ! ,,�.
-,
�,� ,3CIYY HtRLI. ._ FRfDLE'Y ��D�A3i NUMBER _ AE� -� WT( RA13E .-� OF NPRROVED BY
., ;s�2aeO�68� ..� �� �� 910-F15 �� . - 5iI5/7$�: . I . I .
'i�$,4:=$ao4ri tariv� �t.8.
, 1' Q. (.',, � . Bt�OGK �:. TRAC7DR ADDIFiON � . � . . SEE AFTnCHEO ; �; .
�,- ��S _. � � �$�OGAIKIOL -TBg'dCB:.� . . SHEfiT �=. .
�:+ ` Af�iRE3S � � � � ZIP -@MONE '�. . .
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768.9 Sapan �ive lT,E. �86-1351
- M�I�LApDRESS , ZIR ' � � . P-HONE.' ' .LICENSENO:��
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yl��SbNEq ��-� �Ij7'4qppqEgs .. . � :..ZIP ��� PXONE� � � uCENSEf10:� .
µj�,{�QpRE$$ . � . � �:21P � PHONE � :UCEN9EN0..
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� ��}. `l�tEW�� Q ADD1710N��� ❑ ALTEAATION �p'`##EPA#R .�.�MOVE ❑ EiEMQVE
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�,,.it'`2Af x '2+�` �Y e
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- . . � . .. . .: _�
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i x:
� •, �v,f�ide a hard aw�face drive.may. � ���
K nax�„ . . . . . .
2
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_ � ��~�� • �. F
8efore d+�S�S ca�i facat 4�+1� 5
� �RAAIiS �(�}fRED fQR ipFi#it�1►Gy fiEIEPHONE • ELECf R1G - GAS �•
����� �1M8i�+IG �fi1Q SlG�ti/g, �
R�QtliRED gY LA�
,: : :;
d175ARE�R£GU4REOFQStELECTRICAL,PLi1MBING,HEATINO,� �'��� �UpANCY6NOVP � irLiPK{�iCYI.QAD'
PFAIR. CQN�h�'�NfNti.� . �� � � .. �.
�CflMES uULC A'N9'-;VOID IF � W9RK pH f�Wd$iRUGT10N �2Q��� ~' S6.�F7. ��_ GU F7 �.
NQT COMMENCED`�NfITMIN 8(1 OAYS, OR (F C€>,N$TRUCTION ` - �.. , �
$PENi5E0 OR ABANDUNED FOH. A PEpipD AF �'�p DAY�9FT � ��
It.AyOR��:18 'GUMMi@t'�GED. � N8 ,�ViL.&.`; :' , OFiS7pEET PAW[fNG �
I�V THAT,] l,�y.Y� REAO AND EXAMINER THi$ APPI,IGATION �.: I. STf�:LS � -� 4&1i0.6ES �
�K�Q��E'spqJE-AM0E0RRE('.F.AELPROW$Iptd&QFiAWS y��,�qT� ;, . SURTAX
E�.64wERN�l6 iN1S TYPE OP K W+L, �6E..0041PC1ED��� � y�'4r�.��f `'.v, $2.08 '�.
,. ,., ,
a�VEf�'IFfEB.�fEiiE1N� OR NOT Tt1E'�� N7'f� OF� R#ERMIT � �. �
$QA�„R} Gt�}F AU�HORITV TQ yi66ATE OR CANCEL THE pERMISF�,:; $IXCCHARQE
ANV �OTHER 57kTE�OR LOCd4 EAW AE6AlLAY1NG CON- ' ��
iHE�.7EPFOHMIANCE�OP CONSTfil7GYIEiM, . - �`�•"',�`�'� �- r,-'- � -
. PLA GHE.�'.. � � T07AiyREE .
:°i . --�--- �2��
�e�iuwsn 'Y sucur - ro . . ,. ...., .,�...�.. ,..,_ . . ..
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�rY..�s4�� �:"F.�NSP �niE - .
_♦ _ _
• CITY OF F1tI1)LCY ,
' f !tl'i'LIC/�TIUi� FOft 121:SIllf_NTIAL CUJLll1PlG f'Eftl'iIT>
� f1'��w, I1��r�iznTions, AllllI710tdS� oiz R�rnias)
, �,����' '
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Ok;IJGR: \\G�[1�C�a a �� AUILllER: � �c� ""` "" �
Atldress• ��o�� �Cl,�0i1 �. Addre::s: .
Tel. No.: ����—I��.
No.. �
7AT: �� .
COILNLR_LOT:
5treet:
13LOCY.: _� I�DDITIOT�: �c���� m� ��}��•
I1�SIDE IAT: S;:T73RCY.: SIDL•'Y11RDS:
Applicant aCtach 'L-o this form 9WO Certificates of Survey of Lot and proriosed
bui.lding locatioi3 dra��n on these Certificates.
DESCRINTIOPd OF BUILDIIdG
To 73e Used As:
�_��_ Front: _�_ Depth: �� Height: �_ "
Square Feet: Cubic Feet:
I'ront: Depth: __ ___ Height:
� Square Peei: Clibic Feet:
Yype of CQnstruction: 1�J��C:1 �Qi�(��EstimaLed Cost-: $ �
To Be Compleied: � ��,� ,
Proposed llriveway SSidi:h If New Opening Is Desired
Alt. A Alt. 8
S $
(S�E R�VEFLSE SIDE OF SHL'£T)
The undersi9ned he�-eby n+akes application for a pe::mit for the �,+ork herein
specified, <-cgrceing to do all �:ork in stricL- accc+rdance �aiFh tl�e City of
Fridley Ordinanccs and rul.ings of the Dcgartr�ent of 13uildin9s, and hcreby
deelares Lhat all the £acts and representatic�ns st•ated:in this a�plicat:inn .
ax�e Lrue and orrect. See zevcrse si:de far aclditio�za i�iforni�tion. �� .
�/��� i7
DliTE; SIGNA�ror.i;: " V V \�Sl � � (��.
&ti��ulatioi�s:
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BUILDING PERI�IIT FEE SC'riEDULE . .
S�CTION 2. The Inspector of IIuildings shall, before issuinq permits for the erection
�of any building or structure, or for?any addition to any existing building or structure,
or far any alf;eration or rePairs to any existing buildinq or structure, upon'application
therefore, requirc the payment by fhe a�plicant for such'permit of.fees to the amo�.u�t
herein below set forth and in the manner herein provided to-witr
NEW CONSTRUCTION: Single Family Fiomes and Garagcs: $4.00/1,000 cubic feet.'
PLAN CHECK: 25 percent of building permit fee.
ARZVEWAY DEPRESSION: (Concrete Curb Streets Only) � � .
Alternate A: Removal and replacement of conerete curb and
gutter only; Driveway width plus 6 feet x 514.50
AlternaYe B: Itemoval and replacement of concrete curb and
gutter and install a 3 foott wide approach with
5 inch depth; Driveway width plus 6 feet x$1�•20
�1! � � ► �' : 1\
For the purpose of computing fees fpr building permits, the cubicai contents of ar;✓
building or addition, is determined by muitiplying the ground area covered from a
point six (6) inches below i-he floorrline of the basement or tha cellar to the
average heights of the upper surfaee or to the average height of the roof surfaoe
of the main gable of a pitched roo�. .
For repairs or alterations to an existing structure. the fee shall be at t'�e rate
of $3.00 l�er each five hundred dollarS ($500.00) or fraction thereof in the cost
of a11 proposed work.
In ;�o case shall the fee charged for any permit as set forth in Section 2 be less
i.han $7.50'plus S.50 state surcharge.
s
VcRI�'ICATIO�I OF FOUNDATION
130TB: Permits for construction wi21 be issued a minimum of 24 hours from the �ime
of appl.ieation to allow for proper:review of the proposed strueture and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been consEructed will be required before proceedir,g with the framing.
CtRTIFI('e({TE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occt�pancy of any structure for whi.�h a building pexmit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
a,, ,
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Permit by
Legal Descripticm � �
Blk
Acld'n
Value
SLAB:
QBy SUSSE�
❑ By Owner Approx.
❑ In
2-STARTING POthtTS ON LY
S.P.L. Alley
S.S.P.L. House
R.P.L: F. Street
Offier
� ❑Square With -
� Rods ❑ Mesh
❑ Sad Rem. - By
��� ��6BagMix ❑6-BagMix
� � Tamping ❑ No Tamping
❑ A. B. U.
�� Grade Point
❑ Conduit
❑�Blocks OBy�Owner �By Sussel
❑ Maintain S' Total Watl Height
- lncluding Blocks OR .
� ❑ Maintain 8" Wal) �Hei�t on
Top of Blocks
Block Size'(7op course)
� $., Q 6,. � 4..
Wall Height other than 8'
❑Frame with fuH wall height
sold OR
��❑ Cut studs as required for �
� OHD clearance � . � �
� ❑ O.H. Dr Offset � �
❑S.D. Location
❑ Windows
❑ Att Gar Roof Tie-in �
Drawn on attached pictures
Existing garage: No �
� Detached ❑ Attached Yes ❑
SiYe of existing: � Y
Existing garage wiil be: �
❑ Left as is �
❑ Converted to L.S. - By owner
❑ Removed By: Owner ❑ -
Sussel ❑
Junk Must Be Remnved By Owne�
❑ Specify removals by Sussel or
Ow�er - trees, bushes, etc.
❑ S�ow approx. dist. garage to
house and all. prop. lines �
Stzkes visible - ❑ Yes ❑ No
Survey available - O Yes ❑ No
❑Special insFructions from
owner.
WORK ORDER
HOMEPHONf:
NAME,C%%A��F� «2f���1/ BUS.PH6NE-
JOB ADORESS
BLDG CODE
SALESMAN CONTRACT DA7E SIZE
�UO�iSK � . FOR OFFICE USE ONLY .
CONTRACTOR Jag #
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. aussncow..�r.iwe
�/—, 1" x $" Ridgeboard
\ � �
2"'xs..
- 9afte�s
ROOF. GABLE REVERSEGABLE HfP
EAVEOVERHANG:
RAKE OVERHANG:
240�# SEAL DOWN SHINGLES WITH P�YWOOD
ROOF SMEATHING AND 15# FELT
� Plywood Sheathing
� /— 240# Seal Down Shingles
• 2•, x 6„ 3/8" Plywood
Cross Ties Gussets
1" x 6" W-Bracing 2"" x 4° Doubie
when applicable Top Plate
per Minn. State Code 'O `$
rvorE: P v�giNG PN
�Lt "�{'`r 4
1) Trusses set 48" O.C. tGusset - 3/��v�oodl.
2) Intermediate rafters are 2" x 6" 's braced with 2" x 6" collar ties:
31 On 18' and narrower garages, e�iminate the V'J-brocing and collar
ties.
41 Rpof approved by Minn. State Building Dept. as meeting Minn.
State Code Requirements of 30# snow load. Refer to State
Bu'rlding Code Letfer Number 35.
51 Hip roofs consist of 2" x 6° rafters, 2" x 6" cross ties 48" O.C.,
2" x 8"hip rafters and no plywood gussets are used.
RAFTERS: 2" x 6" 16" O.C. 24" O.C.
STUDS: 2"x 4" 16" O.C. 24" O.C.
WALL SNEATHING:
SIDING:
OVERHEAD DOOR HEADER: Double 2" x 72" with without steel
plate.
Slab on grade construction approved per Minnesota State Code. Refer
to State Building Code Letter Number 11.
SLAB: 4" WITH MESH 6" x 6" #10 Gauge
✓.A "' ..
-- \ L; �
� ,
45° .
� 4 �,
�i
3/4" Cove
Trim
Fascia
1" x 4" Sub
Fascia
Soffit
2" x 4" Studs
Siding
'h" x 7" Anchor Bolt
per U.B.C. ` `
2" x 4" Treated Bottom Plate
Grade Line
�. � ��������
NEW
ADDN
ALTER
,�-�a�3�
[] CITY OF FRIDLEY Effective 4/1/2004
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Constructian Address:
Legal De�cription:
Owner Name & Address:
CoMractor:
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. # %G� /�"� /—g5' �
,
MN LICENSE
Tel. #
Attach to this appiication, a Cert�cate of Survey of the
bt, with the proposed construction drawn on it to scaie.
DESCRIPTION OP IMPROVEMENT
Length Widfh Height Sq. Ft.
Lengfh Width Height Sq. Ft
Length Width HgUGround Sq. Ft
Construction Type: Estimated Cost: $
2
Driveway Curb Cut Width Needed: �Ft. + Ft = LFt x$� _$ 2�� ��
DATE: � �g-� APPLICANT: Tel. #
Call (763) 572-3604 for Pemiit Fees N mailing in application. Fax to 7 63 57 7-1 287 if using credit card and we will call
you for card number.
Permii Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$
$
$
$
$
$
� Z Y� --
�
�
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Aft. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ Z �f(� �
�
l � ��
STIPULATIONS:
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official sha.11, before issuing permits for the er�don of any building or structure, or for any
addition to any existing building or structure, or for any alteradon or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such pernut of fees to the amount
herein below set forth and in the manner herein pmvided to-wit:
TOTAL VALUE
$1 to $SW
$501 to $2,000
$2,001 to $25,000
$25,OOlto $50,000
$50,001 to $100,000
$100,001 to $500,000
$SOO,OOIto $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 atxi including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $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 i�luding $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fracdon thereof,to and inciuding $1,000,000
$5,608:75 for the first $1,000,000 p2us $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete C�rb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Permits for construction will be issued a minimutn of 24 hours from the time of application to allow for proper
review of the proposed shucture and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of S�rvey of the lot, showing the location of the existing foundation will be required before
proceeding with the frazning. New Houses Onlv