AF - 36170sue�ecr PER
City of Fridley � 15031
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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r � � PROTECTIVE INSPECTION SEC. ?� 9�
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�L r'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L""� � ,`� 612-560-3450
910-F15 11/20/78 � �
JOB ADDRESS �1�0 Central Avenue N. Es
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 ]_ Tl]. L'O Addition SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Tri Co Builders 2261 Fairoak Avenue, Anoka, NIl�i 427-6250
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW O ADDITION ❑ AL'FERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 4Q.' x 48' 4-Plex and a 40' x 22' Garage
9 CHANGE QF USE FROM TO
STIPULATIONS provide a hard su��ace dri,ve�yo ��ovide sod in the front and side
yards. Provide a verifyi.ng s'urvey be.£ore cappinge Provide �c exterior ramps
(Z0:1� to ea.ch. unit. Provide com'6ustion air to furnace.
DRIVEG�TAY DEPRF�3IDN �SCROVi": 25R -h 6' x$14e5Q = 44�.5Q �uD�
Provide exhaust fans and light in laundry area.
SEWER AND 6�TER TO HE It1�TALLED BY DEi7ELOPER ��,��,"a "i
� ���C�`���,�
Before di��ing call i����i �.�siifies
TELEPHONE - ELEC I ��li� � �A5 Efc,
�EPERP+TE RERtViITS RE�UIRED FOR 'dillRi�a i ,
'HEATItVG, PLUN1�6�1G P►�ID SiC1V�. r REC��J���� �� �,�`�
b l� 5
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONfNG. TATOOC�. Fr�e
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT I.�ZQ �' $SO 39,352
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 4 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 WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT +fi�S�9O� $47o9rJ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION. ' $�-�-908�- $�-�280.00
�a e,} � P ��� ' _ �LAN CHECK FEE TOTAL FEE
�� $63 e 79 $1, 511a 55
� ATUREOFCONTRACTORORAUTHORI2EDAGENT (DATEI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT
" ' ?� ✓`°�--- ���� 1 / 02 U
' SIG TUREOFOWNERIIFOWNE' BUILDERI IDATEI BLOG INSP pA7E
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c��Y or- r-�ziv�cY ,
° O�PF'LIC/1TIDi� FOR f2ESIU(=NTI/1L I3UILDING PERt�tITS .
° (NL"•W, �LTLR/1TIOPJS,. IIDllITI0IJ5, OR REP/�IRS)
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oVn��R: � � nuiLV��z: !�r � ��.d��S
Address : � Address : o�o%�o / �f"C�-t�C�2� � ,
Tel . No . : �� t9-Gt-� • ��.� f,..�S'�
No. a � � �� Strect: ��� � .
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Lo�r: � aLOCr.: �_ nnnzTZOra. �,�r � ��-0� ��=��
CORNER LOT: INSIDE IAT: SLTBACY.: SIDEYARDSs
Applicar.t attach 'L-o L-his form �ao Certiiicates of Survey of Lot and proposed
bui.].ding locatian draF�n on these Certificates. •
DESCRI PTIOPd OF BUI LDI f�G
To Ae Used As: � �
�
� Fronts °`70 Depth: • '��U ' Height: o�d
<
5qv.are Feet: �_ 9�� Cubi.c Feet:
.- -- �
� � Front: ��Q Depth: o2c� � Height: 1�
� . 5quars Feet: � GUbic Feet: ���[^j
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7ype of Construction: �C� ��IiQ� Fstimated Cost: $��, ���
Rb Be Completed: t�vc 11 �%
� - . Alt. A A1t. B
Prciposed Driveway Taidth If Ne�a Opening Is Desired $ $
(SEE R�VERSE SIDE OF SIiEET)
The unclersigned hereby niakes application €or a pezmit for the work lierein
specified, agreeing to do all eJOrk in strict accordance c�ith the City of
Fxidley Ordinances and rulings of the Department oi �uildings, and hereby
declares that all thc facts and regresen��tions �tated in �his application
axe true and correct. See reverse side {�r aclditional infonnation.
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D21TE: I�� �� ` �� SIGNATU}'�E:
Stipulationso . �� ��° ` ��� ,�"��=
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BUILDING PERt�IIT FEE SCNEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or s�t�ructure, 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 amount
herein below set fflrth anc� in the manner herein provided to-wit: "
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)�
Alternate A: Removal and replacement af concrete curb and
' gutter only; Driveway width plus 6 feet x$14.50
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$17.20
�11 � ' ► •' : ��
For the pur,pose of computing fees for building permits, the cubical contents of any
buildinq,or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or th� 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 repairs 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 charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge. -
� � � � 1 I i � \
NOTE: Pex�mits for construction will be issued a minimiun of 24 hours from the time
of appliaation to allow for proper review of the proposed structure and of the
construction sitee
A Certificate of Survey of the lot, showing the.location of the foundation once it
has been constructed will be required before proceeding 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 pernmit has been issued; and
saa.d structure shall not be used or occupied until a Certificate of Occupancy has
been issuede ,
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___ All other construction: Site Address ��
_ Date � Phona Other : �, � , - �
__ LINEAL FT, OF
_ L�XPOSED WALL 1 � � X � y FT. ' ABOVE GRADE � � � " � � .
TOTAL EXPOSED WALL AREA SQ. FT.
OPAQUE GTAT,L CONSTRUCTION:' •"U"VAZUE SQ. FT. (U) A)
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, TDTALS _� 7l � Sq.Ft.� s: ��U) iA)
TOTiAL (U) (A) VALUES DIVIDED BY�y`.• _ �� S ?S AVG. "U�r
TOTAL WALL AREA
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" RQOF/CETLING: � - ' '
TOTAL AREA• ,g �� `` .sq. ft.
Detail -%3�:,. C%�t � c�,��.� X / % 3 v = ��1, �� .
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TOTAL .(U) (A) VALUES pIVIDED BY = ,�� 3 AVG "U"
TOTAL ROOF/CEILING AREA
AVERAGE ►�U"
I & 2 Family Walls .17
All other wall� .22
Vented Ceilings .OS
All other ceilings .10
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CONSTRUCTION � � ..
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b Exterior Air Film
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Tota 1. "R" , 3 �
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1 Interior Air Film .68
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3rExterior Air Film _� _ _ _ .17
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4 Interior Air Film ,61
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6431 UNIVERSITY AVENUE N.E., FflIDLEY, MIMNESOTA 55432
TELEPHONE ( 612)571-3A50
Jim George
-Co Builders
1 Fairoak Avenue
ka, Minnesota 55303
uear Mr. George:
March 6, 197g
It is customary to require any balance of sewer main charges to be paid in
full at the time a building permit is issued on any parcel. Due to the
fact that at the time four building permits were issued on lots in Tri-Co
Addition prior to the time we actually had the plat information from the
County, this was not done.
We have now received the p1at from the County and are requesting the Couneil
to apportion the special assessments at the Council meeting on Monday,
March 12, 1979.
The following amounts for balance of sewer main charges are due and
payable to the City at the present time: '
Lot 1, Blk. 1, Tri-Co Addition
7150 Cen�ral Avenue Northeast
Lot Z, Blk. 1, Tri-Co Addition
7]70 Central Avenue Northeast
Lot 3, Blk. 1, Tri-Co Addition
7190 Central Avenue Northeast
Lot 4, Blk. 1, Tri-Co Addition
1270 - 72nd Avenue Northeast
$ 68.00
70.00
70.00
70.00
278.00
In addition, at the time the building permit is taken out for Lot 5, Blk. 1,
a balance of sewer main charge of $334.00 will be owing, and for Lot 6, Blk, l,
a charge of $72.00.
�
�
Mrs. Pat Sykes
Special Assessment Clerk
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�� March 20, 1979
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6431 UPll1l�RSI'TY AVEPIU� W.E., FRIDLEY, ININfVESOTA 55432
• T�LEPi40PlE ( 612)571-3450
Mr. Jim George
Tri-Co Builders Inc.
2261 Fairoak Avenue
Anoka, MN.55303
Re: Final Inspection at 7190 Central Avenue N.E.
Dear Mr. George:
A final inspection was made on March 14, 1979 of the above address and
the following it�sas were noted which must be compl.eted before the
structure can be finaled out;
1. Past address at both the front and back doors of the structure
by April 6, 1979.
2, Assign numbers and post them on both the front and rear doors of
each unit by April 6, 1979.
3. Call for and get approval of the plinubing final by April 6, 1979.
4. Ramp the west door by May 15, 1979e
5e Complete the parking lot and the garages by May 15, 1979.
We will expect the above items to be campleted by the scheduled dates
when reinspections will be conducted to determine complianceo If you
have any questions o n these it�ns, please contact me at 571-3450.
Sincerely,
DARREL G, Q�ARIC
Chief Building Of �Eicial
DGC/r.ih
,
.� ..
. .
CITY or- r-�zrU�cY .
' � APPLI C/1'f 10P� FOR RES I ll[:NTI/1L BU I 1_D I NG PERMI TS .
' � �., �IVEt�, �LTERItT10NS, ADDIiIO����' OR REPAIRS)
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OWtiI;R: � �I � c C+l��/ZS' � IIUILDL•'R: '
. Address: ' Address: �
Tel. No. �
No. :_ �1 �(� Street: ��JJT,�a- L, �� �L,� .
LOT: � BLOCY.: � i1DDITION: _ //Zr -�Qj A� Q� I l U�
COKNER LOT. - INSIDE LAT: SLTBACI:: SIDEYAI2�5:
Applica'r�t attach to this fazxn 71ao Certiticates of Survey of Lot and proposed
buzlding location drawn on these Certificates. .
�'o Be Used As:
DESCRI PTTOPd OF BUI LDI NG
..
Front: Depth: �� � Height: -
Square Feet: Cubic Feet:
Front: � Depth: � Height:
� Square Feet: Cubic Feet: '
Type of Construction: Estunated Cost: $
?b I�e Completed: Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $ •
• � (SE� R�VERSE SIDE OF SHEET)
The undersigned hereby makes application far a permit for the work lzerein
specified, agreeing to do all caork in strict accordance with the City of
Fridley Ordinances and rulinqs of the Department of Buildings, and hereby
declares �hat.all the tacts and representations stated in this application
are true �.nd correct. See revcrse side far additional informatian.
DAT�: � — � � - rI 9 SIGNATURE:
Stipulations : �, �� �; � ��
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. AUILDI(�G PERt�IIT FEE SCHEDULE
SECTION 2e The Tnspector of 23uildings shall, before'issuing pe�nits £or �he erection
of any building or structure, or for any addition to any existing building or strucat on
ox for any alteration or repairs to any existing building or structure, upon ap}.
there£ore, 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: •
NEW CONSTRUCTION: Single ramily iiomes and Garages: $4.00/1,000 cubic ree�.
pLAN CHECK: 25 percent of building pexmit fee. .
DgIVEWAY DEPFtESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
— gutter only; Driveway width plus 6 feet x$�5.75
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$17.85
:11 � :. � �� � ��
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 from a
point six (6) �nCfe ��eeu°We�surface or to the averageeheighttof thelroof�surface
average heights o PP
of the raain gable of a pi�ched roof .
For repairs 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 co'st
of aZl proposed work.
In•no case shall the fee charged tor any permi.t as set for�h in Section 2 be less
tY�an $?e50 plus $.50 state surcharge.
. � � � � 1 1 � �
NpTE: Perniits for construction will be issued a minim�n of 24 hours from the time
o� applica�ion to allow £or proper review of the proposed structure and of t.he
construction siteo �
� Cert:i.ficate of Stxrvey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
� , � ':\ �
.
Appl3cation for a Certi�icate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building pexmit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been i.ssued.
_ - � � ,� ;�; �, �� �e�:.$�3�• ' �� � �1 r � � .. � �+�i�,►
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`"� ` CERTIFICATE OF OCCUPANCY
. - , . ` . . �uilding Permit No. ��i�`�
Lotation '
y� , � � Fr'idley, Nti'nn.; ��, � 19�`�,
�� � `
� This certifies that we have inspected the building at the above location, situdted on Lot � b'�`' '—
��' ��< :
� `g ' �, ���� Addition to Fridley,: cnd 'find that the same compJies, to the
� Block, � `` . ; ,
best of our knowledge and belief, with all the requirements of the Buifding Ordinances of the city relating thereto,
cnd pei�nnssio�� is hereby given for the occupancy of sai d building, in whole or in part, in the manner and #or the
purposes hereir�' below specified. �
�,�,` Floor �' to be occupied for
��a�,�. �°�"�,�? .�����'
s
"'�Floor to be occu ied for �'��'"d �a _ -
p uT�' ua� `r
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Date Approved�.� ,r �� �, >•: A�>. ° 1��.�ar. ��
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CERTIFICATE OF OCCUPANCY
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location ��� '�-'"�'��'''���' ���� ' Building Permit No. ����
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= Fridley, Minn., � y '� ��� 19��
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This certifies that we have inspected the building at the above location, situated on Lot �
Blo�k ��, �s ���� Additio n to F,ridley, and find #hat the same complies, to the
6est of our knowledge and belief, with all the requirements of tNe Bui�ding Ordinances of `the�city relating thereto,
and permission is hereby given for the occupancy of said buildfng, in whole or in part, in the manner and for the
purposes herein below specified. °
F
;
'� Floor �a to be occupied for `�°`�' i : � ' "� �
_ _ .✓�"'-� �. _ . � �.
Flnor; to be occupied for,
Date Approved,`+� � fx"�* .�` � �� . ��; �`''+1l�
Heating
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8439 UldIVERSOTY Ai�EPlUE M.�., PfiIDLEY, t�ll(dNES�TA b6432
TELEPHOPIE ( 812}bTt-3450
Mr. Oscar Archila
7190 Central Avenue N.E.
Fridley, h1N 55432
Dear Mr. /�rchila:
October 17, 1980
RE: 1980-81 License Application for th� Residentidl Rental
Property located at 7190 Central Aienue N.E., Fridley, MN
At the end of July, 1980 yuu were maileci an application to
lirense your residential rental pr�perty. As of *he date of
this letter, th� City has not recPived �he app?��c�tion and
appropriate fee.
Therefore, we are again mailing out the enclosed application
wh�ch mus� be completed, signed and returned with the license
fee plus the 50% late penalty no later than 11-3-80.
Your prompt attention to this matter i� appreciated.
Very truly yours,
STEUEN J. OLSON, R.S.
Environmental Officer
SJO/kw
Enc 1 osure (1)
Q069A/0�07A '
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March 9, 1981
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6431 UNIVERSITY AVENUE N.E.� FRIDLEY� MINNESOTA 55432
Hong & Plau Associates
2298 - 17th. Street N.Te1.
New Brighton, Na�i 55112
TELEPHONE ( 612)571-3450
Re: Repaix & Maintenance of tlYe Rental Property Located at 7190-92-94-96
Central Avenue N.E. , Fr'idley, NIl�T
Dear Sirs:
It was confi.rmed by a routine or�site inspection on March 6, 1981 that
the above listed rental property was being maintained in violation of
Chapter 22�, Residential Maintenance Code, of the Fridley City Cqde.
The inspection on the a}�ve dat� found the following deficiency which
must be corrected. Any repairs or improvements must be completed in a
worlanansh�,p like manner. It is the City's hope that any deficiencies in
apartments that were not inspected will be corrected as needed.
EXTERIOR
Provide and maintain a screened enclosure to conceal the refuse
conta.iner fmm view. �
A reinspection wi�.l be conducted on ar abQnt Apri7. 13, 1981 to determine
c�apliance. We are confident in your cooperation on this matter and if
any q�estions or ,problems arise, please feel free to contac� me a�. 571-3450.
Failure to abate this aiolation may result in this matter being turned
ove� �6o the City Prosecutor for his legal consideration. �
Sincerely,
S N J. OLSON, R. S.
Envixonmental Officer
SJO�mti
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SuB�ECT
City of Fridley
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
i �
� �
; �,L �_�_�_ COMMUNITY OEVELOPMENT DIV.
r j � PiiOTECTIVE INSPECTION SEC.
, _ .
� �"'1 � CITY NALL FRIOLEY SS132 NuMBER REV
�•--•� ' ,•' 612-571-3450
s�aF�s
JOB ADDRESS 7190 Central Avenue NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
OATE I PAGE OF
6/1/00 � �
�ERMIT NO. `
31005
�_ -�`.
RECEIPT NO.
��� / ,
APPROVED BV
SEE ATTACMED
oescA. 3 1 Tri-Co Addition SFIEET
2 PROPERTV OWNER MAIL AODRES$ 21P PHONE
Kevin Auge 7190 Central Avenue NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Larry Jaskowiak Construction 14180 Dale Street, Becker, MN 55308 261-4719
a ARCHITECT OR OESiGNEF MAIL AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER
8 USE OF BUILDIN!
4-Plex
7 CLASS OF WORK
MAIL AODRESS
� NEW O ADDITION ❑ ALTERATION �7 FiEPAIR
8 DESCRIBE WORK
Reroof 4—plex (45 Sq) Tear—off
9 CHAN(iE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
' SEPARATE PEIiMITSARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, r�rtvr wnsr.
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONtNG
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONED fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS
I MEREBY CEHTIFY THAT I HAVE REAO ANO EXAMINED THIS APPLICA710N 4
AND KNOW THE SAME TO BE TRUE AND CORi;ECT. ALL PROVISIONS OF �AWS yq�UATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED @
WITH WHETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W3,933
OOES N07 PRESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEI TME pEFMIT FEE
PqOVIS10NS OF ANY 07ME TATE Ofi LOCAL LAW REGULATING CON-
TqUC710N A C ONSTNUCTION �gJ.2S
�� PLAN CHECK FEE
� c
S�GN4T EO�CON'N fiORGU1hiORi2E04GENf iDATEi EN RC
,,
��6�_.
� iDATE� s..
STALLS
PHONE LICENSE NO
O MOVE O REMOVE
GROUP OCCUPANCVLOAO
CU FT.
OFFSTREET PAqKING
IGARAGES
$1.97
AC CNARGE
Fire SC $3.93
OT FEE
3.15
r►+is is ua aeRM�r
, �_�
�1LTF
Prepaid Plan Check $
Estimated Cost $
Receipt #
Construction Addreas
Legal
Owner & Address
CONTRACTOR & ADDRESS
! � /U� !�Q
Architect
l0�/
iC 9�
CITY OF FRIDLEY
R-3, COI�IlKERCIAL & INDUSTRT7�T•
BIIILDING PLRMIT APPLICATION
�
Effective 1/1/2000
(612) 572-360�4
(�V�
A �v ��
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Zoning
��` C 7`�!� B Qj" q�/A� Tel# ( )
Ulec � � %%� OI� � f� ' Tel# (�) -� ' � �
t� �� � r /� ��'�d$
_ Reg.# Engineer Reg.#
BU'ILDING CONSTRIICTION
TYPE OF WORit [] New [] Addition [] Alteration -Describe__ �L° f(�+p�
'`�� �� � / � :� � �1��
OFC. AREA: Length Width Height Sq. Ft.
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
APPLICANT
Tel #
Date
VALU'ATION
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) ��
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ )_$
Sq. Ft. x$ Cost/Sq. Ft. - Valuation $ ) TOTAL VALUE
Building Use Construction Type Occupancy Group
Air Conditioning [] Yes [] No Fire Protection Provided Il Yes [] No
Performance Bond Amount $ See Reverse for Schedule Received []Yes []No
Permit Fee $ � oC�
Plan Check $
Fire Surcharge $ ,
State Surcharge $ % �f%
SAC Charge �
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $
PSRMIT FELS
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/lOth �)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1100 per SAC Unit (Plans to MWCC for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $15.50/foot
� � _ �
ATTACB STIPULATIONS
$1 to $S00
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,0�
$100,001 to $500,�0
$500,001 to $1,000,0�
$1,000,001 and up
BUILDING PERMIT FEE SCHEDULE
$23.50 (Minunum Fee is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn'1 $100 or
fraction, to and including $2,000
$69.25 for lst $2,000 plus $14.00 for each addn'1 $1,Q00 or
fraction, to and including $25,000
$391.25 for lst $25,000 plus $10.10 for each addn'1 $1,000 or
fraction, to and including $50,000
$643.75 for lst $50,000 plus $7.00 for each addn'1 $1,000 or
fraction, to and including $1�,000
$993.75 for lst $100,000 plus $5.60 for each addn'1$1,000 or
fraction, to and including $500,000
$3,233.75 for the lst $500,000 plus $4.75 for each addn'1
$1,� or fraction, to and including $1,000,000
$5,608.75 for the lst $1,000,000 plus $3.15 for each addn'1
$1,0(}0 or fraction
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota Building Code - 65 % of building permit fee.
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling
residential project which requires outside unprovements, a Performance Bond or a Letter of
Credit shall be submitted to the Ciry. The bond will cover all outside improvements, including
but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting,
water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The
bond amount will be 3% of the building permit value up to a 2 million dollar project or a
$60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right
to require greater or lesser bond amounts based on unusual circumstances. Projects with no
outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully completed. Reproducible "as built"
drawings of all exterior underground utilities must be submitted to the City Engineering Dept
before the project is considered complete and the bond released. All bonds will be held over
one winter and through the neact growing season to insure the survival of all landscape
installations. The City will then inspect these properties in August of the year following the
initial planting. Bonds may then be released in October of tUat year if all improvements are
satisfactorily completed.
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This is o true ond correcr represenrotipn of o survey of the boundaries of the Iand o6ove dascribed ond of thr
lo<arion of o11 build�ngs� if any� thereon� ond all visibin e�croachments� if on �rom or on soid �ond This survey is
made only in connection wilh a m,oitgage loon now being placed on the Pr perty and no liabil�ty is assumed
excepe to rhe hoMer oi such mortgpge or ony ofher i�teresf ccquired by e reason of such mortgage �� {s
underslood ued ogrea�! no! monume ►s have been ced for the �r ose 1 es{'
corners. Doted this �-�-i day flf : i V. p, p, �p� P� �,r ablish�ng !cf lines or boundary
I L �� �� SUBURBIDcN •�t�ltdEERlN�, INC.
I 1 �ri'`x.lP �/!��' Enb� oe^s . i� !J, -'�'Sur�`ors
Vot Publ�sh'e�� A�� R�qhts Reserveci
�;� �;t
` ' : ADDRESS ,'
; PIN `
� , .
� � CITY OF FItIDLEY PERMIT NO.: 2004-020��
� 6431 UIVIVERSITY AVENUE NE .' ` .
�FRIDLEY, MN 55432 DA� �SSUED. il/16J2004
763 572-3604 FAX: 763 571-1287
REPRINTED ON 11/16/2004
: 7190 CENTRAL AVE NE
" : 123024310041 �
� ` : ° TRI-CO ADD �
: `LOT 3 BLOCK 1
PE� ,� � : �BUII..DING
TYPE' :. RESIDENTIAL .
l'ION TY�'E..,; . ., ADDITION/ALTERATION
� : � $ 0.00
NOTATIONS ON.PLAN.
� STATE ONE AT,651-4540002 FOR UTILITY LOCATIONS. ��` �"
[OKE DETECTORS`IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI�
fATIONAL RESIDENTIAL CODE.
E'
� r . APPLICANT
k A��`ORDABI,E STUCCO AND SIDING CO.
� 358 MAPLE'ST NE ;
`' SPRING LAKE PARK, MN 55432
:> (763) 783-0708 ':
OWNER
;KEi�IN A ;�:
;�NTRAL AVE NE �
,EY, MN.55432 '
:� {:'
PlG12EEMENT AND SWORN STATEMENT
�t becomes null and void if work or construction
�zeti �is not commenced witin 60 days or if construction
rk �s suspended or abandoned for a periad of 120 days
tm0.e �fter work is commenced.
erel�y°cerdfj+:that I haye read,and examined this
�hoa and know the same to be t�rue and correct All
ions of laws;and ordinances governing this type of work
� comp}ied with whether specified herein or no� The
ng af a permit does not presu�e to give authority to
.`or cancel the provisions of any other state or local law
�n� cons ction or tha performance of construction.
Date 1
fnen � ' 11 �n in Datlz � �� �
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
`� � . _
; SEPARATE PERNIITS REQUIRED FOR WORK OTHER THAAT DESCRIBED ABOVE.
..�Y� . .. _ . .
23.50
0.00
23.50
47.00
NEW [] CITY OF FRIDLEY Effective 4/1/2004
ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
� �� �����
Construction Address:
�(`�� C@n��-�I ���.
Legal Description: `� 1� / �
Owner Name & Address: ��i � ft vi�i e� Tel. #�S1-a���' ���°1
Contractor.���d��z �S7��Cc� �ea �'i����l MNLICENSE#
Address: � S�� � w�q� l'o S'-1- rJ� . Tel. #`�63°- 7��3 �`�d �
LNING AREA:
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
n
DESCRIPTION OF IMPROVEMENT '
Length Width Height Sq. F�
Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: �le-���+- �a(�c1"� �nS�af� m� �duS2 o�tn� o/�do/e
A I� d -�'o�✓ v� i�dU� ��n� r% i rl S�e ��
Construction Type: Estimated Cost: $ � � ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: -U APPUCANT• ��2��c� r�- ,�i� CC � �� S `� J'�� C � , Tel. # �� �� 7 �� �7G �
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number. '
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �• �
$
$ �
$ �
$
!
.$ g ,
$
$
$
$
� ���" '�'� �
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ J
STIPULATIONS:
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 bt��ldin� ar �,
structute, 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 $5�
$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
$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 each additional $1,0(�
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 $100,OQ0 plus $5.60 for each additiona.l
$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 $1,0(}0,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter orily - 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