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AF - 35388sue�ecT PERMIT NO. City of Fridley � 12914 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEIPT NO. � • COMMUiVITY DEVELOPMENT DIV. , ��: --.___, �9/0� ' / 1 � � PROTECTIVE INSPECTION SEC. 1 = i � /'��l � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �----� � •'� 612-560-3450 910-F15 � � 4 24 75 JOB ADDRESS 6180 Benjamin 5treet N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 4 Rice Creek Estates SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Briax Homes, Inc. 10134 Central Avenue 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. B USE OF BUILDING Residential 7 CLASS OF WORK �7 NEW � ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' x 45 ` Dwelliang and a 24' x 26. 3' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: 14?' South of Manhole (Inv. 906.11) Wye Elev: 906.70 Top of Footing: 910.20 Minivaum R�' � WATER LOCATION: io.5� soutii of Sewer Service Before digging call local ufilities TELEPHONE - ELECiRIC - GAS Etc. REQIltRED �Y 9.�,i�f SEPERATE PE-�iVIiTS R�QUiRED FOR �V�R1N�9 NEA�'iNG, PLiJM�iNG A(V►� Slt;NS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING 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 OR WORK fS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 32,350 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $31, 500 I.S. %S PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION TH PE MAN ._ F CONSTRUCTION. yS,`S9.SS 325•OO �. PLAN CHECK FEE TOTRL FEE . � $400.60 SIGNATUREOFCON7RACTORORAUTHORIZEDAGENT I TE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �� `��K�.e.�ic..v�i � � 71Y SIGNATUREOFOWNERUFOWNERBUILDERI f�ATE) BLDG INSP DAT v a � \ � � , t ., ., . � �� . i ' r�'-' _-� " � ��` _� ��--..y CERTIFtCATE O��URVEY � . t > � FoR: Briar Homes,1 �Inc. � . � ' a � ��'�� ' ' . � ��#�f� di�i�g c'all loeal utilities tr , '�E�� - �LECTRIC - G�S Etc. � . ,� _ ��tRED BY LA�/ _ � �,: , . � , ."9, � 2.'rJ _' I . � �� ❑ a ., /�/� � �Z�.W b� i IS . � ,. ,�� ' �, 1" �:�� , i � a .'` I d � , ' n r - I� _ I'� . gL ° 'O � 'Io,�, i v o Iut y ,�.r: � �+�► � N Z.. , . r�- i ± � • . , ' � _I ;� , � r-- � % . } �+W } . �sh � • i� W Q� ' � Y � �� •;` � M''� � . � � ' bI n � Ig J � •_ ,. . , �CQ•�1V ' " -.� � .. ., 4 ' .. � , � . ' . � ��7 ��T . - - . . . '_ . � ' . -. .8 • 8: , . I,. �. . .. � � ' . .� . L . [ C . . . . .. � i. . �P. � � o , Deno�es Iron Mqn�m�,nt � , . . • � ' Description: Lot 2, �Blpek 4, k�ICE '' '' , CREEK ESTATES, Anoka County, Minn: ,, , -� � . � :�. ti . ' . � ' Y ' f� i ts. . . .. � . ,F � . - ✓r��.0 ,// �S'.S -C¢ c.+-a�,-/ . . a .' . c� � � %% �]"Ot�ln �7' l� I here6y certify that this is a true and correct 'represe�tation af a surxey of Job No. V LII Ol�li'L�P the boundaries of the above descrihed land and of the Io�atiQn Qf all buildings, °�� , z.os if any, thereon, and all visible encrQachrrients, ifi any; from or on sai�} land. � �I�L/'U6i�0/'� ' ^ Book -- Page L.in�1 Surveyiny • Site Planning As surveyed by me this ►`� day of Apri� , 1� ��. � C�vil Engineenng • 8816 1@th Av. N. II 94 at Boone Av. N.) ---- -��'"�`'l `� Scale � Brooklyn Park, IVIN 55428 . „ Phone: 533 �340 ,. . Minn. Reg. No. 10944 -�'� ''aQ' � s �` _�._ � , . ,, . • _ � � , __ �.�. � __— _ . � �� g S e � �' ��. �, �.�ru ✓, � � � � , l l � � y � y� ��.� � ��, �� a ;; �L�� F �� T�� - 9 /o r � � : �,��,�v,� � � � � � 10 _ � �. �� .�� . � � �°� :. :, - � . �- � � � � 7��' .. _. = : , �. � R ; . � � �' �. � � e � ;• ° C� � >-�' �(e� e �- `� � � �° �e/ �. � _ . ,, . � . ; ; : , :� : , � � . ;, �.� , , :h �,, � e °k i' �, '7 � � � i � • � �, i �! �� 4 ,. �,� {, ,, i, ;° ; , � " 1' I' , ,' 1 � �> ! ': . t d ' � �+� Y I • . �, �, r at � �. r �� t� 'I ' e _. $ '� v , w� o 'i A �--s APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllllI'TiON BUILDING PERMIT CITY OF FRIDLEY, b�INNESOTA OWNER' S N��,�{j ��,�.yk, �C� BUILDER t <<�y�� ADDRESS :��li� ��►- �iu3-�-��'1�-�`.— � ADDRESS ; " NO:. STREET LQT s�,� BLOCK t � ADDITION ;�`� ;� V��,w,�� CORNER I,OT: INSIDE LOT:�SETBACKo,� SIDEYARD: ��'� Applicant attach to this form Two Certificates of SurveY of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING `' �To Be Used As : '� � '�� `c,, ` � � �4�� Fxont: � Depth:_�`°� Heighc; �, �'�� ,r Square Feet:-�� Cubic F�t: _ ��p.��d� �1�, � v-��,'�� _ Front • Depth : �� He3ght • `, � Square Feet; Cubic Feet: � 3�4 � � 7"ype of Construction: �'�•� ��}r''�,� Esti.mated Cost: To Be Gomgleted: _ � � � � � � � ��C� C� The undersigned hereby makes.applicativn for a permit for the woxk herein specified, agreeing to do all work in stxict accoxdance with the Gity of Fridley Oxdinances and rulings of the Department oi Buildings, and l�ereby declaxes that all the facts and rep�esentations stated in this application are true ancl corxect. DATE : �� '� S iGNA • (See Reverse Side For Additional In£ormation.) �-�X 3 I, ��o �c .Sq� v,L ! �.��' , s �'t►N"' `� "�'L.� 3Sa ?G I.�a� � v 4 :. �' �_.__� �f7Ss�c� S�G. a . v � ' � ` c�� d.�� .� -�� =f � .. - BUILDING PEKMIT FEL SCHEllULE SECTION 2. The Inspector of Builciings shall, befare issuing permits for the e�cection of any building or structure, or foa any addi�ion t� any existing building or structure, or for any altegation or repairs to any existing building or structure, upon application therefore, require �he payment by the applicant for such permit of fees to the amount herein below se� forth and in the manner herein provided to-wit: UNIFQP.M BUILDING GODE; Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in svch cubical can�erits, Type 3& 5-$l.$5 for each one thousand cubic feetd ADDITIONAL INFORD�ATION For iche purpose of computing fees fox building permits, the cubical contents of any buildiiig or addition, is determined by inultiplying the ground area covered from a point six (6) inches below the floor line of the basement ox the cellar to the average heights of the uppex suxface or to the averager �height of the xoof surface of the main gable of a pitched roof. For repaixs or alter�tions to an existing stxucture, the fee shall be at the rate o� $3000 par each� five huxidred dol�.ars ($500.00) or fraction thereof. in the cost of all proposed work. In no case sha11 the fee charged for any pe�cmifi as set forth in Section 2 be less than $5.00. . VERIFICATION OF FOUNDATION NOTE: Permits for constxuction will be issued a minimum of 24 hours fx�m the ti.me of appli.cation, to allow for proper review of the proposed structure and of the construction si�e. A Certi�ied Survey of the lot, showing the location of the foundation, once it has been constructed, will be xequired before proceeding with the fraaning. CERTIFICATE OF OCCUPANCY R�,�,,, �,.�D�cation for a Certificate of Occupancy shall be ma.de ten (�.0) days prior to the use or occupancy of any structure for which a building permit has heen issued; and said structure shall not be used or occupied until a�'ertificate of Occupancy has been issued. ,. - _ � �� ya . .G ' t �� o a �- � � �. � � , f ' ��0 X�Z.� � . - �c � SO �1c t�, � .�-= I � 'Z� � 3= 11°1t � k Y � ' �� z� �' � �� Sa ; _ �3r x�a . G 3io . 3 ? _2 �n �� z�sb � 1 X S: � i Stl z � 3 ��C, � ; t _ .,:. - - z ��.s e� � �,s:;,. z.3x i,�a• • �.8� � t_ � �- , ' �o s s• �. r j{7�/ � � 1 � � . l 428,0� � � s�7 ,S� � .a o' f `� � � 1 � , � y i Y, i �: .. i � i � � � 0 � . �"e 0 M � ' � � � r� � � � � � � a M � 4 � � w � �� G ��o � � � � � � � � _ • I i� �"�° � � � � M �I► d► �� . I�� [ � � 0 � r, � k I I � � � r� � � � � M � � a A � � m � � � �'I � w � a° �. oa � � o � � � � � � � � � h � � � � � � 0 w 8 M � ti s a � � m � � � � � a � � o ��2 � -� ,� ,� R° R' � � � � � � � � o � � � � � ... � � � � � '� � t+7 � � x � o v' � � � ��04 8 � 8 8 N M tA V► �.,; �.,. i;!; � �, � � R' a �. � � ��$�� $� � R 4 � � � � � � • � � � � ' � 8 ' � � W��;o � 8 8 � 8 � r � � I � � !I G' � p C �C j� z m � �, �. j A II � � � � �� 7 � � � (j � � � a � � � ro � � ; �� ; j �� 'I x � j i � i � ' � � � �� I� i � ' n i ! � z I i � � . �. x 6 � � � � � �� 9 � � � �;�� o � � . u � � � � � Q � �p � O � « � � � 8 � � �« � � ;i � �� N � �� a � �. � �9 1 � � �y c7 - I � � ~� � !i � � � � c�e5 ��°p� .� o ,07. °i a �' �."° � � � � �� O " � � � "�� ,� � � �_.� �a�� p��a � c �� z �� M Wo ��i �� 5 � .. � � I� � \ 0 � � � � � � � � � � � � ,_� , -- � > =� A � _. �/�G ��,v�.9��N � C qlQ /3Tli HEAT LOSS CALCULATIOIINS DE�/1RT�ENT O! BUI�DIIIIQ�S VILLAGE OF CHAMP�IN' Weatherotrips �� Coastruc2io� Rlo. I�talation ` a Windows � Doore Refere.me� �ae. Wall Iat. Wall Cee7ing Ftoo� �7ooe Kind E�ow p��icd �'— Yee—No Yea— 0 19_ � Fl.�� _ Pl El� m L.ength Widelt �. Heigbt Fl.� Room i..e� Vblidth Eleight Windowa and Doors--Crackage and Area �indows aed p�n—�Cracjtage aod Arss tVldth Heisht No. o[ Llnul t. Ana WIQtA iL�1�At No. ot Lln�al tL Ar�a No. ot pane ot D��e 116ht� ot craclt p. ft. Na ot oaeo et mne IAehb et cnak �a. t�. Dnfiltration 9'3 e�(j ; �ess /93 '� Fzp. walD a ' Nec e:p. wail /p S f �� Ine. wall CeilinQ � l� Floor Total Btu. Required aq. k. E.D.R. or eq�. ini. W.A. Leader ana Fl.�Oko�%� r aom Lemgt6 Width �, Heu Windows and Doors--Crackage and Area w+atb xe��ec xo. oe L�oea� cc. wrea Na ot pa�0 ot paae ll�hb ot eraclt p. tt �Y 7 '2 � dafiltPation � 3 � ct� �� ,� N� �. �.0 In� wall , 3 l d Ceiling Floar ; a � � 7ota1 Btu. Coef. �tu Ia6ltration � � � � o Cdass �" O' S G �.5�� O .S Fap. wall � � Net esp. wall G l a' ..3 �� Ia� wall Ceiling Floor / � 3 /O / 3 � Total Btu. � Required aq. k. E.D.R. or sq. ina. W.A. l.eader area Fl. Room � Length Q/ideh Height R/indows and Doors--Crackage aad Area I Wldth Helsbt No. ot Llneal tt. Aret No. ot van� ot Dsas Iltht� ot eractc m. te. � In6ltration C.las� ,_ Fsp. wall Net e:p. waU Int. wall Ceiling �loor Tbtal Btu. f� E.D.R. or �q. ias.'RI.A. Leader area B�ll RequWed aq. ft. E.D.R. or �q. ini. WA. �.sa&r area Fl.I � ( l.en�c1, W� Hu Windows a� Doon--�Crael�age and Area WldtL ht�l�ht Alo. ot L1nea1 tt. Aroa No. ot pans ef pnn� Ilahb et craek w. [t In6lteatioa Glaa: Fap. wall Net ezp. wall Int. wall Ceiling Floor Total &a Requued u�. k. E.D.R. or aq. ins. Q/.A. L,eader area Fl.� Room I i.tngtl► Rlidth Windorve a� Doors--Crackage aad Area Wldth M�I�ht Na ot Lleoal tG Area No. of pana ot oan� Ilrht� ot ceac�c .e_ n D6Y Coef. Btu Iafiltratioa Glau Fap. wall Net e�p. waU da� wali Ceiling Floor Tocal Btu. Require� �q. k. ED.R or w. ia�. WA. Leade� uea BROOKLYN �RINTING i ADV. CO. �� t� y � � � . � �� • �. • O . � • � • ' • H � • • M ' M Q • � � . � • : . . . , � . � , . � • : � � � O � � . � C�' � . �rr A � � . � . • tA • r wa • � � 9,� H i3 r� n 7� x x � p' .. " g'° d ��° ., � � w :t � E e � E �i �o M n � C� ~ 'r'f �e � � .�.. ^ i"� � � � � x � „ H � �i M � � .�. '.7 h .x.. � G� C •� N � Pi A' � � C x � k x� . 0� c M ,`$ .� � � a 9 � '. , N y � � '� ' � � � • � � • vi —+I � . . . � � . � � . .. � 5 � � � � � � � t]' p � w � � � • • pQ 8 • • • • • �, • • • �. • • • • • � • ♦ � • • • / • � • : • • � • • • � • • • • � • • � • • (� • • • • • • • . • . � .. • • . � • . • . . . � 2 fl'1 0 � � O 1'— N x K N x x x x x k � N1 N N � N � W W � i.�+ N '� 8 w b �� S � $ � S � . p d► t�4 � fN d► f# d� N N I� a � � ! ! 0 � C � . O t~ tl i � � r �i � � � � � � i � � � ❑ �� A O a � 0 � v �Y • ( p .Ir. 'w Iry "'' W ! ��' i a a x � iStoriea X _ � � � w�tt� � � �x,oscTs � S vacw�s � b �ATN R � .,ms o �i a p 9� ` .+w►s $t7 S�HKS a _ �. � wws+r � I tMYS �7 �0 � � � b K a �' ° � " � � c a a � �, � � o ; o " � a � � p n ti E. � � • y � a � ~ a � �\ N � �' � V � � � .:� � -, 7. �' a � � � n o c� �, =' � � � � G 0 � Fl .x 0 � \\, V ORI►1[. lOUNT. �� , y�1N�, � /�.��A � OMtNS UTCr� dASiHS AiliO w�. otis �rvt. c�s ' RANG[ c�s OPfNINGS .. 2 • � N Y n P A } O. O. � 'O Y `� � �� o ,� „ .. ~ p a � � N at � '�o�q, L '��' � � c�~i '� N � � � H�+ � C� tJ (y f�9 .i. O .� a � � � A k � � � � � ��a � � " �x� ti��m �� y b �W h �. G Cp.'. � N �W �7 W y C 0 (9 a ^ � . O � S � O � � �C N � � ��H� a� =� � " � �� 'u � R �� " Q H � �� w. A `1� .a' (� � , n � 3 � !. � � � � . � � � � a N �O � � � 7 � p ti ao �� '�f :i � � a. '��' .... �� • � Q. � � � � � o � .« tA ' � qa � �' ~ w`,� � � �,r�j O � Q � ra 'v A �• �° �. �, . �' � � � � � , • .• � . 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M O ~ Q. � u v' � � � �� p �°° p a ~��' Ctl ��'nm 0 w �xK � � � � m y ti C. 0 ) �°'oo 5' y O L � �'�'+ A a 1 � n �' W � �. � � � ap�'� �� a nR ��o �� ~ M �• A m I� �2 � � w, . - - � C � � tl eM � ..� � N a� , � O II N O I 'z �� i p y � � � I, ~ � I � :a � a � . v � M w� � 4 9 d . '� , °� � �' � � � � � � . � � � � O � sw \ O. M � � � � r o � � v � � � � �// �� SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I i ` ; `L _ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECT�ON SEC. , _ . �� "': � CITY HALL FRIDLE� 55432 NuMBER REV. DATE -°-� � �•� 612-580-3450 9/20/76 910-F15 JOB ADDRESS ° 6180 Benjamin Streei N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 2 2 Rice Creek Estates 2 PROPERTVOWNER MAILADDRESS Don T. Hansen 6180 Benjamin Street N.E. 3 CONTRACTOR MAILADDRESS SAME 4 ARCHITECTORDESIGNER MAILADDRESS 5 ENGINEER MAILADDRESS 8 USE OF BUILDING residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 8 DESCRIBE WORK finishing basement 9 CHANGE OF USE FROM STIPULATIONS � ZIP ZI P ZIP ZIP PAGE OF / / T. 13'76'7 CEIPT NO. �' ��. APPROVED BY SEE ATTACHED SHEET PHONE PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. C3� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE TO gEF�RATE PERMITS REQUIRED FQR �1tF�tt�� HEATING, PLt�MBING AwD �IGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, � rrt ur ��rvsi VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $CJQO.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFiMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � 7..r7O SIGNATURE OF CONTRACT R OR AUTHORIZED AGENT (pATE) ��T ��s.Q,�J °�?A-'l� iIGNATURE OF OWNER (IF OWNER BUILOERI �DATEI r OCCUPANCY GAOUP SQ. FT. STALLS OF OCCUPANCYLOAD CU. FT. �EET PARKING IGARAGES X .50 IARGE FEE 8. �� IS YOU,f� PEEiM1T lil l 1 VI 1 I\l.UI...L.,t APPLICATION FOR RESIDENTIAL ALTERATION, ADDITTON, QR REPAIR BUILDING PERMIT � OWIVER'S NAME: ��' ,jJ ` i ��j.Q,� $UILDER:_��I(J � �� ADDRES S t— �� D Ci �Q,K,\[�/1': t�pi �� ADDRES S: � I d I� ��2yJ�"�/�4� N�- JI i/V.'E_. � NO : . _ b ` � � S TREET : ��.�IV �i�AJl�i ►l� �!C'► � � E LOT: � BLQCI�.: _a r'�-- ADDITION �j(�? I�,YZQA�t ��'��, CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Zt�,o Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As; <. � -- �(,t� � � �. ��IU�'! �� Front • Depth : Height • Square Feet: Cubic �'eet: Front: Depth: Height• Squa�e Feet; � Cubic Feet: Type of Constructian: Estimated Cost: $_ jQ Q,�O To Be Completed: ��J,3 � �%.(Q The undersigned hereby makes apglicativn for a parmit for the �aork herein specified, agreeing to do all woxk in stfict ac:cordance with the -City of Fridley Ordinances and xulings of the D�partment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DAT� : � S IGNATITR� : \ ` � �� (See Revaxse Side For Additional Iniorm tion.) , �� ,� � :�l.��z�i ��-'�: . � ' � ,, � cc�_ . �� l _ , �� e a, �BUILDING PLRI�IIT FEE SCliLlliJLE SECTION 2. The Inspector of Buildings sha11, before issuing pe�.-mits for tha exection of any build.ing or structure, or for any addition to any existing - builda.ng ox structu�e, or for any alt�ration or repairs to any existing building or structure, upon application therefore, require the payment by the a.pplicant for such permiC of fees to the amount herein below set �orth and in the manner herein provided to-wit: �1EW CON5TRUC�LON: Sa.x�g].e Family Homes and Garages: $�.00/lOQO cL;bic feet PLAN CHECK: 25 percent of building perm�t fee. ADDITIONAL INFORTiATION For the purpose of computing fees for building permits, the cubical con�ents of any building ox addition, is determined Uy multiplying the gxound area covered from a point six (6) inches Uelaw the floor line of the basement ox the cellar to the average heights of the uppex surface or i:o the average.* �height of the roof surface of the main gable of a pitched roof. 0 �. Fox repaixs or alterations �Co an existing structure, the fee shall be at the rafie of $3.00 per each fiv� l�ur�dred dollars ($500.G0) o.r fraction thereof in the cost of al1 proposed worke � Tn no case sha11 the fee charged for any permit as set forth in Section 2 be less than $7.50. VERIFIC�#TION OF FOUNDATION NOTE: Permits for eonstruction will be issued a minimum of 24 hours from the time of application, to allow for propex review of the proposed stxuctuxe and of the construction site. A Certified Survey of the lot, showing the location oi the foundation, once it has been constructed, will be required before pxoceeding �aith the fxaming. CERTIFTCATE OF OCCUFANCI' Application for a Certificate of Occupancy shall be ma.de ten (10) days prior to th4 use or occupancy of any structuxe for ti�hich a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy ?�as been issued. � 0 ya � r � s b� G t7 M � v � m 7o C� - "O s ro -�o ��'" v�i ee x s r� y, � 5, r' � u � 7ao r~ 'rf n � o o f~7 t G lf �v " rT N p� r � ►r Crs1 ►t F� �1 7r '+7 M p. � p. �n 5 o h `� `r O o aC ta 7rt ° rt a o � �°f ►p- � % S a � o n .�-� ►�i �c � 'n O O � O '9 m n m � w dy M ? o � n N ro G x O � � � M � 1� .'7 f{ y 1 � O �O C G o ��o c rn x o �+ �. p, � � ° ,...� o s N a P~. O �poC o • K'Q O ` O W 1-' t�D O 1''� � n h uZi H � r =� o �� • H � n C � .�'„ p � � Vf �--�r o _ $ �°� � � . � � C- � . --{ , . �T7 , � C/) c� _ m . r� z c . o rn - x x x x x x x x x x x. x q f/1 . 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Fixt � p = z a m �s Ranqe O R L x � n other .� ' a s � E . d O b • 3 O R pp 4 K x Z o G� • a C 0 fA �q t�D c M � ' r� Z Q � m � s � ' z d � � a :; � . • �r v a +�no_ c� � o p. m H Y K�O Cf • -� � Q S 'C � --� A r� rt r o ►�tf b O Y 1� G N� M 3 LL Z � b 7 p. O� Y�J 7 O v m a►�s u r�t-- `T °s v � �p m a O. O m ar�sm � os'� � r� �f o � K ea •-• '�O ? 7 Q � � t7 0 ° �O �' a � � m m o � � � � �'►as o�C ° O � � � ~ p t'�i � � � r s R � � " �' �,°o � . � � r o c r � ,'a ,,oc °' l.r. a � � . r p. m o 7 r R R `�i � e'► .70 Y- O V] > m o � y m `* h, � '1 9 6 n n � rN �a o � y � ►~- m d 'O �� n a m -��l .°. ar � a o � � K � o r h p p r► O n rz►s - 0 n m � � . '� e s � s n n �r r � � r* � X ' 6 P ff 7 4- HOUS�,_ HEA�TING TEST ADDRESS 6].80 NE •��.�a �ln St' APT. — N OCCUPANT Dan T° a'rise.� OWNER. RECORD Base Fridle;� F�oo� cinr suBURa HEAT LOSS M— e aDS��HTG. INST. SOLD BY g INSTALLED BY � . Eleehical Work By Gaa Lina By �^� '� � TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OT jER '�'i�'eP�-af'� S DESIGPI CONVERSION MAKE �18g�'A� MAKE OF BURNER Modei �F' 2 �` `"2 Model Ssrial � " �� Max. BTU Ratiog INPUT 2� MAKE OF FURNACE Nlodel �n CONTROLS THERMO T T /vl '� � eat Plug Vent Size Valve �' KIND OF LINER S�ZF N�F Limit Draft Hood Regulamr Limit Satting Filters Size Number Fa� �ff��9 C�himnay Loeation Inside Outsida Pilot Type � ' � � �imney Construction Pilot Make Pilot Model ��"' ��' �'` Smoke Bomb Wj��9 Pilot Timing �-� �� a'�t Test Tag L.W. Cut Off Door Pressure Lighting Inst. �° '� — � � — e� Pressure � � � Pereent CO2 Date Tssted � � � � � Irtput CFH �- � Pereent 0 Company Testing 2 r Staek Temp. Percent CO Name of Taster Form 235 �G .Z � � � � � � � H W � V � 0 � �n N O H %i m t�] � � !�C � y H r� N � ro � t�7 � � � � w � r � � o a � `�C I � � � � N ro � � � r y o � O �.�. 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O 'A ' � , � � N �� o � K a �C n � W � fD a m � � �b F+� � M O tn ta tn tn tn tn tn tn � i � C H � � � � 0 ��} ' H • y i 'l ' O ' � H b�0 d � � � � � H t� � 0 � � r-► C �° 00 C H � � � D �1 �' � � a .� .i a n�i 00000 O O O O O t� tn tn v� tn � �A J �1 N y pOOO (r� O O O O 'Vi �Vl tA N O r � �� F�+o�° � r r � cn rn � a� a a ��n� K�N W r�S ww� J tD W N is O. O M MN W O W M � m w � � o0 � w w °" ►w-� �. �ro�� to � m � °'�"� a r � � � o �d �' � a a �n ►s m � � � �c►-��°.+ M 'J F+� � � � 'w o • ,a�m�� o a a� � K � � � y � � � � � � � � G t R � � a x ►�t �1D� � � � . � a�� BK�x � � a � � � ��5 a. 0 tt A�. �' N 0 � � � �� n`� ]� v � r n D --i O Z '11 0 � O � m �o a r-o .'V p O y C D --( � o = z D � � Z CA G7 -G � y � � �" °o �+ r � " t� C < � n ►-. m � ti -1 , 0 z � m � � � m a -i O Z a z e n ---1 -�G O T T � d r � � � ..� - q-. . a ^ � . `.. .t 5:.? rt• � -,� s;..-.,.,...:is� ( .,b.... •v'`'r.,,,,R..,,.r a ,. e., b$, o ,� r � . ,. q , ,�.�, .. r °cG" � Sat� -- ..,�.. r,�a�Ge . , . � � �� , ,m � , .�'�'6. �- .. , • ' . , _. . � . . sus�ecr PER ��y �f ��a��y � � �.� �. AT THE TOP OF THE TWINS g U I L D I i�l G P E R M Ir � ° . ECEIPT i �` ��_� COMMUNITY DEVELOPMENT DIY. iy � L � PROTECTIVE INSPECTION SEC. �� 1 �� r , , �l � �•"1 � CITY HALL FRiDLE� 55432 NUMBER REV. OATE PAGE OF APPHOYED BY - L��°� � ,�j 812-560-3450 � � 910-F15 �/21/t38 �oB aooRess h180 d�anja�ir� Strea� N.E. LOT NO. BLOCK TRACT OR ADDITION 1 LEGAL SEE ATTACHED DESCR. 2 i �.C� Cx'f'�E?�G ES'��3.'�4S SHEET 2 PROPERTYOWNER MAILADpRESS ZIP. PHONE Dan Ta Hans�n 6130 't3anjacnin S�tre.at td.E. 571-I.79�i 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. S o1TCt@ 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADdRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDINO Resa.den�ial 7 CIASS OF WORK � N�W ❑ ADDITION � ALTERATION � REPAIR � MOVE � REMOVE 8 OESCRIBE WORK �'1T13.BY1 bA. ±el2lCrit 9 CHANGEQFUSEFROM • TO • STIPUtATiONS znstcall smolce de�eector in hall.way in base.ment leading to bedrooms, ,�� ;� � �� ' �,�` . • �.� � ,�L> � ��-'\ SEP�2AT� PERt�1TS REQUIRED FC}R 1MIR!{�G., -`c� - �; HEAf9NG, Pl�U�18ING ��D S�G�lS, � " �,'�'J � r �� SEPARATE PERMITS ARE RE�UIRED �OR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPAIdCY GROUP OCCUPANCY LOAD YENTILATING OR AIR CONDITIONING. �1�00� �i'cZQI@ THIS PERMIT 9ECOMES NULL AND VOID IF WOflK OR CONSTRUCTION ZONING SQ. FT. . . CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTRUCTION OR WORK �S SUSPENDED OR ABANDONED FOR A PEfliOD 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 APPLICATIO,N �. STALLS GARAGES AND KNOW THE SAME Tp BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITN WHETHER SPECIfIEO HEREIN OR NOT. THE GRANTING OF A PERMIT y 5CJ7. �O S• �O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE ' SACCMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $.��,4 STHUCTION OF THE PERFORMANCE OF CONSTRUCTION. PIAN CHECK FEE TOTAI FEE ' $ i3. 00 SI6NATUREOFCONTRACTORORAUTHORIZEOAGENT IDATEI '1 WHEN PROPERIY VAUDATEO THIS IS YOUR PERMIT 7 _��t:�� , �--�t�,� j� c�..� � � � ` � � , ; � `T..�. <<:.. ,- .�.,J . ,,' -- + :� � - �. SIGNA�UREOFOYJNERUiOWNEH8ULL0ERi IOATEI BLUG �NSP pATE � . f 0 • � CITY or- i=1ZIllLEY . � � ' APf'LIC/1TT011 FOft fZL"SIll[:tdTIAL LUILDIPIG PER(�IITS . ' ��1�L"•W, �LTL"Rl1TIUt'�S, nDllITI0fJ5, OR REPAIRS) � � ; Oj�'I��R: _ ___! _ 1C� ' , �V�� I3UILll�R: � �o� � •.• , l�.ddzess: ��V . ��'J,q��t.1 �(, I�.,�Address: � Tel . 1Qo . � % l '- L� � � N'o. � � C�� Street:---�� f� � �%� �. c LOT: � }3LOCY.: � ADDITIOPJ : �� ,�� I � �� CO12I1ER LOT: IIJSIDE LOT: SLTBACY.: STD�YARDS: Ap�licart attach 't-o L-his form �ao Cert-ificates of Survey of Lot and proPosed • bui.lding locatian dra�m an these Certiiicates. . 0 DESCRI PTI Ol�d OF BUI LDI NG To Be Used As: � � • ��f�f.�-.�4{ ��l.��Fxont: Depth: • Height: Squaxe Feet: Cubic Feet: F�ront: � Dep�h: � Height: � Square I'eet: Cubic Feet: ' 7.'ype of Construction: EstimaL-ed Cost: $_�� xb Be Completed: �1�. p� Alt. B Pxoposed Driveway �r'idth If I�ew Opening Is Desired $ $ • (S� R�VERSE SIDE OF SHE:ET) The undersigned hereY,y makes application for a permi� for the work herein specif5.ed, agreeing to do all e��ork in strict accordance with the Gity of Fridley Ordinances and rulings of the Deoartment oi Buildings, and hereby decJ�ares that all the facts and re�.�resentations stated in i:his applica�ion are true and correct. See reverse side far aclditional infozmation. DATE: ( &TGNATUP.E: �� i ��.�C `� �� Stipulations: � � . �� , .� ---� � �'C1 � . - , , . i � BUILDIiVG PERt�1IT FEr SCHEDULE SECTION 2. The Inspector of Buildings shall, be�ore issuing permits for the erection of any building or structure, or for any addition to any er.isting building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applican�L for such permit of fees to the amount herein below set fortli and in the manner herein provided to-wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$14.50 Alternate B: Removal and replacement of concrete curb and � gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$7-�• 20 �11 � ' 1 �' : � For the pur�se of computing fees for building permits, the cubical contents of any }�uilding or adda.tion, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or 'to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 gier each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In�no case shall the fee charged for any permit as set forth in 5ection 2 be less than $7.50 plus $.50 state surcharge. ► � � � � �.�� •11 NOTE: Permits for construction will be issued a mini.miuu of 24 hours from the time of application to allow for proper review of the proposed structure and of the eonstruction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. ► : � � ' : 1 '� Application for 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 saa.d s�:ructure shall not be used or occupied until a Certificate of Occupancy has been issued. SUBJECT City of Fridley AT THE TOP OF THE TWINS gU I L D I N G P E RM IT ;, � � � �L __�_ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 = � � �"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. �'""'� � ,�� 612-571-3450 910-F15 JOB ADDRESS 6180 Benjamin Street N. E, 7 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 2 4 Rice Creek Estates 2 PROPERTY OWNER MAIL ADDRESS Jay West 6180 Benjamin Street N.E. 3 CONTRACTOR MAILADORESS 5ame 4 ARCHITECT OR DESIGNER MAIL ADDRESS I d'c,o PERMIT _ 19599 RECEIPT NO. DATE PAGE OF APPROVED BY ?/20/88 / � ZIP ZIP SEE ATTACHED SHEET PHONE 571-0139 PHONE LICENSE NO. PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK � NEW �J ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE 0 REMOVE 8 DESCRIBE WORK Construct a 12' x 16" Sc�een Porch Addition 9 CHANGEOFUSEFROM STIPULATIONS See notations on pla,n, TO SEPAR�►i'E ��l�N�l�'� RE�ElFREQ �4R' 9�IiRN�t�, l��tTilV�, P�U�Bi�� y �E��S. lNA�HiC�G �efore �i�ging cal( local utilities ��LEI'H�� EC�CTRiC - GAS Ete. REQE�� BY LA1� SEPARATE PERMITS ARE RE�lUIRED FOR ELECTRICAL, PLUMBING, HEATING, � rrt vr c;vrvsi. OGCUPANCY (3ROUP VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFS' I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURT AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2 �FjSO 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 C PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $S4.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TURE OF CON i RACTOR OR AUTHORI2ED AGENT IDATEI -�► �� zo/ � ` URE OWNER tIF OWNER BUILDERI IDATEI OCCUPANCYLOAD CU. FT. T PARKING GARAGES . 33 AL FEE $55.33 �_ �IS IS YOU I�1 [ ] � [] AL�R [ ] �nstructian Address Legal Descriptian:_ City of IYidley R-1 Ai�ID R-2 �,; � ding Peanit App]. icatia� EEfective 5/L88 Owr�er Nane 6 Address: C�i I��I Tel. #�7 1�° f, �� ntractor: ` ° �. � Addre�s: � Attach to this ication, a Certif 3cate a� S�uvey of the lat, with the pro sced oonstructiasi dra�m on it to scale. '`L'ESQtIFPION OF' I1�ROVII�:[�TP LNII� ARFA: Length Width Heic�t St�. Ft. � .� . Length Wic� : � Bei t ' c� 3�. I�t. D�cst �: L�gth Width Bgt/Gro�d �. i+t. �g� �CcLC�s� � 'k�R..l� IZ�(/�, '� t�l a- r��.�e ��D�� .�� Onrr�er Lot [] Inside Lvt I] Ft. Yd Setback Sic3e Yard Setbacks Zj�pe of Gbnstruction: C��o� ��t�� Fstimatea Cost: S t�(o�Zi Approx. ComFletion Date: '�� . Alt. A Alt. B Propcsed Driveway Width If New Opening Is Desired: S S Width + 6'� See Back Page n�: —20 �� ic�,rrr: Ae�i.t Ppe State Surc�arg�e SAC Ct�arge Driveway Escrow Park F�ee F ee Sewer !lafn marge 'l� ��UI�I�: s �/,� S �� $ S S � e� Tel. # (:QY OSE Qd.Y 1�1ee Schedule on Reverse Side 5.50/51,000 Valuation �550 per SAC Unit Att. •A' OL' Alt. •B" AbOV@ P�e Determired by Fhgir�eering ee Agreener�t Neaessary [ ] Nat Neaessary [ ] �6 � ��QV�- �.FS'�c� t �G °� �� ,� u ,� .. =.0 � ,. ' �+;w Y �� `N:i��. 1 �e Qiief Building Official shall, before issuing permits for the erection of any building or structure, or for any additian to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require �e payment by the applic.ant for such permit of fees to the amount herein belvw set forth and in the manner herein prwi.ded to-wit: �TAL VALUE S1 to �500 5501 to 82,000 52,001 to 525,000 525,001 to 550,000 550,001 to $100,000 5100,001 to $500,000 _f�� S15 Q�iinimtm F�ee is Sl5 plus surcharge ) �15 for first $500 plus �2 for each additia��a7. 5100 or f raction thereof, to ar� iricluding S2, 000 S95 for f irst S2, 000 plus �9 for each additional �1, 000 or fractioc► thereof, to and including 525,000 �252 for first �25,000 pl� 56.50 for each additianal 51,000 or fraction thereof, to and including 550,000 5414.50 for firs� 550,000 plus 54.50 for each additional 51,000 or fracti� thereof, to anc] iricluding 5100, 000 8639.50 for first 5100,000 pl� 53.50 for each additicnal 51,000 or fraction thereof, to and including 5500,000 a:�J,001 to �1,000,000 �2039.50 for the first �500,000 plus S3 for each additional �1,000 or fraction thereof, to and including .51,000,000 51,000,001 and up 53539.50 for the first 51,000,000 plus S2 for each additional �l,OQ�O or fraction thereof � �Concrete Curb Streets Only) Alternate "A": R�nwal and replaaement a� curb and gutter only - Driveway width plus 6 feet times 513.50. Alternate "B": Renwal and replaoement a� curb and gutter and install a 3 foot wide approach with 6 i,nch depth - Driveway width plus 6 feet t�imes �15.75. I�, �i . M �l� �l' a�.U� � : M �l� P�rmits for construction will be issued a minimum of 24 hours f rom the time of application to allaw for proper r�view af the proposed structure and of the construction site. A Certif icate of Sl�rvey of the lot, ehowing the location of the foundation once it has been a�nstructed will be required before prooeeding with the frmming. 0 �� ^ �� 0 . `' � .,�,�r.�_ ��., 9`,�. >> �' . �— _ �� a � � rj, ,.��,.,,� �, � -_ ; � �`- �- � . , �.- �� - � � �\ � �� a � � � c k� �'� �` � � '�.._ _`� �. �� - ''�- i ; i � ,, -- : . �, � � . , �i � � � �i � � �� . � \� I� � --.�\� �' � �� ` � �� O` �. � ,� ,, �, � . . 1 � �� t , 7 ,, � N -�� t� .,. � 0 < � � T� �= �'�- � � � r , 3 � �. � � � d . �� \ O �;,, �W � . . �b,� \ ,� /� � �� ,� . � � �-' � . �� t � �� > • Q` m � O a � �• :� F � , . .. � � �t � � � CERTIFICATE OF SURVEY F'�`� i i�.�� '; rr c::t: ild� ��, �nc . N •' �CV VV b i �c .i .w � I � � ° ! a�n . '_ � � lo � o , Q � ; �.9 O I � r ��, � ' T � ' zi.9 r , _ y � '`•. Fovndrition �+ d I H �,, .,' ` o . ��W , '•..12' 45 b�� G�( . _ 120.00 � � i5 � I °i �, ..�, � r ., I� � �D = i v I� �is ± I{ W �� r� � is 25 I i �i �i, Z �I Qi til W, 25 � I o Deno�es Iron Monument Revised 5- 14-15 To Sl-iow Founda��on ( �ou�n t C oui: fry � l�i �� i� Ol~.� . . ...,.�.. , � •�E•�i �� , � . ' . . . � ' �•. . :! � . . . . . r • . . F'.�' � . . •.''� 1,�, . ,. .�,i i s�i'1 `'�:.C:?'i: �1C;:. .O`., :', .'10C''r� �r, z.,C�' L... I_t{ i..�`;J�i:_, , r..:0:.« < OL;:.1: � �.11.':. 53 � � 4 %' G j� ' �" •J � ��.... �;. � 'r','i '��,;' Iln.� , .� !�.��. �'�f� �.�ii�..�_r i�.,�ir ,., r:i1��1't �.�? .� �t::�...� ��t • .n, � .i� � . �i , �• ,, iv'.� , .��i � N�( I.��.�( ,a'i�l i�� ' l�� ,_1�.�.!iU�l �i .f�� t��.��1�1�r�j-. � .fi � �!i i� � . .�" 1 nl ��,:�h, ��•1.J�1a1 fini, �f�, � ��'�., ��(itil . , ,. �t7 I.:. . �� . ., �,� ,,, �,, �q ;,,:, ,, April _ ,��,5 Y [� � �� 7 , • ,,,�.�2-QiYlU-Q _. �S f Q�,.� . � �r�I . i�9� / �.' i' � �) ,6 �: ;� ..._ Z�.r7 _ .'_ S-�8 ��' � sue�ecT PERMIT City of Fridley � � � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ,J r � � , � RECEIPT N . � • COMMUNITY DEVELOPMENT OIV. r � L � PROTECTIVE INSPECTION SEC. � s`� � � � � � �O � � /"'{ � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVEO Bv �""'�'� �'� 612-571-3450 9�0-Ft5 8/1/95 / / JOB ADDRESS 6180 Benjamin Street NE 1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 2 4 Rice Creek Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vipin Rum.a.r 6180 Benjamin Street NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Suburban Roofing 13418 Crooked Lake Blvd Andover MN 55304 755-0423 20038 7 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) 2nd La er 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIH 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 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEHM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE S�. � _ � s SIGNATUAEOFCON'RACTORORAUTHOAIZEDAGENT IDATE� WHEN PqOPERIY ALIDATED THIS IS YOUR PERMIT �V� ��Z�� S�GNnTUAE O:OWnIEAiiF OWNER BU4DER� �DATE� BLD ��NSP Dti1E NEW ADDN ALTER [) Ll �) CITY OF FRIDLEY SINGLE FAMILY AATD DUPLEXES R-1 AND R-2 Building Pernut Application Construction Address: �� / � � S e � , �, � �r . Legal Description: � o �� .� o� e� C r a o-� Owner Name & Address: Tel. # Effective 8/ 1 /95 �� Contractor: _ �'�! �,¢SA o o ; � , MN LICENSE # Address:____�� `l �� sd � � d .�,� �� %�l� �I. Tel- � 7 �S- -a �� Z 3 LIVING AREA: GARAGE AREA: �ECg AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the progosed construction drawn on it to scale. I,ength Length Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Width HgtlGround uS � co G° a v � _ Sq. Ft. _ Sq. Ft. _ Sq. Ft. e� zZ S , Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ �� 3�C' °�� Approx. Completion Date: {Cost on Back) Uriveway Curb Cut Width Needed: Ft. + = Ft x$ _$ DATE: -�'S APPLICANT: Tel. #� S-'�- d42� Permit Fee Fire Surcharge State Surcharge SAC Charge Licgnse Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � ��s" $ 1,.�� $ $ �. L� L� $ $ $ $ $ �� . �7 CITY USE ONLY Fee Schedule on Reverse Side .�1 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $850 per SAC Unit $5.(10 (State Licensed Residential Contractors} Alt. "A" or Alt. "B" Above $450. � Conservation Pian Review F� Determined by Engineering Agreement Necessary ( ] Not Necessary [ ] �LTILDIN(i 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 payment by the applicant for such p�rmit of fe�.s to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,� $2,(�1 to $25,� $25,�1 to $50;000 $50,�1 to $100,�0 $1�,�1 to $5(}0,(�0 $5�,(�1 to $1,OW,� $1,OQ0,�1 and up FEES $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 $1,000 or fraction thereflf, to and including $25,OQ0 $349.75 for first $25,000 plus $9.00 for each additional $i3O� or fraction thereof, to and including $50,�0 $574.75 for first $50,0� plus $6.25 for each additional $1,0� or fraction ther�f, to and including $1Q0,0� $887.25 for first $100,� plus $5.� for each additional $1,0� or fraction thereof, to and including $5�,� $2887.25 for the first $5�,� plus $4.25 for e,a.ch additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,� plus $2.75 for each add.itional $2,� or fra.ction thereof DRIVEWAY DEPRESSION ESCRUW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus b feet dmes $13.�. 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 constcuction will be issu� a minimum of 24 houts 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 fdundation once it has it has been consbructed will be required before proceeding with the framing. Building [nspections 763-572=3604 �A� i � /�/�'� >ITE ADDRESS � i b � I'EiLS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATTON PROPERTY TYPE PERNIIT TYPE TYPE OF' WORK: BUILDIN� RESIDEI�TTIAL APPLICA'TION CITY OF FRIDLEY YOUR E-MAl �I�te �Vw1 � � �" � °� ❑ OWNER �ONTRACTOR NAME:� . �? �� ADDItESS: ,. � � ��t. ��Fi` F PHONE: `� : a - `°� � , ° � � NAME: �� I�,S� STATE LICENSE # C� S � � _ PHONE �— FAX FAIvID,Y/NEW CONSTRUCT'!ON EX}' DATE u rwaniivrv u vtitcnvrr�nnu ia,wlrvuvw� o 0 BASEIv1EN'T FWISH ❑ RQOF ❑ DRAIN TILE ❑ DECK � SID]NG ❑ OTf�R � SWIIvIA�ID�TG PC�L DESCRIBE BdORK BEING DONE: sS SIZE_OF I1VIPROVEMENT NUNBER OF SQUARES GAttAGFS PROPOS�ID SIZE: PROPOSED HEIGHT: SIDIIVG ❑ Vinyl ❑ Alem�inu n tm [j�'Odter 4 ' � LENGTH _ 0 HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATfACF�D GARAGE ❑ DETACHED GARAGE C1Soffrt ❑ Trim ❑ Fascia Pemui No.: � - - -. : � `' _�� 5'i�� .�'J � BJIDTH HEIGHT WIlVDOWS IN EXISTING OPENINGS �Yes �tJo A'1'IO OF. l OR FOR NEW OPENINGS-DESCItIBE SIZE OF ��7 ��25 ��'e��s f�a'Li �' ��%��'f /]�. OPENING CI-LANGES & ��e d,°�,t A � � .� �r �e�- �, ��i( �� TYPE OF WIIQDOW TO BE 1NSTALLED � NiJMBER OF�WWDOWS ATE,�d �-`'�IP J � �� .'['E�z°IP,��3Z BASEMENT REMODELING SUBMIT: 1. Fxistmg Ffoor Plan 2. Proposed floor plan 3. List of structural members to be used F� FOR IdEW CONSTRUCTION INCLUDWG DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site PlaniSurvey showing the �isting structures and proposed project. 2. Two sela of com�trurxion plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDIWG TF� COST OF LABOR AND MATERIALS: (USING THE 1997 U.S.0 FEE SCHEDULE) TOTAL JOB VALUATION $�J', �� `° OCCUPANCY TYPE Permit Fee Plan Review Fire Surcha.rge S�ucharge License Surcharge SAC Gharge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Toial Due $ g�l. �Z j $ $ -G� $ �% .OZ� $ .� � UZ� $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation :0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pemut and I aclaiowledge 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 Construction Codes; that I understand this is not a pernait 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. SIGNATURE OF APPLICANT o�` � .+ ��q � PRINT NAME C� .'YG �'��/✓ _DATE � �%�� Page 2- Bui.lding Residential Application BUILDING PERMTT FEE SCAEDULE The Chief Building Official shall, before issuing perrnits for tb.e erection of any building or structvre, or for any addition to any existing building or structure, or for any alteration or repair to any existing btvldi.ng or structure, upon application fherefore, require the payment by the applicani far such permit of fees to fh.e amoun.t herein below set forth and in tb.e manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for canstruction will be issued a m;nimum of 24 hours from fihe time of application to allaw for proper review of proposed structure and of the construction site. A Certifica.te of Survey of the lat, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv � � �,Ci,Z� �7,� City of Fridley 2 � Buildi.ng Inspections Department �,w 6431 University Avenue NE Fridley, MN 55432 763-572-36Q4 Fax: 763-502-4977 Building Inspections 763-572-3604 763-502-4�77 FAX DATE� SI1'E ADDRESS � � THIS APPLICANT IS: — U c� PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMTT TYPE TYPE OF WORK: DESCRIBE WORK BEING D SIZE OF IMPROVEMENT_ BUILDING Permit No. �� 0 � RESIDENTIAL APPLICATION Received By: �V� CITY OF FRIDLEY vat�'�jd�CY 4 EFFECT[VE 1-1-08 YOUR E-MAIL ADDRESS l►t'�C1 �'Y� t'CaZ � YU ►'l (% �� C O 1'n . OCONTRACTOR �� STATE�I� ZTir p�D�s; CITY STATE ZIP, PHONE STATE LICENSE # �.SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION FAX EXP DATE SIZE 0 ADDITION ❑ GARAGEiSHED ❑ WINDQWS ❑ BASEMENT FINISH i�.ItOOF ❑ I�RAIN TILE ❑ DECK ❑ SIDING ❑ OTHER � SWIMMING POOL ❑ NEW HOME CONSTRUCTION O ADDITION �IvIAINTENANCE/REPAIR ❑ REMODELING ItOOFING b� 2 NUMBER OF SQUARES'1 .J � GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING 0 Vinyl O Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes CINo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE � DETACHED GARAGE F'f BASEMENT REMODELING SUBMIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of structura! members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Trim - 1. Site PlanlSurvey showing the existing swctures ❑ Fascia and proposed project. 2. Two sets of construction plans 3. Energy Calculations LOCATION OF WINDOWS NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: f,, �. �,SI�TG THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ��l `� �� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ � � �,�, � See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ .,3(—a .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) � � 1 l0 Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge 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 Constru ti � that 1 understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance w' e in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT �' - PRINT NAME �;�q rl�etZ DATE OQ'� �I �i�d � APPROVED BY __ DATE ' Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official sha11, 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 provide�l to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for l�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 15i $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or � fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraction 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 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 framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 � 763-572-3604 Fag: 763-502-4977