AF - 35353� � '�`' ��
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N° '768
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vallage of �ri�iley, Minn.
BUILDING PER.MI�
Office of �TSPECTOR OF BUILDINGS
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Owner ` ���
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Architect Fridley, Difnn., ,r � � _-�- � � ' ' � - �'"-' , 19 � �� .
Builder _ �
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' �U��' i�OCATION OF BUILDING
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No. ��� �� � Street ��� °-'°"�� Part oY Lot
Lot Block Additfon or Sub-Division
DESCR,Il'TION OF BTJILDING
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Front .�� `n~° Depth r`'?� �' Fleight � Stories �'��Manner of Construct9on ���'"_� '�" __ __�
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To be uaed as � °�' �t ~E`°,� �°t ' r �'r�°� � � �° :;' To be com leted " � -; ��'° �- s� " -f �� &' Eatimated Cost
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Permit ie hereby grauted to ��' • '�- , +�°��'-�, �;- ��'� to � ��' a ��' �-�_--�-�---- -
the buflding �""�"`�`a� � deacribed in the above atatement. 'This permit fe granted
upon the espress condition tha.t the person to whom ft is granted, and his agents, employees and workmen, in a11
ihe work done in, arotmd and upon eaid buiiding, or an.y part thereof, ahall coaform in a,ll respecta to the ordi-
na.nces of Fridley, Minn., regardfng the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and thie permit may be revoked at any time upoa violation of a,ny of the proviaions of said
ordinances.
AGR��EMENT AND SVPOftN STATEMENT
In consideration of the isaue and deliverq to me by the Inspector of Build'anga of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above sei forth and according to the provisiona of the ordina,nces of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated b� me a�d conta,ined in the above pex�it are
true as therein stated,
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Subscri'bed and sworn to before me at Fridley, 1�.'innesota, this �•-� °�°�= ��"�
day of ��"���'�°�'"=� A-D. 19 ``�`� - � ��r� �.� _ ,�r°r � �;�_u�:-��"�;,�,;..�.,�,y.,� _
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. Reported by:
k. Name of Violators
7. Nature of Gumplaint;
8. Complaiat received by;
H E A L T H C 0 M P L A I N T
CITY OF FRIDLEY, MINNESOTA
Z. Addreas:
5. Addresa:
9. Complaint Referred to;
11. Rtport of Action Taken� (Specify date of action)
12. Report Made by:
. Phoae No.
6. Phone No.
. Date
. Date
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r�cx�c � Ci of Fridle , ;n*�. , �� � 01
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6431 University Ave. N. E., Minneapolis, Minn. 55432
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��: � May 4, 1971
p��• Midwest Federal & Bvrc,�n C°mn�ny B�� SAmP
Address 36L�7 Mrl.ix�.1,e.�Str+eet 1�I.E. Address S��
LOCATION OF BUILDING
No. _ 5961�, g�t �Benjamin Street N.�. Part of Lot
Lot ....�2.._._...._.__ Block 1 _.._._....._. Additian or Sub-Divisian Acorn.�iills Addi.-tian
Corner Lot .___...._.._........ Inside Lot � Setbaek Sideyard
Sewer IIevatioa
Foundation IIevation
DESCRiPTiON OF BUILbING
To be Used �s:
Wie��k Nou.se ._..Y Front � Depth �� Height _.._2$.t Sq. Ft. CtL F�
Front ..� Depih Hei�ht Sq. Ft Cu. Ft.
Type of Construction Est, Cost �$55Q _ OQ.. To I� Completed
In consideration of the 3ssuance to me of a permit ta construct the building described above, I agree to do
� proposed work in accordance with the description above set forth and in co pl3ance with all provls�tons af
Ordinances of the city of Fridley.
Tn consideration of the payment of a fee of $_.LQ.._4�_, permit ia hereby granted t� �ohn �a� o; _
to construct the building or addition as described above. This permit 3s granted upon
the express condition that the person to whom it is granted and lais agents, employees and workmen, 3a all Wo�k
done in, around and upon said building, or any part thereof, shall conform 3n all respects •to the ord3nances oP
I�'ridley, Minnesota. regarding location, construction, alteration, maiatenance, repair and mov3ng of build3li�
pyithin the city limits and this permit may be revoked at any time ugon viola.tion oP any of the provisions of said
o�cdinances.
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EIOTICE:
'ihis permtf does nof eovee 4he eonstrueTion, installafion for wiring, plumbFng, gas 6eafmg, aswer or water. Be surs to ses
the Building Inspecta� for separafe permi4s for iheae hems.
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Inspector of Buildings,
6431 Univ. Ave. N.E.
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�9CA'�ON F`OR �CKING P'ERM�'T
• No
Fridley, NLinn.;���y` 19,�
The undersigned hereby makes application for permit to wreck the building as herein specified, ag7reeing to
do all work in strict accordance with the City Ordinancea and rulings of the Department of Buildings, and hereby
declares that�all the facta and representations stated in this application axe true and correct.
No.
59��
Street
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LOCATION OF BUILD�TG
Part of I.ot Lot Block
a �
I}ESCRIPTION OF BUILDIloTG
1`owa, Add�tioa cr �ub-divi�.ion
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Fraat Depth Hefght Stories TYPe of Bufldiag No. of Taxes Paid To be Com leled
aad Construdioa Dwlg. �'nits P
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Owner _ �' � �'� S� �F nr� l �ddresa
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����'�L� li ST ��� d�a''�S.
Content : Cubic Feet Estima,ted Coat of OVrecking $ �7 � 0
Appruved by: `
�� •- =-� = —�- � � . . �ter & Sewer Depa,rtment
Utilities Notified:
.�-� � � C��
_ M�n*�ea,golis Gas Co. (date) / J�" 7)
tZ'itle) `'
Northern States Power Co. (date) ' J 7�
(Tit1e)
Northwestern Bell Teleghone Co. (da,te) ' 0'� l
(Title)
s���a
w:�s
GENERAL IN5TRUCTIONS
(See Copy on Other Side)
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GENEftAL INSTRUCTIONS
The foIIowing must be secured before wrecking germit will be iss�ned:
1. Tax receipt showing that all real estate ta.xes due have been paid. Dup-
licate receipts may be obtained at Anoka County Audtor.
2. Approval from the Fridley Water and Sewer Depa�tment showing tha�
bills chargeable againat the property ta be moved have been pa,id and
water connections have been discontinued at the curb line or at the
main. (See reverse side of form.)
3. Notific�tion to, and signature of utility companies :(See reverse side
of form.)
(a) Minnea,polis Gas Co., 739 Maxquette Ave., Eng�ineering Department,
Fourth floor.
(b) Narthern Statea Power Co., 16 South 5th Street, Application and
Extension I}epartment.
(c) Northwestern. Bell Telephone Co., 224 South 5th Street, Business
Office, First Floar.
1 i 250-8-58
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YF592'�. ,
SITE ADDRESS_�61 Benjamin Street N E
WHAT INSPECTED Fire Dama_g;ed_ arc 18. 1971
PRINCIPAL USES_ Residential Dwelling
TISE ZONE_ R-1
LEGAL DESCRIPTION
OWNLR Mr. John Ma.loy address 5961 Benjamin Street phone
AGENT addreas phone
OCCUPANTS
LIBI�O�DERS
address phone
address phone
adclress p�o��
CONSTRUCTION OF BUILDING Frame no, of stories
P�RMITS ISSUED ON BUILDING
AIMEI�SIONS OF BUILDING 24' x 26' + 12' x 21' = 11,580 Square Feet
r
SETBACKS � front rear sides
build.ing inspection-date March 18, 1971 inspe�tor 4�
���e�, ��� :
inspection-date tvlar�'�y,�� 1971 , inapectvr
electrical inspeetion-date inspector
fire inspection-date
health inspectipn-date
photos taken-date Ma,rch 18, 1971
ItECOMMENDATIONS OF THE INSPEGTI.ON DEPARTMENT
inspector
inspector
Cover Sheet A
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CITY OF FRIDLEY - INSPECTIO�T DEPARTMENT
RECORD Oi TI�SE INSPECTIONS SENT TO TIiE CITY ATTO$REY: date
RECORI2 OF T$ESE INSPECTIONS SE�TT T0:
NAME
ADDRESS
NAME
ADDRESS ,
$UILDING CONDEI�D FOR OCCUPANCY-date inapector
date inspector
LEi'TER SENT FROM CI7R A':'TORNEY T0:
0
ADDRESS
RECQrIlr1ENDATIONS OF THE CI� ATTORNEY
DAZ'E FOR NECESSARY PERMITS
DATE . WIiICH WORK MUST BE CONIPLETED BY
RECORD OF SUBSEQiJENT INSPECTIONS AND LEGAL ACTION
ti
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CITY OF FRIDLEY - ZNSPECTION DEPARTNIENT
BU I LDING RE PORT ^
DATEMarch 18, 1�71 INSPECTOx � i�s���� �
OWNER Mx. John Malov
ADDRESS 5961 Beniamin Street N E
EXTERIOR WALLS
SILLS
DOORS
WINDOWS
ROOF
CHIMNEY
SOFFITS
ACCESSORY
BUILDINGS
GENEBAL SITE
PRESENT CONDITION
Need ma.intenance
Need repaix
Need ma.intenan.ce
Need repair
Adequate
Adequate
Rear steps need replacing
MISC,. No fire damage except to
windows
CHANGES NECESSARY
sp
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CI1R OF FRIDLEY - INSPECTION DEPARTME�T
BUILDING REPOR A
DATE March 18, 1971 INSPECTOR
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OWNERS NAME Mr. John M�.1ov
ADDRESS_ 59F�1 �en ja_*nin Street N E
INT'ERIOR PRESENT.CONDITIONS CAAAGES NECLS3ARY
BASENII.+NT C�acked thru out. Failing at
Southwest corner.
FOUNDATION
WALLS
.1�LOORS
CEILINGS.
FIRST FLOOR
WALLS
CEILINGS
�'LC10RS
ADDITIONAL FLOORS
WALLS
FL00RS
CEILZNGS
CHII��iEY
DOORS
ruse.
�
Fire damaged
Living room and kitchen
burned through.
Beams and 1/3 of joists
burned beyond repair.
F3re damaged
Sagged and burned
Burned through a.nd 2 x 8"
over spanned.
Burn.ed through in closet. At
fire damaged.
Inspect if used
Need repair
.
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To �h� Ci-�y of F'ridley
.Tu1� 30: 196�
�Je tY�e unc3�rsior.ees bel; evc: trie Iaquse at 5961 }3eri jami�n Street
Northeast, Fri�ley, P.inn�sota as l�.a�aidously a��°1 1�a�alt�i-��rise
unsafe f'or human iralaa.bitation and t�iat is d�es rot live iap '��
the latia.�c�in� ce�s�e of Ia'ri�ley.
�:Je «ant tl:e Inspection De,p�rtment of �'ri�3ley te irispect tlze
inside a�zd out��,c�e oi �96], Benja�iin Stree� Nortliea�t, Ii`rirlle�•,
rqinn�so�a and �ct accflrdingly.
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Building Job Report �
ADDRESS
OWNER �� ��
BUILDER � � ,� j - ] ��.�p
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DATE PERMIT NO.
DESCRIPTION�� �� � � � � ��, �',/,
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INSPECTION RECORD
DATE REPORT
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OWNER - REP. INSPECTOR
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I
City of Fridley
AT THE TOP OF THE TWINS
;�
; `L _ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
� S �
�� �"'1 � CITY HALL FRIDLEY 55432
""� � ,�� 612-560-3450
sue�ecr PERMIT NO. ,
BU ILDING P R •" 139�
E MIT
RECEIPT NO.
NUMBER REV. DATE PAGE OF APPqOVED BY
910-F15 2/22/77 � �
JOB ADDRESS 5961 Benjamin Street N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 2 1 Acorn Addition
2 PROPERTYOWNER MAILADDRESS
Cedax Ba.y Builders, Inc. 1700 - 3rd Avenue N.W.
3 CONTRACTOR MAIL ADDRESS
Same
d ARCHITECT OR DESIGNER
5 ENGINEER
MAIL ADDRESS
MAIL ADDRESS
SEE ATTACHED
SHEET
ZIP PHONE
Z�P PHONE LICENSE NO.
ZIP
ZIP
PHONE LICENSE IdO.
PHONE LICENSE NO.
8 USE OF BUILDING
Residential -
7 CLASS OF WORK
X NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK °
Construct a 29.5° x 26` Dwe113.ng and a 21' x 26" Garage
�� � '
SEPER�4� PERt�l�S �REQUIRED F#� IIli1RING, ee�� di� r.Ni � m
9 CHANGE QF USE FROM �ei • i � iVi�IMii! A�ii► d1M�t�!► '
STIPULATIONS provi,de a verifying survey before capping. Provide sod in the front
and side yarc3s. Provide a hard surface driveway. Provide truss design.
SEWER LOCATION: (Approx. 16' Deep) 100' North of Man.hole (Inv. �� 950.35)
WYE ELEV: 950.81 with 4.50 � riser = 955.31
TOP O�' FOOTING: 958.81 Minimum
WATER L�ATION: 10.2' South of 5ewer Service (Exi..sti.ng D/W apening)
�
n� cm o� Fwo�r �o�s rresT c�v� n�� �-1MPORTANT--�
tiCGU�GV oE u�.liY I�CAftONS ANp ELEVATi�. �,, ND��y �{E FAIDCEY ENCR.
T::aS OAT/l i8 fGR lNF4iZMATt4N PUl:POSES �,� � p�y�Sy�N REQ�ARp��G CUR�
�� � � �� �Y � �� REMOVAL AND REPI-ACEMENT
OM ill� � AT DRIVEW�►Y OPENINGS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING', HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. �ppd Fr�IIle
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFUCTION 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 R�. �.4�.4 + 546 2%�4%2 TO'ta
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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 TYPE OF WORK WILL BE COMPLIED. 40�445 $`ZO.22
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OH LOCAL LAW REGULATING CON-
STR ION OR THE PERFORMANCE F CO STRUC O� N. ' $�-O9 . S9 $375. OO
\/ �'•-''C� PLAN CHECK FEE TOTAL FEE
J� $27.47 $532..�8
ATUREOFCONTRACTORORAUTHORI2E0 GENT IDATEt WHEN PROP RLY VALIDATED THIS IS YOUR PERMIT �
. %) d � �,_L`l �irin_,. / �� 17-�77
1 DATE)
:�
1
C I�1f OF FR I DLEY
RPPLICATION FUR RESII3E(UTIAL BlJ.ILDING PE1�IITS
�NE�1, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWN�'R' S N�ME • BUILDER: .
> �
ADDRESS: �j ` ^ r
ADDRESSt—� ��G �– �':� �� �� �iil�
,
TEL. NO. : ,.,�.��,
�vo : . s��x • .
LOT• BLOCK:_ j ADDITION;
0
CORNER LOT: INSIDE LOT:�^SETgACK:
. � � STDEYARD;
Applicant attach to this form Two Certificates of Su� of Lot a.nd propased
building location drawn on these Certificates. '
BESCRIPTION OF BUILDING
'' To Be Used As : g�, G �
oZ �
-�—�
Front: � �-- Dep�h: � Height; ° �
Square Feet; Cubic Feet;
Front• Depth: Height:
Square Feet; Cubi.c Feet:
2'YPe of Cons t�:uctioil : •' p o t�
�� - Est�mated Cost:�S_ ��,
• To Be Completed: �, ��,, .,�
PROPOSEb DRIVEWAY WIDTIi IF NEW'bPENING I5 DESIRED �lp �
, �� �,
The undersigned hereby makes applicatinn �or a pexmit for the work h�rein
spaciiied, agreeing to do all work in st�ict accordance wi�Ch the City of
Fridley prdinances and rulings of the Depaxtment of Buildings, and hereby
')daclaxes that all the facts and representations stated i.n Chis application
� are true anr� co�rect.
au' � r
�
DL�TE : ..._ �i � `7 � S TGNATURE :
� �
(See Reverse Side Fox Additiona.l Informa�ion, ) ��A��, � e� 7`i ��5°
�,,,�t � /vg �� � ,,1
.�,�'l G� �,� �? / .
� � .
.�d, z» �. .
'
5•4�, • � �',�°� o a � . ��� r i � � ��-� � t� �� /� �
1
. � �,
;r... ; i �,� A. « '°'�.
_ �,`'`�'' n'���.�%r` " �. .
/ . . . �_ ,;:.-: .... ' .
e
BUILDING PERMIi FEE SCIiEDULE
•SECTION 2. The Inspector of Buildings shall, before issuing pennits for the
erect�.on of any building or structure, or for any addition to any existing.
building or structure, or for any alteration or repaix�s to any existing
building or structure, upon application thersfore, require the payment by the
applicant for such permi.t of fees to ihe amouni herein below set forth and in
the manner herein provided to-wit:
NEW CONSTRIJCTIOI3: Sa,r�g],e Family Homes and Garages: $4.00/1000 cubic feet
Driveway Depression(Concrete Curb 5treets Only): Driveway V7idth�plus 6 feet x$11.75/LF
PLAN CHECK: 25 percent of building permit fee_.
ADDITIONAL INFORMATION
Fox the purpose of computing fees for building permits, the cubical contents
ot any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches t�elow the floor line of the basement
ox the cellar to the average heights of the upper surface or io the average:-
•height of the roof surface of the main gable of�a pitched roof.
For repaixs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) ox fraction thereof in
the cost of all proposed work.
In. no case shall the fee charged far any permit�as set forth i.n Section 2 be
less than $7.50.
VERIFICATION OF FOUNDATION
NOTE: Permits for eonstruction will lie issued a minimum of 24 hours from �he
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing tha location of the foundation, once it
ha� beea constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application fox a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has'been issued. �
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!'OAITFtP.C'�OR W1TE g • '
Deter�in� ro�king squar� foatage of eaoh �•
1. Toxsl expo�ed w.111 area . . . ' D sq.ft. x �1� .. � � "i, � _ ,
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�+ ����w�-..��
c. Total aZiBing glaes d�or area. . . . . . . . .��� `�.
. c3. Tc�Z �irep�.�ce �ra.11 area. . . . . . . . . . . . �
r'• 'i�Ad�l t}"�j.i �ra�ing €11Q� (�4@YiQ� i���• • • • •
i. ��->tral asall (a�a•c) r.rea a've.•e floor. . . . . . , ' �
g. �o�ei rim joiet �ie3• • • r • • . • • • • • ♦ �
.. Tot�l expoe�d fonndation area� . � ! d � � '
...:►. To�atl fourn?a�ioaa wdn3ovr area , , . . . . . . , . l,�
,, i. � Tot�l net � ndation ar� abone gzade. .'.� ;--, _.�- ._
. .� � �•, ;-; � �, � -- 2. ��
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A ��t V" , / l � �. I � � �
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k. Total too!/ceiling �sa�ing area . . . .
1. Total net insnlatad zoo!/ceiling. ...
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o! 98C 6006(c)1. • •�
1►lt�s�nate Bnildir�g Envelope Da�sign � � �
�To ntilize the tatai aavelops sTrrt�a �ethod� ths valoa� ��tb�,i�hb
`' by the ao� o� ite�s 3 and 4 shal� nat be greater tt�$ tb� at� o!
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City of Fridley _ 1715�6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
; ` CEIPT .
� • COMMUNITY DEVELOPMENT DIV.
r i� � PROTECTIVE INSPECTION SEC. 9���
� _ �
� /'��1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""'"� � ��� 612-571-3450 910-F15 5/20/83 � �
JOB ADDRESS 5961 Benjamin Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 1. ACOY:YI. A[�l'tlOri SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
James R. Thill 5961 Benjam:i.n Street N.E, 571-0656
3 CONTRACTOR MAILADDRESS Z�P PHONE UCENSENO.
Same
4 ARCHITECTOROESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW �7 ADDITION � ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 40' x 20' Deck
9 CHANGE QF USE FROM TO
STIPULATIONS
�I�RNiNG
Before digginB caA �oc�t util�ios
iEIEPf{ONE - �LECTRfC - GAS Etc.
������,;�T'E PERMITS R�QUtRED FOR W{Rtl� �F�l1l�tFD gY LAW
��A"���1�, PLUMBINC AND SiGNS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTI�ATING OR AIR CONDITIONING.
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 $OO
OR WORK IS SUSPENpED 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 VALUA IqN SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED y�4�rJGO tiS`Z.ZS
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITPEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- yS`SO. SO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
�`52. %8
GNA UREOFCON7 ORAUTM i2ED G NT �DA7E� WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT
�
♦
� � aC�
SIG EOFOWNERiIFOWNERBUIL ERI l0ATE1 BLDG iNSP ATE
C1TY Of FRIDLCY �ifective �uq. 1, 1981
APPLlCAT1Qi FOf� RESIDCNTI/1� gUILOli�G PLRi+IITS
(HE+,r. Alterotions. Additio�s. or Rep�irs)
ONI�ER: _ ����5 1� �h, � 1 I
ADDP.ESS: � �`�1 �, I I� � v�n��n �'. �V. � �
TEL M0: �,,,��?� � .
—
BUILDER: ____�QIY111�l�dJJ �ln�n,,
ADDRLSS:
TEL N0:
, , Const'�uction Location
. szw�r t�o: q' srr�.-r: �
�
ZA'1'i . � ,Z�iiai ��
; w�� �
��,�, � � l 1s
� � • . �'�„�T� � �r ...� � � '� ' �
Cozne= Lot: �_ Inside Lot: ___�__ Cetb�ci:a ^_______ Sid�yazbs:
J1p?licant attach to t)�is fosm tvo Certificates of S1�rvey of lot ar�d
pzoposed buil�ing locatian drawn on certificates to scale.
• DESCRIPTIOit OF ODI�STP.UCT10q S�C �1��, Ske�'Gl/1
> > � �
��- Front: � Depth: Neight: � 2.s� "�'� !�
6quare Feet: � Oubic Feet: , �
, Front: DeptA: Hei9ht:
� 6quare Fe�t: Oubic Peet:
, ,�.
� ' f? o � �v P�.al� �-� ' �S7e"b
.
/�� 1. 08
Zype of Cbrst.zuetion s_ VaW►�u►i i►�`�' �pr�,b� �.�� Fstimatee Cost: ` ��
�j c •
7b Be Cbr.,plcted�� � Q! CQI PT p` P�' iYl+� ,
P
��t. �, ut. B
propesed Dzivc��ay l�idth If Ncw Opening is Desired: �' j
.__---_-_._,_ �_
, , . SE� R%VER;E SIDE OF SHF,�T �
si�e undersigned ?��reby mal;es app2ic�,tion foz a per�it icz the ��erk herein specified,
egzeeinq to d� ,all vork it, strict eccozd�ce aith the City of Fridle�• Ozdinances end
sulin�� of !he Del�►�stmc�nt of Duildi�gr, and ?�ereby declazes thr►t all U�e facts and
zepresent�►tiens stated Sr� this opplicatio�aze tzue and correct. _
a�rE: , � ��— _ sic��►zv�:
EtiPulations:
�,s � ,,5�
� ,�� o
� ��.°7°0
�
�
� 5
A n
�LIILDING PERMIT !EE BCHED�LE
The Iaspector oi Duildin�s s?�all, �efore issuiaq pezmits foz the
�s�ction oi any buildin9 oz struetnze, oz toz any addition to any
�:iatiag buildiAq oz stzuetusl, or foz any altezation os sepaizs
to.any •iistiny Duilainq oz atructnse, npon applicatio� thezefoze,
sequis• the paysent �y the applicant toz such permit ot.i�ss to iAe
•souat a�reia b�lor s�t fozth and in t?�e sanner bezeiA provided to-vit:
'i7R71L VJ1L[)A?IQJ
:i. oo ea isoo. o0
:SOl �ri i2, 000
i2.001 !+c t2S, 000
i25.001 to SSO•000
iSD,001 ta tl Q0,000
!'EES
i10.00 �linim� Fee 515.00 plus surcharge
f10.00 ioz the firct iS00 plus S1.50 foz each
�dditional �100�or fzaction tAereof, to ar�a
ir�clvaing i2,000
;=32.50 foz the fir�t S�•000 plus 56.0� for each
addittonal 51.000 oz fzaction thrseof, to and
1�elu din9 i25,QG0
i170.50 foz the tizst S25,�OD plus 54.50 foz
eaeh •dditional 51,000 or izacticn theieof, to
ar�d includiag iSO, 000
�283.00 toz the first t50, 000 plus S3. 00 for
each addi�iona� 52,000 oz fzaction thezeof, tc
ar�a incluaing Sioo,000 �
:100, 0�l ard �ap 5443.00 foz the. fizst s100, 000 plus S2. 50 foz
�ach additional s1,000 oz iraction thezecf
PL�W C�OC: 25 pezcent ot building permit �ee
DRIVD�tAY DEFR£SSION ESOtOid: Conczete Q�rb 5treets Only
111teznate 'A": Relacv�al and s�placr�o�t of c�rb and quttez only ,
Dzivevay vidth pIus 6 feet :¢l3. SO . �
111ternate •B's Reaoval ar,d rep2scw�ent oi cuzb ana guttez and � nstall a 3 foot
vide appzosch witA 6 inch depth:
Drive�ay vidth plus 6 teet x f15.�5 -�
VERIFICATIQN OF FOUNDATION
Pera�ita toz constsvctian vill De issue8 a �eini�r+�rn cf 24 houzs fzan the time of
application to allow foz propez zevier+ of the pzoposed strvctuze and of the
constrv ction site.
�1 Gert3ficate of �rvey of thc Iot, aharing the loeation of the four�dation once it
has been vonstructed Mill be sequired before roceed� with the framinq.
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sue�ecr pE
City of Fridley o 19 5 7 3�
AT THE TOP OP THE TWINS g U I L D I N G P E R M I T
;,
� � IPT NO
COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC.
� . � �� /�-3
' � ��"1 � CITY HALL FRIDLEY 5S4$2 NUMBER REV. DATE PAGE OF APPROVED BY
�'""'� � ,�� 612-571-3450 et0-F15 6/29/88
� �
JOB ADDRESS 5961. Benjamin Street N. E.
7 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 �. ACOYri Hill Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
James Thill 5961 Senjamin Street N.E. 571-0651
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Res identi,al
7 CLASS OF WORK
0 NEW �l ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOHK
Constxuct a 42' x 32 & 28" Deck and a 27' Round �I� Above Ground 5wimming Pool
9 CHANGEOFUSEFROM TO
STIPULATIONS gee plans for stipulations on deck. See letter dated 6/29/88 for pool
stipulations.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GAqAGES
AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2 � OOO $1. OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $45, OO
STAUCTION OR THE PERFORMANCE OF CONSTRUCTION.
P�AN CHECK FEE TOTAL FEE
$46.00
SIGNA Ui±EOFCONTRA T t o 2E nc�E T IDATEI � - WHEN PROPERLY VA ATED TH S IS YOUR PERMIT
� )
SiGN TURE OF OWNER �IF OW R BUILDERI �DATEI BLDG INSP nATE
l� t � �
�DN [ ]
ALTER [ ]
City of �idley
R-1 Ai�ID R-2
Bu3lding Permit Application
EEfee�ive 5/L88
Q�n.�ructian Address: � � � ,
Legal Descriptiai: �,
-_.. 1
Owner l�ne � Address: ��nNnC�� Il��n� l �. �
Q�ntr actor : L G�`Me ����i >> 1 Tel. #
C'r-: � 1 r� � . r' 1 �, �- r-� _ I �
Ac3dr�S :
Attacii to this appl ication, a Certif icate of S�irvey of the
lat, with the proposoed constructioai dra�m on it to scale.
�' •• �• r, •;� i� � • a �:� � .
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mrner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Rj�pe a� �nstrtiction: __ P U,YV1 2-i Fstimated Cost: 8_ � Ca, c� c�
Approx. cbmpletion Date:
Alt. A Alt. B
Proposed Drivevay Width If New Opening Is Desired: S $
� ^_ nw�ttj : 6� See Back Page
. �_
nATE. APPLICI�NP:
Ae�it Flee
state s'urcharge
SAC Cbarge
Driveway Escraw
Park Piee
Sewer lsain marge
�
�"�OI�IQiiS:
S pG�
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- ��r+ 7►,
Fpe Schec��le on R�verse Side
5.50/51,000 Valuation
$550 per SAC Unit
Al� '�+," or Alt. '�" Above
P�e Detenni.r�ed by Fingineering
Agz'Eement Neaessary [ ] Not Neaessary [ ]
A ?
=:�1 � �. ' �+:w M �� `�+:���. 1
7�e Q�ief Building Official shall, before issuing permits for the erection of any
building or structure, or for a�y additi� to any existing building or structure, or for
any alteration or repair to any existing building or structure, upon application
therefore, require the paym�t by the applicant for such permit of fees to the amount
herein belaw set forth � in the manr�er herein prwided to-wit:
�TAL VALOE
S1 to $500
5501 to 82,000
52,001 to $25,000
525,001 to $50,000
550,001 to 5100,000
5100,001 to 5500,000
_�� .
815 (Minimua F�e is S15 plus surcharge)
S1S for first 5500 plus S2 for each additional. 5100 or f raction
thereof, to ar� iricluding S2, 000
S45 for f irst S2, 000 plus �9 for each additional S1, 000 or
fractia�n thereof, to and irxluding S25,000
8252 for first 525, 000 plus 56.50 for each additiana]. S1, 000 or
fraction thereof, tro and includi,ng 550,000
5414.50 for first 550,000 plus 54.50 for each additional �1,000
or fraction thereof, to and including 5100,000
SA9.50 for first $100,000 plus $3.50 for each additic�al 51,000
or fraction thereof, to arul ir�c].uding 8500,000
�:�:J,001 to 51,000,000 $2039.50 for the first �500,000 plus S3 for each additional
51,000 or fracti� thereo�, to and including 51,000,000
51,000,001 arid u� 53539.50 for the first 51,000,000 plus �2 for each additional
�1,000 or fraction thereof
(Concrete C�rb Streets Only)
Alternate 'A" : Renwal and replacement a� curb and gutter anly - Driveway width pl us 6
feet times 513.50.
Alternate 'B": Renwal and replaoement a� curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet t,imes 515.75.
��+; � r: M ��� ��' a�.�l� � � �► �;�
Permits for construction will be issued a minimum of 24 hours f rom the time of
a�pplicatian to allaw for proper review a� the pr�sed etructure and of the aonstruction
site.
A Certificate o� Sluvey of the lct, stwwing the locatian of the f�ndation once it has
been constructed will be required before prooeeding with the franinc�
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CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
J�e 29, 198�
Mr. Ja¢ries Thi11
5961 Benja¢nin gtreet N.E.
FYidley, NN 55421
Re s�vimning Pbol Coa�structioaz at 5961 Benj a�nin Street N. E. , Fridley
Dear Mr. R�iill:
This letter is to ma]se c],ear this depar�nent's r�urements for the �wimming pool
c:o��struction at the a}�vve address.
1' ���t�� �e il) sk.imnex aPproved by the Natica�a]. Sanitation Foundation
will be provided.
2• As indicated, or�e (1) inlet of a�roved design for fresh and/or repurified
water will be provided.
3• The filter and pump shall be appraved by the N. S. F. and be of suff icient
capacity to provide a minimum turnaver of at least two (2) times in 24 hours.
This depar�nent reoannends a turrnver rate of 6- 8 hours.
4. A deck of at least three (3) feet wicle, measured froan the pool waters edge,
shall be pr�ided which exterx3s c�an�letely around a11 private residential pools.
AUwe grownd private residential pools may be provid�ed with decking of a minimum
size of 4 feet by 4 feet at pool entry points and provided that such decking has
the a�praval of the City.
5. Fencing or other effective means including but not limited to walls or
builcli.ngs, acceptable to the City, shall be pravided to positively control all
access to public and private residential avi�mu�g pools. Fencing shall meet the
follaving c�~itteria;
(al The fez�cir�g sha11 prevent t��e entx-ance of �ild�.en �nd � without hand or
foot tnlds that would errzble a person to climb wer it.
m) Z�e fen+cii�g s�iall be at least 6 feet hic,�i and entrar�ces st�all be equipped
with self-closing and self-latchinq gates cagable of beirbg locked.
(c) Self-closing and self-latchinq devices shall be placed at the top of the
gate ca otheYwise inaocessible to �a7.1 chilc�en.
(d) The opening between the bott�n of the fence and the ground or other
surface shall be not unre t��an foa�r ir�ch�es.
6 .
Jtu�e 29, 1988
I+�. Jaanes Thill
Re: 5961 Benjamin Street N.E.
Page 2
6. An auto�iatic chlorinator slwuld be provid�ed with a suitable test kit.
7• A7.1 electrical and pltanbing installations s�Y�all be inspected and appraved by
the City Inspection Depar�ment.
8. A11 overhead electrical lines must be a minirrnan of 10 feet horizontally frcan
the pool surface, and 18 feet straight line distance from the waters edge. An
alternative is to b�y said lir�es.
9. The pool fill spout must be protected by a vacuian breaker ar� ai�gapped.
10. Siiitable safety equipment to include but mt l�mited to a ring buoy and rope
that is 1-1/2 times the pool diaaceeter and sheph,erds crook pole must be prwided
and mai.ntained with the pool at all times.
Furttiernwre, these and any other requirements must meet the provisions of the
FYidley City C;oc1e, Sectio� 115, ,7winmirig pbols. The building permit is appraved
contingent ca� fir�al inspectians and appraval of the City.
If ariy questio�zs or prnblens ari.se fro�n this letter, please feel free to contact
me at 571-3450.
Sir�cerely.
i
G. C3�ARK
Chief Building Official
DGC/mh
� . s �
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� ' COMMUNITY DEVELOPMENT DIV.
i ►L __"'_,
r � � PROTECTIVE INSPECTION SEC.
� . �
i-.--� ��"' �,� CITY HALL FRIDIEV 55432 NUMBEF REV DaTE
� 612-571-345o s�aF�s 6!4/98
JOB ADDRESS 5961 Benjam.in Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 2 1 Acorn Addition
2 PROPERTY OWNER MAIL ADDRES�S ZIP
Marcel Eibensteiner 5961 Benjamin Street NE
3 CONTRACTOR MAIL ADDRESS ZIP
Imperial Homes 4196 Lexin�ton Ave N, Shoreview, MN 55126
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER MAILADDRESS ZIP
6 USE OF BUILDINO
7 CLASS OF WORK
8 DESCRIBE WORK
Demo deck
9 CHAN(iE OF USE FROM
STIPULATIONS
❑ NEW � ADDITION ❑ ALTERATION O REPAIR
ol
TO
Clean site of all demolition debris.
TYPE OF CONST.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHOR�ZED IS NOT COMMENCED WITHIN fi0 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD OF /20 DAYS AT
ANY TIME AFTER 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �SOO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION. �LI.00
1/ ��- PLAN CHECK FEE
�( �i� �--J License S
SIGNATURE 0:'COf1'RACTOR Oii AUTHORIZED AGENT 1DATE� . ...
STAILS
$5.00
PAGE OF
/ /
P�MIT NO.
26146
_`—''
RECEIPT NO.
��� �
APPROVEO 8Y
SEE ATTACHED
SHEET
4$5-5518
PHONE LICENSE NO.
483-5518 20014320
PFIONE LICENSE NO.
PHONE LICENSE NO.
O MOVE � REMOVE
�OCCUPANCY LOAD
CU. FT.
ET PARKING
IGARAGES
�..5�
�C CHARGE
Fire SC $.50
)TAL FEE
$27.00
7wIS IS YOUR PERM
- I � �vi���.�fir� �-5 -
SiGNATURE OF OWNERpF OWNER BUILOER� iDAT6 w� nr. tico � �,..�
�
NEw t ]
ADDN [ ]
�-� [ l
ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
6 l f� � �,.�-�.-�
Effective 1/1/98
I `°('�v
�'� �
�
r�
Legal Description: Z�-(- 2 �.�� j G�— (�.d,f �---
Owner Name & Address: �►� �,�^�--��- -- Tel. #'-�� S' S� I�
Contractor: � „�._,.,,� �,(�-�--�— MN LICENSE #� '
Address: ��/4'� C �-�V'-U— �-� _ �D. .��-=�--- S51zb Tel. # `�� 3 � 5 5/�
�,IVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Attach to this application, a Certificate of Survey af the
lot, with the proposed 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.
D.�.� �.�- � ,��
Estimated Cost: $ �.s D �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 6 - `( � �g APPLICANT: � `�� Tel. # �-/4� 3 - 5 SI,y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� �/. D�
$ SO
$ .S d
$
$ �- Od
$
$
$
$
$ �7Uo
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$10� per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
STIPULATIONS:
�, . �
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building O�cial 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,�1 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 $500 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,�0
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.
- F-.�
� ' ' SUBJECT . '
c�ty of Fridle�
�
AT TNE TOP OF THE TWINS g u I L D I N G P E R M I T
„
,�
COMMUNITY DEVEIOPM�NT DIY.
� ; V ����� � .
r � � PROTECTIVE INSPECTION SEC
� . ,
� _ �"'1 � CITY HAL,L FRIDLEY �Ia2 NuuBEe pE�
�----�: ,.� 612-571-345p 9t0-F15
108 ADDRESS 5961 Benjamin Street NE
t LEGAI �OT NO. 9LOCK TRACT OR ADOITION
DESCF. 2 1 Acorn Addition
2 PHOPERTY OWNER MAIL ADpqE$$
Craig Ryd 5961 Benjamin Street NE
J CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR OESIGNER MAIL AODRESS
5 ENGINEER MAII AODRESS
B USE OF BUILDING
Residential
7 CLASS OF WOFiN � '
6/24/02
ZIP
VAGE OF
� �
72
APPqOVEO BY
SEE ATTACHED
SNEET
PNONE
763-586-0242
PHONE LICENSE NO
PMONE LICENSE NO.
PHONE LICENSE NO
❑ NEW p ADDITION 0 ALTERATIQN � REPAIR O MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof House & Garage (18 Sq) Tear-off
8 CHANf3E Of USE FROM
STIPULATIONS
TO
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIREO FOF EIECTRICAL, PLUMBING, HEATING. TYPE OF CONST
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WQRK OR CONSTFUGTION �+pNING
AUTHOR�ZED IS NOT COMMENCED V�1ITHIN 80 DAYS. OR IF CON$TRUCTION
OR WORK IS SUSPENDED Oii ABANQONEO POR A PERI00 OF 12p DAYS A7 ''
ANY 71ME AFTER WORK IS COMMENCEO. ` NO DWLG. UN
I HEREBY CERTIFY THAT I HAYE READ ANO EXAMIN�D THIS APPLICATION 1
AND KNOW TME SAME TO BE TF1UE ANO CO�iR�CT. ALL PROVISIONS qF LAWS yp�UATION
AND OiiOINANCES GOVERNING THIS TYPE OF WQRK WILL �E CpMPLIEO @
WITM WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT W1,929
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CAMCEL THp pEqMIT FEE
PROVISIONS OP ANY OTHER STATE OR LOCAL LAW REGULATING coN• �69. ZS
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
UaE OF
nGENR �DATE�
� ��
E
�
STALLS
ROUP OCCUPANCYLOAO
CU FT
OFFSTqEET PAqKING
IGARAGES
SURTAX
$.96
SAC CMARGE
Fire SC $1.93
TOTALFEE
� �%Z.1�F
D THIS IS VOUR PE IT
� •��' ��-
NEVV [ j
' ADDN I J
a��R Il
Construction Address:
Legal Description:
Owner Name 8� Address:
Contractor. °—� V
CITY OF FRIDLEY
6431 University Ave NE, Fridiey, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATION
°t � � � 2rn r► C�',c 6V� � � ��
Effective 1/1/2002
(763) S7Z�604 Bidg Insp
�" �' c
Ill�
SS`���
Tel.# � ��- 5��+��
LICENSE # �
Address: Tel. # ^
LMNG AREA:
GARAGE AREA:
DECK AREA:
o-rHeR:
Attach to this application, a Ce�tificate 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 HgUGround Sq. Ft
� c' �o� �o� �� � �S CSZ� ���.t'� �
Construction Type: Estimated Cost: $ � ,��
Driveway Curb Cut Width Needed: F� + 6 Ft = Ft x$ _$
DATE:�� UI� C�"' APPUCANT: Tel. #� 1O� ^ J�b ����
Call (763) 572-3604 for Pertnit Fees if mailing in appl 'on or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
� � - �J-'
$ -
$
$
$
$
$
$
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conseroation Plan Review
Fee Determined by�Engineering
Agreement Necessary [ J Not Necessary []
TOTAL $ �� • I STIPULATIONS:
BUII,DING PERNIIT FEE SC�ULE
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 e�sting 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 $5(�
$501 to $2,0(�
$2,Q01 to $25,Q00
$25,001 to $50,�
$50,001 to $100,000
$100,001 to $500,000
$500,�1 to $1,OOO,QDO
I���.y
$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$1,000
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 $1 �,000
$993.75 for first $100,000 plus $5. � 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
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
Permits for construction will be issued a minimum of 24 hours from the time of applica.tion to allow for proper
review of the proposed structure and of the construction site. .
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing
proceeding with the framing. New Houses Onlv
foundation will be required before