AF - 35553l� �
- City of Fridley, Minn. �
BUILDING PE1�.MIT No
Date: .._._.__! ._......._�. �. .. `..___.�---.--_l
Owner:
Address
A
4o�rs
1_ �
Builder .--`�'..�••--=-(--.••� _ .... ._ . _ .._ ... _.__.�/�°'_� C�
Address ........---•------- --
LOCATIOI�, OF BUILDING
� p , e.
No. ....._ .--��-�------.. s+�t _.._ - �-----_ . .. .. .._---��„�►.
�'(,�._..--•-•-----. Part of t _...._.._..._....___._...._._...._.._ ............._.........._.._._.
Lot ....._...........�1 ............. Block --�•----�--�---•-�-�.......................... Addition or Sub-Division ... .. ......
..... .. ......._. _----�---•---._...._.........---_.....__..._.....
Corner Lot .-- ... � .................. Inside Lot ....._................................ Setback �� .— ��_........ Sideyard ._l �..� �. �....ln/�`3 T �f A9�
Sewer Elevation
To be Used as:
-�- -� -- -- .� - --..�� ----��---
Foundation Elevation
DESCRIPT10fo1 OP �l11LDINiG
� � ./�7�"
a � 2 � e....'s //� /
Front �.�..�..:.�.� DeAth ��1�..`.� Height �.�.�..�:.� Sq. Ft <�llFd-....��. Cu. Ft. ._....... .._:_..
Front...------.......... Depth ...............�- Height .............._........ Sq. Ft ....._................. Cu. F'� ---
Type of Construction ....... . ................ .......�-----� -......_........ Est.
�-�
- ............. To be Completed ....._...........---.....
�
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In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed war�k in accordance with the description above set �or�i and in compliance�ith all provisions of
ordinances of the dty of Fridley. �� vj' ��/) _�
�'.�
In consideration of the payment of a fee of $..- .__.��..._�_.__.....�.._, permit is hereby granted to....._ ............._............._.
....---•--.._...---�--
----___._...----••---•--.--......._----....-------....-•----. to construct the building or addition as described above. This pernut is granted upon
the express condition that the person to whom it is grauted and his agents, employees and workmen, in a11 work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, canstruction, altera.tion, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ardinances.
Building Inspector
NOTICE:
This permit does not eove� the eonstruetion, insfaliatitm fo� wiring, plumbing, gas heafing, sewe� o� water. Be sure to see
4he Building Inspector for sepa�ate permits fo� these items.
4
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APPLICATION F()R BiT�LDING PERMIT �
CITY OF FRTDL�Y, MIlVNESOTA
.
.
Owner s Name t � � � Btii.I:iier '�� `�`�'� �.r�-��° '���'°<� �' _ �
� ...
� m.,��' �, �°
A�.dress._ Addx�ess ��°� —� .°� ° , ' � �' �
,, �� . . . . .
-:�t: :�. . - LOCATION OF BUILDING . � .
,�, �, �-; . _ � �,.
No. ... ��� S�.reet '����''�??��/ ��r-�-� Part of Lot
• � ,.
Lot _ � Block / �d.dition o.r Sub.I3iv. ��`��' � •
...; � � . � .
Corner Lot_�Inside Lot Set Bacls �� 5ide-Yaxd
., �:
SEWER. ELEVATION � FOUNDATION ELEVATION �
Applican� atta�h to. th3.s form Certificate of 3urv�:y of Lot and proposed bui].ding
.: ,,-,.; .. �
�OCB.'t7.021• �- .
DESCR2PTI�N OF BUILDIlVG
To be us�c� �.s : - . . . , ..
o� i �'�° �
l ��"�� � _ Front �� �� Depth �- � Heigh� . ��
Sq. Ft. � � � � C�. Ft. � _ .. : � . � . �
�
Fr�ont • Depth He3ght...
�. Ft. � ... � Cu. Ft. .
� � �
Type of ConstructiQn '��`��'r>�� ' , Estimated Cost �
-.��
To be completed. � � °m' � � `�� �'
.,
The undersigned hereby ma�ces'application��or a permit for the work herein specified�
agresi.ng to do all work in strict accordance with t�e �ity Ordinanees and ruling of,
ihe Department of Bu3.ldings, and hereby declares tha.t al��the facts and representa-
tions stated. in this applica.�ior� axe true and correct. _
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DATE � � ��� � ��, � . � % � SIGNATUR� �,e . , iA�'� a -��' -� �_ ,
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(A Schedvle of Fee costs can be found on the Reverse 5ide.)
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^'. : .. -� -_.- .. . �IIILDING PFR,MIT E`EE SCHEDULE
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Section 2. The Ira.s�ector �of�"Btxi�i:di.ngs�`�h.�.]-1.�``3�efore iasuing any permit
for the erection of ar�y building or atructure; �or �for any addition to
any existing building or stri�cture, o"r'�for any alterations or repFCir�--ts�r,,,,�
.. ;:.
any exi.s_tix�g,tau�lding or structure� upo.� appiication therefor, require �
the payment by the appYicant for such �e.rmi.t ..of fees. . to the amount-„-,.--. .._ . ._
. ---, ..... . .� , .
• .k��ein.,b.e.�ow set.:�err�h, and in the manri�� her�ei3i provided to-wit.
:...�.... ....... e , ::�:, ;, .:, . �.
, ��� .
2.1 For any such perr�it fer the er.�ction,of any fireproof b'�ilding,
other �P�n a garage, 'waxehouse, fac`tory ar 'gr�i�� elevator, or for .the
... �=
erection of any fireproo� .�dcli.�i�n, for� s�mi.lar.: occupancy� to any —;--_.-��,_._
..._.._. .. ..
•_ "
`�� exist�T��$uilc�ir��shall' be at, th:� r��e of $l./�0 for each: one �thousan
cubic feet .or f�a� c'tion� ther�q?, in_ such" Cubi�- �onte�ts. ��°-- �_..._,,_._ __
..:..:.:,. r�';,.�,._ _ .:_ � �
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2.2 For� any such �e�mit for the erection flf �:n�'�=£�.�e roo f garage, w 3 x' e- .. .,_ .
�:. .. �,:
= P�ouse, fa-ctory o'r grain e].evator, or fs��',� the erection- of an�r fireproof., .
addition for similar occupancy, to any existi�ig�bii33�.x�ing slzfill be a� the '-- :�r..• -
rate of �1.25 for•-�.ch one thausand cubic feet, classified as "f3;,�'��'o_of"
by Section 502 of the Minneapolis Building ��id��>•:,}` ""° ''� ''
„ �,,,...
HOUS�:S`.; ..�:-k .. v--� `�:=;: � ^
2.3 For �any sucYi p�rr�it� for the erection of any non-fireproof building. :; �• :
other than a garage, ' warehoitse; �actoriy--o�....grain elevator, or any - t;: :,_ �-ta.a: ;L;,:
n�fire�roof addition, for aimilar occupancy', to any existing building.
=- _ .
Permi� �:OD�: for � eacY�: one thousand ctitb�.c feet. -�•
, � .. .. . _ , �_._`°""�.--�: g. .y... � _ �
- =_.- .. . ..; .., ...,, ..
GARAGES i -. . _ • •
,�;�/� For any such permit for the erection •f.. an� non-%ireproof gax°age ��� "'"" '-- °°� •
warehouse, factory ox_grain eleva tor�-4gr-ior �hererectidn of any �non-
__fireproof addition, f'or .simila.r�� �tecupancy, to a-ny existing building or "-�� °=�� _,_.
� for each such bizilding or additio�. �-Ni�nety , Cents . for. each one �� .. ., ,_,
�� thousand cubic fee`t�-vn-fraction thereof, in tFi'e cubical'contents thereo�""��--°' ' .
with a ��ii'mua•��-; �4.Q0. - _ _.. � - � � `- .
Fo'� ��the �purgiose of �compu,ting fees �6r bi�ilding permits the � cubical �.:�.:.:-: ,„
. c� h�_en ta_ o f ariy � b u i l d i n g, or add��itin to a uniform hei ght throughout by�
multi�lying the ground area coves��: fx?o�n a point six (6) inEhes belt� .t�,
��: th��'��lt�o�:..�ine of the base�.�nt or ce�-lar to the average heigh� of the V'�
.`. uPper�� sixr���e; tar to_ th�,.average heigh�t . o� �ti�e roof surfaue , s�f the mai,rx .:•. t . "
={a ,r �,
• gable of a g�:��h�d roof... : . .-
. . . >;. _
2.5 For repairs or �1.teratioms to �an �e�.�.s�ing �'structure, the fee: �ha7a1
be at the rate of �3.00 for e�.ch Five Hundred.Dollars: (�5�.00)�`.or :
�..
r. :_ . . .. . � :,,
fraction thereof in ��he� c�st of alT proposee� �rork. �'�
2.6 In no case sha11 the �fee chaxged for a�.y pernit as set forth in
Section 2 be less than �1�.00.
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Phonet GReeawoad 3-835Z
ARLEIGI� ��C. SIVIITII
iLe9istered Professionai Engin,eer and Laad Surveyor
16215 Wapzaia Boulevasd
1iVayzata, Minn,espta
P��� �� S� ��� ,
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OF PROPERTY OF :�. ,; 4 i�� ; '-, ��'� . ,,� ��m���„ � �,�" �:P�`-�'
described as follows� .��. � �a� -
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Scale; i in�h ���ee�
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CEATIFICATE OF LOCATION OF BVILDING CE:Ri`iFYCATE_OF' SURVEiL
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I hereby certify that on�� �� 19 � I hereby certify that o�;��� �'�� �--� 19=
I made a survey of the proposed location of the' I surveyed the property described above and that
building on the above described property and that the above plat is a correct representation of said
the location of said building is correctly shown on survey.
the above plat. ,
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XERO � '-vrr�,r�. � - '
COPY
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Date: �u�st 2, �965
City of Fridley, Mi.nn..
BUILDING PERMIT
02 �' �-� 9°
N° �300
�: �r. Clem �overs'ton s�� �ndre� 1'. Gawel Const. Co.
Ad�re� 785 Bennet� Dr3.ve N. E. Ad� 2I�o7 ���.shington st. N. �.
Fridle�a Minnesota 1'�iinneapoli�� �innesota
LOCATION OF BUILDING
No. 785 Siaeet B��ett Dri.ve 1�. E. Part of Lot
Lot �- Slock 1 Addit[on or Sub-Division �'istie �ddition
Carner Lot Inaide Lot Setback Sideyard
Sewer IIevaf3aa�
Fotmdatioa IIevation
DESCRIPTION OF BUILDING
To i� v�a as:
�t ��
�t
Ty�e of Construction
x��t sq. Ft. cu. �t
Depth I�ei�t Sq. Ft. Cu. Ft
.�. Est Cost �.�2 300.00 To be Completed
Repairs - Storm D�nage
In cwnstderatton of the 3ssuaac� to me of a perinit to camstruct the building desc�ibed above I agr+ee to do
� P�PQSed work ffi accc�r+dance with the d�acript3on above set f and in c�mpliance a�l provisfona oP
ordinancea oP the dtq of Fridley.
�
In co�deratto� oP the �Yment of a fee of � 10.00 ,�t 3s herebY granted to ��TUREW P.
C;.�tn�'T. C�N�'!', to c�nstruct the building or addit3on as described above. Thisp�rm� t is granted upon
the espress eonditioa that the person to whom it is granted aad h3s agents, ennployees an� worlmien, fn all work
done fn, "around-�nd upon said building, or anY part thereo$ shall conform fn all respects to the ordinances of
FridleY, Mi�onesota la�tion, constructfon, alteration, maiateneace, repa3r and �oving of bufldings
w3�� dty ]imfts�� permit may be revoked at any tiane upoa violation oY at�► of the P��ona oP said
.!�I�EYV G . JEi�S�IV g�1� �
^ NOflCEs
'll� p�emif doa eof wrer t6s eouafnrel�e, dutatl�tee �se vrirTng, piumbtu�, Ya ��9, +awe or wal�r. B� auro ts sN
N» Bnqdtn8 te�r tor aP�r+b P�+mtb fo� tha� it�,
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APPLICATION FOR BUILDIIJG PERM[T
,CTTY�OF FRIDLL�, MINNESOTA
. ANDREW P. GAWEL CONTRACTORS, (NC,
2407 WASHINQT"ON �1'. N. �,
OWNER' S NAME Mr. Clem Coverston BUILDER MINNEAPO�IS ��� M�RIw�'r�►
��! !eE
ADDRESS 785 Bennett . N.E. ADDRESS
LQCATTON�OF BUI�,DING �
N0. STREET , PART OF LOT
� �
� I BLOCR � ADDITION OR SDSDIVISIOIJ
GORNER LOT INSIDE LOT SETBACK SID�-YARD -
SEWER ELEVA'�ION FODNDATION ELEVATI014
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn. on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front�`Depth Height
Sq. Ft. Cu. Ft.
__ Front Dept _ geight
Sq. Ft. .. Cu. Ft.
Type of Construction ��
Estim,ated Cost� � ,� � o
To be completed
The undersigned hereby malces application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and.ru%iags of the Department of Buildirega, and.hereby
declares that all the facts and repreaentations stated in this application
are true an,d correct.
DATE SiGNATtJRE
(Schedule of Fee Gosts can be found on the Reverse Side).
~ � / \ � � u1 a . V
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BUILDING PERMIT FEE SCHEDIIL$
SECTIOP 2. The Inepector o� Buildi�s shal;l, before isauing aay permit for
the erection of aay buiid3ng or atructure,�or�'for afly addition to anq exiating
b+��.laing oY structure, o� for atLy alterations or�,repaira to any eaciaeing
building or st�ucture, upon �pplic�tion therefore, require the payment by the
appli�ant for such p�rmit of fees to the amount_h�rQin b�low eeX forth and i.n
the manuer herein provided to-wits.
2r.1. For auy such permit for •the erection of any fire•proof building,
other Chan a gara�e, warehouse, factory o�c grain�eievator, or for the erection
of any fire-proof addition� for aimilar occupancy, to any.esiaeing building,
�ha1l.�be at the rate of $]..40 for each.one thous.and cubic feet, or fraction
Chereof, in such cubica�. contents. .
2� .�'or any such:permit �or the'erect�ou,o.f any fire-proof•garage,
warehousa,-faetory or grain elevator, or for �the erection of any fire�proof
addition, �or similar .o�cupancy, Co.any es3sting.building ehall be at the
rate of $1.25 for each one'ttiousand cubic feet, cYassified as "fireproof°t
by Section 502 of the Minneapolis Building Code, �
SOIISES
2,3. For any such permit for the.e�ectian of any aoa-fireproof
building, other than a garage, warehousa, factory or grain elevator, or
any nou-fireproof addition, for a�milar occupancq, to 8ny esisting building -
permit $1.00 for each one thousand cubic feet.
GARAGES
�,4. For aay such permit for the erection of any non-fireproof garage,
warehouse, faatory or grain elevator, or for the erection of any non-fire-proof
additiony for similar occupancy, to any egigtiag buildiag or for aach�such
building or additiom - niaetg ceats ($0.90) for each one thous.and cubic feet
or fracCion thereof, in the cubieal contents-thereof with the minimum of $4,U0.
For the purpose of�c�nputing fees for building peranits� the cubical contents
of any building or addition to a uaiform height throughout by multiplying the
grouad area covared fram a goiut si.x (6) inches below the floor line of ehe
basement or cellar to the average he�tght of the upper surface or to the average
height of the roof +surface of the main gable of a p�tched roof.
2,5. For repa:ire ox alterations to an existing aCructure,.the f�e shall.
be at the rate of $3.00 per each Five Hundre:d Dollars ($5•00,00)�or fraction
thereof 3n the cost of all proposed work. �
2.6. In no case sha11 the fee charged £or any permit as seC fflrth in
Section 2 be less than �4.00.
STORM BEPAIR DAMAGE FEES: .
Res3dential; Eatimated Cost of work up to $500.00 •$5.00
Estimated Gost of work over � 60:00 -$10.00
Commerc�a�; ` Estimat4'''�Cost of wogk up to $500.00 -$�00 ,F=''
Estimate, CosC of work over $500.00 -$`c_ ,00 -"�
�
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Ca.ty of Fridley, Minn..
BUILDING PERMIT
D$�: _ July 30, 1968
Owner: �� �m c_ove�stoa Builder .3a�_
Addre�a 785 Ben.n.ett Drive Ad�.�$ Same �
����9�
11T� 9855
LOC�4TION OF BUILDING
p�. 785 S�t � Ben.n,ett Drive � ..__._ Part of Lot
�._,_,_ 11 .,_,___ gl� 1 ,_,_. Addition or Sub-Divi�tan .�_ Christie Addn.
Corner Lot _ ____ Inside Lot .._._ Setback _..___ Sideyard
Sewer IIevation _____� � Founda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
Garage �nt � 24' �p.� 22' Height .�10� Sq. r-t, 528 �� 5280
Front Depth _.._. I%ight Sq. F't. (�, Ft,
Type of Construction � Frame Es� Cost ^$2300^00 ___ To be Completed
In con�deration of the isauance to me of a permft to construct the building descril�d above, I agree to do
the proposed work fn accordance with the description above aet forth and in comp]iance with all provisions oP
ordinancea of the dty of Fridley. _� _
In cons4deration of the payment of a fee of $ $• �� , permit is hereby granted to Clem Covers ton
to construct the buflding or addition as described above. Thiapex�nit is granted upon
the expresa condition that the peraon to whom it is granted and his agents, employees anc� worl�znen, 3n all work
Fridl e�Minnesota d u�n said building, or any part thereof, stxall conform 3n all reapects to the ordir►ance� oP
within the dty limitseand�thia lpermi� Y be revoked t any time upon ovi lati n of r and mov9ng of bufldings
o��� any oE the P��� � eaid
� ���"�
Breher
Building Inspect�
� NOTICE:
'fhis peemit does eot cever t6s eoestructioe, installafiee for �rtrine, plumbin8. en heaMne, ww�r ee wNs�. B� sun ts �
tiro euilding Inspe�tor fsr separat� Pennils fo� t6pe ihmi,
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sn�ac�:�v� �oR �u�L�a�� �T
c��► o� �srn�t,.rrr�x�so�
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_ , • . OWNEIt',�5.;�1ME_ ��.� . , v' "]� BOIZDER��
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:.Ai?DR�$5�,�) , ��Pf�/0� x�_7T ' . �,��.�..�L'°.�� j l�1DI�itE$S� .����;.
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; . _ _ . • .. , � ' LflCA�`ION ' OF� • BTJI�Di1�3G . � .. � , . � ; . �,
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IJO.�� �STREET �' � �� `� .� r�''���.� `�:..,.__.�::
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�..,,. _ LoT�_� �ocR�„_ Al?DITI01`I OR SU�3DTV�tSIO�J
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.. ., �� C�ItP�R ;.OT�,;Z1�ISIDE LO"r r`�� SE'i�I� STDEqA$D
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SEG1�R ET�,VA�IOH TaP OF F04T'sN6
,�Apnlicant attach to.�l�is form Two Cert3ficates oE Surveq of Lot and pxopoeed
bn3.ldin� loca�oii dia'wa au tAese Certi�#f'�'a'te's. " '� ,
.. . � .•.':'�� . ;!},. . . . '�} � � � �i `.�•. ' . Je • • r.
. , ' � DESCRI�TIQN OF .�iJ�Dil� � , , ,
,t
.�.. ' .., .. . ,
To Se Us ed As : � ` G- ,� h �1-� � � ' . . . .
Froat Degth Seight,�
... ....,.. . �_
. ��''� • � ' �'Square' feet � Cub3c: Fe�t . � . y
_�p_� ��a�' ,_ Fraat ��r ,, Denth �.Z. . •Hei�h� fp
, �� »a• • i;' . .. . . . . --- —..---
Square feet ��� � • ��ub�c •��eet .,:,.5°� �-�
Tppe of iCoastructiott "'�1�i4`k�� ' E��t�a�ed-�Li��t� ��•�-�l5 C� .
To Be Campleted� �.4-�� ?'
The undersigned hereby makes appliaatioa for a permit for the work herein
�peeified, agreeing to do all work in strict accordaace with the Citq of
Frid2ey Ordinaaces and ruliags of the DepartmenC of Buildinga, and hereby
declares that all the facts aad representations stated in this applicaCioA
are true and correct.
m
DATE �
(Scbedute oY Fee costs can be found oa the Reverse Sidej.
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� BUILDiNG PERMIT FEE SCHEDUL,E
SECMON 2. Ti'e,In�a�ee�aY of .Buiidings _shall, befare issuing permits for
the erection of �ny building or structure, or for any..edditian Co any
egisCing etructure or building, ar fox ar►q �l,e�geCf.ori or repairs to anq
existing bui�;�ling or structure�� � upon app�3ca.tio�t th :�e€ore� require the
the paymettt'�iy the 'applicant for sueh permit of. tzes� ito the amount herein
belaw set foxtih and in the aian�►er herin pro�ided to-wit:
� . • �:
Uni£orm �uildin�.Code: Tgpe 1, 2,�•6 4+'•$1.75.for each-ane t�iou�aad cubic
feet, �r fraction thereof�, in auch��ubical contenta. Type '3 b 5- $1.50 for
each oae .thc�ssaad culiic feat . . . _ „ . . - • � - �
.. , � .'{' . . _ . :.
. , _. , . ,,
�'�r t'He,�rur�ose•ef cnmputing feeis far building=•perm3ts, the cubfcal
•' contents �f.apy �uildi�',or addition ti a�u�iform height•th�oughout by
mnitiplpiag�the ground area cover�d frpm.a po�f.ilt�siu (6�..inches below the floo:
line of t�ie basement or: tt�e e'ellai� ts�the• average �hei�iat of the upper aur�ac�
or.to,the �verage height of the rooi�suxface of the mair► gable of a
pitched roof . � �
For re�airs or alterations to an existing_structure,�t�e iee shali be.at the
rate of $3.00 per each five hundred doli�re ($5�0.00) or fraction thereaf
in the cost •f alI proposed work. • �.. �•-
In;no case,ahall the fee charged for.anq permit as s�C forth ia SeceiDn 2 be
• Less thaa $S . A0. . • � . � '
�NSSSD C�nnection ,Ch..argea bgsed oa locatiea-�Area 1 or �.
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/hei'ebr� ce�fi�y fhot lh�is is o frue ond eorre�f �e��esenfo%ion v�'o st�'✓e1f Q��IIC �nrlorie5 �'�e obar� c�Y6�d �and� erx/
o�'ffae taofinn a�'a/l bwldin�s , fhereon , or�ol/ r�s�b/e e��croodr.n�enfs ,;`o�cJ, �rri or av soid /ond. As su�veyed � me /his���o�ny
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City of Fridley, Mirm..
BUILDING PERMIT
Da�; September 11, 1970
p�: Clem, Coverston B��r Roy Lund
Addres,s ? g 5 RP�?� rn-�.�� �L �.,._ �,ddress 241 42nd Avenue N E.
� �-3 �.�-�
�
. 10824
LOCATION OF BUILDING
No. 785 Street Bennett Drive N.E. ,� p� of Lot
Lot 11._ __ Block 7- Addition or Sub-Divisian . Christie Addn.
Coraer Lot — Inside Lot ____ Setback � Sideyard
Sewer IIevatian _._.._.. Fouadation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Rm. Addition Front 15�' Depth 27 � Height 12 � Sq. Ft Cu. F't �
Front Depth fTeight Sq. F't. Cu. Ft. _.._.
Type of Construction Frame �� Y$4, 870. 00 _ To be Completed 11 months
In consideraf3on of the issuance to me of a pern�it to construct the building d�bed�aby� I agree to do
the proposed work fn accordance with the description above set forth and in com ce a'11 provTaions of
ordinaaces of the dty of Frfdley. ,� �
Ea consfderation, of the payment of a fee oP $ 19 . 00 ��t is hereby granted to Roy Lund
to conatruct the buflding or addition a$ descrYbed a'bove. Thispe rmit fs granted upon
fhe exPress condition that the peraon to whom it is granted aad h3s agents, employees and worlunen, ia all work.
done in, around and upon sald building, or any part thereof, st�all conform in all respecta to the ordinanceg of
Frid1eY, Minnesota regardia lacation, conatruction, alteration, ma3ntenaace, repair aad movin� of bufldings
within the dty ]imits and � pern�it may be revoked at any time upon vfolation of aay of the Provlsiona oE eaid
o�dinanc�e.
7
Inspector
NOTICEs
Tl� psrmtt does not eover �hs eoemuctioe, installadon foe vririe6. P�6+8. 9+s be+�e� pvve� e� wafsr. B� wre to as
, tha BuiWiee Inspsato� for �sparatr permiis fa� t6e� tienu.
�
e
� �
� � ",_
APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITiON BUILDING PERMIT
CITY OF PRIDLEY, MINNESOTA
OWNER'S NAME: ��e�f�l � ��rS'%/ BUILDER: O � �
ann��s : `7�°��.v� N r/,� Annx�ss • � ��' � a �''"�4 �,� �/,�
^
NO • . i �'S STREET •_ .� t° ��r ,� i-T � r , �Cf, /�
� •
LOT:_ /� BLOCK:__� ADDITION'-- � � y, `c �"'� ��
CORNER LOT:__�i INSIDE LOT:� SETBACK: SIDEYARD;
Applicant attach to this form ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As : �D � svI �p�,i�� ���„' ;
� �' 2
Front :_ !. i Depth : � �,_ Height • , s
Square Feet• �Cubic Feet:
Front: Depth; Height:
Square Feet; Cubic Feet:
_._..
�pe of Construction: �'r,g �n .p Estimated Cost:_$_ � � �p ��
To Be Completed:
The undersigned hereby makes applicati�an for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Qrdinances and rulin�s of the Department of Buildings, and hereby
declarea that all the facts and representations stated in this application
are true aad correct.
DATE :�� l 7 �� j� S IGNATURE • -
(See Reveree Side For Additional Infonnation.)
l �i U-�
e" . � r
' .. �
� �-
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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 ma.nner herein pravided to-wit:
U1�TIFORM BUILDING CODE : 1�pe 1, 2
feet, or fraction thereof, in such
each one thousand cubic feet.
& 4-$2.15 for each one thousand cubic
cubical contents. Type 3& 5-$1.85 for
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, 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 ma,in gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per 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 Section 2 be
les� than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot,.showing the location of the foundation, once it
hae been constructed, will be required before proceedinf� with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Cextificate of Occupancy shall be ma.de ten (10) days prior
to the use or occupancy qf any atructure for which a building permit has beea
issued; and said structure shall not be used or occup�ed until a Certificate
of Occupancy has been issued. �
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Building
Inspections
763-572-3604
� ��
BUILDING
RESIDENTIAL APPI.ICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
S1TE ADDRESS ?�' .� l�•vN � 77 � 2.
THIS APPLICANT IS: ❑ OWNER j�ONTRACTOR
Permit
Received By:�,�
Date Rec'd: ��� � � ��"+.��-�
PROPERTY OWNER/ Np�: �,��,c�-� S� ���/�
TENANT ADDRESS: ��° S ��,�- a✓t. T 7' �/1 �CITY �'�2 / Q C� STATE/�9 f�IP
5_.�3 L
PHONE: �G 3 - S`�/- y's =8�
CONTRACTOR
G�
�
SUBMTT A COPY OF STATE LICENSE # �z-1 Pr' � EXP DATE ���/,�o ''�
YOUR STATE LICENSE ADDRESS: �� S LQ� �zc� �¢-r/�. y e, CITY /j7�i� � STAT�/� S S;�/�
WITH APPLICATTON PHONE � /� - 7 �/ - �S'�d' FAX �/� - 7 d" / - i S -r�3
PROPERTY TYPE- �SnvGLa
❑ TWO F
PERMIT TYPE � �DTTiON ❑ GARAG
O BASEMENT FWISH �ROOF
O DECK �-SIDING
❑ SWINIM
TYPE OF WORK:
❑ DRAIN TILE
❑ OTHER
DESCRIBE WORK BEING DONE: �'Ef►.e - o�� .�' 2ca� `�- � id i N G' f�fiv s e �! GfJ�z � 6E
SIZE OF IMPROVEMENT
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDIIVG
O Vinyl
❑ Aluminum
❑ Other .5' i�-
❑ HOUSE & GARAGE
O ATTACi�D GARAGE
0 DETACHED GARAGE
�Soffit
O Trim
❑ Fascia
\i'INDOWS
IN EXISTTNG OPININGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
WIDTH HEIGHT
�ASENIENT REMOAELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
FOR NEW CONSTRUCI'ION DVCLUDING DECKS,
,ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA,TERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $/.>, aoo,� � OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surchazge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chatge
Total Due
$ �s �. a
$
$ °I , S"�
$ I -�C�
$ 5 .c�� �
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) tunes the total job valuation — Minunum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS 1S AN APPLICATTON FOR A PERMTf-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the infarmation 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
permit 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 � �hich requires review approval of plans. '
SIGNATURE OF APPLIC � [d�� �c� PRINT NAME �v8 / >// A • F�S�LCid�ATE �/ /° �
�
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 altera.tion or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such pemut of fees to the amount herein below set forth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applica.tion 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 Departrnent
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977