AF - 43879�
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City of Fridley, Minn.
BUILDING PERMIT
na�: .° .� �
ow�: s�ua�
Adaress Addrese
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NO ?24fi
�,�� O �F�ING
No. Street e B 6 P of Lot .._ /
Lot ��– Slock .! Addition or Sub-Divlsion a�� �'. .—_ J�������
Q� �} �/ /° �
Corner Lot _ Inside Lot Setback ��,2 �� -- Sideyard �.�_ o
Sewer IIevation — — Fouadation IIevation
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DESCRIPTION OF BUILDING
To Usec ` / � J _��'� �.� Sq. F't. � ���
Front �?'� ��� Depth Height C�u. Ft
��. Depth �� I�eight _.�.� Sq. Ft _�� Cu. FL �� ,T f�
.��,�� �D � � a
Zj►pe oP ction F�t. C'osf7� � __.. To be Completed
In conaideration oY the issueace to me of a permit to construct uilding cri above I agree to do
the proposed work in accordauce with the dr�scrlption above set Po with a!'1 provisfons of
ordinances of the dtq oP Fridley �„/� ,� �
Ea consfderation of the �yment of a fee oP $.o� � , permit fa�hereby granted to
to canstruct the buflciing or addition as descrlbed above. This �ermit fs granted u�n
tt►e egpress condition that the peraon to whom ft is gi�anted and hia agents, employees and worl�nen, ffi all work
done 3n, around and upon said building, or anypert thereof, shall c:onform ffi all reapects to the ordtnances of
Fridley, Minnesota regarding lacation, construction, alteration, maintenance, sepair aad moving of bufldinge
within the dty lfmits and thfs permit may be revoked at any time upon violation of any of the proviaiona oE said
o�clinancea � _ .� ...
Bualding' Iaspector
NOTIC�
T�s pqneh doa ee1 eov� f6s co�lenoMen. 6uhQatioe fer wlrtn9. P��6► 6a h�aNeo, snr�� e� water. B� sure h sss
�» BotWioa lusp�etor fo� apanb p�imks Mr fkas hems.
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sue�ECT PERMIT NO.
City of Fridley o�- 7 3 9
�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
; � EIPT NO
' COMMUNITY DEVELOPMENT DIY.
� �,:- �%�/�
r � � PROTECTIVE INSPECTION SEC.
� _ �
� ����1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BY
�"""'� � ,�� 612-571-3450 910-F15 / /
8 23/82
JOB ADDRESS 6021 Central Avenue N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1], 1 Meloland Lakeview SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Tom Walinski 6021 Cen�tral Avenue N.E. 574-1514
3 CONTFACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Woodsmith Builders Inc. 151 Silver Lake Road New Bri to -
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO.
8 USEOF BUILDING
Reside ti
7 CLASS OF WORK
❑ NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK �
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9 CHANGE OF USE FROM TO
STIPULATIONS
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w�►a�d ����
� int tia111ac���� �EPER�tT� PE�A+II`�5 �t���JIf�,D Ft��R 1�R� -
�`�� �$g�E1��t�t � WEA�tiVG. �LUM811V� AN� SIGN� �
���pHON'� R� �y ��► .
�E��1
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE QUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CON�DITIONING. WOOCI Fi3ICl
T, I$ PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
A�THORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 272 2�48
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEHEBY 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 $4,500 �`Z.ZS
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`SO. rJO NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
e
� /� � � z3 � _ $iar 63 $65. 38
SIG REOfCONTRACTOROfiAUTHORI2EDAGENT 1 TEI WHEN PROPER Y ID T D THIS IS YOUR PERMIT
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SIGNATUREOFOWNEPIIFOWNERBUIIDERI IDATEI BL�G INSP �ATE
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CITY OF fRIDLCY Effective Auq. 1, 1981
APPLICATI�J fOf� RCSIDC(VTI/li_ 6UILQIt1G PCRi4ITS i��
(1��►�. Alterations. Additions, or Repairs) ��s
//
0�lNER: �l� W�+-lr.lStLl 13UILOER: (�14nYlS�"IITH- ��1LD�Y�S'� fNL•
ADDRESS: �o0 2 l Ol-� C�1�2.A�L ADDRCSS: I S l S tLV�12 1-1�. ��. �w �tfra,J
TEL N0: 5Z`f � t; 1`/ TEL t�0: (0���-3y�/
Construction Location
- STJtI�T N�: C� 8 Z. � STItEET: O �--� G�"�l��L �-�1L=
I.OT: I I HLOCK : � ADAITION : M E Le� t-A� v (.�(C� J! �J .
Corner Lot: Znsiile Lots � �
?� setbacr,: � � Sicteyazds : I 'z
Ap�licant attach to this form two Certificates of S�zvey of lot and
pzoposed building locatian 8rawn on certificates to scale.
DESCRIPTIOid OF COtJSTRUCTIOW
p
j✓n� Pd+P�e�t� Front: l� Depth: �� Heiqht: �°'��
Square . Feet_ 02-% �— Qibic Feet: � y�
Front: Denth: Height:
Square Feet: A�bic Feet:
a>2�t �(.,�° �I�� �. '��'��
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Rj�pe of Cflnstructien: �.Ic�CJ t-f�f1�� Estimated Costr 5���
Rb B� Nr.�pleted: ��, � � ► �j �?�
Alt. A Alt. 8
Propose8 Drivc�iay Wicith If New Openinq Is Desired: $'� $
, , SE� REVER: E SIDE OF SHi�T _
7�ie un8ersigned hereby ma�;ea application for a penait for the ��ork� here3n specified,
agreeinq to ca ,all work ir, strict accordance w3th the City of Fridle�� Ordinances �nd
rulings of tlie Deik�rtment of Duiidir�gs, and hereby declares that all the facts an8
represr�►tations stated is� th3s application are true and correct.
D.��E: / Z 31$ Z S�Gt�tt��vrt� :
St•fpulatiions : �
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BUILDING PERMIT FEE SCHEDULE
The Inspector of buildinqs shall, before iasuing permits for the
erection of any buildiag or structure, oz for any addition to any
�xisting building or structure, or for any alteration or"repaizs
to any �aisting building or etructure, upon application therefore,
require the paymeat by the applicant f or such permit of fees to the
amouat berein below set fortb an8 in the manner herein provided to-wit:
TOTAL VALUATION
51.00 t� 5500.00
S501 bn $2,000
S2,001 m $25,000
�25,001 to $50,000
S50,001 to $100,000
5100, 001 arxi up
FEES •
510.00 Minimum Fee $15.00 plus surcharge
510.00 for the first 5500 plus 51.50 for each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the first $2,000 plus 56.00 for each
additional $1,000 or fraction th ereof, to and
ir►cluding $25, 000
$170.50 for the first S25,000 plus S4.50 for
each additional $1,000 or fzaction thereof, to
ar►d 3ncludiag $50, 000
S263. 00 for the first 550, 000 plus S3. 00 for
each additional $1,000 0= fraction thereof, to
and including $100,000
S443.00 for the first $100, 000 plus S2. 50 for
each adr]iticnal $1,000 or fraction thereof
PI.HN CHECic: 25 perc�t of building pezmit fee
DRIVII�tAY DEpRESSION ESQtOW: Concrete (�rb Stxeets �nly
Alternate "A"a Removeal and replacemen t of curb and gutter only
Driveway wi8th plus 6 feet x$13.50
Alternate "B": Removnl and replacem�t of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 feet x$15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issne8 a minunum of 24 hours fro�n the time of
application to allow for proper review of the proposed structure ar�d of the
construction site.
A Certificate of Suxvey of the lot, shaaing the location of the found�tion once it
has been oonstructed will be zequired before proceedi with the framing.
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CITY OF FRIDLEY
8�31 UNIVERSIT1f AVENUE N.E.. FtiIDLEY, MINNESOTA b5�32
December 10, 1982
,^g°�s;
'g
Woodsmith Builders, Inc.
151 Silver Lake RAad
New Brighton, NIl�] 55112
TELEPHONE ( 812)571-3450
Re; Sun Porch Addition at 6021 Central Avenue N.E., Fridley, Nd�i
IIear Sirs:
On December 9, 1982, we made a final inspection of the room addition at
6021 Centsal Avenue N.E.
The owner had srnne caanplaints, of which six were verified and are
listed as follows:
l. Z'he existing kitchen floor covering, in front of the counter t�op
st�ove, is loose and reported to have happened when water came in
when the roof was opened for the new addition.
2. The kitchen light fixture was broken at the same time.
3. Z'he basement light defuser has a water stain that also happened
at the same time.
4. The new french door hels some defects in the wood.
5. There are scme nail pops �in the sheetrock.
6. The sod needs repair due to the construction equipment damage.
Would you please resolve these problems with the homeowner as soon as
possible. If you have any questions on these items, please feel f ree
to contact me at 571-3450.
Sincerely,
D L G. CLARK
Chief Building Official
DGC,/mh
CC: Mr. Tom Walinski
6021 Central Avenue N.E.
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CHIMWEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes� No ()
2. I s free from rus t or deteri orati on Yes � No ()
�
3. Has no foreign objects lodged within Yes,�� No ()
4. Is securely supported Yes.(� No ()
5. Meets all current Code requirements for size and
total BTU connected Ye� No ()
6. Has Total hea ti ng BTU's of �
All other BTU's �� D� �
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TOTAL � �� ���
Rema rk s � �`T�'/�---
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3uilding
11S�eCt10riS
763-572-3604
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;I'f'E ADDRESS �
f'HLS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
r�
❑ OWNER �ONTRACTOR
Pernut No.:
�
Received By: �S
Date Rec'd: �' �' `��'
NAN1E:
ADDRESS: CiTY STATE ZIP
PHONE:
SUBMIT A COPY OF STATE LICENSE �
YOUR STATE LICENSE ADDRESS:_�
VdITH APPLICATION pHONE � � Z ° �
PROPERTY TYPE ��GLE FAWII
❑ TWO FAMILY
PERMIT TYPE
�rYrE oF woRx:
�
O BASEIv�NT FINISH
❑ DECK
n
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
�����
,c.�'u,,,..
E3� DATE
crrtir ���� sra,T� J3�%3c�
�I� 3- J�f �_ r c� 7O
�ROOF ❑ DRAIN TILE
❑ SIDING � OT�R
0 SWDvIMWG PaUL
HEIGHT
F�
Kuvr n�a --- -- -- -
NUMBER OF SQUARES �_ �iOUSE & GARAGE BASEMENT REMODELING SUBMIT:
❑ A1"fACI�D GARAGE 1• ��B ��r Plan
GARAGES 2. Proposed floor plan
PROPOSID SIZE: ❑ DETACi�D GARAGE 3. List of sm�cd�ral members to be �sed
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCTIOAI INCLUDING DECKS,
O Vinyl OSof6t �nni'rIONS & PORCHES SUBMIT:
❑ Alominum ❑ Trim 1. Site P1az�Survey showing the existing struc4ues
❑ Other ❑ Fescia and proposed project
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN pQSTING OPENINGS DYes DI�To LOCATION OF WINDOWS
OR FOR NEW OPEMNGS-DESCRIBE SIZE OF
OPENWG CHANGES &
TYPE OF WW�W TO BE INSTALLED NUNBER OF WII�IDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING TI�� U. .0 FEE SCI�DULE)
TOTAL JOB VALUATION $ �� �� �C��� T�E
Permit Fee
Plan Review
Fire Surchazge
Surchatge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
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Sewer Main Charge
Total Due
$ �� ,� j See Back Page for Fee Schedule
$ 65% of Building Pemnit Fee
$ � .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ �_ � $5.00 (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for determination)
$ $+68= 8x$21=$
$ $450 Conservation Plan Review
$ G� -� , a S 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 UIdTIL PROCESSED
I hereby apply for a building permit and I aclmowledge 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; that the work will be in accordance with the approved
plan in the case of all work which requu s review and ap rov � plans.
SIGNATURE OF APPLICANT �Gm GG�'r'✓ PRIr1T A1AME / !G �L � `���''"—' DATE � ' �� " �
Page 2- Building Residential Application
BUII..DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
struature, or for any addition to any existing building or sixueture, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such perm.it of fees to the amount herein below set forth and in the manner herein
pmvided to-wit:
VERIFICATION OF FOUNDATION
Permits for construction will be issued. a minimum of 24 hours from the time of application to
a11ow for proper review of pro�sed structure and of the construction site.
A Certificate of Survey of the lot, showi.ng the location of the existing founda.tion will be
re�uired before proceeding with the framing, New Houses Onlv
City of Fridley
Building Inspections Deparlment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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ENGINEERING� INC. N1inn�wfa
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o�/lr /acvlmn gf'Q!! br�r/din9s, �eon , md ad/ ris'�6/e axmochma�fs ,��'any. �n or ar� soid /and. As surveyed by �e fhrs –_ cby
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