AF - 36104;� °�"� � .;���� .�c � ��'�,�,�q '� 7�',Y`4'°'� , � � "
cz � s� ��� � ,,�-`'�„ '� ' � _
� v3��e Of F�itu�y,.n��.
����� �*��
. N° 456 a►��� o� nv���roR o� �s�i►n��s
o���P �,,---,—��"'� _-�������,,,��
�rchiteat Frid'_e3', Minn., ���r� � > 19�
.... qy .. . . ., _. . . � . . � . . . . : . . � ., �. .,:
Buiider • ��_ :
_ LOC,E�TIOl'�T �JF �UIL�3IlVG
Na. �. Street ��� ������ ,��� Part of Lc�t
Lot �3tock �iddition or Sub-DfvisiQn "
£3L;�CRIPZZC�I t3F BUIL�IIP�3G
Front�,�! � Ti�epth� Height� Stories� �P�aner of Co�stru�tian .�.� '}`'"..,...+ =�"-�.�
i_"____._
,.�, ^�n �.�r ��
,�4�
To be a� To be completed �tilmated Ct�t-,����� �
� � .,
Is�rmit i� he�eby �'r�ted to � � - , ,�+��,�;,��_ tp � �" ,�,��
_ �._..��...�` '�!���``
the b�#il�g described in ti�ia abtrue' �tatena�mt. ' Thfs .�erxnit is g�nted '
ugan the �xpr oiiditioa th e perso� io w2�om it is granted, and P�is ageuts, eu�ploqe�s;and rovorkmer�, <in all
the work.�iaae ; araund an �. on :sa,id �ruflding, or any gart ther�of, sha.li confarm in all;respects to tYse ordi-
nancea oi `Eridley, Mina:,, regarding tt�e cona�ruction, alter�tfc�a, maintenaince, arepair .tuid 'm4'�in� �i' huildiugs �
w#thi� the eity ti�its, .#utd tYtis pernuit may be revoleed at any t'vne up�t+ violaticth c�f any af the gx�crv'i�n� of s�,i�i
ordinances.
: , k ��, '!.
- inspeetar af Bu€ildings;
, � ` �G�MF.�+1T ANi7� �'(�VQR?�f ST=A'�EJ�#E1�TT ' `
., ,
In cc�nsideration of the issue and delivery ta r�e by the In�pectar c�f I�ui�dings of �idle� �f
the a�v'e pe�t, i herei�� ��ree tt� do the pxx��o��d wnrl� ,in accorc�anee' w��h the : descrip�atm
above se� �orrt,h and ac�mrdin.g tQ the provi.sions of the ord�na.nce� of Fr�dley, and, bei�tg :first ctutly
sworn, i h�x��y' $tate and say �hat the facts s�ted iay me a.nd co�t�,in� ,�. �he , abave p�r�n,i.t mre
' true ar therair� sta�. : . . �
Sub�cri�i sns� swz�r� to b�fcsre me at �''rit�e�, Minn�;so�a,. i . ', ;
F �,, 3 .c�a,y o�,i��"�'`"""'.�, �►.D, 19.��. � _
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City of Fridley S�B�E�'
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
; �L _ COMMUNITY DEVELOPMENT DIV.
r i � PROTECTIVE INSPECTION SEC.
1 , ,
l---_� ��"" �,� CITY HALL FRIDLE� 55432 NuMeER REV.
1 612-560-3450
910-F15
JOB ADDRESS 5947 Central Avenue N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 8 1 Meloland Lakeview
Z PROPERTYOWNER MAILADDRESS
Mark Johnson 5947 Central Avenue N.E.
3 CONTRACTOR MAILADDRESS
Sussel Company 1850 Como Avenue, St. Paul
4 ARCHITECTORDESIGNER MAILADDRESS
5 ENGINEER MAILADDRESS
DATE PAGE OP
9/21/77 / /
Z�P PHONE
645-Q331
ZIP PHONE
Z�P PHONE
. . i. i v
RECEIPT NO
�
APPROVEO BY
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW �1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 27' x 23' Addition to dwelling
9 CHAN(iE QF USE FROM TO
STIPULATIONS pmvide smoke detector in bedroom hall area. Firestop baloon
frami.ng at cei.ling line.
Befor ����� �
SEPERATE PERMITS REQUt�ED FOR 1�IdRdN�� jE���+E�-ft���l �';�'1 "���
�iEATIN�P PLU�91�1�� A�i�� SiGN�.
kEQ��RF� � � - �;a;
�1
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCZ FYdIIl@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING so. F-r. 62�, CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R—�. X$���i 8, 694
ANY T�ME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET 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 tiS`'C>� OOO �`3.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIO OR THE PERFORMA CE OF CONSTRUCTION. � .,S`3F).00
� � � �� � ` � � PLAN CHECK FEE TOTAL FEE
� / $39.00
G TURE CoN7RAC ORORA !10Ri2EDAGENT ��A7E1 WHEN PROP RLY VALIDATED THIS IS YOUR PERMIT
` �^� �` �
` ' 02 -
SIGNATUREOPOWN UFOWN UILDERI 1DATEI ainr inic _.__
h
0
CITY OF FRIDLEY
APPL.ICATION FOR RESIDENTIAL BUILDING. PER��tITS
�NEW, ALTER�TIONS,.�ADDITIONS, OR, REPAIRS}
T
O&df1SR: BUILD�R: � .
Address : l�� � � �"� Address : ��`� U ����� �-
Tel. No. : T'`� � -� -�s. �,wA.s�-��
No. : �9�� S��t: r��,�.��--P ��
LOT:
BIACK: ADDITION:
CORNER LOT: INSIDE IAT: SLTBACK: SIDEYARDS:
Applicant attach ta this foxm �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. �
DESCRI PTION OF BUI LDI NG ,'
To Be vsea As: L� � j
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Front: � � Depth: � Height: � � -
Square Feet: ��/ Cubic Feet: �� Q%�
Front: Depth: � Height:
Square Feet: Gtibic Feet:
Type of Construction: j����Z� Estimated Cast: $ ����� �
Zb Be Completed: �i''�
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
� is� REVERSE 5IDE OF SHEET)
The undersigned hereby makes application for a permit for the work herei:n
specified, agreeing to do all caork in strict accordance with the City of
�Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations sta.ted in this application
are true and correct. See reverse side for addi•tional information
��T�: ` 6 �� � SIGNATURE: � � �P�/L
Stipulations:
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BUILDIfdG PERt�1IT FEt SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issui.ng permits for the erection
of any bvilding or structure, or for any addition to.any existi:ng building or structure.
or fox' any alteration or repairs to any e�cisting�building or structure, upon applicati�n
therefore, require the payment.by the applicant for such permit of fees to tlie amount
herein below set forth and in the manner herein.provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic fee�k.
PLAN CHECK: 25 percent of building permit fee.
DRtVEWAY DEPRESSION: (Concrete Curb Streets Only) .
Alternate A: Removal and replacement of concrete curb and
gutter only; Drivecaay width plus.6 �eet x$11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
- 6 inch depth; Driveway width plus 6 feet x$15.40
� 1 1 i � � � ` � �
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered fro:;� a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main 3able of a pitched roof . •
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 �er each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
»
VERIFICATIO� OF FOUNDATION
1dOTE: Permits for construction will be issued a miniminn of 24 hours from the time
of applicaticn to allow for proper review of the proposed structure and of the
con�truction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedi.ng with the framing.
. � � ��
► = -
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building pe nnit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued. .
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THE SUSSEL COMPANY • GARAGE DIVISION � ROOM DIVISION � NEAR-BILTT�""� HOME DIVISION
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1850 COMO AVENIJE, �AI�lT PAUL, �/IINIVESOTA, 55108, PHOf�E 1612) 645-0331
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��� EXTERIOR ENVELOPE kVER/LGE "U" COMRUTATION
04��dER �dr� �dnh s�� �n
!2N 3 - /0.5/
r,�nJ 3 — S. i
�z��—z�.z�l
,� f N`� '�- = —
SITE A�DRESS S9 y % �L-�7�ra � /�F�►e �%.
CONTRACTOR %� � �i•�,,���� �0 DATE � /% PHONE 6 .� C)�3�
Determine working square footage of each.
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6� �'� r�>
1. Tota1 exposed wall area ..... '7' � � s�q. f�. x .17 = �
2. Total roof/ceiling area ..... �� ?` sq, ft, x .05 = zl.�
Total exposed wa11 area above flaor = ��g :��
a. Total w�ll window area ........................... SG?.9 D
b. Total door area .... ........................... �-�.
c. Total sliding glass door area ................... .-�-�
d. Total fireplace wall area....... ... ........... --�-�-� �
e. Total wall framing area (ayerage�l0%)...:........ y 2,4
f. Total net wall area abave floor ................. 3 Y,(o. �
g. Total rim joist area ... ....................... -�-�---
Total exposed foundation area = ! --�_
h. Total foundation window area...... ............. —�
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i. Toal net foundation area above grade .....,...... ---Y--�=-
' Determine "U" value of each wall seg►nen�.
Cl. S�i ( X 71��� .s J� ' ? A. V V
L, . ' �� V 11' 11f �
LI /\ U
4.. y tl�ll ^
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e . �/Z , �
f.
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3�� .Z
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X 11�11 _
X�� � �, @� Z-7 _ S c./ �--
X �,�,� . DC� = Z �. �.�
x ��u��
n. �� x ��u��
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i. X "U"
3............a ........................Tota1 - .�� . i
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If item �3 is the same as, or less than item #1, you have met the intent
of SBC 6U06(cj2.
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Total exposed roof/cei 1 i ng area = �� �� .��v �
. Total gross roo-F/ceiling area = - ,
j. iotal skylight area ............. ..........
k. 7ota1 roof/ceiling framing area ............ y 2, 3
1. Total nEt insulated roof/ceiling area....... -3 g�,�
Determine "U" value for each roof/ceiling segment.
� _ _ �_ X �� U �► _
�. y�. 3 X „�,� � ,�� _ �� �s
1. ��� . ? X „�„ n ��� - !a,C��
4 ..................................Total = � ,
If total of �4 is the same as, or iess than #2, y�u have met the intent of
SBC G006(c}1,
Ta u�tilized the total envelope system method, the values established by the
sum of items #3 and #4 shall not be greater than the sum of iter�s #1 and #2.
1.
3.
+ Z.
+ 4,
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RlI2 F"� t� v✓t —%1 =.�n 2'
�--3/u"P�y�.�oo — 2 = . 9 �
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3y''s��B — R= . z2
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. 3/�!'sr`�2,y y�'� 12 = �l, �,�
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Building
Inspections
763-572-3604
763-502-4977 FAX
DA'['E L �
SITE ADDRESS _
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
��� ^
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
_ �r�cTTVE i-�-zoio
❑ OWNER
. �!(
Permit No.• '�% `� �
Received By: ?
Date Rec'd: "1 �
��A.��� � � crr5r �i��� �J1 ��,e sTA�d`siC ziP,
J i./ A / S
CONTRACTOR �Jp�: � `l �.� � � � L � �
SUBMIT A COPY OF gTATE LICENSE # �,� ej �,� �f
YOUR STATE LICENSE �� �` DR'� _ �— �� p°° /
AND CERTIFICATE OF ADDRESS: � � /�/ ��2p � � � /� CITY , J�' � fl�� STATE IP ��
INSURANCE pHni.rF ? 1� �,_� �/-� __� s� a �. �
PROPERTY TYPE
PERMTT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING
SIZE OF IMPROVEMIIVT
� SINGLE FAMILY/NEW CONSTRUCTIi
❑ TWO FAMILY/NEW CONSTRUCTION
❑ BASEMENT FIIVISH
❑ DECK
❑ NEW HOME CONSTRUCTION
❑ MAINTENANCFJREPAIR
O SIDING
NG �L
��YTlON
MODELING
❑ WINDOWS
� DRAIN TILE
�ER
���G �OUSE ONLY
NUMBER OF SQUARES �_� ❑ HOUSE & GARAGE
GARAGES ��!� � �p p'f'I'ACHED GARAGE
PROPOSED SIZE: ETAC D GARAG
PROPOSED HEIGHT: ������ `�?�r �� I `' I- I/'7�
!�%,' 1
sIDn� _ -�---�3[ L u. . ��
0 ��l � (�/ _L ��ffit � —.z,�-
�������� O Trim -
❑ Other �
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
2., Proposed flaor plan
3. List of structural members to be used
FOR NEW CONSTRiJCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT•
1. Site PlanlSurvey showing the existing structures
and proposed project.
2. Two sets of construction plans
VVINDOWS 3. Energy Calculations
IN EXISTING OPININGS OYes C7No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPINING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LA,BOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION � nrrr ru � wrrv •.•�,,...
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Swchazge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �� �� See Back Page for Fee Sch�dule
$ 65% of Building Permit Fee
$ s .001 times the total job valuation
$ .0005 x Permit ValuaHon Minimum $.50
$ � ` $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ fr+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ _, e Make checks pavable to: Citv of Fridlev Attae
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 applicarion 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 1 w rk which reyuires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME v � G I(� C� DATE rI '�^ '- ��
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any �addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit: �
TOTAL VALUE FEES
$1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fracrion, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $I,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1� $50,000 plus $7 for each additional $I,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1� $100,000 plus $5.60 for each additional $1,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,000
$1,000,001 and up $5,608.75 forthe 1� $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. �Tew Houses On�
' City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977