AF - 43530sue�ECr P E .
City of Fridley �- 17 5 9 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i � R�
� � .
• COMMUNITY DEVELOPMENT DIV. .� '
� � �.—^_._—, �
r � � PROTECTIVE INSPECTION SEC.
� � �
( � r'��1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPqOVEO B
�•---�•� `.� 612-571-3450 910-F15 7/9/84 / �
JOB ADDRESS '7b00 �� Bxigadoon Place N.E.
1 LEGAL LOT NQ. BIOCK TRACT OR ADDITION SEE ATTACHED
DESCR. $ 2 $�.OI[t�?eY'CJ Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Garjac Inc. 481 - 206th Avenue N.E., Cedar, MN 55011 434-7096
3 CONTRACTOR MAIL ADDFiESS ZIP PNONE �ICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
If2ED FOR SIViR1NG.
6 USE OF BUILDING
xesidentia� NEATING. PIUMBING ANQ SI �iN�,
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 OESCRIBE WORK
Construct a 42� x 26` Dwelling and a 26� x 34' Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a haxd surface driveway. Provide sod in the fxont and side
yards. Provide City with copy of veri�ying survey before capping. Fireplace
and hutch are encroaching into 10 foot drainage and utility eas�ent - okayed
by Mark Burch.
SEWER LOCATION; (Appr�. 6' Deep In Street) 35' S. of M.H. (Inv. 893.94)
WYE ELEV: 894.08 TOP OF FOOTTNG; Expose service prior to establishing footing
elevations . � RN���
WATER LOCATION: Approx. 10` S. of Sewex' Service { F
DRIVEWAY DEPRESSION ESCROW: $@���SL�Q �30 `+' � x ��•
$efore dig mg cali {ocat utill;�"':
.; _: L�r� � ��ao��r oo�s r�oT ��,�KANTr��= � -., iELEPHONE -fLECTRlC - GAS �_�r3f
.�--:+►� •.cY o� urnmr �oc�nor+s AND ���_�;:,�:
;. ��:,� ,s FOP. INFO�MAiION PURPOSES 6U�:�� , REQUlRED BY LA�
r:_�t:.�,;. _� �JSM�1G !' Si1�0UlD VF�NFY tHE INFfl�MAiiC;�:�
o c�
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OF CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OFi 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 PAFiKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. 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 $70, 200 $35. ZO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfIMIT FEE SAC CHARGE
PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION O THE PERFORMANCE O ONSTRUCTION. $346.00 $425.00
� PLAN CHECK FEE TOTAL FEE
$. 86,� 50 $892. 60
SIGNATUREOFCON' ACTORORA ORIZEDAGENT ionrE� WHEN PFiOPERLY ALIDATED THIS IS YOUR PERMIT
/ �
SiGNATUAEOFO`NNEAUFOWNERBUILDERI IDATEI BLDG INSP ptE
S�rvP�r�s CQrt��'�r��e
COMSTQCK & DAVIS, INC. Consulting Eng'v�eer� and Larid Survcyors
1446 County Road J, Minneapolis, MN 55432, (512) 734-934b
SUR�IEY FO'_t:
B & G Investments
961 Hillwind Road
Fridle_y, Ptinnesota
v��,� �-w�.�,�����,t� ,.i:
� a �� ca11 1� .
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DFSCRZPTIO^i.
Lot 8, Block �, B1oLnbera Estates, City of Fridley, Anoka Cot.:nty, Minnesota.
.., �iio' P.J'� i d�l�,./�l��:. i �" i �+..5 ; �ir '',,�.` .. .. .
� � Ll� i. RC\7dVIR�Ld !�':.a.'�3'. �.`�%,��i.
SCALE• 1" = 40 �E1Y1C3VA�. 61ND REo �AC�R: '� ,,
• p Denotes 1/2" diamete��'iro����e��"��� can"ned No. 10832.
0
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Re�ster�d Land Surveyor undar the laws of the State
oi Mir►nesoia.
, � 1�332 + Nov 17, 1930 4278
Rcg. Na Date Job I'Io.
9
Boo�C Na
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CITY OF FRIDLEY
APPLICATION FOR PWMBING AND �AS FITTING PERMIT
�° >, m �qia u • k w Water
y a� �-�i F m H ��C A � Q m A6 3.� pQ', �" � Heater
►"�i m a � � .0 G C 3 N ��.�i O.�C � u � W
v�i u � `K � ai 3 o t� ai g u�� 3 � � c� O a lec
.,
� 1 l i
i$e ( ( �
2nd
3rd
4th
(R) e E�ture Connection Ogening Connected with Sewer
(*) � New Fixture, Old Opening Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixturas
Future Fixtures
Old Openinq, New Fixture
Beer Diapensar
Blow Of! Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receivinq Tank
Water Treating Appliance
Hot Nieter 8eater
Gas Ranqe
Gas Dryer
�
�
�,
�
RATE
$ 5. 00
$ 3.50
S 1.50
S 4.00
$ 5.00
g 5.00
S 5.00
S 5.00
S 5.00
g 7.00
S 5.00
g 10.00
$ 10.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
lt of Value of Fixture or Appliance
State Surcharqe
Reinspection Fee S
($15.�Q) TOTAL PEE
TOTAL
s 3S. a�
S /Q.�Z
S
$
S
S
S
S
S
S
S S• OC�
S
S
S
$ .50
g S/.UO
Effective Aug, 1, lynl
Job Address �b �' ° (.��Z t G µ� c s� �� ,
Department of Buildinqs
City of Fridley
Tel. k571-3450
The undersiqned hereby makes application for a permit for the work herein
specified aqreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representatios►s stated in this application are true and correct
Fridley. Mn. / � �,3 . 19�
owt�R ��`L � P%�
KIND OF BUILDING � �r%1/�n•�.r '
USED AS
TO BE COt�LETED ABOUT t 1 � I 3 ^�`�
ESTIMATED COST ! / � °
OLD �UILDING PERMIT NO. PERMIT NO.
�PanY �� S � C� c / �
Siqned SY �,�- —
Tel. No. �O F r��� D
ROUGH INSP.
Date
FINAL INSP. � ` � d � O /
Date
APPROVAL FOR PERMIT r�
MINIHUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 ST�TE SURCHARGE
CiTY OF FRiDLEY
APPLlCATlON FOR POWER FLANTS ANO HEATING, COOLING. VENTtLATION, REFRIGERAT[QN AND
AIR �ONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
lESIDBIiTUL
Furnace Shell and Duct Work,
Burner (Also t�plac�ant turnacs)
Gas Pipinq
(pipinq n�d�d vith nwr lurr�c�)
Gae Aange
Ga� Dryar
• Air Conditioning (ell �izes)
RATE
S 20.00
$ 10.00
S 10.00
S 10.00
S l0.00
All Others/Repair• and Alterations
l� oi Value of Applfance or Mork
COM!lBRCIAL/INOUSTRIAL
1• oi Value of Applianca or Mork
State Surcharge
TO'1'l1L !EE
Rein�pection Eee (515.00)
Rough insp.
Date
Final Insp. �
ste
Approvsl ios p�rwit ��
MINIMUM PEE FOR ANY HFATING PEEiNIIT IS 510.00
PLUS 5.50 STATE SURCNARGB
To�r�r.
S�,_W
5,�,__C'X�
F.[fective �uq, 1. 19H1
Job Addres! /((/�D L�r� Q �/.���!I! /�
Department o[ euildtnqs 6131 Univereity Av�, N.E.. Frldlay. MN SS�l2
Clty oI Frldley
Tel. N571-3150
S Tha under9tqned hereby wake! epplicstlon [or a pe�it fot th� wrk h�rsin
apectfled aqreeinq to do all work !n atrict •ccorda�ce vith tM City Cod��
$ and rulinqs oE the Departwent o[ Buildinga, •nd hereby d�cl�res that all th�
facts and representattons •t�ted t� this application �s� true �nd oorr�ct.
S
S
s
S •S�
S o�SC�
S
Att�ch stack verittcation foif wiN teplace�ent turnace penits
•11ir Conditioners csn not bi+ placed in sid�• yard witlwut
wrltt�n p�•rnisalon tra� adjo[ning neiqhbor.
Fridl�y. MLnn. , 19_
OMNER
RIND OF BUILD2NG �'�� 9
. _ . . ,
USEO AS
10 BE QOMPI.ETED A80117' - -
ESTIMI►TED COST
�l /��
�~'
OLD - NE11 BUILDING PEPMIT 11�. P�PMIT NO. <.- /�JL
�escaxprtoN oF Pua+�ce/eu�wea
HFJITING or POMER PLINTS. Steo, Hot M�t�r, M�n Ais- No. _
Trade lla�e 1_,r�1►� �(�l-�� Sls� 1b. `� �� 0�._
Gpaci ty����� _ Sq. Pt. EDR 07U �_ Mp � _
lbtal Connected [oad ��/ c�O Klnd oi fu�l l�(J�✓
BUPNER - Trade Na�e Sizs No.
capacity Sq. Ft. EDR iU6YR8�AN AIR CO1�IT101�UNG CO.
f M1! CENTER DRtV�E
Cowpany
�/1p0�{$, MINNES07A 6513'Z
5iqned 8y
Tel. No. /O`'I �l Jl 1
M
..�1 � �0
M � �C
v�i v �
0
w
� �
� �.�i ,� t '�
W i9 N i G
����
CIiY OF FRIDLEY -� .
APPLICATION FOR PWMBlN& AND GAS FITTING PEHMIT
�
�
a
� w r c
� g u o�
� �
Rp U
V �
•
�M
0
� �
�
Water Job ]lddress �
il�attL _ �
Department of Buildings
City of Fridley .
�s � Tel. •571-3450
The nndersiqned hereby sates applfcation for a pazait foz the wrk herein
4pecified agreeing to do aIl +rork in strict accordance with the �Citr podes
- and rnlings of tfie Departseat of, Buildings, and hereby �aclues tMt �11 �-
#he facts and re resentatia�rs stated in thi
� ; P s dpplicatioo �re tsue,�+d Qori;eo
2nd ?, � , �` �� ,�, , a-�, � � � �- >, � ��s,• �
�,y �� '�- � �.,� '�� � ` r�,,�� "� � �
3s4 � � � �� . ; ,,� �' �' �": � 1tri -
?. S:: fr n` 'y � r i �,; , ^. c+s,�r< -.
_ ` 1 y ' cW''L ? G. � ��'4�4� � x
�L ' � � g �
„ , < .. , � . .. � d #- r�
: . � Y{ rt � , . ". ,.,. - � < < � . a'.
. .. . .. -:. . �
}'F�� . nJ^ �G � :�.�+� � � 4 F Yrt �.utiu �, `�`✓ �.
' : , ; . iCIND �! y * r . �.:
��J � intura Oonnection Openinq , Coanected with � ,.� ;�e�+er� _. � , = � . .:
t BUII�I1iG `
- _ , . . _ , . �:' v - � * �r �.. = 3i'� �- a r .. , .'�;, � .
� : .. ,
•) � 11av Fixture. Old Opening ; Aiater '• �; - USED AS. �. '� ,""; ��-�"�''�, . .,,�.`±
, _ . , `, , C3`� _ � _,.
,
., " � ; <
,
TO SE 00l�LETBD i1BOU! C3`
��p '�..Q! �.k., .
V �
- RATE SCHEDULE � �w►�n oosr � � � .. �} •�k � �
a ., , � ,
_ .: .
� . , ,. . , � � . . �>
� _ � r __:
� �Li!!l�ING fIX1'URE itATES: � <<, ;'°. '. : N0. itATE ' , . _ . • : ,� .:;. = > a . � ,
, ° i! , -?OTAL � � '. . ' _ �;� - .
_ __ . .
OLD �iEii BITILDING PENlQT "' PERMIT ,MD » �*
�tteir'�iutnsis � �� 5.00_ _ 'w'. ,�,.:._ ,,,,M,.,Y .�^ � �: .,,..,�. ,�,.�� �
S S .. � =� -�� �
- 3►atarr Pi:tnr�a" � �-.50 .� � j, � � � e. �, � "��' � _
. . �. e�-,.. . ." k 'S+i+°.. ,y �.
.e . . . _ *�[, . c� ,` ', . : &"c'. `f � .
°Old Dpeninq, Nev ?i:ture � $ 1.50 ; ' � �9oed �71 ' �`-`''
,
Baar t�ispenser � . " _ r S l.fl0 8 ; , . :- ; ., . ��� �'`'� �
�� ��_ # .
. ., lf�l. �o. �,
. alor Off.Basin - i s 5.00 t . ,. - .
... _ - ..
, : .. . . , . c ., �
Gtc� Baeia 1 s 5.00 = . " � -
. � .
Raio Matar Leader 4$ 5.00 S gp�� INSP. '� �
? �ydraulic Yalv� � ' S 5.00 s _ Date ` _r ;. �: '
-. � „
Snap or Receivinq Tank �$ 5.00 i
ilatez Tzeatinq 1lppliance �, b 7.00 f FIN11L INSP. �t l�`0.5 . n
got Kater Heater '. g 5.00 S Date .
Gas ltsnqe -- ; S 10.00 g . A
Gar Dryer - S 10.00 ; APPROVAL POR BEwiiT �fY�+/,�
-
.
]►LL OTHERS AND/OR REPAIRS AND ALTERATIONS
lt of Valua of liYture or 1lppliance
Asinsp�setioa tae $
�515.00)
State Surchazqe
TO?AL PEB
a G'� �a
S . SO
: �b U
!lINIHUM FEE FOR AtiY PI.�[BING PERMIT IS 510.00
PLUS THE S.50 STATE SIIRClI11RGE
NE�i [] City oP Fridley Effective 4/1/84
ADDN. I] R-1 AiD R-2� ��'� %� S��
AI,TER. I] Building Permit Applieation
YConstruction Address: �lo�G �i�l�%f/.C. �-�0��- ��l�c c�� � ��
Legal Description: �
�Ownez Na�ne � l�ddress : t"/i9-��% !� � I I �'—� �'--'� Tel. � .,% �� "��' �'
Contraotor: Tel. �
Addreaa:
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction draWn on it to scale.
DBSCRIPTIOH OF IMPROPBMENT
LIVL�G ARBA: Length liidth Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECI� AAEA: Length ilidth H,gt/Ground Sq. Ft.
OTHER:
Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setback
Type of Construction: Estimated Cost: a
Approx. Completion Date:
�� �
� C7 �� i`��� . Alt. A Alt B
�
Proposed Driveway Width If NeW Opening Is Desired: �j � ��•-S a
�. See Back Page for Explanation
' �! � -G�.� � Tel . � %�� `� �G �
�DATE: �� <y�' ��� `� APPLICANTc�/ /�- �-�� % � ~�---
�
Permit Fee
Plan Check
State Surcharge
311C Charge
Park Fee
S�.wer Main Charge
TOT�L
STIPULATIONS:
�
a
_
_
_
_
�
CITY IISE ONL7
Fee Schedule on Reverse Side
25i of Building Permit Fee
#.50/�1,000 Valuation
=425 per SAC Unit
Fee Determined bq Engineering
Agreement Neeessary [� Not Necessary [ 7
SuBJECT •
c�ty of Fridley 25 35 5�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I
r
� .
� � •
� ` __._ COMMUNITY DEVEIOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC.
i �
� �
( � �'��1 � CiTV HAL� FRIOLE� 55432 NUMBER pEV DATE PAGE Oi APPROVE BY
�•---'�: `.' 612-571-3450 910-F15 8/7/97 � �
JOB ADDRESS 7600 Brigadoon Place NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 8 2 Blomberg Estates SHEET
2 PNOPERTY OWNER MAIL ADDRESS 21P PHONE
Harold Tieden 7600 Brigadoon Place NE 780-8306
3 CONTRACTOR MAtL ADDRESS ZIP PHONE LICENSE NO.
Same
4 AFCHITECT OR DESIGNEF MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS Of WORK
Q NEW C� ADDITION O ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK Deck
Construct a 15'8" x 11'9" Addition
9 CHANGE OP USE FROM TO
STIPULATIONS See notations on plan.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK 1S SUSPENDEO OR ABANDONEO FOA A PER100 OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO, DWLG. UNITS OFFSTREET PARKING
I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAI.UATION SURTAX
AND OROINANCES GOVERNING THIS TVPE Of WORK WILL BE COMPLIED $1,651 �.H3
WITH WHETHER SPECIFIED HEFEIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE Ofi CANCEL TNE pEpM1T FEE SAC CHAFGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $54.00 Fire SC �1.65
STRUCTION QF THE PERFORMANC� OFy C)ONSTRUCTION.
���4��� /� z��� �' �' ��� PLAN CHECK FEE ro �56E 48
4 ��,,
S�GNATUREOFCON�RACTOROA.4UTHOR�ZEDAGENT �DATEI WHEN PROPERI� V DATE THIS IS �OUR PERMI
VV � �
SiGNATUREOFOWNEAUGO�NNEABURDER� iDATE� BIDG NSP � ���TE
IVEW [ ]
ADDN [ CITY OF FRIDLEY
ALTER (� SINGLE FAIVIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: � �`� � ��-L �,�700 � ��
Legal Description:
Effective Ul/97
Owner Name & Address: �"�t�c.� �(��T(, Tel. # 7�0�-S3oro
Contractor: MN LICENSE #
Address
LIVING AREA:
GARAGE AREA:
DECK A.REA:
OTHER:
:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length i� � �3 c� Width ( ( � �l � � Height � �
�ng� Width Height
�ng� Width HgtJGround
Tel. #
Sq. Ft. �2 x � ��
Sq. Ft. = � ��. �
Sq. Ft.
Construction Type: W 00 � Estimated Cost: $ 8 4 O- o o �G�� j�
(Fee Schedule on Back)
Driveway C�rb Cut Width Needed: Ft. + 6 Ft = Ft_•x $ _$
, -
DATE: 7 2�1 '�i 1 APPLICANT: Tel. # 7�� � C�.3 0�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
�roz�aL
s�rlP�ri�n�rrovs:
CITY USE ONLY
$ �� Fee Schedule on Reverse Side
� t L .001 of Permit Valuation (1/�Oth%)
$ , 0 $.50/$1,000 Valuation
� $950 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 [ )
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NEW
ADDN
ALTER
Ll
� l
[l
Effective 1/1/97
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: l `�' d � � �( � � � � � � ��� � �
�
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
�ng� wid� Height Sq. Ft.
�ng� . width Height Sq. Ft.
�ng� Wid� Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $
� �� , (Fee chedule ack)
Driveway C�rb Cut Width Needed: � Ft. +�t = �Ft x $ �� � — $
DATE: � � °� � APPLICANT: �
�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
$_
$_
$
$
$
$
$
$
$
CITY USE ONLY
�P-�as�a�
Tel. # 7 a d � ��d (o
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
_ $. SO/$1, 000 Valuation
_ $950 per SAC Unit
_ $5.00 (State Licensed Residential Contractors)
_ Alt. "A" or Alt. "B" Above
_ $450.00 Conservation Plan Review
_ Fee Determined by Engineering
_ Agreement Necessary ( ] , Not Necessary [ ]
w
sue�ecr P IT NO. �
Cit of Fridley 2 82 � �
r
5�2L��p� THE 7WINS g u f L D i N G P E R M I T
� .
� � •
COMMUNITY DEVELOPMENT OIV.
f � L � PROTECTIVE INSPECTION SEC. /,,, p� �
i � �rJ o
i
� � �"'1 � CITY NALL FRIDLE� 55�32 NUMBER REV DATE P�GE Of APPROVEO BY
�'"""�"� �'' 612-571-3450 9�0-Ft5 10/13/98 / /
108 ADDRESS
7600 Bri adoon Place NE
t LEGAL t�T NO. BlOCK TRACT OR ADDITION SEE ATTACMEO
DESCF. 8 2 Blomber Estates sHEET
2 PROPERTY OWNER MAIL ADORES$ 21P PHONE
Harold Tieden 780-8306
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO
Thurs Roofin 5717 113 h A N -
4 ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PNONE UCENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK [}�g REPAIR O MOVE O REMOVE
O NEW ❑ AODITION O ALTERATION
8 DESCRIBE WORK
Reroof house and ara e 24 S Tear-off
9 CHANGEOFUSEFROM t0
STIPUlAT10NS
Underlayment must comply with the State Building Code.
TYPE OF GONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PEFMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING. MEATING.
VENTI�ATING OR AIR CONDITIONING
TNIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONS7qUCTION LONING SQ. FT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONS7RUC710N
OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOO OF 120 DAVS AT
ANV TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIFV THAT I HAVE READ AND EXAMINEO 7MIS AVPLICA710N STA��S GAFAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Oi LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMP1.IEfl
WITH WHETMER SPECIFIEO HEREIN OR NOT. THE GRAN7ING OF A PERMIT $2056 $1.03
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMIT f EE SAC CMARGE
PROV�SIONS Of qNY OTHER STATE OR LOCAL LAW FiEGUTATING CON-
STRUCTION� Ofi THE PERFORMANCE OF CONSTRUCTION ]�}. ],rj Fire SC. ��2. �6
,�,. PIAN CMECK FEE TOTA EE
`'e�"�- 6 �D ~i.,�� Li e 5 0 $ . 84
S�GN4fUQE OF CONCPACTOQ OA AUTNOQ�ZED AGEN� �D�rE� HE ROP VALIOAT THIS IS 1'OUR PERMIi
a-i� -9�
S�GaaiuQE O� OWtiEp��� OWtiEQBUi�DEQ� �O�TE� . B G ia5� � � r�<<E
� �.
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description: _
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
.�}�
�� p��
�D a
Owner Name & Address: /�c r�(� �': � n,i ,�oOG i�r r �GQ�w p��� < Tel. #�?�Q ��1'Z_
Contractor: �� u r� �,c, � s"t' MN LICENSE # g.3� �_
Address: S�� I%-�l l���-v� �c� . Tel. # �� 4� S6 a<!
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
�t
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: /�e.,ro o� �.�,� o�� Estimated Cost: $��' o�d� %
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: _�(� -I?',-��'-� APPLICANT: �.��_�,����i __ _ Tel. # �� � 6��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � 7�
$ � Q �o
$
$
� � Ud
$
$
$
$
$ ��
CITY USE ONLY
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 �
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
sue.,ecT P O.
c�ty of Fridley 3 3 9
AT THE TOP Of TME TWINS g � I L D I N G P E R M I T
r
; ` CEIPT NO.
• COMMUNITV OEVEIOPMENT DIV. j
� � a.------ � ��`� 1
r � � PROTECTIVE INSPECTION SEC.
� � �'�'1 � CITY NALL FRIDLE`/ 55�32 NUMBER REV DATE PAGE O� APPROVEO BY
�'""'�� ,�' 763-571-3450 910-F15 10/ 1 /03 � �
JOB ADORESS 7600 Brigadoon Place NE
t IEGAL LOT NO. BIOCK TpACT OR ADDITION SEE ATTACHEO
oesca. 8 2 Blomberg Estates SHEET
2 PFIOPERTY OWNER MAIL ADDFES$ 21P PMONE
Carl Towberman 7600 Brigadoon Place NE 763-786-9034
3 CONTRACTOR MAIL ADDRESS ZIP PNONE LICENSE NO
Same
� AqCHITECT OR OESIGNEfi MAIL AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADOFiESS ZIP PNONE LIGENSE NO
6 USE Of BUIIDING
Residential
7 CLASS OF WOFiK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR p MOVE O REMOVE
B DESCRIBE WORK
Construct a 12' x 16' Shed
9 CHANGEOfUSEFROM TO
STIPULATIONS
5ee notations on plan.
�� ��r
i ��3efore qi
all gg,ng �all fo,r
utility �o�atio�
����11R5a-0002 S
�a sY �wW
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVIOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING. HEATING,
VENTiLATING OR AIR CONDITIONING •
tMIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTHOfiIZED IS NOT GOMMENCED WITHIN 60 DAYS. OR IF CONS7RUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AfTER WOqK IS COMMENCED. NO OWLG. UNITS OFFSTpEET PARKING
1 MEREBY CERTIfV 1HAT I HAVE REAO AND EXAMINED THIS APPLICATION 1 STA��S GAfiAGE$
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VALUATION SURTA%
ANO ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPL�EO @
WITH WNETMER SPEC�FIEO MEREIN OR NOT THE GRANTINC, OF A PEAMIT �4,245 y�L.12.
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMl1 fEE $AC CHARGE
PROV�SIONS OF ANV OTHER STATE OR LOCAI LAW REGULATING CON-
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION � L 11 . Z.S Fire SC ��1 . ZS
PLAN CHECKfEE TOTA�FEE
$117.62
S�Ga UAE O� CON' •.TO AUTtiOA�ZED OGENT i•tE� W EN PqOPERLY VAUOATEO THiS �S VOUQ PERMiT
_�' � -��/ ' .� YCC -- �- ---��
S� Bw�DEQ� �D�TE� o qcrE
NEW ( ]
ADON ( ]
ALTER ( j
Construction Address:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R•1 AND R-2
BUILDING PERMIT APPLICATION
�� O i� ��G ac�t�_n� I�-�c
Effective 1/1/2003
(763) 572-3604 dg insp ��
(763) 571 •1287 x
�� ��-
1 �
i i� �
Legal Description: �/ � s-� �d � `�`'" "" "
Owner Name & Address: �a�� ( �� �'' �� Tel. # '�l 3- �� - yo ��
ContraCtor. � � � MN LICENSE #
Address:
• Tel. #
LtVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height _ Sq. Ft.
Length Width Height �_ Sq. Ft.
Length _, Width HgUGround Sq. Ft.
. _ , —�
Construction Type:. �.� �" t� �-` Estimated Cost:
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$
' Tel.# - �' ' b �
DATE: l� o APPLICANT: -
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
PeRnit Fee
Fire Surcharge
State Surcharge
SAC Charge;
License Surcharge
Cur� Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$� �
$ L � .
$ �-. � ..2
$
$
$
$
$
$
$ l�,
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%) '
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering � ,
Agreement Necessary [ ] Not Necessary [ ]
_ •,
.�
. �UIDE TO ASSIST �OU WITH YOUR
E=Z F E YARD BA.RN
COPYRIGHT, MENARDS INC. AUGUST 1999
Window Not Included,
Sold as an Option.
�GENERAL
Prior to beginning construction, the area selected for the shed
location must be leveled and cleared of obstructions.
2. INVENTORY
Separate all lumber, hardware, etc. i�
3. FRAM� PREPARATION
Unfold, each frame, setting aside
two frames. to be used as end 1°'�9ure 1•
walls. From 1"x4" Pine boards, cut �y-1%
Gusset plates 6" long l`
• 24 pieces for a 12' building ,\
• 32 pieces for a 16' building ��
• 40 pieces for a 20' building ��°`
Apply gusset plates on each side ��
of the top and bottom fold
locations. Frames to be used as
end walls require only one gusset �$
plate tap and bottom on the side
opposite of the metal plate, and to
the inside of the building. Use
four 8d nails on each plate. See
Figure 1.
PLEASE Na1'B: T6is shed coostructioo aid is fatended
rokly to p�ovide �enerrl knowkdge as W one of the waye a
s�6�e�d� �m�ay 6�-e eomfencted usiog materlsle awilrbk hom
�. We �oggeet you check wit6 your local
bniidio� otticials ngardinQ eite location, permit
procedures, sa(ety regul�tioos and specitications of
materiale nfe8 to coostruet your new etorage shed.
Builders who ntiliu t6fe aid mnst proceed �t their own �
risk fnd sn aokfy raponsible tor comp{ying wilh all �
b�n�ild�in� e�a��les w6kh pertpin io their rnmmuoity.
4�' 6asby dieclaime dl liability tor �oy damages
whether conecqueotial, iecidental, epccial or otherwise,
whk4 may iaull trmn [ollowing this do-it yourad[ aW.
2"x4" Upper
and Lower
Roof FYame
Member
2"x4" Sid Wall
Frame M mber
You rrrn� �ad rrnre or
i�ss rrataials deper�d�g
ar� t�ow yo�.�. b�.�c'L If ynu
r�d rrn►e u� s�l ynu.
rr�o►� i�'y�u F��e le�t
ouers, brlrr,� it Uac�C!
Lumber listed as nominal sizes
1 ��X4��1CF)" ,
long gusset
plate at top
fold locaUon
T
_��
High Roof
� Low Roof
Overhang
. � ii�
Treated 2"x4" 1 "x4"x6"
Bottom Frame long gusset plate
Member at bottom fold
� location
l-1/2" 12'-0"
E-Z BUILD BARN FRAME
s4�
-1/2„
, I Fligure 2.
3-1/2'
�
,��:�.�: �
�
22-1/4" ?A-
E�
s-i�a•
�
95"
��
45-1
2"x 4"x12'
endwall studs
cut to fit.
2"x 4"nailers, cut
to fit.
2"x 4"x 10' Endwall
studs, cut to fit
Toe nail studs into
place
20-1/2" 20-1/2" 20.1/2" 22-1/4"I
�i2� -o"
2"x 4" Gable studs
cut to fit at
locations shown
45 4"
2"x 4"x 10'
Header cut to
iit
2"x 4"x 8'
door frame,
cut to fit
�-�iz-
'Tn ma�u,� areas building
pe►mits are not required for small
scale storage bulldings, but it's best
to check wirh your locxa.l o�"�cials."
BACK WALL ��� ,Q,.
Place siding on frame --mark
and cut to fit.
; -------------------------------------�
, �
�
� �
� �
� ,
� ,
; ; 3-48"x 48"
� ' siding
' � pieces cut
�
as shown
3-48"x 96"
Siding
nieces cut
as shown
4. BACK WALL FRAMING
Using one frame selected as an end-
wall, measure and mark stud
locations according to dimensions
shown in Figure 2. Place the proper
length 2x 4 studs at those locations.
Mark required length and angles
and cut to fit. Toe nail studs into
place using (2) 8d nails top and
bottom. See Figure 2. Cut 2x4
nailers and install at dimensions
shown in Figure 2.
5. FRONT W.ALL FRAMING
Using the remaining endwall frame,
repeat Step 4, using Figure S as a
guide.
NOTE: When using a roll-up door, the door
opening must be frcuned to the exact size of the
door. Example: 8x7 Roll-up door will have a
ished opening of 96"x 84".
6. SIDING BACK WALL
Cut two 4'x 8' sheets of siding into four
48"x48" pieces. Use three fu114'x 8' sheets and
three of the 48"x 48" pieces. Cut each piece as
required. Nafl siding pieces onto back wall
frame with 8d nails every 8" on center. See
Figure 4.
7. SIDING FRONT WALL
Cut one 4'x 8' sheet of siding into two pieces
48"x 48". Cut one 4'x 8' sheet into two pieces
,;, �'' 24"x 96". Cut each piece as required. Nail
:: � � siding pieces onto front wall frame with 8d
v nails every 8" on center. See Figut�e 5.
� NOTE: (for step 7) In order to keep moisture
-� m wicking into the siding, keep the bottom
� of the siding 1" aboue the bottom of the
treated bottom frame member.
8. FRAMING
From two treated 2x4's, cut two rim
joists:
• 143" for a 12' building
• 191" for a 16' building
•239" for a 20' building
Place the cut rIm joists 12' apart in
the area selected for the barn
location. Stand the front and back
walls up at the proper ends of the rim
joists. Nail rim joists to the end wall
frames using lOd nails. Temporarily
brace each end. Stand the remaining
frames up:
•7 far a 12' building
•9 for a 16' bullding
• 11 for a 20' building
Nail to rim joists as shown in Figure
6. Install a temporary brace across
low roof inember. See Ftgure 6.
9. SQUARE THE BUILDING
At base of building,
measure across diagonally.
Adjust the building until
AC=BD. The building is
then square.
10. FLOOR SUPPORTS
From the remaining treated 2x4's, cut four
21-1 /4" floor supports and the required
amount of 22-1/2" floor supports,-
• 8 for a 12' building
� 12 for a 16' building
• 16 for a 20' building
Install using lOd nails, at dimensions
shown in Figure 8.
11. FLOOR SHEATHING
•12' Building:--FYom two 4'x8' sheets of floor
sheathing, cut three pieces 48" wide by 47-1 /2"
long. Cut three 4'x8' sheets to 95-1 /2" long.
•16' Building:--Cut six 4'x8' sheets of floor
sheathing to 95-1 /2" long.
�20' Building:--From two 4'x8' sheets of floor
sheathing, cut three pieces 48"x47-1 /2" long.
Cut three 4'x8' sheets to 95-1 /2" long. In
addition to the cut pieces mentioned above, you
will need three full, uncut 4'x8' sheets.
u Y u u "
� Ftglu+e 9.
� �
NOTE: (fqr step 11), Each
piece_ mu.�t be_ notched on
sides to fit around� wall
frame members � as Seams . �
required. Stagger; end ' ' '
joints front to back. � Nail
-----p ----,------------1--------
in lace with 8d nails �:�
euery 8" dn center. .
�
,
; Notches
� .
12. SIDING SIDE WALL
• 12' Building-Cut (6) 4'x8' sheets of siding to 71 ", long.
• 16' Building-Cut (8) 4'x8' sheets of siding to,? 1" long.
•20' Building-Cut (10) 4'x8' sheets of siding to 71"�
long. Make certain end walls and frames are plumb
(vertically level.) Then apply siding using 6d nails.
13. FASCIA TRIM
Nail 1"x6" to exposed ends of roof overhang using 8d nails. Top edge of fascia board should be 1/2"
above the top_: of the roof frame member. This will cover the exposed edge of the roof sheathing.
•12' Building Eave Fascia:---Use two 1"x 6"x 12' trim boards. NOTE: Tack gable end trim into place
•16' Building Eave Fascia:---Use two 1"x 6"x 16' trim boards. and check fit. Make any required
•20' Building Eave Fascia:---Use four 1"x 6"x 10' trim boards. �,1��n� ��� P�Or t° na.ti.ing in
From lx 6 Pine boazds, measure and cut remaining trim to fit Gable Fascia. Attach to building.
Nail roof'sheathing in place using 6d nails every 8" on center. Stagger sheathing end joints from frame
: to frame ,whenever possible. , �
;� 12' Bu�lding: Overhang: from one 4'x8' sheet of roof sheathing, cut two 8"x 96" and 8"x 48" pieces,
leaving a�piece 24° wide by 96" long.
; 72" Lou� Roo : Using the 24"x 96" piece, cut two 24"x 48" F�9ure 1 O.
'pieces.�FYom�one 4'x8' sheet, cut two pieces 48"x48". Cut 1-13 ls�
� , ..Y. �� �� , _I 1-11/16" 13/4
another 4'1c8', sheet into two pieces 24 x96 . You ll also need �1 � Bot.
: Top _ :.::
two full. uncut 4'x8' sheets. �����
45-1 /2" H Fic�Q.�R .,�:' Cut three 4'x 8' sheets to 45-1/2" wide. 1-13/ls^ i-ii/is°
59-9/ 16"
From one of those pieces cut two 45-1 /2" wlde by 48" long 4 pcs. req'd.
; pieces. i°Xs» �►�
•ig� guildiug: Overhan�: from one 4'x8' sheet of roof 1-11/ls" 1�4"Xbuck
sheathing, cut four pieces 8" wide by 96" long. � 1-3 4°
,.
_ . ...
72" Low Roof From two 4'x8' sheets, cut four pieces 24"
wide by 96" long. You'll also need two full, uncut 4'x8' 25„ `�-1�4�
sheets. i- ls/ ls„
45-1 /2" Hiah R� Cut four 4'x 8' sheets to 45-1%2" wide by 8 pcs. req'd. :
I 2• 94�
96" long.
•20' Building: Overhan�: from one 4'x8' sheet ofroof .�_1�4„
sheathing, cut four pieces 8" x 96" long and iwo pie�es 8"x 48".
72" Low Roof• From two 4'x8' sheets, cut four pieces 24" ' i%� : i: �
wide by 96" long. From one 4'x 8' sheet, cut two pieces 24"x � �,pic� ���
48". From one 4'x8' sheet, cut two pieces 48"x48". You'll also �i: M�ter I-�" � I
need four full, uncut 4'x8' sheets. 2 pcs. req'd.
45-1 /2" Hic�,h Roof• Cut five 4'x 8' sheets to 45-1 /2" wide by
96" long. From one of those pieces, cut two 45-1 /2"x 48" long pieces.
15. DOOR FRAMING
Cut two 4'x 8' sheets of siding to 48" wide by 94" long.
Cut 2"x frame members as shown in Figure 11. Attach
to door siding pieces and attach hasp and hinges. Cut
and attach 1"x door trim and crossbucks as shown in
�g11TC 10.
16. TRIM
From 1"x 4" trim boards, measure and cut 8 corner trlr�
pieces. Place (2) 94"-1 "x 6" on each outer side of door
opening. Mark and cut (1) 1"x 6"x 12' running across
the top of the door opening and extending out to meet
the lower roof trlm. Nail to building and hang doors.
17. FINISHING ROOF
Apply roof felt. Apply shingles using 3/4" rooting nails.
Follow instructions found on the bundles.
18. FINISHING BUILDING
Paint/stain to $nish.
Figure I1.
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CITY OF FRIDLEY INSPECTIO(V DIViSlON l:ttective Jat�ud�:y 1, zttu3
�643] UniversityAve NE
mFridley, MN 55432 APPLICATi01d F4R P�OWER PLANTS AND yEAT�NG, C04LtNG� VENTILATEORI,
�;763) 572•3604 RE�RIGERATiON AND AIR COhIDITtONiNG SYSTEMS AND DEYIGES
�FAX (763) 571-1287
RATE SCHEDULE
2esidential
Furnace Shel! and Duct Work, Burner -
kiso Replacement �urnace
(Side Vent • Fill Out Back)
Gas Piping (�leeded witfi new furnace,
but not replacement)
Gas Range
Gas Dryer
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00
$ l 0.Q0
�Air Conditioning • All Sizes $ 25.00
�
�All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appfiance or Work
ommercial/industria!
1.25% ot Value of Appliance ar Work
State Surcharge
N TOTAL FEE
m
�
�
�INIMUM fE� FOR ANY HEATI[�G/COOLlfdG/YENTILATION
�:�RtGERATIONlAIR CONDITtONING PERl�t}1T IS $25 O�U
_US THE $.�0 STATE SURCHARGE
m
m:INSPECTION FEE $47.00/Hr
�
mir Conditioners can not be placed in a side yard without
Nitten �ermission from adjoining property owner_::
�
�
m
�
m . .
� •
�
�'
•.
owrv�R�� E �%ll�
;
/
�
BUILDING USED AS V�eS��en t
ESTIMATED C05T I��o-�° PERMIT NO. ��5� L;�,�
DESCRJPTf41�J o FURNACE AND oR g(�RfV�R
$ T ade Nameng U�its Circle One (Stearn} (Hot Water) (Warm Air)
8.�� Size No.
HP EDR
$ - Fuel Total Connected Load
Burner Trade Name/y�.�- f�%uw Size No.��c�,�. l X J
$ BTU 3G, r cU _ Hp EDR
��sf4�r G� ���n��ee "'/��s
$
$ .50
$a�.�o .
i
The undersigned hereby makes appl�cation for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that alf the facts and
representations sYated in tyis applicat�on are true and correct.
DATE i C�- g -l> :�
HEATING CO ca.s ��r ��S ���5
Signe �-t . TEL # L01S%%�-��%7
FAX # �9� �- %� • �o"� %�'
� Approved By� RO4g�_tn Date _ F�Raf Date �� �< 0�
�
OUT BACK SInF Fnn eTe�u ..�„�.-�,,.�.,,.. .. _ _ _ _ _ _ _:
Building
Inspections
763-572-3604
763-502-4977 FAX
� / a5� BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-2010
DATE YOUR E-MA[L ADDRESS
SITEADDRESS '��L�'G� .c�1���7 ��c�ON /�G �v� �'�DLGS� MN SS�f 3v�-
THIS APPL(CANT IS: f�OWNER ❑CONTRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
��%� ��!{z/C
Permit N
Received By:_
Date Rec'd: .-�
�
ADDRESS: �T��C� l3fd /�i�:� v�i`� y-'L /11t CITY �-7�'% .DL�/ STATF� l�/ ZIP 5-��/� 2
PHONE: '��, j— '7�/ Z— G %✓�
NAME:
STATE LICENSE #
EXP DATE
ADDRESS: CITY STATE ZIP,
PROPERTY TYPE �.�SiNGLE FAMILY/NEW CONSTRUCTION SIZE �2 cn� J S�
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ B;4SEMENT FINISH
❑ DECK
TYPE OF WORK: I❑ NEW HOME CONSTRUCTION
❑ GARAGE/SHED ❑ WINAOWS
❑ ROOF ❑ DRAIN TILE
J�"SIDING ❑ OTHER
❑ SWIMMING POOL
❑ ADDITION
� REMODELING
DESCRIBE WORK BEING DONE: i���i l2 �-%rZ �. ;i r s f�c r-/v G: ��: �{-- �i�4-� /z �� �-- 'i�.j�= E,�-Jt�d E�
SIZE OF IMPROVEMENT �/;� pD $,.,y,t� S/ D.��/G LENGTH G� WIDTH ��f HEIGHT SQ FT � 7
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl.
❑ Aluminum
❑ Other
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
O Trim
❑ Fascia
WINDOWS
IN EXISTING OPENINGS ❑Yes �No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
BASEMENT REMODELING SUBMIT:
1. Existing Fioor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECIES,
ADDITIONS, & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
FOR WINDOWS — PROVIDE U-VALUE AND
MANUFACTURE STICKER ON WINDOW.
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �,00 D, c� � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
�/%i'�' ,
���
16� %
_ �r
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)
$2100 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
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 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 on site; 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 �.'�"CliL✓�' `r��f PRINT NAME �'% Z �"��% �_ DATE C�j � 11i `/�