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AF - 35648,� � '�"� City of Fridley, Minn.. BUILDING PERMIT Da�: __ AIIGIIST 20, 1965 Owaer: ELVERT I. HAUGEN Builder SAME ,Ad� 5229 Capitol Street N. E. Ad� Fridl�y 21,, Minnesota LOCATION OF BUILDING No. 5229 S�t CAPITOL STREET N'.E. Part of Lot I.ot Corner Lot ,� Sewer IIevaiaton Block Inatde Lot Addition or Sub-Division Setback Sideyard .� Founda.tion IIevation ��a � � N° 8392 DESCRIPTION OP BUILDING To � v�a �: Front Depth Height Sq. Ft Cu. F't Front Depth I�eight Sq. F'� Ctl. F't. Zj►�e of Conatruction F�t. Cost �,�1� UUO��..__ To be Completed R�BU=LD GARAGE AFTER TORNADO In consideraifon oP the isauance to me of a permft to conatruct the buildiug described above I agree to do the PrcPosed work ffi acaordance with the d�scription above set �Arth and in c:ompl�ance with a'll provisions of ordina,nces of the dty of FridleY• y" �� / In co�fderation oP the �yment of a fee of $�'•00 , permit fs herebY granted to ��T I. �G� to construct the buflding or addition as d�cribed abave. Thispe rmit ia granted upon the express condition that thep�so a to whom it is graated and his agents, e�hployees and worl�en, fn all work doae in, around and upan said building, or anypar� thereof, shali conform in all respecta to the ordinanc� of FridleY, Minnesota g la:atton, conatruction, alteration, maiatenauce, repair and moviug of butld�n�s �� dty ]imits�an�this permit may be revoked at any t�me upon violation of aay of the provis�tona of ea�d ALLEN G. JENSEN B�� NOTIC& '1l�S penek doa eo� corer t6s coesfruaHan, �IHltoe. ter vridao, P�uml+te6� �+� 6uNo9� +ew�� er water. B� an to � Na Bnildine I�or fo� apuat� p�m�tfs h� f6�q tt�. APPLICATION FOR BUILDING FERMIT CITY OF FRI1n,EY, MINNESOTA OWNER' S NAME �L�(��21 -°� • ��} I,! P'�� BUILDER annx�ss � � � i � F�� z. S c , �/. L �,nn�ss LOCATION OF BIIILDING � . NO � STREET_ S�-„1 `� C'' l� � l TCeL. S!.�V�, pART OF i0T LO�' BLOCR ADDITION OR SUBDIVISION CORNER LOT TNS�DE LC1T SETBACR SIDE YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certiiicates. DESCRIPTIOR OE BUiLDIRG To be used as; �-� %'� i2 %C12 nlc�lJ � E ��U I c_.() � ��}i2.� � E Front�_Depth � � $eight � � Sq. Ft._ ��C� Cu. Ft. U� Front Depth Aeight Sq. Ft. Cu. F't. Type of Construction Estimated Coat_ j(�J(J(j o= To be completed � � The undersigned hereby makea application for a permit for the work herein apecified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildinga, and hereby declares that all the facta and representationa stated in this agplication are true and correct. DATE SIGNATURE �'Yl l • (Schedule of Fee Costs can be found on the Reverse Side3. �v _ �. � . � ��_ � � � �� BIIZLDiNG PERMIT FEE SG�EDOI.B SECTTON 2. The InBpector of Buildings shall, before iseuing aay permit for the erection of anq building or structure, or for any �ad�d.ition to any exfsting building or structure, or for any alte�ationa or repairs to any esisting building or etructuxe, upon applic�tidn therefore, requtre zhe payment by the applicant.for such permit of fee� to the amount herein below eet forth and in the manner herein provided to-wit: 2.1. �.For anq euch permit for the erection of anp fire-proof building, othei than a�ara�e, warehouae, fa�ctorq or grain elevator, or for the erection of any fire-proof addition, for simiZar occupancy, to any esisting building, shall,he..at the rate of $1.40 for each one thoueand cub�c feet, or fraction thereof, ia such cubical contents. 2.2 For any such permit for the erectioa of any fixe-proof garage, �rehouse; factory or grain'elevaCor, or for the erection of any fire»proof additioa, for similar occupancy, to any esiating building ahall be at the rate of $1.25 for each one thousand cubic feet, clasaified as 'tfireproof" by Section 502 of the Minneapolis.Buildiug Code. BOIISES 2.3. For any such permit for the erection of any noa•fireproof building, other than a garage, warehouso, factory or grain etevator, or anq non-fireproof addition, for s3milar oacupaacy, to any existing building - permit $1.00 for each one thousand cubic feet. � GARAGES 2.4. For any auch perm3t £ar the erection of anq non-fireproof garage, warehouse, factory or grain eZevator, or for the erection of any non-fire-proof additiva, for similar occupancy, to any esisting builditig or for each-such building or addition - nimety cents ($0.90) for each one thous.and cubic feet or fractio� thereof, in the cubical contents thereof with the mini�m of $4.00. For the purpose of computing fees for building permits, the cubical contents of any building or addition to a uui£orm height throughout by multiplying Che ground area covered from a point six (6) incheff bel�ow the floox 3.3ne of the . basement or ce�lar to the.average h�s�ght of the upger aurf�::e or to the average height of the roof surface of the main gable of a pitched roo�. 2.5. �For r.epairs or al'terat�.ons to an esisting stru�ture, the fe� sha11 be at the rate of $3.00 per each Fi-ve H�an�red Do1I�;e ($5�JO,G�)•or fraction thereot in the cost of aZ1 proposed work. . 2.6. In no case sha11 the fee charged for any permit as set'forth in Section 2 be less tI13A $4.d0. STORM REPAIR bA,MAGE r�ES: . � Residential: Estima.�ed Cost of work up to�$500.00 -$5.t10 Estiai.�.�ed Coat of �ork= over $S�Q.Oa - $iU.00 Commerci�t;- Estim.a.ted�st of work up �o $5n��00 -$10� _-� �_,� Estimated .st of work over $50II�.00 -$20, � SUBJECT -- �°j�('�=a=� City of Fridley � 12831 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ' r � '- RECEIPT NO. � `L _ COMMUNITY DEVELOPMENT DIV. � r i � PROTECTIVE INSPECTION SEC. 1 . , t4 � �'�� CITY HALL FRIDLEY � 55432 NUMBER REV. DATE PAGE OF APPROVED BY "•�-'� � ,�� 812-5603450 910-F15 12/9/74 � � JOB ADDRESS 5229 Capitol Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED DESCR. S S Cd��.SOri � S S1'I�IId].'t MSIlOZ' $OLl'�1 At�C1Y1. SH EET 2 PROPERTYOWNER MAILADDRESS 21P PHONE Dale Brodal 5229 Capitol Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. North Central Builders 7401 - 42nd Avenue North 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house and garage with steel - cover soffit and facia- install � 9 CHANGE OF USE FROM TO STIPULATIONS �`�� ',� 4 �, ��ai�� ',. �. _ ,�,._� � �m@� 6 � 1�.� 4 4�a'� ;�� 6;$�._ 0.^.r /- q� r"',' i.�, r� p` 5 �� t'. 4 s e ��.��3��F $'9��-��v'�'��2��.� i��'�+�' �u��:�i��, + SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 'te@],�F].Y)@i dSS THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK �S COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ,�i�C $3, 500 �.. %5 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR�N OR THE RFORMANCE OF CONSTRUCTION. � yS`2].,OQ PLAN CHECKFEE TOTALFEE ` i;� � `�t� $22.75 <, 5 ATUREOFCONTRACTORORAUTHORI2EDAGENT (DATEI WHEN PFiOPERLY ALI ATED,�THIS IS YOUR PERMIT � �O� �SIGNATUREOFOWNERUFOWNERBUILDERI IDATEI BLOG. WSP 4A E � AP.PLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA owrr�x's r�: �^' � �� ad�( BUILDER: f�a� i�i C��%r�- ( t'�� t�l��s ADDRESS :��. z� �zp eTo �' /f/�.� ADDRESS : 7�0 /-�� Z�-� e lr% NO :. S 1�`Z % STREET :�?,�'1 r�b I LOT : ,� BLOCK :� ADDITION :��. ir l5 p�/ S�c�'v� r� .� Sc� , CORNER ZOT: INSIDE LOT: SETBACK: SID�YARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on thase Certificates. ��e� c;� % ocss e� ar-� ��.v� L, S 1��( . 5 /�' f °_ �o U� �o��-� % /��c � � - /�v5>ai( �=�5v-c �las� slo�� a��rak �Py e��ti� �� t'�o�Ji ,� !� ��,e HESCRIPTION OF BUILDING � To Be IIsed As: Front: Depth: Height: Square Feet: ZBC,C7 Cubic Feet: Front• Depth• Height• Square Feet; Cubic Feet: Z�pe of Construction: Estima.ted Cost: $��a�`� To Be Completed: �l a/�i / � % �' %� The undersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in st�ict accordance with the City of Fridley Ordina.nces and rulings of the Department �f Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. � DATE: ��T' `%' %`� SIGNA ` ��`' (See Reverse Side For Additional Information.) � �C �p p� _— ��' � � � ��:'l (�'�(�4'� ��r �. �• a rr � � � �� s � ,_ a . _ � . � ,��. �r . a , 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 amaunt herein below set forth and in the ma.nner herein provided to-ti:it: IJNIFORM BUZLDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, i.n such cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building percaits, 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 07: the cellar to the average heights of the upper surface or to the average � •height of the roof surface of the main gable of a pitched roof. For repaixs 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 chaxged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for eonstruction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A CerCified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Oc�upancy shall be ma.de ten (IO) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occup3ed until a Certificate of Occupancy has been issued. r ra � � —....�..�,r,--'-'_�_ _....., ...... . . . . . . . . ..,� _ sue�ecr City of Fridle� , , �� s� BU ILDIN� PERMIT .� COMMUMITY OEVELOPM�NT DIV. L' PROTECTIVE INSPECTION SEC � ` _ , _'•' r ; ; � . , � _ �"'1 � CITY HALL FRIDLE� SS1�2 NUMBER REV D�TE �°"�' �'' 612-571-3450 910-F15 11 JOB ADDRESS 5229 Ca itol Street t LEGAI LOT NO. BLOCK TfiACT OR ADDITION DESCR. ,r 8 Summit Ma.nor - South 2 PROPERTY OWNEF; MAIL AOOR�,S$ Dale Brodal 3 CONTRACTOR MAIL ADDRESS Brian Claypool Const. 810 112th Ave,NW Goon Ranidc 55 4 ARCHITECT OR OESIGNER MAIL ADDRESS 5 ENGINEER MAII ADDFIE$S 8 USE OF BUILDING Residential ZIP PAGE OF / / 28616 � �� APPROVEO BY SEE ATTACNEO SHEET PMONE LICENSE NO 173 LICENSE NO. LICENSE NO 7 CIASS OF WORK O NEW 0 ADDITION � ALTERATIpN g REPAIR O MOVE O REMOVE B DESCRIBE WOFK Reroof house and �ara�e (24 Sq) Tear-off 9 CHANCiE OF USE fROM STIPULATIONS TO Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION IONING AUTHOR12ED IS NOT COMMENCED V�1ITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANQONED FOR A PERIpO OF 1i0 OAYS AT � ANV TIME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS I HEREBY CERTIfV THAT I MAVE READ ANO EXAM�N�O TNIS APPLICA710N AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILL QE COMPLIEp WITH WMETMER SPECIFIEO MEREIN OR NOT. TME GRANTiNG OF A PERMIT ' ZOSC DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CAMCEL THE pEqM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING GON- STRUCTION OR TME PERfORMANCE OF CONSTRUCTION � `�E; � ' � � ^� � � Q � PLAN CHECK FEE % sy��/r.�r S�GNAiURE OF CON'FACTOA Op AUTMOA4E0 AGENT IDATEi M SiGNATUWE O� OWNEFd� OWNEA8U40EA� �DATE� . ' � B OG �NS SQ. fT STALLS FEE OCCUPANCVL.OAD CU FT f PARKING GARAGES � �� Ii6TF NEW '' ADDN ALTER ['l [l �� ConstructionAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Sa� 9 c��;�� s�- �-�,��.� y Effective 1/1/98 �� r �� I,egal Description: Owner Name & Address: i � /� L F � �"n� �— Tel. # � 7 � � 9 ° � � Contractor: � � - �� e( � Y /� �n �- C? h S f � MN LICENSE # a n � � � � � � Address: �'1 � ll 1 � ,� ��` .�-. u-, C ,2, �.,-, s s �t � d Tel. # 7 5' S � � � � 3 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: OTHER: DESCRIPTION OF IMPROVEMENT Length W idth Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: /� � /l � � � Estimated Cost: $ �J = 5�. � (Fee Schedule on ack) � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � �� 9 �l Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: %�`'" �°`��" Tel. # � f S - `� � ° � � �- �� $ o� � /�v3 $ $ 5°� `'a � $ $ $ $ $ - �. �`� 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 [ J Not Necessary [] � - f BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such 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 $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for �rst $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 0 � � rn m � C�i � � � � m � � �- � � N . . v a � � � m N CNn O�p o = �D °,m� � N� c D � � z c� �, v � �Oo � c ;p o m ,mD � o � � � �� °• � �v D � � O Z � � � Z m v � r z 0 V N N � 1 W �n1 N flj pj �� C N i1f p a�D � � `� �' m m c��c 3 � ci � � � � .n v � � � -, 'Q � p v, � ?! ro o � � 2 2 ,� � � W �t y � � �� i� cD tn, W� r�' 1 .o ��D m m cr. m�� II1 � cc m -, � -, -, � �' r' y. fN V! co , m�c �� 5 c� Z � d � �c -� � � m � � �°- �' � -n � � � � � � � c�i � � � N � I � I I �I I I I I l I I I � � 0 0 � C � 00 Z � n 0 � a z � r" C � Z � � � � m � � � �� .� � w w � � � � � ... � 0 0�+ w,c�,'' o 0 0;o 0 0 0 -I °a o° °o °o °o °o °o °o � °o °o °o °o m � -� � m v (i 0 � 1 O� � 1$ � m z � z O �'` W C 6 z � e � m v !'� O > > � � aaa� �' �v � N � � p� :U N ."(1 �p ��c4o v, � t��v�D� � N �� Z�� o�o`° c�'i,Nm C. � N ,'1�7 Q- o � � tG N ? o �� >> y 7 � Q. � ? w (D � � � � N a 0� n � � � a �' � � � w � � � �� :� g � a N y O � � � O � � W � _ � �i W d w � �D c�, :< C � N � C � .� `� �'� 70 � � c � � Zm : m � w Z .�i 'U , m � � z _ C � � � lv � � � m � J N 0 � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNtNG APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacin� an existins� furnace, the undersigned hereby ver'rfies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's spec�cations. This does include AGA GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The exisilns� comt�ustion air is sized a�d in�taited io meef ihe curr�nt cod�� and manufacturer's spec�cations. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installin�a a new ventin4 svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This. does include AGA-GAMA Category I Csntral Fumace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes ( ) No ( ) Apaliance Tvae and Siae/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tatal Btu Input _� _ Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter _„_in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describel HEATING CO: Signed By: Date : � � � � - �� y � __ � . . i . ; �' ; � !� � ; ; . , � 1, �, '� , ��i• , , � �.,,._, � 4:� �� ; � �� , „ � ► , � ,.,«- :+ ;.. � _. � � �' ' � • � � �. 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