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Kind of �3uildi o �
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Permit No.
PL�;i�i�1;�J � �'r'�i1IT APPLIC,�Ti�id
i 'Ft�V. pAT:
-r 1.8:'� 0 2. :�5!;
Ad�ress�
A�c r s s -
�Use
��
stir�ated—;�'rast —
,
�
RF?NJ ED 8Y
800
one
one
� � ��
____
P lumb ir_g E� ix �ure Ri tc�s : NO . RA.TE TOTl-iL
Ni�mber Fixtures �� � x $2.00 $ ,� �,DC
Futux2 F'ivtures �- x $1.50 �•UO
NeTu Fixtuxe-Old Opc:n. x $1.50
Catch Ba�in x $3.25
wa�ex xcatc,r-59, ooa Bi�r � x y3 , Op �• O O.
Grotind I:ur� 01d Bldg. x$3.25
Elec. Y;a4er Heater x $2.U0
G�t3 FitL-ix:a Fees :
1st 3 I'ixtures / x$2.00 a-O� '�,
Additional I'ixtures x $ .75
�as Ran�e�193,00c� BTt7 x $5.00
R�airs & Alterations
� See
Descriptioiz: Code
S tate Surchar�;e . 50
TOTAL FEE $ O � S�
The undersi.gned hereby makes application for a, perniit
for th�� work t;e�r.ein specified, agreein� to do a11 work
in strict accord.a.nre with the City Ordinances and ruling
of the Dep�rtmerAt of Iiuildirigs, and hereby declare tliat
alI the facts anc� representations stated in this
application triie and correct.
�'- �_� �o /.s- � �
5i„n�tuxe ate ,•
App�aa�ion �a''ow�r Pta�Ns and HtaMng� Cooling, Yentilatioe, R�ig�ratioe aed
Air Conditioning Sirst�n�s c�d Devic�s
PARTIAL RATE SCHEDULE
GRAV*TY WARM AIR: �� T��
!'urnace Shell & Duct Work . . . . . . . . . . . . . . a10.00 =
Repiacement of Fl�rnace . . 6.00 �
Repairs & Alterations--np to ;500.00 6.pp a---_- -
Repairs d� Alterations each add. s500.00 . 3.W =—___ ____`
I�IECH. WARIri AIA �
Fltrnace Shell & Duct Work to 1�0,000 BTU .. .. . , a10.00 ;��.
each add. 60�000 BTU ............. ....... 3.W ;
Replacement of Furnace 6.00 E
Repaira dc Alterations--up to a500.00 6.00 ;
Repairs & Alterations eaeh add, s500.00 3,pp ;
STEAM or HOT WATER 8YSTEM
F�rnace Shell & Lines—to 400 sq. ft. F.DR Steam $2Q.00 $—_ ____ __ __
F�unace Shell & Line--to 640 sq, ft. EDR Fiot Water 10.00 $_ ___
Each add. 200 aq. it. EDR Steam 3,00 �.__ __ __`
Each add. 320 sq. ft. EDR Hot Water 3.pp a-----`
OIL BIIRNER—!o 3 gal. per hour
over 3 gal. per hour-�ee Fee Schedule
GAS BURI�iER (up to 199,000 BTU)
wer 199,000 BT[J See Fe� Sciudul�
S.OU �-----
6.0o s
��
GAS FIITING FEES: NO RJ►TE TOT]►L
-T
lst 3�xtures xE 200 S-- __
Additional Fiatures x .76 i �
Gas Range to 199.000 == bpp ;
Aia connirio�i�a
Fnx r�►rixc s�rs�s
VEI�TILATII�G SYSTEl�
11LTERATIOIfB �e REPAIRa
��. //-�/-7`�
��
SM FN Sch�dnl�
� 5�
TOT11L FEB
(SURCN
D.pt. oi Bldys. Phw�. �90-3490
.�.,� /5��� �
� �
�
City oi Fridley:
The undersi�ed hereby makes application for a permit !or the work hereir
specified, agreeing to do all work in strict accordance with the City Orditiance;
and rvling ot the Depar�tment of Bnildings, and hereby declares that aIl the facts
and representations stated in this application are true aad correct.
Owner
lS _
Kind �f Building ._---_�/.t'--�/�f,fy�/�,�L=
Used as . — �1�j,.����+ j� �'9 —
T� be completed about ------���>._.�! %�
• � _�
Estimated Cost, a_.____�_�G%�?-------.— ---_-
�� c; �%
Old . Building Permit No. _ P•rmit No. �, �_; �`
DffiCAIpTiOlf OF WORS )
HEATING or FO PI.ANTS-�team, Hot Water, arta Air No. /
Trade Tvame____�� ��-�1.-'� (s
•�•� . size xo� L% i �
���� ��
CapacitY�� Sq. �'k E.D.R r L�' ,_ g� gp
� �% '
Total Connected Load � v' Rind ot lwe �
Y"
SURNER — Trade Nam � ' ' '` � � Size No_ � �1%�' �
cap$�c� G6d c''i'r�' �. �. �.n.x G(o ��Z� s,�,
�
(REMARKS-OYER)
�
sisn� QAY��El.TER HEATIiVG C+�.
4637. CHICAGO AVE.
..- ............,s.... ....�.�r�..�-rw acll'�
a�� �
SUBJECT .
City of Fridley , 1 269
�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I
; � ECEIPT O.
� ` COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC. ��C,I ���
1
i � � ��'1,, � CITY HALL FRID�EV 55432 NUMBER REV. DATE - � PAGE OF APPROVED B
`""'�' � 612-560-3450
910-F15 8/6/73 � �
�j08 ADDRESS 1541 Berne Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACH D
DESCR. �LO 1 Innsbruck Sth Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Stanley Lehman
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENS NO.
Rodney Billman, Inc. 151 Silver Lake Road, New Bri¢hton, Minn.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENS NO,
5 ENGINEER
6 USE OF BUILDING
MAIL ADDRESS
Residential
PHONE IICENS� NO.
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE �
8 DESCRIBE WORK Construct 50' x 28' Dwelling and 22' x 26' Garage
9 CHANGE QF USE FROM
TO
STIPULATIONS provide a har d surface driveway. Provi�e a verifying survey be
framing. Grade at rear of building must be 12" above curb at east
1ine.
WATER LOCATION: 10.8' West of Sewer Service
SEWER LOCATION: 94' East of Manhole (Imt 982.98)
Wye Elev: 980.13
Top of Footing: 983.13 Minimum
�EPERATE P�R!?"►T� �r.'�"`nrt� �OR WIRIN�G,�
HEATING, FLui'riisi►:v� i+��y:� �;v��5.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 R�1
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
ANO 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 �41��H7.74
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $$,rj,OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
�,� -f
I RE OF CO i RACTOR OR AUTHORIZED NT � .IDATEI WHE I PROP
i��I � r , . � t
t.e�
SiGNA1URE OWNERIIFOWNERBUILDEFI IDATEI BLDG INSP
OCCUPANCY GROUP OCCUPANCY AD
SQ. FT. • CU. FT..
OFFSTREET PARKiNG
STALLS GARAGES
SURTAX
20.79
SAC CHARGE
$275.00
TOTALFEE a
$380.79 ;
ERLY VALIDAT T IS YOU PERMIT J
i
DA7E
e
,-�
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�a�' - �.
�--`�~.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME ;���i �� iv�Y,-�a�-c� BUILDER : r� s��'ti,-�-� �//n-.,--�.-� �-� c�
T-� �
ADDRESS : ADDRESS : ��� � =s�"�K� L ,��.. /�--�
��-- /3-'s-�y �r�-� h/...,.., ,� _� •� z
NO : . ;� lj^�, S TREET :_ �.D .2 �Z,d -P / � �
—�.--�- .
LOT • �/ c� BLOCK • / ADDITION :�� ^ �"�� ��
�-�-�-�.. ., � Z�� �
CORNER LOT: INSIDE LOT: � SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building Iocation drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As ; � .�-��� '`- �`" `�'�—
� Front t -�� Depth • Z� d- Height •/� S,�"
/��,�� �.�'.''.` �
Squaxe Feet: �6 � .� ubic Feet:
Front• Depth: Height: .
Square Feet; Cubic Feet:
Type of Constructiont ?��.�,,, , Estimated Cost; $�%�,.� ``-y
To Be Campleted; _ �_,-� � � � �� �`' �.,,. r E> ;�J J � �./
� , /
�
Tha undersigned hexeby makes applicativn for a permit for the work herein
apecified, agxeeing to do all work in stiict accordance with the City of
Fridley Ordin,ances and rulings of the Department of Buildings, and hereby
declares that all the facts and representationa stated in this application
axe tru� and correct.
, :� �-// .�� � �.
AAT� : ' .'� S IGNAT[JRE : � ,
(See Revexse Side For Additio�nal Informa on.)
' � � '� � ' � I F F �
t � '
� � �� r � �, � '�"" �,�' "✓ �i� f;� �� � . � ,�„:.
>= � � �. / /�.,` �.
� . ,
' � � ' �`� s , � . � � � � �% 4 �` ��-�' � U %'. ��
-,' , ,� ; '� �... �- .. �. ,c� �. � t � / -�-�
SU�L�ZNG PERMIT ��E 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 stxucture, 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:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
�or the purpose of camputing fees for building pern►its, the cubical contents
of any building or addition, is determined by multiplying the gxound area
covered from a point six (6) inches below the floor line of the basement
or t�e cellar to the average heights of the upper surface or to the average
heig�t of the roof surface of the main gable of a pitched roo�.
For repairs ox alterations to an e�cisting structure, the fee shall be at the
rate of $3.00 ger each five hundred dollars ($500.00) or fraction thereof in
the cost o� all proposed work.
In no case shall the fee charged for any permit as set €ozth in Section 2 be
leas than $5.d0.
VERIFICATION OF FOUNDATION
NOTE: Permits for conatruction will be issued a minimua► of 24 haura from the
ti.me of application, to all� for proper xeview of the praposed structure and
af the coastruction si�e.
A Gertified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required befare^proceedin� with the fxaming.
CERTIFICATE OF OCCI�PANCY
Application for a Cex�tatficate of Occupancy sha11 be �ade ten (10} days prior
to tk�e uae or occupancy of any structure for which a building permit has been
issued; and said a�ructure shall not be used or occupied until a Cextificate
o� Occupancy has bee� issued.
�ity of Fridley ^ 53-e�;-s-915.51
�� �i .�� ��r� �� �� �� e�d � � � �� ��t �
I�p�t. of Bldqs. Phon� 560-3450 �- -
DESCRIPTION OF WORR 151�1 N. F. Berne Road
� Numb+r, Kind a�d Loc�.tion ai flxluraa ���°"
O . � 3 � I � I 1 � ( i I � f � '� ( o �
Base
lat
2nd
3rd
4th _, � � � � � � �
' Futur� Coaa�ction Op�ninQs
t N�w Fixlur�, Old Op�nings
��o o iS � I< � lu 2 lu ` I� $
�
WATEN MT�.
O •
► N G�S F�fC.
S�w�s �
���� �
PARTIAL RATE SCHEDULE
PLQMBING FIXTURE RAT£S: NO. RATE TOTAL
Number Fixtures . . . . . . . . . . . . . . . .
Fl�ture Fixture O��ening .. . . . . . . . . .
x 32.00 S
X a�.�o s—_.
New Fixture Old Opening . . . . . : . . . . . x 51.50 a,-..---
Catch Basin . . . . . . . . . . . : . . . . . . . . x �3.25 a
Water Heater :Up to 99,000 BTU1. ..• x$3.00 $
New Ground Run Old Bldg. ... . x a3.25 $
Elsctric Wat�r ii�at�r. . . . . . . . . . . . s $2.00 i
3AS FITTING FEE8: I?O. RATE TOTAL
isL 3 Fixtures • • . • • • • • • • • • • • • • x S2.00 ;
Additional Fbctures . . . . . . . .... . . . . . x ; .75 ;
Gas Hange to 199.000 BTU . . ... . . . . .. ' x :6b.0U `
City of F�idley:
The undersigned hereby makes application for a permit for the oso:k herei
specified, agreeing to do all work in strict accordance with the Cit,� Qrdinance
and ruling of the Department oi Buildings, and hereby declares that a1i the facl
and representaUons stated in this appllcation are true and correct
1+'ridley, Minn 6-21-7� 19,..
owner Stanley Lehman -
Kind oi suilaing Fr2Jtle
Res.
Used as
To be completed about 6-2�-7U
Estimated Cost, a 10.00
Old—I'�4�7�3uilding Permit No. P•rmit No.___ ��:5'�.� �—
`" - r�.,.� ....,....
Signed,� i �,���/l ->� ^'�
. � - :•s,.
gy 9�i+'lfi�F!'7'F'�l�e :" -- -
Business Phune No
ROUGH
f'INAI, .3 " .�L ' 7 Lo
AEPA2RS tc 11LTEA]ITIONB—R•t•s to Cod• . 50 State Surcharge
Description . . . . . Ins tall � Ga's . Gr.ill . . . . . . . . . 5 • 00
.... ._.3
. Tar,�w � = 5. 50 .
� � , � ��� �Uruhc'.';;" �r'.
�irSS• f� _
n
SUBJECT P
City of Fridley 2 O 3 5
' , AT THE TOP OF THE TWINS g� I L D I N G P E R M IT RECEIPT .
�
� � COMMUNITY DEVELOPMENT DIV.
v PROTEC7IVE INSPECT�ON SEC. 3�pa�j f
i _
, i _-_- ,
r , �;
1 � /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�'"""� � ,�� 612-571-3450 910-F15 5/15/�0 / /
J08 ADDRESS 1541 B:erne Road N. E.
t IEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oESCa. 20 1 Innsbruck. 5th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Stan Lehman 1541 B:exne Road N�E. 571--44�7
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
H�me Enhancers Tnc. 5460. � 145th S'treet W�st, S:avage 55378 431-9059
4 ARCHITECT OR OESIGNER MAIL ADDF;ESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Resident�al
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRtBE WOFK
Constxuct a 10Q sq, ,�t, Deck.and � 230 s.q. ft� Scxeen Porch.Addi,tipn
9 CHANGE OF USE FROM TO
STIPULATIONS
S�e�e notati.o,n�- on p],an
� wa����� �
Before digging ca11 for
all utility loeations
454-OOC2
REQUIRED BY LAW
SEPARA7E PERPJlITS RCQ�JIRED FOR
V'J�R!lVG, HEATING, F'LUMBING AND SIGNS.
TYPE OF CONST. OCCUPANCY GFOUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHOAIZED 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 OFFSTREET PARKING
I HEREBY CERTIfY THAT I HAVE READ AND EXAMItSED THIS APP�ICATION �- STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WOFiK WILL BE COMPLIED $4 � lO.O $2 , OS
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOFiITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $'72 � OO
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
��?� /.L _ �l/.Sl 90 $74.05
S�GN TUAEOFCON�RACTOAOAAUTHOA�ZEDAGENT IDATEI W EN PROP fi ID D THIS IS VOUR PERMIT
, �L���-
S�GNATURE OF OWNER 11F OWNEA BU�LDERI IDATEI ' lDG �NSP n TE
Prepaid Plan Check $
Estimated C'ost $ CITY OF FRIDLEY
Receipt # �-� �_
%�Lj� 22 Huilding Permit 1,pplicatiou
- - •�
zv��'t �� : J.,�
�1IL��
,� �
� �,
Construction Address _/��'{/ ��er,d� ,� Zar�ir�c1 1�,` f
Legal Description
�Y �/�ss �e Te1. # .� 71- yS/9 7
aortr�c�R & �ss h�- ���rr�� .�.�-. ��v �vs-�`�S�� .�ri.4-�£ �.# y�/-9aS �
Archit,ect & �dress �q. #
E�ginePx & Address Re�g. #
TYPE OF WiORK �[� N�w ��Addition (] Alteration -Desc�ribe r��� eN ,�y �Pi�
Applicant
r- . \ ^
Tel #��/-r�oS9 Date !
BUIIaING DIl�]SIO�LS
Length Width Height Sq. Ft.
�� �P � �Gi i 2 -t-- �3� S� rs� < <U�
�FC• ARE'A: Iength Width Height ,
# of Stories
Sq. Ft.
WHSE ARE'A: Le.ngth Width Height Sq. Ft.
'��� ARFA: I,�ngth 9 idth Heic�t Sq �F't ��
�x �e.� � 3,3�8.� a- �coo�c �.a� _ ���.�� o?�ao �3 � �
�- v�,TTOx �
Sq. Ft. �`�x $ cbst/Sq. Ft. = Valuation $ ) � �
Sq. Ft. _dz�� x$ Cost/Sq. Ft. = Valuation $ )_$-.`�c��,
B�
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) TOTAL VAIUE
Buildirig Use Construction Z�e Oocupancy Gro�xp
Air Conditioning []Yes []No Fire Protection Provided []Yes [}No
Performance Bond Amount $ See Reverse for Schedule R�eoeived []Yes []No
P�ermit Fee $ ���OU See Fee Schedule on R�verse Side
In E�cc�ss of Prepaid Amount - See Reverse Side
State �e $ (�J $.50/$1,000 Valuation (See Sched. for > $1 Million)
SAC Charge $ $600 per SAC Unit
Park Fee $
S'pec. Assessme.nts $
Driveway Escrvw $
Z�0'I�lL $
C1tsc. -�— � �',Uv
�0 q.p �
Fee Determined By F��clineerir�g
Agreem�ent Neoessary [] Not Neoessazy []
feet x $13.50/foot
�nriza�,L szz�rr�TTa�s a�r � s�
a�v �
lo ov= �lo.�b
' 3 �c� ��u�
�
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� �� ■• �� ��•
I� �� •• �� ���
�� �� •• ��� 1�•
��� �� �i • •
$1 to
2�001 t�
25,001 to
50,001 to
100,001 to
Ot�' $356, 000
:�n ��� ca• iu a :�•:.��i -
� -- • -i• :i•-
•'. "r�� • _ Y •; _�• ��• �� • ■ .� • ■• . • • • r► ���
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Yy •. Y� ��� • � . 1 •, a:• .�• 1�� • • .� • �• . •
• • `t�� ��1
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SUBJECT ,
City of Fridley 2 612 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� ` RECEIPT NO.
COMMUNITY DEVELOPMENT DIV. �/'
r � V � PROTECTIVE INSPECTION SEC. Q� � (1
� �
1 � �
� � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV OATE PAGE OF APPROVED BY
�°°�"� ��� 612-571-3450 910•F15 6/2/98 / /
JOB ADDRESS 1541 Berne Road NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHE�
DESCR. 2Q 1 Innsbruck 5th Addition SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
Tom Harrington 1541 Berne Road NE 571-8530
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Horizon Co Roofing 1333 Larc Industrial Blvd, Burnsville, MN 55337 890-3900
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
20012795
5 ENGINEER MAIL AODHESS ZIP PHONE LIGENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
6 DESCRIBE WORK
Reroof House & Garage (19 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID If WpRK OR CONSTRUCTION ZONING S0. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERT�FV THAT I HAVE READ AND EXAMINEO THIS APP�ICATION I. STA��S GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VAlUAT10N SURTAX
AND ORDINANCES GOYERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OH NOT. THE GRANTING OF A PERMIT �isSH�F �.79
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW FEGULATtNG CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �S 1. ZS Fire SC � 1. SH
PLAN CNECKfEE TOTALFEE
License SC $5.00 $58.62
S�GNATUAEOFCON'RACiOAOAAUTMOA�2EDAGENT IDATEI WHEN PROPERLV l�LIDATED THIS IS VOUR PERMIT
� �_Z--�
$IGNATUAEOFOWNEAUFOWNEABUILDERI IOATEI BLD �NSP ��FTE
•. . . �
NEW
ADDN
ALTER
[l
[l
�
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ��'�'I
Legal Description: �
Owner Name & ddress: � Yl
Contractor:
� Address:��� l_L,l r ( � l
i�� �
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: ' Length
OTHER: � 2
Effective 1 / 1 /98
�` l�'
�� , �1G
� ��
�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESC�tIP'TION i�� �'v�PRflY�R^IENT
W idth
Width
�idth
��i c� t (,
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
.� . _,.
' � ° �5�?3�
Construction Type: Estimated Cost: $ '
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: �� �i Tel. # ��J��
-�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� � /.�.5�
$ 1. ��
$ �
$
$ �� � C`�
$
$
�
_$
$ �� -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
.....
C'
O '
��.
` I� ��
)�
CITY OF FRtDLEY INSPECTION DIV.
6431 UniversRy Ave NE
Fridiey, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
Urinat
APPLICATION FOR PLU
MARK NUMBER OF FIXTURES TO 8E
�>; :r'::;::�;�,» Wash 'Dnnl
: .: F . . � . . �.'vY,
� Shcwer .Siri(C > Trav Fe�i
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB AI
New Fixtures S 7.00 The un
Old Opening, New F'uRure $ 4.00 specifi�
Beer Dispenser S 5.00 and rul
Blow Off Basin 3 T.00 and�re)
Catch 8asin $ 7.00
Rain Water Leader S 7.00
Sump/Receiving Tank . .S 7.00
Water Treating Appliance 510.00 Owner
Water Heater –Eledric $ 7.00
Water Heater – Gas•� 1 510.00 G. �'4 Buitd'rn
Gas Range'* $10.00
Gas Dryer** $t 0.00 Estima
Back Flow Preventer Required ()Yes () No •
Type $15.00 PLUME
Reinspection Fee 542.00/Hr S{GNE
ALL OTIiERS AND/OR REPAIRS AND. ALTERATIONS
1.596 of Value of Fixture or Appliance �"�
� Appro�
State Su�charge $ .50
MININ
, TOTAL FEE S�� PLUS
, "•COMBUS?ION AIR SHALL BE PROVIDED PER UMC SECTION 504(�
r� • -
f •
Effedive On January 1, 1997
�S FITTING PEFtMiT
EACH FLOOR "
�c�,'��'> Auto. Ga� ,; Gas
si���`s Washer �i4DDf ,:; Ran�
1 S�l -���iv� /�,D
Water Heater
Gas Elec
.>: . .
l�=�=
�eby makes application for a permR for the work herein
�do all work in sirid accordance with the city codes
r� .
iilding Division, and hereby declares that all the fads
�:
stated in this application are Vue and correct.
�
- % / � � . t 998
�
/ ��vm�s ���;;�lrti` N
� �
�.- . .
— A/i��� � � �
�iO�USTAYAV�. N. �114
�
'� /� TEL N0. T Z,'� I�U
in Date Final
A MINIMUM SIZE 9 S� INCHES.
�::.
�
�
����
sue�etT PEfiMIT NO.
City oi Fridley � 3 0 4 91
AT THE TOP OF TNE TWINS g U I L D I N G P E R M i T
r
; � ECEIPT N
� • COMMUNITY DEVELOPMENT OIV.
r� � y ' PROTECTIVE INSPECTION SEC.
, ,
� .
l--.-�,��"' �.� CITY MALL FRIOLE� 55�32 NUMBER NEV O�TE v�GE OF �PVROVEO Br
L 612-571-3450 910-F15 11/8/99 / /
JOB ADDRESS 1541 Berne Road NE
t LEGAL LOT N0. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 2O 1 Innsbruck 5th Addition SHEET
2 PROPERTY OWNER MAI� ADORESS ZIP PNONE
Tom Harrington 571-8530
3 CONIAAC70R MAIL ADDRESS 21P PHONE IICENSE NO
6Vellington Windows 3938 Meadowbrook Rd St Louis Pk 55426 933-6300
4 ARCHITECT OR DESIGNER MAIL AODRESS 21P PMONE LICENSE NO
5 ENGINEER MAII ADDRESS tIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS Of WORK
❑ NEW O ADDITION ❑ ALTERATION Xgg REPAIR O MOVE O fiEMOVE
8 DESCRIBE WOFK
Re lacement windows
9 CHANGE OF USE FROM TO
STIPUlAT10NS
Provide smoke detectors in all sleeping rooms and on all levels of the house.
Permit insp�ction Cards
Will �e Mailed
To Nomeowner To Post
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAO
SEPARATE PEiiMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, MEATING.
VENTILATING Oii AIR CONOITIONING
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTFUCTION 20NING SO. FT CU iT
AUTHORIZED IS NOT GOMMENCEO WITHIN 60 DAVS. OR IF CONS7RUCTION
Ofi WORK IS SUSPENDED OF ABANDONEO FOF A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFfSTREET PARKING
1 MEREBY CERTIfV THAT I MAVE READ ANO E%AMINED TMIS APPLICATION STA��S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PFOVISIONS OF �AWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TVPE Of WORK WILI BE COMP�IED
WITM WMETMER SPEGFIEO HEREIN OF NOT. THE GRANTING OF A PERMIT �HISH �4.OH
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEqMITFEE SACCMARGE
PROVISIONS OF ANV OTMER STA7E OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERfORMANCE OF CONSTRUCTION 167. ZS Fl SC H. ZC)
PLAN CHECK f TO l FEE
$�GN4iU�7E O� CON'AACiOQ OR �UTHOp�2ED OGENl IOAtEi �� •��
ME PFl P AL10 D THIS IS VOU P IT
i f
S�GNa7UAEO�OWNEQ��%OWNEABU�LOERi iO�TEi B G�h5 "� �i�TE
NEW [ l ..
ADDN
ALTER
[l
[l
Construction Address: � �
Legal Description:
Effective 5/10/99
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
B DING PERNIIT APPLICATION
�i�
-� l � �� �r����,
�\
� �
� n��
l
Owner Name & Address: p �q,�' ` ✓� l��C 2r �G � Tel. #� Z i—� s�v
Contractor: w L� 6 � r � O MN LICENSE #
Address: � � l,v � ���3 Y�y` t� Tel. #���- � 30�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI-�R:
Length
Length
Length
D�ESCR�TION OF I1VIP1tC�VEMENT
Width
Width
Width
Height �
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: C G-c i��- l,�%(�(i(,,� Estimated Cost: $ �( 5�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: v '�i APPLICANT: � �G� �r� <'"" �e . # �� C7
�
CITY USE ONLY
Permit Fee
�ire Surcnarge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIl'ULATIONS:
$/�o�- �S� Fee Schedule on Reverse Side
$ , l Co .O�i cf Pe.:mi� �Ialu�tion (1/10�.h ,°10 � � ��i ���.
$ - D g $.50/$1, �� , �%�
$ $1 per SAC Unit —� �� �� �
$ �' ��'L _ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ • Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ '
��9 �9
„� . .
BUII..DING PERMIT FEE SCHEDULE
The Chief Building O�cial shall, before issuing pemuts 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
$2,001 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
$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 $100,000
$993.75 for first $100,000 plus $5.60 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
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alternate "A”: Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
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 $23.25.
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 Cert�cate 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.
3uilding
:nspections
763-572-3604
EUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Permit No.: ����`1 �� U
Received By:
Date Re��� " � `� 8 2007
�a� �' �3 � �� YgOUR E-MAIL ADDRESS ll�li�ll�l�'G�/,Ol� S C �il/C_'lPl/� eGLfd� L7/�/?�DGU• U��
�ITE ADDRESS l7 �i� �l�� �U�'-( G
i H1S APPLICANT IS: ❑ OWNER (t�.:ONTRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATTON
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
CId%% � �!�/'G'1G/ 7`� /�I
PHONE:_1? ? "J'`7� 8S.3D
STATE LICENSE #
PHONE ��a 9�
❑ SINGLE FAMILY/IVEW
O TWO FAMILY/NEW CC
❑ BASEMENT FINISH
❑ DECK
CTTY
L% STA IP ✓�S�a"�
�'p��
EXPDATE
� /�G/� CITY �Lf/�US A� s�Z�
FAX
❑ GARAGE/SHED � WINDOWS
O ROOF DRAIN TILE
❑ SIDING THER �n /��"C� �, 1� �J/! �D �
0 SWIIvARING POOL /�scf.•
� � MAWTENANCE/REPAIIt O REMODELING
�
DESCRIBE VJORK BEING DONE:
SIZE OF
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
0 Vinyl
❑ Aluminum
❑ Other
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
OSoffit
❑ Trim
❑ Fascia
WII3DOW S
IN EXISTING OPENINGS ❑Yes �Tlo IACATION OF WINDOWS
OR FOR NEW OPENWGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WT
HEIGHT
BASEMENT REMODELING SUBMIT:
I. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
F�
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. 8c PORCHES SUBMIT:
1. Siu Plan/Survey showing ffie wcisting structures
and proposed project
2. Two sets of construction plans
3. Encrgy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(LJSING THE 997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $?�, (�Q � OCCUPANCY TYPE
ermit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
��`7 _ —
$ �, � �
$ �, UU
$
$
$
$
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)
$1550 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 aavable to: Citv of Fridlev
77�iIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
Attach Stipulations
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
canformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
perrnit but only an application for a permit and work is not to start without a permit; that the work wi31 be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT /�,y����/,���I ,� PRM7' NAME ��% SG?�-�/�.�i� DA'fE i� �� '�i 7
��� ���L� �
Page 2- Building Residential Application
BUILDING PERNIIT 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 pemut of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minnnum 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�` $2,004 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and includin $SO,OOt�
$50,001 to $100,000 $643.75 for 1�` $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 $],000 or fraction to
and includin $SOO,OUO
$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
$1,00O,OOl and up $5,608.75 for the 1� $1,000,000 plus $3.15 for each additionat $1,000 or
fraction
VERIFICATION OF FOUNDATION
. , � , -�� �
Perniits 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 con'struction 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 Departm�nt
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977