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HE�T •LOSS CALCULATIONS DEPARTMENT OF BUILDINGS �'° �
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How Ap�
Yes—Nct , Yes—No 19_
; Fl.� Room � Length ;-,�' Width �, Height Fl.� Room Length ,� Width ,,��
Windows and Doors—Crackage and Area Win ows and Doors—Crackage and Area
�Vldth Height No. of L1nea1 ft. Aree Width Helght No. oY Ltneal fL Area
No. of pane oP pane lighta of crack eq. ft. No, of pane of pane . llghte o! crack eq, ft.
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� Infiltration
Btu
� � Infiltration � � � �,
Glass �,°��,� Giass
Eap wall ,� � � (� e � ,j' l�
Net exp. wall " �SP. wall � � � ( �
Int. wall
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Ceiling . In� waU
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_ . �.:.- -- - - - - --- - ' - �'toor `�_�_ _ .a
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Total Btu. � = � , � �� � Total Btu. � � °
Required s. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leade�'area '1
� . Room � Length � Width � Height �" - �'
, F1•I , ,� Room j Leagth ,� Width ��Height
� aws and Doors—Crackage and Area Windows and Doora—Crackage and Area
ldth Height No. oL Llneat ft. Area
Na yane ofpane lfghta otcrack eq. it. Wldth Helght No. ot Llneat ft. Area
d No. o! pane of pane Hghte o! crack efl• ft.
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Glaas �_ � a� ' � , e � � . � .
Eap. wall '
Net eap. waq .
Int. wall
Ceiling �
Floor
Total Btu.
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Required sq. f!, E.D.R. or aq. ins. W.A. Leader area
Fl. ,�',. Room � Length � Width � Height �`'
Windows and Doors—�rackage and Area
� Width ; Heig6t 1Vo. or Llneal ft. Area ' � '°" -'
No. ot pane of pane Ilghte oL crack sq. ft.
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In6ltration
Glaas
Eap._ wa�
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Int. wall
�Ceiling '
�loor '�"
Total Btu.
Coef. Btu I
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aq. k: E.D.R. or sq. ins. W.A. l.eader
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Total Btu. _ ._ _ _ .
Required sq. h E.D.R. or sq. ins. WA. Leader area
Fl.� �- -� %��; Room I Length ,� Width � Height
Windows and Doora--Crackage and Area
Width Hefght No. of Llneal ft. Area
No. ot yane� of-Dene tighte ot crack eq. ft. i
�° �' � �-• �1 � �,u9 �
Infiltration
Glass
Eap. wall
Net exp. wall
Int. wall
Ceiling �,"�
FI� �
1'otal Btu.
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v � / .S'% ci I
Caty of Fridley, Mirm.
BUILDING PERIVIIT
1�T° 6324 >
nate: � '"""" �; �
� �
owner: "
der
Ad Address
� : ,�„L _�TI � .UILDING
No. Street ._... ��� --���� Part t
a
�+Ot _ BIOCl{ ` flf�'t{OII OT S11�hD�VYB�
Coraer Lot � Ine�de Lot _.. �back _ Sideyard .
5ewer Elevation _ F dation IIevation
' � ' ` . � � DESCRIPTION OF BI�ILDING � "
To U
� ' Front _�,� . Depth �:�� �3 �%ig#st -�� �1• F`t. �,��� Cu. F't�e,� ;�
' Front Depth ` I�eig�t �, .. Sq. F't. ,. �• � Cu. F't.
`Ij�pe of Construction ������;,j�.- �,-���,-,�� � To be Completed
' `� r
In cons�tderat[on o4 the 3ssuance ta me of a permit %� construct the building descrlbed above, I agree to do
th� proposed work in accordance with the d�scription above set foz�tth and in compliance with all provisions of
ordinancea of the dty oP Fridley.
_ �?�F'� `
In consfderation of the paymeat of a fee oP $ T, perixutt fs hereby granted to
to consi:ruct the buiiding or aiidition as de�cribed above. This �rmit fs graated upon
the =�xpres�a conditiqn that theperaon to whom it is grant.�d`aad hfs agents, eniployees and worl�nen, 3n all work.
doae- �n, around and upox�-"satd building, or any part thereof, shall con%rm fa all respecta to the ordinanc�s of
Fric�leY, M�BOta regardi�g lacation, construction, altera#on, maintenance� repair and moving of bufldings
wlthin the ,city ]imits and thia perm�it may be revoked at any �ime .upon vio� ,' .of; apy�► oE ttie provisions of said
ordinancea _ ,
- � ��� � �
.J+i ..,/� .. .+.f_.r .1��y+Fiaat.. i i
� �_,�r�s-��r.E -
NOTIC� -
iWs per�eh doa not cors� �hs comteueH�, Iesfallallon ter vrie�,'IQmbieo, fa h�aMng, swr� or vrat�r. 8� wn to a�
Nn Buildln9 le�ete� fe� +�Pu+�� Mrmih fee t6� ttx�.
� "' '�_ _ ��
�
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESpTA
OWNER ° S P]AP�E ��' �1��'i%l� � .� L,%�ra $UILDER
I�.DI�RESS ��� � _ F�,rr��,� �e% ADDRESS
LOCATIOAT OF' BUILDING
No._.�-��� Street ,��ot/T.P%G �i��' Part of Lot �f„� ���Pic/.
Lot „�� B1ock -� Addition or Subdivision�,p�"�`�-�,� �j�r,�/�,�
Corner Lot Inside'Lot �f Setback Side-Yard
SEWER ELEVATION FOUNDATION ELEVATTON
ApplicanC attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on.theae Certificatea.
DESCRI�TIOAT OF BUILDING
To be used as: �
� "`-'�
— �.�l�� �,� Front_ �'� ` Depth �� � Hei�ht_ �'� �
Sq. Ft._�',�� Cu. Ft.
Front Depth Height
_ Sq. Ft. Cu. Ft.
Type of Coastruct�on._ /���� Est�mated Cost �,��� B�
To be Coimpleted
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the Citq of Fridley Ordiaances and
rulings of the, DepartmQat of Buildings, and hereby declarea that all the facts and
xepresentations stated in this application are true and correct.
n �z� /� � --- _ s icx��� A
i����
(scheduie of Fee Costa can be found on th Reverse Side).
4 . , _ . ^ �"� �, �
. R �
BUILDZNG PEIiNQT FEE SCHEDULE
5ection 2. The Inspector of Bu3ldings sha21, before isauiag any pea-tnit for
tki� erPce3ou of any building or structure, or for any addition to any �xis�-
ix�� bui.ld�x►g or structure, or far mny aI"te�atioas or repaira to any e�is��.ng
bu:�.lding or stcructure, upon application therefor, require the pagmnea� by the
agplican� for such permit of feea t0 the amount herein below set forth and
in the manner her�in provided to-wit:
2.1. For any such permit for �he erection of any fire-proof building, other
th�.n a garage� warehnuse, factory or graia elevator, or for the erection of
any fire-proof addition, for similar occupancy, �o any existing buildiri�
sha11 be at the rate of $1.40 for each one thousaaad cubic feet, or f�aciion
t�ereof, in such cubical contenta.
2.2. For any such permit for the erection of any fire-proo£ �arage, warehouse,
£2ic�ory or grain elevator, or foa the erection o£ any fire-proof �dditiQ�s,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as °'fixeproof" by Section 502 0�
t:�e Minne�polis Building Code.
fa�USES -
2.3. For any such permit fos the erection of �ay n�n-fireproof building o�ther
than a garage, warehouse, factory or grain elevator, or anq noa-fi�reproof
additioa, for similar occupancq, to any existing iauilding - permit $1.00 for
each one thousand cubic feet.
�i�A�ES
i.ts. For any such permit for the erectian of any non-fireproof garage,
wGrehouse, factory or grain elevator, or for the erec�ion of any non-f3xepro��
addit3.�n, £or e3.milar occupancy, to any existing buildiag or for each such
b�iidin� or addition - nine�y cents ($0.90) £or each one thousaad cubic feet
o� fractioas thereof, ia the cubical contents thereof with a minimn� of $4.04.
For the purpose of computting £ees for building permits, the cub3cal contents
o£ aay building or addition Co a uniform height throughout by multiplying the
g��und area covered fram a point six (6) inches below the flaox li�ae of the
basemen� or cellax to the average hei�h� of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or altesations to an exis�ing structure, the fee shall be
at the rate of $3.00 per each Five fluadred Dollars ($500.00) or frsction
th�reof in the cost of all proposed work.
2.6. In no cas� aha11 tihe fe� charged for anp permit as set forth in
Section 2 be less than, $4.00.
� _ _ _4 � /� A..�-.� Y-�= 4.
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Quit Claim Decd. g� - •-
Fo�n No �-lvl biiUer-Davis Co., Afianeapoli�, Mian.
lndividuelto Corporatioa , r.� • • Ddianesota Uaiform Conveyancing Blanks (1931).
- -- _ � __ _ _.. __ .. _._ _ _.
� ��
�"�� � �� �ws�� �°- 1'L°'�u
���' . 30th December 70 ,
����t���• .hlade thts .............................:..............day of..............................................................., 19............;
bet�.veen......�ALERED..2�.....�.F,kT,Sk�T.s...�1.i2,�TQ.az1.d .........................._.............VF..�RA....Q.�....TF��IS.FI�T.s...�.��.....................�..... ?�..�`/..�
� . . . ��--�
of the County of ...........................A.rtoka.........................................and State of...........Mi.nniesnta.....................................................-,
. part..ies. of the firat part, and .........................CITY...DE...ERIDZEY.:..........................................................................................................
............ ...... ........................................................................... . . .. .
. . . ............ .......... ...... .............................................................
.......................,
m c�� ............ �Tinnesot�
cc^co por co�L under the La%vs of the State of ............................................ ................................., Part�y of the second ,-�art,
�ftne��et�j, TTtat the said parti��... of the �'irst pc�rt, in considera.ti,on of the sum of
Q�� ..�c�zt�.x.�.d...�i.�.�y.....az1d...�TaI.�.QQ.....(.�.�.S.Q.�.Q.Q�....a,n.d....o.th�x...ua�.ues...xeG��.v�d-:-: --.-:-.--.--..-.DOLL�I�S,
to ....................�!����,�s...................in h,cznd paid by ihe said party of the seconcl part, the receipt whereof is
hereby aaknowledged, do............ hereby Grc�nt, Bargain, Quitcldir►z, and Conve;� unta the said pmrty of
the second pc�rt, its successors and asaign,s, Forever, alb the.tract...... or parcel...... of lurcd l��in�s and beins
in the County of ......................A7t1Q�t8................................................and State of dVlinnesotQ, described as folloavs, to-wit:
A five foot (5') drainage anc3 ut3lity easement descxibed
,- as be3ng a21 t�aat part of Lot 36, Block 4, Parkvie�J Manor
described as follows:
� Commencing a't the most Westerly coxner of said Lot 36,
, thence Iv"ort�east along the Northwest line of saict Lot 3S a
. distance of ten feet (10') being the actual poing of begin-
� ning; thence continu� Northeast along the North�aest line of
said Lo� 36 a distance of five feet (5'); thence Sautheast
` � ,parallel with the Sauthwest li.n� of said Lot 36 to the-Sou�h-
east line of said Lot 36; thence So�thtaest along the Southeast
Iine of said Lot 36 a distance of f�ve.feet (S'}; thence
Northwest parallel caith the Sout�i�Test line of said Lot 36 to
the actual point of begix�n.ing, there terminatin�.�
�, ; .
A1I Iying in the tdorth Half o£ Section 24, T-30, R-24,
City of Fridley, Coun�y of �sioka, M3.nnesata.
I�0 ST1�.TE DEED TA.� REQUIRED
This instrun�nt prepared by the City of Fridley,
6431 University Avenue N.E., Fridley, i�iinnesota.
�
� '�o �?abe AnD� to �olb i�je �a�ne, To>>cther tvifT� «ll tFrc� hereclita.�rzenis a�ad appuf�te�aa�zces tlzer•e-
�,. u�zto belo�t�in6 or in ar�jwise appertainin�, to the said nart, af ilae second n2f•t, it.s stcccessors and assisns,
� Forever. �
�(n �Cegtfmottp ��ereof, The �aicl >>ar6 3.�R.. o�" fhe �r.ct puri hcbte .... herezeritv set. .. .. theis..... .
i� l�Iae fla,u .a�ad �/rnr fr.rst abc�rc u�ritfe��.
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City of Fridley � ``
ATTHETOPOFTHETWINS gUILDING PERMIT 2�.366
i �
� � RE O.
COMMUNITY DEVELOPMENT DIV. �
f � L � PROTECTIVE INSPECTION SEC. �/�/
1 . ; '/
`--_- � ��'��,,; CITY HALL FRIDLEr 55432 NUMBER FEV DATE PAGE OF APPROVED BY
i ��� 612-571-3450 910-F15 5/29/92 / /
JOB ADDRESS 5gg'7 Central Ayenue NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 36 4 Parkva,ew Nla,riOY' SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ronald Herlo,fsky 5887 Central Avenue NE 571-7 88
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
A, ARCHITECT OR DESIGNER MAIL ADDRESS ZiP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Canstruct a 29� x 12� DeCk and a 13� x� J� Deck• A slidin lass door
9 CHANaE OF USE FROM TO
STIPULATIONS
See natatiqns on plan
1IV������G
Before digging call for
$1! ttt�{ity locatians
'454 ;0002
REQUIRE�� 8Y LA,V�
SEP��ATE PERMITS REQUIRED FOR
WIRiNG, HEATING, PLUMBING A�p SI��S.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFiM1T BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION �- STALLS GAFAGES
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 $3 r3�2
WITH WHETHER SPECIF�ED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-.69
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqp�1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAT�NG coN- $63..00 ,FlY@ SC yS3. %2
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION-
PLAN CHECK FEE TOTAL FEE
$68.41
SIGNATURE OF CONTRACTOR (�R A THORI2E0 AGENT IDATEI HEN PROPERL � VA IDATED THIS IS YOUR PERMIT
� j �— Z?` �'-( �Z �_�_ � �
Si NATURE OP OWNER �IF O ER B R� IDATEI �E iNSP bt.TE
�'�
i
NEW [ ]
ADDN [ ]
�-�R [ 3
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
Building Perrnit Application
Effective 311/�2
���on Ad��s: s��� c��.+�1 �- �.� �. �
Legai Description: 1 D� 3�, Q 1� c�c L.� Pa r� i e , J 1�ct v�Q �('
Uwner Name & Address: �c�v� �d er�c,-�s�� �t � e Tel. # 5 7�"%�'S.�
Contractor:
NiN LICENSE #
Add�'ess: Tel. #
Attach to this applicarion, a C.ertificate of Survey of the
lot, with the proposed constritction drawn on it to scale.
DESCRIPTiON OF IIVIPRUYEMENT
LIVING AREA: Length . yVidth Height
GARAGE AREA: Length ,- Widih Height
DECg AREA: Length f�� � Ground
��' ;� � :V�idth Hgt!
OTxFat: �� Y I� ��i ��:'�¢^7 e I;.� ;,��. � 1�
Sq. Ft.
Sq. Ft.
Sq. Ft.
�, r. r 4,` . ` ' . ` v .
�
Corner L.ot t� Inside �.ot I) Ft: Yd S�back' ' o- Side Yard S�backs
Type o f C o n s t r uction: � 1 c��a+� °.�``'' Est�at�d Cost: $-
� �
Approx. Completion Date: �'�°�'� �
(Cost on Back)
Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ _$
DATE: �-Zg-�'Z APPLICANT: e`;`f=>•..,. Tei. # S_i7/-7�$$
.� �_���'� .�
�
CITY USE ONLY „ ,� e.,,}�.''� �' •:
,r. �f fi� : .,
. - ' � 'ryrh .•f�t'� �?,�y°�c
Permit Fee $ �, �� Fee Sch�lule on. Reverse Side �.
.�, -: ;
Fire Surcharge $ ,�, � � .(�1 of Permit Valuation (1/lOth%) `° S . �
State Surcharge S � � �� $.50/$1,(l00 Valuation - ; ,�.�
SAC Charge $ T--°-� $700 per SAC Unit �
License Surcharge $----� $5.00 (State Licensed Residential Conhactors)
Driveway Escrow $---°-� Alt. "A" or Alt. "B" Above
Park Fee $----�----- Fee Determined by Engineering
Sewer Main Charge $ - Agreeme�nt Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
v �� � a �
�������
� �
BUII.DING 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 applicatioa therefore, require the payment by the applicant for such permit
of f�s to the amount herein t�low set forfh and in the ma�nner herean provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,t100
$2,�1 to $25,0�
FEF.S
$15 (Minimum Fe� is $15 plus surcharge)
$15 for first $500 plus $2 for e�ach additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 pius $9 for �ch additionat $1,000
or fraction ther�f, to and including $25,000
$25,001 to $50,000 $252 for first $25,� plus $6.50 for each additional $1,000
� or fraction thereof, to and iacluding $50,000
$50,001 to $100,000
$1�,001 to $5�,000
�, �� �� � �, ��� ���
$1,UOQ,001 and up
$414.50 for fust $SU,� plus $4.50 for each additional
$1,000 or fraction ther�f, to aad including $lIX?,000
$639.54 for first $i�,000 plus $3.SU for each additional
$1,�0 or fraction ther�of, to and including $500,000
$2039.50 for the first $500,0� plus $3 for each additional
$1,(�l0 or fraction thereof, to and including $1,OOQ,�O
$3539.50 for the first $1,�,000 plus $2 for each addifional
$1,000 or fraction thereof
� ` f DRIVEWAY DEPRESSION ESCROW
(Concrete C`�u� Streets Only)
Alternate "A" : Removal aad replacemem of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alteraate "B" : Reinoval and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 f�t times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issu�i a minimum of 24 hours from the time of application to allow
for praper review of the pro�sed structure and o€ the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be requir� before proceed�ing with the framing.
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6973 NEST 6ROADtOqY � BFDOK:LVM FARK 1 fyINWEBOTA 7 9942$ 1 1-612-933-21H9 4
"f!5?'��EF �n�� 7%�� HE�cLQES�,Y fl' LA�ES�A�d �A�E :�RED �-!
s�ELi'dE`;`� �DDRE5S : llELiE'�EtY 1�ATE :
�ELi+JEF;Y C;TY : QE�IUERY DAY �
HQ�E �HO�dE ; 571-7988 T��E �F DR� ; -
�V1Si\ if7UtVL i LtiTL [R�LI{ i �—L�-7L
DEC� ➢ELIVEftY INFQF�ATI�C; # Ct1SFQ�Ek I�����ATIQ@�
T�T�FI� L�TY I}Pd;T QESCf{IPTI�P: IiE�, S;C# CCt5T ERTE�DEi? P�t1t}l1CT �JSA&E GFY L15R&E
LUP�lE�ER
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HARlttadARE
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� ...a.a.29..,.E�G�i.,..3/8 FLfiT �ASNERS ......................�r:'9.'s81......
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_� .....�..I...,�ACH.,,.SSD 6�;_.V i�ASii�� `: � ...................:i6�15.,..=,
�_........1...,EAv�E....la I—t/� 6Fii..4f �15T �I6R .................9�777_ti......
...,.,.�,i9....<.,�L.69.
...,,..8.49....,.,16.°9.
...,..i4.7c?.......?9.�ti.
....=.st}.39...,,..�{�,78.
.:,....J.�.�'�.......,?.'��.
.a,,..,1.�9,..,...i5,46.
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.,,....(t.�5..,.,...2,?{�.
....�..$.9�,.....a.$.99.
......,�.�9.a.....,8�89.
.,.,...3.u�........�.69.
.,...,.{J.B�,...,_..�,5E.
.,.,.,.�.89.....,,.�.89.
...,,..�.99...,....I.R°.
fi�LL PRICES AR£ AS OF (s5f29/92 R�D ARE 604D Fflft 7 DAYS. CLEf;F��t ERft�ftS
�ftE SUE+,IECT TD C�FtREGTi[��. �E RESETiVE THE kI6HT 7Q CIiAP�6E iNE PRiCES Q�
CEt�TAIP! BtIII.DI�B �A7ERIALS tF �Af{k;ET CO�U'ITIQ�S SHCI�i(.L' DEE� IF i�ECESSfi�tl'.
T17DWAY t HRDOl:LYH PARK i PURHBVILLE i LITTLE CANADA
CDDN kA�7D8 t EAOAN t SDUI% FALLB t FAk6D
c r �c+�. ,� �
a.
DEC�: RAIl.I�6.,........,.2.374.
DECk SiAiR TCtEAi15. . . . . , . �3. UQt�.
UiC�;F�6 ................1.;.4v6.
�EC�: �tAI�iN6..,.......,.2.�1�.
�ECk J�I�TS...,.....,..1�?.75�1,
BECp: Hf9➢fft5.........,..1.�s'.
��t�.� ����� ..............�.f)1��+.
DfC� STAFTi LiAG�;S........�.c�{�{�.
1���� �'i�i�Ji�J ..............�.t}FIt7,
CC��LRETE ...........:...I�..'_57.
�ECk �Aii.iN6......,.,..76.t�;?tt,
t�ECK HAFt��RRE......,....8.{)trfr,
DEC�; KARa�fiRE. . . . � . . . , .1� , �'1�}�? .
�EG� kRRll�fiRE..........�9.flUQ.
pLCK H��tD�RRE, . . , , . , . , , .8.�}4�fl.
��OIST HA�6ER5..,,.......5.5£�(►.
[�EC� FitA�FtdS fdAi:.S......{�.516.
DECkI�i6 �AIL5.........,.t�.5i0.
�ECk FRA�,�G �AiLS.....�fs,!�L.
t}EG� NAR��AfiE. . . , . . . . . . .4. �icai; ,
�EG�I�6 ��1i�S,,.,.......t:,:;ci4.
�DIST i'A�6Efi P1A'LS,,....�,364.
SllBTOTAL $I$.51
TA� 26.94
FQtA�fE�CL. DEL.} 4�i.45
HOPIfINB ' t MEHPDRT
DUlllTH t BILLINBB
- ' .. � .. ;i�'�,., i� ��.,.'i! ��"�i. utw:��
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CJSTO���i t�t��E : t�OA iiER�QFSa� fN Sfl1.E5�A�# Nr�#�E :�kED H
�ELIVERY ADDRESS : DELIVERY DATE :
IlEL'a�lERY CITY : #}ELIUERY OAY :
H��E FHO�E : 571-7988 TI�E DF �AY ;
�Q(i�; FN��E : �ATE TAg;E� : 5-27°2
DEC� DELI+tERY I�F4RMRTIU� � CUST��fR 1NFOR�ATIDN
T�;T�FIt. �TY UNIT �ESCRFFTI�� ITE� S/� L�ST E�FE�UEB PRQ�UCi L�SA6E QTY �1SA5E
LUME�EFt _
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NAf�DIrlAFtE
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.......8.59........8,59.
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..,,...i.9q.,..,,..3.98.
fiLL PRICES ARE AS �� 4�5128/9L ANd ARE S�OD fQR 7 6AYS, CLEftICAL ERRORS
ARE 5k1BJEGT i'� C4RRECTIQ�. �f �iESERVE THf �I&HT TO CHA�6E THE P'RICE5 DF
CEkTAF� BUIL�I�6 �ATERiALS I�' �AR�ET GO�IIITIQ�S SHOi3Lll DEE� IT �ECE5SARY.
NIBMAY t bROOKLYt-0 PARK t PUftHBVILIE t LIT7LB CpNRDR
CDDN RAF1D3 t EADRN i @DUSX FALLS t FARBD
C FrHCyC 1 �
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DECK RAILI��.....,...,.,z,994.
UEGN; �TAFR 7REAllS,......:,,c1c,U.
DEC�I�16.......a,.......4�.844.
UEC� RRILI�G.,..........�.9°9.
QEG�: HEA�E€tS.,..........5,8i��r,
I�EG� Jd3STS.........,,.��.75�,
UEC�: �EA�S . , . . , , . . , � . . . . 4 .?7fji, ,
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G�idC�EiE ...............13,�$5.
DEC�: �AI�i�S,..........96.crt��.
pEG� HARD�ARE. . , . . . . . . , I2, (�f�(r,
DEC� RAftO��RE, . . . . . . , . . L4. f}�f[�,
��c� ii�������, , .. . . . . . , 5�. �=)ci.
�EC� HARD�ARE..........12.�Ut1,
d�IS1 HA�6ER5.....,..,.1;.5(��1.
DEC� �RA�I�6 �AIL�......1.584.
DEC�?�6 ?�AILS.,,.,......��.8'8,
�ECk �RA�iN6 �AiLS�.....C.69b.
DEG��. N�Ri��ARE.. . .. . . . , . . b.:ics(s,
DE£�:I�G ��;FLS.,......,.,1�.38�.
3�I5T HA�fiEfi �AIL�......1.39�.
StlRTaTAL 94t+.4b
TA� 61.3f+
TQTRL(E�CL. DEL.I 3Qfl1.16
HOPK 7 H8 R tdED1PORT
DLLUTH R AILLIldBS
. ?I,ti) �'� `1:�'r.-r�L' f _ .
LOT SURVEYS COMPANY, INC� �NVOICE N0. �39z
F. B. NO.'� 7B7" 7
. LAND $1JILVEYOB$ �0 � D�ENOTES iqpN
HFCd878RED UNDE6 LAWB OF BTATE OF �9P1NE80TA �
T801- 78rd Avmos� �nnota 66028 � � S� / �� �� 14- i1� 4a �
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JOHMSOM i LUfBEN ING.
Prop�iy located in Seetion :'
24. Toe4ship 30, Ban9e 24. / A , ..,ar`
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1
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When realacina an existina furance, the undersigned hereby verifies 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 piastiGPVC 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 specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the cuRent codes
and manufacturers specifications. _
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturers specifications.
Yes ( ) No ( )
_ Yes ( ) No ( )
Yes ( ) No ( )
When installina a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and meets the cuRent codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
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. Yes () IVo ()
Apaliance Tvpe and Size/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 Total 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• (Describe)
HEATING CO:
Signed By: Date :
.
_
_
CIIYOF
FRIDLE.Y
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 23, 2001
Roger 8� Carolyn Abbott
5887 Central Ave NE
Fridley, MN 55432
Re: Final Inspection at 5887 Central Ave NE
Contractor: Residential Heating & Air & R A Johnson & Son
Dear Roger & Carolyn Abbott:
Mechanical permits were issued on February 6, 2000 and November21, 2000 for the
installation of a furnace, air conditioner and water heater at your address. According to
Section 305(a) of the 1991 Uniform Mechanical Code, a final inspection shall be
performed on the mechanical permits. As of this date no inspections have been called
for.
The permit fees that were paid covers the inspector's time to check to make sure the
appliance was installed correctly. We also need to check for the installation of
combustion air, vent and connector sizing.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, your permit will expire and.any inspections on this installation will require
a new permit. �
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
D7�/��IENSEN �
Bui iyfg Inspector
DJ/mh
City of Fridley
AT THE TOP OF TME TWINS
�
i L
; �v __��_ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
, . ,
� _ �"'1 � CITY MALL FRIOLE`1 SS�32
������� ,�� 612-571-3450
J08 ADDRESS 5887 Central Ave NE
�UILDING PERMIT
s�aF�s
11EV
DATE vAGE OF
12/18/00 / �
3 i 5,�
RECEIPT NO.
����
1PCROVED 8Y
t IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oesca. 36 4 Parkview Manor SHEET
2 PROPERTY OWNER MAIL AODRES$ 21P PFIONE
Abbott 5887 Central Avenue NE
3 CONTRACTOR MAIL ADORESS ZIP PHONE �ICENSE NO
Citywide Home Improvement Inc 1005 W Broadway, Mpls., MN 55411 612-529-2489
4 ARCNITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
3013
5 ENGINEER MAtL AODiiESS 21P PHONE UCENSE NO
8 USE OF BUILDING
Residential
7 CIASS OF WORK
p NEW
B DESCRIBE WORK
Replace windows
9 CHANGE OF USE FROM
❑ ADOITION 0 ALTERATION
TO
� FiEPAIR O MOVE ❑ REMOVE
STIPULATIONS
Provide smoke detectors in aIl sleepin.g rooms and on all leveTs of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
������ ��i�������� ���°ds
�,�� ��� ���0���
To Hom�o��er '�o P���
SEPARATE PERMI7S AqE RE�UIqEO FOF ELECTHICAL, PLUMBING. HEATING, TYPE OF
VENTILATING OR AIR CONDITIONING.
TNIS PERM17 BECOMES NULL ANO VOIO IF WORK OR CONSTpUCTION ZONING
AUTHORI2ED IS NOT COMMENCED Y�!ITHIN 80 OAY9. OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 pqyS AT
ANY 71ME AF7ER WORK IS COMMENCED NO. DW
I HEREBY CERTIFY 7HAT I HAVE READ ANO �XAMINEO THIS APPUCATION
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVtSIpNS OF LAWS VALUATI�
ANO ORDINANCES GOVERNING THIS TVPE OF WOiiK WI�L BE COMP�IED
NCV LOAD
CU FT.
.G. UNITS OiFSTREET PARKIN(
1 STALLS IGAFAGES
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT �9,330 $4.(6
DOES N07 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OF LOCAL LAW REGULA7ING CON-
STpUCTION ON THE PERFORMANCE OF CONSTRUCTION $181.25 Fir ;S�'i $9.33
PLAN CHECK F TOT L FEE
Licen S $5. 0.24
$�GNATUAE OF CON'AACTOA Op 4UTNOA�ZEO AGENT �DAT�� EN �iO�E ALID,�T THIS IS YOUR RI
� �� ' 1 //1� %� / �� 'J!. � ,
r�w � �
ADDN
ALTER
[l
�l
Construction Address: :
Lega1 Description:
Owner Name & Address:
Contractor: � �i,
_ Address:
Effective 5/10/99
CITY OF FRIDLEy
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
� J i
Tel. #
MN LICENSE # ��,_�'
_�;��Tel. # ��'��,',��' � L��
Attach to this application, a Certificate of Survey of the
lot, with thz proposed canstruction drawn on it to scale.
��C�Ta��d ��' �4�d���EM�1�'I'
LIVING AREA: Length Width Height Sq. Ft.
GAR�lGE AREA: i.ength Width Height Sq. Ft.
DE�K AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
�/ �
Construction Type: � � , ` i��i � ' Lr"��� st �;��Lima,�Cost: $ �
, �
Driveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ .
DATE: � "� ��C� APPLICANT: � Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surchazge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ � ����
$ �
$ `�i ���
$
$ �
$
$
$
$
�
TOTAL $ �
��r�,.�y
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth�)
$.50/$1,Q00 Valuaxion
$1050 per SAC Unit
$5.00 (State Li�censed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
A�greement Necessary [ ] Not Necessary [ ]
sTrnui,a�oNS 2f�L'l��' �o.�' ,������n'�-�- �-� ��-
�� �-S i4,�.�► o.� r..� ,��y��. o � ��/� �t.�'�"'
�� . ,�t�. `�- /, �� �� 1'? �.�-c,�
�
C.�'�i•�!�-
��
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addidon to any e�sting buitding or smicture, or for any alteration or repair to any e�sting building or structure,
upon application thereforey� require the �payment by the applicant for such permit af fees to the ainoun� herein
below set .forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$',�1 to $25,Qp(; _.
$25,001 to $SO,OQO
$50,001 to $10U,000
$100,001 to $500,000
$500,�1 to $1,0�,0�
$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. f�rs� $2,(�0 pl�as �14.Q0 f�r ea�h �di�on�;. �? ,�1
or fraction thereof, to and including $25,0�
$391.25 for first $25,(�0 plus $10.10 for. each additional $1,C100
or fraction thereof, to and including $50,0�
$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 $SOQ,000
$3,233.75 for the first $500,0� plus $4.75 for ea.ch 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 DEPRES5ION ESCROW
- _ _ - --- ------ -
(Concrete Curb 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 curt� and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
P�rmits 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 oIICe it has it has been constructed will
be required before proceeding with the framing.
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existin�a furance, the undersigned hereby verifies that the
venting has been examined and is free from nast, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all cuRent 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 manufacturers speciflcations. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturers specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes()No()
When installina a new ventinp svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
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. Yes () No (,
Appliance Tvpe and Size/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 Total 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• (Describe)
HEATING CO:
Signed By: Date :
SuB�ECT
City of Fridley PER"'
AT THE TOP OF THE TWINS � � I L D I N G P E R M I T 3 i 6 8
r
� �
; �V �__„� QOMMUNITY DEVELOPMENT D1Y. //�� '
r j � PROTECTIVE INSPECTION SEC.
� _ �
l.-__ A;����,•� CITY HA�L FRIDLEV jj�32 NUMQEN REV DATE PAGE OF APPROVEO 8�
L �� 612-571-34b0 9t0-Ft5 3/15/Ol / /
JOB ADpRESS 5887 Central Avenue NE
t LEGA� �OT NO. BLOCK TRACT Oii AODITION SEE ATTACHEO
DESCR. 36 4 Parkview Mattor SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PHONE
Abbott 5887 Central Avenue NE
3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO
Citywide Home Improvement 1005 W Broadway, Mpls., MN 55411-2503 612-529-2489
4 ARCHITECT OR OESIGNER MAIL AOORESS ZIP PMONE LICENSE NO.
3013
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WOHK
Aluminum trim, soffit & fascia
9 CHANdE OF USE FROM TO
STIPULATIONS
Install soffit ventilation to meet the State Building Code.
SEPARATE PERMITS ARE fiEOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CdNST OCCUPANCV GROUP OCCUPANCV LOAO
VENTI�ATING OR AIR CONOITIONING
THIS PEi;M1T BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. fT CU fT
AUTHOR12ED IS NOT COMMENCED V�1ITHIN 80 DAYB, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEfi WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PAqKING
1 HEREBY CEi;TIFV TNAT 1 MAVE READ ANO �XAMINEO TMIS APP�ICA710N 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVI$IONS OF LAWS yqLUATION SURTAx
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPL,IED �
WI7H WHE7HER SPECIFIED HEREIN OR NOT. TME GRANTING Of A PERMIT �2s2OO �I.IO
DOES N07 PRESUME TO GIVE AU7HORITY TO VIOLATE OR CANCEL TME pEqMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �83. 25 Fire SC �Z . ZO
P�AN CHECK FEE T07A EE
Lice SC $5. $ .55
$�GNATUAEOFCON•RACTOAOAAUTMOpIIEOoGENT iO�TEi M PROP R VALIDATED HIS IS YOUR PERMIT
— G.� 3 ls =v
S�GNATUAE O� OWNEQ��F pyVNEA8WL0EFli IDAfE� DG �NSP ' f�p}E
.�
�,�, s '
rr�w � �
ADDN
�.�
[l
��
Construction Address:
Legal Description: _
Owner Name & Address:
Contractor:
Address:_
LIVING AREA:
GARAGE AREA:
DECK AREA:
1 •� �
_�
Effective 5/10/99
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
0
l� 4
e
Tel. #
� ���r���
� �. t�� �
MN LICENSE # ��_
Tel. # �(a ��� -� �L
Attach to this.apglication, a Certificaxe of Survey of the
lot, with the proposed constniction drawn on it to scale.
Length
Length
Length
-
� : � ,, : e� . �= � � :, .. .s � ,� �-y
�Vidth Height 5q. Ft.
Width Height Sq. Ft.
Width � Hgt/Ground Sq. Ft.
��
Construction Type: ��or� � ��� Estimated Cost: $ „����
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: - � � APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
�
Sevver Main Charge
TOTAL
ST'IPLIL.ATIONS:
$ .3..�-.5�
$ o�. k%
$ � la
� ��
: $ -�'�'.�"'�
$
$
$
$
$ ��
CITY USE ONLY � ('
.�� �
Fee Schedule on Reverse Side ��
.�1 af �'�a�nit Valua�i�n fl/10th%� �
$.50/$1,(i�0 Valuation � % �
$1050 per SAC Unit �
$5.00 (�tate Lzcensed. Residential Contractcrs) � �
Alt. "A" or Alt. "B" Above ��
$450.00 Conservation Plan Review ��
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
3 ls` d�
. �.
BUII�DING PERMIT FEE SCHEDULE
The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any .e�sting building or structure, or for any alteration or repair to any eacisting building or structure,
upon application, thereft�re, require� xhe paym�nt 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 $2,0�
$2,001 to �25,OQ0
$25,0�1 to $50,000
$50,001 to $100,000
$100,001 to $5�0,000
$500,001 to $1,0OO,OUO
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or ;_
fractivn thereof, to and including $�,0(�
�6�.25_ fcr first $2,C1(�! plus $14.Q0 fc�r each additiQnal �1.,(1(�f1
or fraction thereof, to and including $25,000
$391.25 for first $25,�0 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 $10a,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $SOU,Q00
$3,233.75 for the first $SOO,OOO plus $4.75 for each additional
$1,0� or fraction thereof, to and including $1,0(?0,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,(NJO or fracti�n thereof
D1�IVEWAY DEPRESSION ESCR4W
(Concrete Curb Streets �t�y)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $15.50.
Alternate "B": Remova: and replacement of curo and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for nroper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the founda.tion once it has it has b�n c���c�ed will
be required before prQCeeding with the framing.
��
'w° J
�' � SuB�ECT . - . .. .- .
c�ty of Fridle�
AT THE TOP OF 7HE TWINS g�J � L D i�I � P E R�/t I T
r
� .
� �
' j L ��'�•�,
COMMUNITY OEVELQPM�NT OIV.
r � � PROTEC7IYE INSPECTION SEC. ������0�
1 � � r
� �'�'� ' CITY HALL FRIOLE� 53�32 NUMBEp t1EV DATB PAGE
�' �� ��� 612-571-3460 910-F15 7/19/O1 /
JOB ADDRESS Sgg� �entral Avenue NE �
t LEGAL LOT NO. BLOCK TFiACT OR ADOITION
oesca. 16 4 Parkview Manor
2 PROPERTY OWNER
Roger Abbott
3 CONTRACTOR
Midwest Roofin
a ARCHITECT OR OESIGNE
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASS OF WORK
5887 Central Avenue NE
MAIL ADDRESS
7385 Mark St, Greenfield, MN 56357
AAAII ADDRE$S
32014
NO.
���
Of APPROVED BY
/
SEE ATTACNED
SHEET
502-0286
Z�P PHONE LICENSE NO
763-416-4804 20010277
ZIP PHONE LICENSE NO.
PHONE LICENSE NO
❑ NEW ❑ ADOITION O ALTERATION � REPAIR O MOVE ❑ REMOVE
B DESCRIBE WOF;K
Reroof House & Garage (13
9 CHAN(3E OF USE FROM
STIPULATIONS
) Tear-off
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIFED FOR ELECTfiICAL, PLUMBING, HEATINO. ��rC �r cvnsr,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WQRK Ofi CONSTRUCYION tONING
AUTHOR12E0 IS NOT COMMENCED V�IITNIN 60 �AYS. OR IF CONSiRUCTION
OR WORK IS SUSPENOEO OR ABANQOMEO fOR A PERIQD OF 1T0 DAYS A7 �
ANY TIME AF7ER WORK IS COMMENCED. ' NO DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN�O THIS APP�,ICA710N 1
AND KNOW THE SAME TO BE TAUE ANO CORRECT. ALL PROVISIQNS Of LAWS yp�UATION
ANO ORDINANCES GOVERNING THIS TYPE OF WQRK WILL Q€ CqMPUEO
WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTiNG OF A PERMIT $1,329
DOES NOT PFESUME TO GIYE AUTMORITY TO VIOLATE OR CAMCEL THE pEAMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �SO.95
�/� I PLAN CNECK FEE
� `iQ
fT
STALLS
� � Lice SC $5
�GNATUAE OF C NC AC 0• MOpi2E0 nGENi IDAfE� M PHO
A.,
�DATE�
�
5
UPANCV�OAD
CU FT
OffSTREET PARKING
IGARAGES
$.66
SAC CHARGE
Fire SC $1.33
T TAL FEE
$57.94
� TMIS IS VOUR PEQMIT
� 7-�9-D�
r�plE
NEW []
ADDN [] CITY OF FRIDLEY Effective 1/1/2001
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��63) 572-3604 Bldg Insp
BUILDING PERMIT APPLICATION
Construction Address:
�� � -� (�e�,�h�, l �-ve � � 3a�i y
Legal Description:
Owner Name & Address:
Contractor:
Address: �
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
� l� bb� 1'�
�
Tel. # s0 �- 'd�� �
MN LICENSE # �(7010 �7 7
Tel. # 7G�°Lilb��i�Uc.r
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 Hgt/Ground Sq. Ft
- I`��� � � � °r G [ SCR-IAG�� ��POT"�
Construction Type: I�ro� t Estimated Cost: $ o���'` ��� �
0
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: ���'` � � APPLICANT:
Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ ��A �S Fee Schedule on Reverse Side
Fire Surcharge $ Cs� .001 of Permit Valuation (1110th%)
State Surcharge $ a�� n $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ �s �� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
r
� �
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, �fore 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 $500,0{�
$SOO,OQ1 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $5� plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.� 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,�0
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,(�0
$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,(�0 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "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 stzucture 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. New Houses Onlv
�
SuB�ECi
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
i L
; `L ����� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
' s '
�` �""1 � CITY NALL FRIOLE`1 SS132 NUMBER
L�'�'� � �.J
763-571-3450 910-F15
JOB ADORESS Sgg� Ce�tral Avenue NE
t LEGAL �OT NO. BLOCK TRACT Ofi AODITION
oesca. 3b 4 Parkview M:
2 PROPERTY OWNER MAIL ADDFiESS
Roger Abbott 5887 Centrai Avenue NE
3 CONTRACTOR MAIL ADDRESS
$1ffi2
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAII ADDRESS
REv
6/20/03
P p. -
33632
-,�
< �� �
PAGE OF APPqOVEO BY
/ /
SEE ATTACHED
SNEET
Z�P PNONE
_ 763-502-0286
Z�P PHONE LICENSE NO
ZIP PHONE LICENSE NO.
Z�P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION O ALTERATION ❑ REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Construct a 22' x 26' Gara�e
9 CHANGE OF USE FROM
STIPULATIONS
TO
Existiaag slab and 3 wa�ls - slab extension and truss roof. See
notations on plan. Provide a hard surface driveway.
�EPARATE PE
REQUIRED QR�� �efore eli�gs�� �II foP
�IIIRfNG HEA�N �t6 ut;l,�, �ocation�
�LUM�ING ANp S16�Y� �5�-0002
E�UIRE � LAV�
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PlUM81NG, NEATING, TVPE OF CONST OCCUPANCY GROUP
VEN7ILATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION 20NING SQ. FT
AUTHOR12ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONE� FON A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DW�G. UNITS OFFSTREE'
� HEREBY CERTIFY 7HAT I HAVE READ AND EXAMINEO THIS APPLICATION I. S7ALLS
ANO KNOW TME SAME TO BE TiiUE ANO CORRECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPLIED
OCCUPANCYLOAO
CU FT.
f PARKING
GARAGES
WITH WHETMER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT �y3�OOO �I..SO
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE Oi; CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGULATING CON-
STRUCTION OR TME PERFOfiMANCE OF CONSTRUCTION $83 . ZS , Fire SC �
NATU�7E �C � A RA MOQi2E0oGENT IDATE�
��
h �� � a�- e� �
F�c q��fpyyNEpBWLOEA� �DAiEi
9
AL FEE
87.75
+is is rnua
fl
�
�
�
NEW
ADDN
ALTER
�l J
I]
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/2003
(763) 572-3604 Bldg Insp
(763) 571-1287 F
� �� ��
Construction Address: � R� .�w����,��( � _ �'r� ��.�� � q —�- ��
Legal Description: -
� �.
Owner Name & Address: ,���P,�_��,�_ Tel.# 7���,;;��2—n� Z��
Contractor. �cV �►.e� MN LICENSE #
Address: Tei. #
LNING 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. S�Z
Length Width Hgt/Ground Sq. Ft. �
%r "u��� .�'�,•.. �- �,4�s�,��o�aT�o.r.r
Construction Type: ,��.�+�° V 5��,�� Estimated Cost: $���� � ,�
Driveway Curb Cut Width Needed: F s Ft =�,Ft x�$ _$
DATE: �L- ll��- b �
�
� f;, ���
Call (763) 572-3604 for Permit Fees if mailing in ap�lication. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �.o�
$ . - . �Z�
$ �s�
x
$ /�'�
$ ./
$
$
$
$ S
�i1 / � _
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 [ ]
_ •►
zC��c� / ,
��-�'�' �� � %��G�� --- � ��' /
,� � � �%���D-�..
'� '� ���� i�� �,
BUILDING PERMIT FEE SCHEDULE
The Cluef Building Official shall, before issuing pernuts 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 applica.tion 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 $5�
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $1(�,000
$100,(�1 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 ea�h additional $1,W0
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,OQ0 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 pins $3.15 for each additional
$1,000 or fraction thereof
CLTRB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
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.
VERIFICATION OF FOUNDATION
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
., �
� `+ � �.,U �! �� r�-� � ! 3
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From: 6512929614 Page: 2/6 Date: 12l23/2008 10:12:52 AM
.
$u1ldi.ng WATk;R OR 'SiE+ WE� permit 1v .. �� �-�
Inspections p�,i',RM�� �p��,��ATIUN Received Hy:
��3-�7z-�so4 �IT'Y C�►F FI��,EY �&t��'p�: � E C � 2 0�
%�3-��2-4�^%� ��,X 6FFECftVE l-1•OB
APPLICATIOIV DATE: e�, 'a �� "(`i �i YDiJR E-MAIL AD1aRESS:
'IT�IS APPLTCANT IS; l�.CO1riTRACTpR O dWN.�R
Jt7B ADDRESS: "FS'1�" C7.�'n.�'Y�R }Ir C, h►1 G
NEw Cp�vSTRUCTIaN riE�trr # (IF �PLiCAHLE):
PROLiP�E'tRnTY NA.ME�c�� GY � G b 01"�
Q�'►'1`I�+N i�Yill�C.��: �j � •K.�LI li�i + IJT�: — f 4��' STATE� Zir: �V 5~ �ar
`P�NANT PHONE: t� - �p .. � t.�
c��c�rott rr,�: P'I� '� s r�n •<-us. �.¢ 1� ��,
SU$MIT A COPY OR ADDRESS; C : 5 t•�"� �� 1_ STATE: ZII': .� �►
YC1UR 3TATE LIG�NSE PHt7IV�: Cd 5-��'.�. - Ca � CL�LL PHCaNE: �.
AND $OND STATE LIC: �7/.y U_Q 1�G P f 11_STATE BQNp; ��(p:
FERMYT �Y�'E
0 SEWER CONN�CTION PEFt�YT $50
WATER CQNNECTIt�A1 PERMIT �50
�WATE SEWE�t LiNE REPAIR PERMIT �40 � C� � a�
a �►r� sTA� strRCxp►R�E �.so . �a
❑ SAC CIiARGE __ �a �1825
�'OTAL � � � ��
UTHFR CHARGErS �IF APPLtCABLE) PAY TO UT1LiTY BIL�,ING
NEW WATER METER C�ST sEE UIILTTY BLLLIN(�
5�'ECrAr, A���S$MENTS g�FINANCE •
WPkTER TAP SE� BNGtN�Ett�NG
NQTE: WATER METER REPAIR,INSP OR SHUT-CIFF % WEEKENDS Bt HOLIDAYS $12� J FIOUR-BILLED
THiS IS aN APPLICaT1UN FQtt a PERMiT-NOT v,�.,iD UNTtL PROCESSED
I heroby apply for a water or scwer (nEw connection or repair} permit and I acknowledge that che infarnsation above is camplete and
�courate; ehat the wark will be in conformance with the ardinanees and cades pf the City of Fridley. i understand this is not a permit but
only an application for a pernnit work ie nat��,�rt 'thou � pe�nit,
SIGNATURE QF APPLIC : � �INT NAME � ���Li���i'! DATE �� � �U
A� _JL�Li�L.L
APP�.OVEI� BY: '� ° ! DATE : � � f �
COPY C3IVEN'f'4: UTILITY BILLING
C�ty af �'ridley
Bu��d�ng Xnspectians Dep�rtment
6431 University Av�nue NE� Fridley, N!N 55432
763-572-3604
FAX; 763-502-4977