AF - 38330City of Fridley, Minn.
BUILDING PER1ViIT
N° 5186 �
Date: .......�,...�.._.._�..'._..�J._�........ � /.........--�-- ............._...._........_....._
r ...................-�---��--•-�---.._.._........- --... -....._.............-�--....
Owner: .... ���'/_.'�..._.._. Builder ...---� ......................-- - -
..._.. ...
Address- �--� ............. .......--------�-- •-------��---�--�--�--�--- �-�--��---�---...-------�----..._..... Address ------ --- - - � -�:rl.i. .r_..- �------- �-- --�-----...---....--_.......
la 3 �`�r� �CA'I�O BUII�D�JAJG
No. -- ..: .... reet ---- ---/��,�-:�.a/..--�-- -�- rt o t ... ---�-�-��----�--- .............--
- ----....._... /l�
Lot ...:.....yZ-� ............... Block ..........._..-•---.._..------...-• --�- -... -. Addition or Sub-Division ... . ......._..........-- - •--- `-����------�-�
�,+��i2.� _ _/
Corner Lot ....................---...... Inside Lot .- -- ..�^"."..'..'..,...._....._. Setback ....._,�. ,t�.,i.....�.......... Sideyard ......`�/Q
.............................................�� �-•-�--�
Sewer Elevation .--------...-----.-•-----.--...--_----.---..--_-------..._---------------_.--..--..----...... Foundation Elevation
DESCRIPTION OF BUILDING
T... j� !e:�'. d`..-.� -- Front �� _�_._._-- Depth p�.�-. Height �.�........_.. Sq. Ft.`��.l7 Cu. Ft �1..i••••�O
/J- �
�4Ale�
-•----�---�� ...................... Front ....--•---��-�-�------ Depth ....----...--�•---. Height ....._...--•--•-�----- Sq. Ft. .....--•-------�--�--- Cu. Ft. ....._......._----__
.rr
Type of Construction ....._ ..��.�.���'1'..Q.. Est. Cos ���.......'.._� To be Completed ....._ ............._......._...._...._......._.._
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
.�....._.--•--••---__.-•---..._.� .._..._...�.....r .�
� ..,�,,:
In consideration of the payment of a fee of $...�.%....__ .................... permit is hereby granted to....._......._...._.....______.___..._.__
._..._ ............._..._...__...._............................_..... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. 7
Building Inspector
NOTICE:
This permit does not cov�r fhs eonstruction, installation for wiring, plumbing, gas heating, sewer or watsr. Bs suro to sN
the Building Inspeefor for sepante permits for thass ifems.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
_`�
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Owners Name Builder ' "
Address Address�� !S�L°��--��sr �D,-��"� �z
IACATION OF BUILDING
No. Street 1�� 1� ,����Part of Lot
Lot ',� Block A�ddition or Sub.Div. �'�i� .�i .�.•�.G�
Corner Lot Inside Lot l�^ Set Ba.ck �'./J � 5ide-Yaxd e�":rf ��.�.. �'' /o � 1.�
SEWER ELEVATION �, % Z FOUNDATION ELEVATI�N �, S d
Applicant atta,ch to this form Certificate of Survey of I�ot and proposed building
location.
DESCRIPTION OF BUILUING
To be used as:
� �,�,..� Front , �y� Depth � ``% Height �''
G�����
Sq. Ft.l, p�: � Cu. Ft.
Front Depth Height
Sq. Ft. �. Ft.
Type of Construction �� Estimated Cost %�. o-r� -e�-r�
To be completed�_ _�.� �' I �---
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ru].ing of
the Depaxtment of Buildings, and hereby declares that all the facts and representa-
tions sta.ted in this application axe true and correct.
DATE r'_,�.l� ., t � � �,�, �`SIGNATiktE
_ �
(A Schedule of Fee costs can be found on the Reverse Side.)
• � � � � 1 � • . � , �
a
BDILDING PERMIT FEE SCHIDULE
Section_2. The Inspector of Buildings shall, before issuing any permi:t
for the erection of any building or structure, or for any addition t,o
any existing building or structure, or for any alterations or repairs
to any existing building or structure, upon application therefor, 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:
2.1. For any such permit for the erection of any fire-proof building� other•
than a gaxage, warehouse, factory or grain elevator, or for the erection of
any fireproof addition, for similar occupancy, to any existing bui7.ding
sha.11 be at the rate of .$1.�.0 for each one thQUSand cubic feet, or fract�.on
thereof, in such cubical contents.
2.2. For any euch permit for the erection of any fireproof garage, ware-
house, factory or grain elevator, or for the erection of any fireproof
addition, for sim3lar occupancy, to any existing buildi.ng sha11 be at the
rate of �1.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non-fireproof building
other than a garage, warehouse, factory or grain elevator� or any non-
fireproof addition, for similar occupancy, to any existing building.
Permit $1.00 for each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non-fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non-
fireproof addition, for si.milar occupancy, to any existing building �r
for each such building or addition. Ninety Cents for each one thousand
cubic feet or fraction thereof, in the cubical contents thereof with a
minimum of �4.00.
For the purpose of computing fees for building permits the cubical contents
of any building or addition to a uniform height throughout by multiplying
the ground area covered from a point six.(6) inches below the floor line of
the basement or cellax to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
�
2.�. For repairs or alterations to an existing structure, the fee shall be
at the rate of $3.00 for each Five Hundred Dollar,s (�500.00), or fraction
thereof in the cost of all propoaed work.
2.6. In no case shall the fee charged for any permit as set forth in
5ectio� 2 be less than $4.0�•
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City of Fridley
App�ication for Plum6ing ond Gas Fitting Pernrit
DESCRIPTION OF WORK
Number, Kind and Locafion of Fixtures
N � � � rc �
N W ?
.� FN Z=N � Y�� Zo � oZ �Z o� <a �Z �W
� 3c�i � m� m uZ, 3� oLL N LL o�� '<3 t�< c�� c�o
Base � I
lst R ` � �
2nd
3rd
WATER HTR.
� s
F N GAS ELEC.
�
4th � � �_ � � � � � � � �—�L � � � � �
• Future Connection Openings Connected with
� New Fixture, Old Openings I Sewer'�
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures . . . . . . . . . . . . . . . . . . . . . . ____C� x $1.50
Future Fixture Opening ................ x 1.20
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00
Catch Basin ....... .................... x 3.25
Water Heater (Up to 200,000 BTU) ......� x 2.00
New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25
C OTAL
� � U U
$
$
$
� � �� U
$
GAS FITTING FEES: NO. R.ATE TOTAL
lst 3 Fixtures ...... ...................�— x$1.50 $ �' S
C�
Additional Fixtures . . . . . .. . ..... . ..... . x .50 $
Gas Range to 200,000 BTTJ . ............. x 2.00 $
REPAIRS & ALTERATIONS—Refer Yo Code
�
Dept. of Bldgs. Phone SU 4-7470 ,� /J /]
Location ---""° � 1� �� /
City of Fridley: �� -� ��L��-��.c��''G��°>
/ �
The undersigned hereby makes application for a permit far the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Bepartment of Buildings, and hereby declares that all the facts
and representations stated in this applicatio -e true and correct. ,�
Fridley, .
�/i`CY/ 19—
Owner _ � ' � , , 19—
Kind of Builcling ��'�'� , 19—
Used as —�
To be completed about
Estimated Cost, �
Old—New. Building Permit No. � � � �
_ <
Signe
By �
Business Phone No. -�� �� 's� a L
� ' J �(O�
Description .... $
.. .......
TOTAL FEE $� C1 11 POST t M-i 2-ss
0
City of Fridley, Minn.
BUILDING PERMIT
Date: _.._...._S ep t emb e r_2 5�,..__19 7 0_..._....__..._.._._.__. _. _
�_ � �
N° 10845
Owner• Donald Carrigan_.._......._..._......._. _._...._.., Builder ...._.._Same..._._._ ............._..-�-�-�--�--....---�-�-��----..........._......._...._......._...._.._._
.. .
Address ....._....._123...Chesney...Wa.Y.._.N..E.�......--�•---�---��--•-�--�--.... Address -----•-Same .
LOCATION OF BUILDING
123 .--.- S�t .--..---.--Chesney .Way _N.E.._...
No. ---�- ---�---•---•�--•-••- _._.._..........--�-�--�--...---��---��--- Part of Lot -�-�----•---�--•-----......._....__....._....-•-----------_._...___._
Lot .....�..........- .............__ Block ..-------..----••--.---•--...........---•-.-----.--. Addition or Sub-Division _...._Ch,esn�y._.._�C���...._......._...._......._. _.__ _._._.._
CornerLot ----._ ............._......._ Inside Lot ---.._..X.......---��-•--••-� -�--�-- Setback ....._....--�--��--��---�---��---....... Sideyard .--�-�---••-.._..._..__...----•---------�--•-----.�_.�..
Sewer Elevation .----.•--..-----•---._.._.--=--••--•----------..---.---......._.----.-•--.----_----.._.._ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
_ Gara�e --------._ F'ront _..24' ---- DePth .....24-�----. Height ---._1�.�..._. Sq. Ft ._---------- Gii. Ft _.._.__...._..
---------------.___...._-•-•-----•--- Front -------�-�------.. Depth ---•-----._..._.. Height --�---•------------_ Sq. Ft. _------------_ Cu. FL ._.----_._._--
Type of Construction _-.---.Eram�_...---.----•-----•-•----.. Est. Cost -----.-$2-,..QDD�..0.0�-----...... To be Completed _.__.1..Y.ear_____�
Provide Hardsurfaced Driveway
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
__�._.—�_ ��?:_.`����`�_..,.
In consfderation of the payment of a fee of $....._ 11�00_ � permit is hereby granted to._. D�.? Sarr;__o__an_
...---.._.....--.--.._..._....-•-.------...._......._........... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at ar�y time upon violation of any of the provisions of said
ordinances.
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NOTICE: I
This p�rmif dou nof eov�� th� eonmudion, installNion fo� wieina, plumbing, �as h�aNng, snw�� or w�Nr. 8� wn to sN
tho Buildieg Insp�eM� for s�pa�ah p�rmih fo� fhu� Ibms.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : �� � h a� cl �a r v,� � ti BUILDER: �t,Q�
ADDRESS •�� 3 C� p g h H y � e� /Y% , ADDRESS •
C.+irv�.�
NO • %� 3 S TREET • C/7 � s h r� c� � a S IV �C'
.
LOT : � BLOCK: ADDITION :_ C� P,5 �, � y �J C Y� S
CORNER LOT: INSIDE LOT: � SETBACK: SIDEYARD:
Applicant attach to this form Tfao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As:
(n � v a� -P Front : �. � � ,
Depth: � � Height• /p �
Square Feet: Cubic Feet:
Front: Depth• Height•
Square Feet; Cubic Feet:
Type of Construction: fra �--�-, � Estimated Cost: $�, ��
—��
To Be Completed:
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
,
DATE : � - .7 5 - 7 d ' S IGNAT[JRE • ��
(5ee Reverse Side For Additional InfoYmation.)
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing pern►its for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such peYtnit of fees to the amount herein below set forth and in
the manner herein pravided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building peztnits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average�
height of the roof surface of the main gable of a pitched roof.
For 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 $5.00.
"'"""`"� VERIFICATION OF FOUNDATION
e
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�' NOTE: 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.
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A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedin� with the framing.
CERTIFICATE OF OCCUPANCY
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 pennit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued. •
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Phone; GReenwood 3-8352
ARLEIGH C. SMITH
Registered Professional Engineer and Land Surv: vor
• 2030 East Wayzata Boulevard Wayzata, 1Vlinnesota
PLAT OF SIJIt\/EY
�,
OF PROPERTY OF _ ,:.� -_ ___ !L L ,' i _1..�' �� /�J �_' k�', -�_y f� "� - - � 2_� ��/ =f - -, �1_C �
N --- -�- I,�/ L � ;: � 3Z
described as foilo�vs:. ___ '�� ___ 2 _ _—�CY '4 �_�G. _ �-�
% . ,_ - ,_ , � .�
; • --- -
---- -- .... . _ _-1 - '` - -- - ------
Scalc: 1 inch-_� �?__feet.
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�' N F S N�` v I/V A Y /v . E�,
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CERTIFICATE OF LOCATION OF BUILDiNG CERTIFICATE OF SURVEY
, I hereby certify that orLl�"� +� 1:_%, 19-'�' I I hereby� certify that o M-►� Y �� , 19 �' ° I
made a survey of the �1 location of the building surveyed the property described above and that the
on the above described property and that the location above plat is a correct represenlation of said survey.
of said building is correctly shown on the a e plat.
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sua�ecT PERMlT.t�lO. '
City of Fridley ° � 16165 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
' ' RE
� � �
� • COMMUNITY DEVELOPMENT DIV. a� (/
' j ►.-------� c7 U J /
r � � PROTECTIVE INSPECTION SEC.
� i '
�, � /'��1 � CITV HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BV
`'�«�./ �.J
612-571-3450 910-F15 5/11/81 � �
JOB ADDRESS 123 Chesney Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 CYl@5:112y ACZ'eS SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Dona.ld Carrigan 123 Chesney Way N.E. 571-0283
3 CONTRACTOR MAII ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAI�ADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Res.idential
7 CLASS OF WORK
❑ NEW ❑ ADDITION �l ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof clHrelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be 2nd but not 3rd roo�. Install ridged �;alvanized valleys.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTR�CAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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 ABANDONED FOR A PEFIOD OF 120 DAYS AT
ANY TIME 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 $SOO $. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiMIT FEE SAC CHARGE
PRQVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $'��SO
STRUCTION' OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$8.00
SiG TUREOFCONTRAC70RORAUTHORIZEOAGEN7 ion7Ei {_ . WHEN PROPERLY VALIDATED THIS IS VOUR PERMIT
�� � C' ` 3 �i -�/ 2� ,�-�� x �
SIGNATURE OF OWNER�IF OWNER BUILDERi IDATEI B�OG iNSP ��Q7E
CITY Oi" rRIDLCY
A('PLICl1�(I0'd FO(t {;ESIUI�i�lTIA�_ QUILUIiIG ('ER1�iITS
((de►�r, A1 �er�ations, llddit;ions, or {Zcpairs)
�1 �
.
� � Ot�1 �dE R : ,� .f' i.�i�'''�'"��-�.,^...
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ADDRESS : � 2. _3 � �
TEL h0: .5 �I / a' L 5� 3
0
GUI LDLP, : .
/IDURCSS.: -
TEL (d0: '
Consi:ruction Location '
sTruru�� rio :/� 3 s2�r��:T: �,,('�-n.e�- Gtr,�t., �
—� T—� .
Lo��: � BLOC�c: �nnz�rza�: ���e� �ir.�
Corner Lot: Insicte Lot: �_ SetbacY.: Sideyards:
Ap�licant attach to t}iis form twa Certificates a£ Survey of lot and
proposed building tocation drawn on certi�icates to scale.
RESCRIPTIOiv 0� COPaSTF.UCTIOPd •
� �_ I'ront:
Square.Feet:
DrptYi : Height:
Glibic Fcet:
� ront: Depth: Height:
Squar.e� I'eet: G1.ibic I'eet:
Type of Co��struction: Estimai:ed Cost: $�(""� � �"'�
Zb Be Cbr,�pleted:
Proposed Driveway Sr'idth Tf New Opening Is Desired:
Alt. A Alt. B
$ $ -
S�� Rr�VERSE SIDr, OF SHEET .
Ziie undersigned hereb�� make� applicaticn for a pernlit fcr the �:�ork herein specified,
agreeing to do .all work ir� strzct accordance �•�itii tite Ci4y of I'ridley Ordiiiances zi�ci
ruliiigs of i:he Dep�lrtment. of Buil.dings, and hereby decl�res that all the facts and
repreGCn t..zt5.ens stated in this applic�tian are truc: and correct.
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n.:Tr : s zcNn��v r.�: : �-
St:iF�ulations :
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� . rul�n����crl>er��i�r r-�:�� sc.�ir.nui_� � .
51:C't'ZOi� ?.. 7.'hL 7n�.c��ecLor. vf' 13ui.lt'.ii�r� ;::lui).7_, }�efal�c� i.r;r,uiu�J-��enniLs tor t:he crecL•i.on
uf r�ny l�u�.l.�l.i.i,�� c>r :,t:ruct:tu�e, w- fa�.• c,ny �ic]cii.t:ir�n !:o any er.i�t:i.n�J l�tiilcli»cj or :.tzuc�ur.�:,
. cir. !:c>1� tu�,y �iJ.t�.cr<<t:ic;i� or. r.cl,��i.r.:; t.o •�-�ny c.:.i.r:t:inr� },tli.l.di.�1-J or �L•xucturc, u��c.rl ar���lS.cat.i.or�
�tticl:.:f.�or.c, rcqu.i.r.c tJ�� l�r�yinr��t: }�y tlic aY�Z�l.i.�ari?: fc�r. sucli ��cr.ini.L• o!� fec:� to t)ic aino�ant.
hrru.i.ti bcl.c��•r sr.L for.tl� �incl �.�i t�hc mannez hczcS.n �,rov.i.cic:cl to-t•::it: - .
P:1:1�1 CONS'I`I;UC7.'IOIJ: Si�zcJ).0 3.'ami.:l.y Ilotr;es and Gar.�ZC{es: Y4.00/l_,0�0 etzbi.c �ec:t:. •
l.'7.Ts:�� <:I!):Cl;: ?..5 F�crceiii: of ]�ti;.lcli_ncJ }_>cr.mit fee.
UKZ1�I:l•;11Y llI;l'P.c:SS70I•; : (ConcreL•c, C�irb �Lrcets Only) � '
' Al.tcr».zt.e n: ]te�noval ai�d rep2acement of conczete cur.b and
quLter o�ily; l�riveway �•rictt}i pl�is 6 Leet• x $13. �0
l�lternate 13: Removal and rep�acem�•nt of concrete curb and
• guttcr ar�d iiista..11 a 3 fooL- v�ide anProach cait.h ''
� .� 6�inch depth; Driveway a�ic:th �plus G feeL- x$15.75
• . _..L�QI i 1 � �/� L I f� f= R��1 'LI o r!
I'or the purl�se of comput�_ng fees for building permits, L-ize cubica]_ co;:tents of any
2�uild�,ng or a.ddi�ion, is detercniried by rnultip)_yir�g +.:lie gr�und area covcrc�d fro:n a
p�int six (G) inches belo°�� the i'loor l.ine oi tlie basemcni: or th� cellar to 'tiic
average iieights of the �upper sw-face or L-o the average izeight of the roof surf:�ce
of i:iie nain gable of a pitched rooi. '
For. ze�ai.rs or alterations io an existing structure, t'sie fee shall be at the rate
of $3 . QO rer. eacii five huildred dollars '� ($a00.00) or fracL-ion 'Jiere:of in tlie cost
oi' all propos c;d wor.k . . �
In •no a�se stla�.l the fee cliarc�ed �or any pennit as set iorth i.n Se�tion 2 be less �
t�l'd11 $7.50 plus $.50 state surcliarge. •
_ VERIFICATIO�! OF Ft1U,�Dl1TI0f�1
' NOTE: Permits for const.xuction ���ill be issued a minim� of 24 hours f_r.om the time
oi application to �].].ow for proper rcview of ihe proposed st-�ncture and oi the
construction site. '
I� Certificate of Suiv�y of the lot, sho�,*ing the location of tiie foundation onc� it
has been cons�nicte� �,Till be required bef.ore pr.oceedinq with the �rami.nq_
�_j� I F I C/`LTE �F O�CUPA���CY . .
j�PP�-�.�ation for a Certificate oi Oceupancy sh�.11 be mad:>. ten (ZO} days prior to the
u�:e or occup:,ncy oi' any stz�cture for �al�ich c}iLij.].t�1_I1cJ ��1"I;11t }:as been issued; and
s��icl struci.uxc : iia�J. r�ot be usecl ar. occupied t:iiti.l a Cezi:�.iicZ�e o1' C�ccuj�;ir,cy h�s
UCCIl i�succi.
.. . _ �
sue�ecT PER
City of Fridley 2 210 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i � RECEIPT NO.
� �
� • COMMUNITY DEVELOPMENT DIV.
� �.: ------ 31 g�
r i � PROTECTIVE INSPECTION SEC.
� ' /"'1 � CITY HALL FRIOLE`/ 55432 NUMBER HEV DATE PAGE Of APCHOVED BV
�""�"� ,'� 612-571-3450 910-F15 9/13/93 / /
JOB ADDRESS 12 3 Chesney Way NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 Chesney Acres SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Don Carrigan 123 Chesney Way NE 571-0283
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Roger Redmond Homes 11735 48 Place, Plymouth MN 55442 420-9570 1207
4 AFCHITECT OR DESIGNER MAIL ADDFESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE I.ICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Construct a 16' x 18� Living Area Addition
9 CHANGEOFUSEFROM TO
STIPULATIONS See notations, on plan. Variance approved for rear yard setback on
August 17, 19.93,
WARWiNG
Before digging catl far
el► utility iacations
454-0002
REQUIRED BY LAW
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIF CONDITIONING.
THIS PEfiMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1. STA��S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUfiTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $20�000 $ZO.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHAfiGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $2O%.00 Fire SC $ZO.00
STRUCTION OR E PERFORMANCE OF C STRUCTION.
PLAN CHECK FEE TOTAL FEE
�,-- � �� ° �(� License SC $5. 00 $242 . 00
SiGNATU EOFCONTRACTORORAU7HORIZEDAGEN7 �oarEi yyH OP VALIDATED THIS IS YOUR PERMIT
. � � �-/s ��
SGNATUAE OF OWNEFlUF OWNER BUiLDEAi iDATE� � G�NSP q4TE
NEVV
ADDN
ALTER
[l
[l
[l
CIT� OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
�uilding Permit Application
Effective 5126193
Construction Address: 1�- � C h� s� e� �av
Legal Description: L.c; �"L.. C�� SV\C. �1 l� c� �-S
Owner Name & Address: �C � o Y� C c��C �� q a�. Tel, #y� � I- 0 2 Q, 3
Contractor:
a��
MN LICENSE # IZO `�
�
Address: �1� 3� �14�� � ��a c � �, ��,�i/3?�'(.� i i-r� -`� `��;��`�� Tel. # yZ.D-9 51 �
r
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF iMPROVEMENT
LIVING AREA: Length `� Width `� � Height ��
GARAGE AREA. Length Width Height
DECK AREA: Leagth Width Hgt/Ground
OTHER:
sq. F�. Z8
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot [�C] Ft_ Yd Setback Side Yard Setbacks _
Type of Constniction: �1 fk� �n '�c�c� i� i a Y� Estimated Cost: � ZC: , C7O0
Approx. Completion Date: ��- �- cl3
(Cost on Back)
Driveway Curb C�et Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: °l— Z-' �i3 APPLICANT: Tel. #`i �"�1 S�O
, ,
)l�CJc �c`'[� fl;C'�
('ITY USE ONLY � � rl ,� i f� -� � � �` ���
/� �-,�1,� C��l�z � S� T � ��-}�K
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
T4TAL
$ .xC�'7. G�-
� �C.CIIJ
� %C>. C.>C;
$
$ �.C'<�
$
$
$
$
� r� ��,
� --u �-;,� ,
;
Fee Schedute on Reverse Side
.001 of Permit Valuallon (1/1(}th%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" At�ove
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary ( ] Not Necessary ( ]
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 strucdire, or for any alteration or repair to any existing
building or stnicture, 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 $SQ0,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
� $252 for first� $25,000 ples $6.50 for each additional $1,000
or fra.ction thereof, to and including $50,000 �
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction th�eof, to aad includimg $100,000
$639.50 for first $i00,0(b plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,�00 or fraction thereof, to and iacluding $1,000,000
$3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof -
DRIVEWAY DEPRESSION ESCROW
(Concrete (.'urb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15. 75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed stnicture 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.
�
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f �,�►� �";D LUC;AL qfldir�.41iCES
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P{i,'?tUP CONST� WA9TE5 DAI�:Y
�.ri���i` IN APJ APP�OVED h�S/INN�R
.;: �,��_��t� n,.� �r.Fl��� W��K�.Y
this Pian Must ,�
Be "''+intained And Z_ �7/�x�� ���}��_\
Acc� :�"e On The � a� i6� (o
Const, �:,:;on Site �_
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FILE DATE � 3
DUE DATE
ADDRESS:
COMPANY
i
�UIIrDING INSPECTION DMSION
BUILDING PERMTT REVIEW CHECK LIST
ROL3TE TO
COMMEAiTS
[ ] BARB D ��� �° U�""�.c-J��'
��� �. �
t l �o�v F �. - �.�
�.- --� �-�- I���.._.
[ ) SCOTT E
[ ] CLYDE M
[ ] LEON M
j ) POLICE
j ] FIRE
[ ] TOM BLAZINA
[ ] RETURN TO MARY H
0
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�7C"f��il(2R� �:'�IV'4=�tlNWF 14{/�F�CAE "4J" �4�16w��9N'l��'9CAKV
QWNFfa ----a DON CARRiGAN 8/31(93
�'11F�00HE5S -- 123 p-IESNEY WAY, FRIDLF(
CdiIM7�Y11CTL7R -> JOE= FiEDMOND Hhone
�DE�RNiiYN11E 5N/QIfiKlNIG 5GiUAHE FOOTA(yE OF EAt�-1
A'TOTNL f�OSE:D WAI.L. iai'�tE_A 473.650 SQ.FT. X 0.110 = 52.102
E3 TOTAL f�C�OF / CEII�NU RREA 288.000 SQ.FT. X 0.026 = 7.488
C TOTAL FLOOR ! CANT. !il�.'�.�A 288.OQ0 S(�.F'l'. X O.U50 = 14.400
T(D'lf/i!_ �.�CIf�OSE�J WA!_L. ARIEA
T��'AI.. �i�tiqC WAL..Q.. A�i�AA
���rnt. �t��NOAno�v r�r,�.d. n�s
4:32.000 SC�.FT.
�. TOTAI_ Wi�l..l. WINDOW AREJa 108.4Q0 5Q.Fi". X
b. 'T'dTAL (700R ARE:A _---------- SG1.FT. X
c. TOTAL Sl1DI1VG GLAS5 DOOR AREA �.b0() SQ.FT. X
d. TO�fAL F1H,E:F't..A(;E AFaEJ� _ SQ.FT. X
e. �fC�TAL Wf�1il 1=W-1ivfING Al=if-::A .- __ ___ 43.� SQ.FT. X
f. T01'LiL NEi W/U.i <1RF_A lai30VF RU 240.900 SQ.F7. X
p. iOTAL RIM JOIST AREA 41.6>0 SD.FT. X
S(�.Ff.
h. 70TAL V�/ALL VdIN[7QW 1�A SQ.F`T. X
i. TCaTAL DOOR AR�A _--_._.---SQ.Ff. X
j. TOTAL SLJDING GLASS DOOR AREA SG1.FT. X
k. TdTAL F�F;EF>LAC� ANEA _..-- ----- S�.Ff. X
i. �fOTAI.. WALL h�AMING AREA d� SQ.FT. X
m. TOTAI._ NET WALL NF�E,4 O.OdQ SQ.Ff. X
n. Tai � r�ri� ,�ois�r <v=t�a, sa.�r. x
so.�.
o. TQTAL WALL WINDOW AREA SGl.FT. X
p. TQTAL DUOR Af1EA ------.___ Sq.F'f. X
q. T4TAl_ SLJf)iNG GLASS (30QR AREA � � SQ.FT. X
r. 7�TAl. FIREPLA(:E Ai��1 _..._--_._...-----SC�.FT. X
s. TOTAL WAU.. FRAMING RREA - __ 6f� SQ.FT. X
t. T�TAL NET WALL AREA 0.000 S(�.Ff'. X
u. 'fQTAL INSULA"fFD CCJNC:FiFTE ARE11 SQ.�f. X
70'TAi. �-UHii�D FOUM�A7lON AIRkA SQ.F7.
0.3Q0 = 32.4Q0
0.000 = O.tlOU
0.300 = 12.000
1.176 = 0.000
0.09C1 = 3.906
0.043 = f 0.384
0.041 = 1.691
0.30p =
0.000 =
0.300 =
1.176 =
1.176 =
1.176 =
a.oas =
o.�oo =
O.OUO =
4.390 =
1.176 =
1.176 =
1.176 =
I.176 =
0.0(l�
0.000
0.000
O.p00
0.000
O.00U
a.oao
o.000
0.000
0.400
D.000
O.ODO
0.000
O.DOU
v. T07AL. FC}UNDATION WINDOWS SQ.FT. X O.00Q = O.OW
w. TOTAL FOUNDRIION Fl1RRiNG A13F� 0.t100 S�.FT. X 1.176 � O.ODO
x. 'iOTAL �dUNDA'iIOAI INSUI.AI�D AR 0.040 S(�.F'i'. X 1.176 =a 0.000
__.._. ____. .. _ __._._ _. ._. --.._._..--- --- -
-- - --
_TO AI. D .
�d'tAll'AL i�i4DSSIE:tD �i00F ,A��iEA SQ.Ff.
a. TOTA!_ R04F WINpOWS1SKYLfTES SQ.Ff. X 0.000 = 0.000
b. TOT�AL (-1�0� f-RAMING ANLA ___ O.UOU SQ.F� (`. X 0.562 = 0.000
c. TO"1"AL IVET INSUIlaI"ED �IU()F' AREA 0.000 S(�.FT. X 0.562 = O.00U
�fi'f.�1fl�i.. iIAQJ�.iIE.H,I FiCiCJI� �IFi�l1, ?.88.00p 5Q.Ff.
d. TOTAL R00f= WINDQWSISKYI..fl'ES SQ.FT. X 0.0� = O.ODO
e. TU7Al.1�OQF F'f-i,�1PAING A�t�.A ._..____�S.$Dp -SG1.Fi. X O.Q38 = 1.091
f. 70TA1 NE°f' INSULATED RQOF' AREA 259.200 SQ.1= f. X 0.02Q = 5.116
--.. . .. ._..__ _ . .. _ _
.._ _ _ __.__ _ - --- -- __ --'i`(sr'AC�_ -.-,_ __...-._-��J7-
TOTAL Cl�1"i1L.�V�IFIED AREA 288.000 SQ.Ff.
a. TOTAL c;RMf h?�AMING AHE.N 28.t30p SO.FT. X 0.052 = 1.500
b. TOTAL NLT INSULATED �AiV1' AHFA 2592W SQ.FT'. X O.Q20 = 5.241
�4'A�"A�_ i1d�ECi9Bi110.91F�i A�:!\ SQ.F�T.
c. T'OTAL TUCKUMDER FRAMING AREA O.00d S�.FT. X 0.413 = Q.400
d. TnTAL N�1" INsIJL.. TUC�CUNDER AFiF 0.000 SQ.FT. X 0.413 = 0.(lQ0
_ .. _ _
- -__ ---- _ - ------ -----._,_.. _. ._ _ . _.__.. _. ._
._ �i'b`PAL 6.
S+U�NiAM�►�t1f IMUMxYlrlulrl wCrlYw9..
__ __ ___ - -- - .._ -
A. 'S7_.i il'l IF `( OfiAL IN 7H� ACflJAL CO�UtviN IS -_.._ ___ D. .381
f3. 7.488 LESS I�F�APi 'THE T(7TAL. IN -T'FiE E. 6.21"17
C:. 14./!(R7 PAFI�MUPvf GQLI.I�ii�! YC�U d l/�,V��: f>ASSF; F. 6.741
�J _fOT �°':i�k�_ ___ ___. _ _ _ _ . T,�,.�,nL _.. _.; „3_
/ /�6/ /
�AtCu�9� t) S� _... ..__..
C1.4e,� . 8 __ � ._� ! s.7. _
�. bC�g') �F=.� VY'Ntl..7. 7'4-9�?�.9 5'9�4JN)
__.__
�KDS�� YW/►kJL �1�4A IWSUIUi'9'IAIAI
�Iplf�lC 1iKA,�..� I�IIRII Sl'alli
B�8RC9C WA�..L T411R11 MRNSULATION
31 FAL"'f'C)�i
- __ _ _._ _ ___..
IM1I�fEFiIQ� RIR �-ll�M 0.680
SHE=1:��1'FiC�CK �.4ti0
s ruo s��7o- -----
- -------._.
;iHE� T}�ING 2.C180
.... .....------- _-_
siairac o.s 9 u
E�C'iERIOR AIR FlLM _.. _ __-�i�--
_ __ ._
TO l'�AL f�V�I�U� = --- _. _. . _ _.. ._ _-- -- 11.
U VALUE (11fi) _-� p.U90
IN f�F�IOR AIR �li.lvt— -----. _
SHEF= fXiUCK
INSUlAT10N
SHEA7'HING
51DIiV(.:
�rrEaio� a� w�u�
..
?'tl�'AL}� VALU� _y___
U VALUE (1lRj =
_ _ ._ iN`t�F�TI'SFi Ai��'Q�v�__ _
SHEE-TROCK
:�TI.1D
SHEl1'll-IING
EiRICK UR STONE
�xr�woa w� �run
"f O�AL F21fALUk. __. _ _.
U VRL.UE (1/R) _
!i �ACd'O�i
_ _ _--0.—�...
0.450
i9:(l(� __
_. _... .2.08U
---- -- 0.8fd ..
_ -- ._..._
•r3��o
0.043
R FAICT'CDFi
_..__.....
_�___..._.�i.,��
-. .- - _--- --------- -
1.176
IN"i'E'�iT�F� AIR RCNA _._. __ .. _
SHEETROCK
INSULA110N
SHEETMING
BRICK ON STONE
F�CTERIOFl AIR i�LAA
ta�r,v�av�u __...
___.._____.
U VALUE (1/R) =
��d�41NDATRd'JN 'WALL fi�#�iU S�'UD
_ _ ._ _. _.. _.._. _. _ ..._...._.__..-
. . _...... _ ..
.RI A1 L.M
SHEETROCK (c7P'T'J
STlJD
SHEAThIINU
SlDING
EiCTERIqR AIR Fillvi
. _____..
`rCiT`�L Fa Vi�uE _^ _
U VALUE (1JR) =�
R IFA[�11'OR
_ ._
o.000
___-- -
_ _O.f100
__... -
. (.
b.85�I
1.176
fi FACfO�i
b.b$6_
_ 0.1�
__... _. O.S�l7
l . t 76
FOU!1W�AT�Ol� WAII. T�11RU 1NSULAT�OA�i R FACiOR
_... __ _ . _.. ___._. ----..... .._ ._ _ .
_ _.._�. _ _
. LM .
SMEEff�Of.:tC (OF'T.) 0.000
INSULATIUN .—__ _--- -
SHEATHING _ --- --- b.0�0 -
SI[)IN(.y _... _- U.C100
k::�CTERInR AIR FII.AA __ _- (l.1 ffl
i'U7�U.. H vA1 UE :.: . . ..__ __ ._ _(i:8�0. .
U VAI...U� (11Fi) = 1.176
3'I�J634� :Fdl� .�t�9S�' 1/tl'jS9fl�alG
� �pc�re�r3
---- _ IT+fT'€f�17JR A1� �-5LM _ __ __...__.. - -------- 0.68Ci_.
INSUtATI(7N 19.000
9-1I2' WOOD 1.890
SHEATHING 2.080
SIUING ___ _.. O:Sib_
E.X7FRIUR AIR FILM 0.1`�0
T'dl'AL. N VAL.UE _ - - _ _ _ _ - _ _ _ _ _ _ _ _ _24.6ab
U Vlal_U�: (1l�1) �� t�.U41
_':�r,h: i. pr n
����r�� �� .�c�ws�r� wJa�a�c:�c o� s�row� i� FAaCT'OR
_ __ _._
_ __
_ _-
I(J'T�f�l R I>I Llvi
INSULAl1�IV 13.OW
1-1I�" WODD 1.890
sw�r�in�c� o.000
BRICK OA 5�"UNE ------- 0.&�
EXTEFUOR AIR F1LM _- - (�.170_
---- __.._.- --
1'(7i`AI. R VACUE-_` _ _...-------.. __ _. 2 .
U VALUE ( 91R) '= Q.04b
�#Fltl9 1BvI.SiIDIIAl'C�tA (:OWC.&i�TE FUUN0.�A9,�l101�i tc F7FiEQLLAd� �# FAC:�'OR
__ .._... _...,._.,__ _..---.. _. ...- ,.. _
. __. .. _. _ Ihft`�F�1CSFt �F� �iltvi - --- ..___. _. 0.
INSULA"fION (OP1".)
- - --__. .
CONCREI� WAl1..
EXi�ERIOR AiR FlIAA _ _ _-0.17t7
TOTAL.. I� VALU� _., _ _ _ _ .._ l�.Ei5b .
U WaLUE ( 9(R) == 5.176
F=dy�i,f3�i9 .�Z9UN1)A71QN9 WALL T}i �FtU SIfU�
__._ . __._. . _
_ ._..._.--- .. .__..__...IP+11`�Rit�R-. ._�_�� __. _. .
sfi��oc:sc �aar.�
s-n��
CUNCRETE 4VALL
SIDIIVG
F.XTERIOR AIR Fll_M
_ _ _..
Tf��'AL H VAL.U� -
U VALU� (1JR} .=
�'4A�iG1�RA F[DUINiAd4�949N1 WAfl9_ `13���t1 IIdSIYLATIUl�
_._ . _.....__- ._ __ .. _ _ _____ -- . -
A�1T€f�lUFi AI� F�IILM _. _ _. _._
5S-iEEl'RUCK (OFJT'.)
INSUL/1T10N
CONCRFfE WALL
SIDING
�RioR aR r-�u�n
v���c�w u �wcr��
�AS�NA�iY�Ifi VY�a��QW lD FA9�:`�UR
�JICD4a�t �JI �ACT(D�3
�A�f(b 47iDCC�l� UI !�'ACTi7id
"!f'Fttl'y"SiE:� ROIQAIF Y�1�IRlD FAi/Ud99�1(i�
TOTAL R VALUE =
U VAUIE� (1�Fi) =
2 PANE 1 LQW-E
? PPWE ! LdW-E
2 PANE ! LOW-�
I�RI�R A7F1 �(LM _
SHEE f'RC7C�C
C:EIUfVC; PAEMBER
INSULA�Tl(7N
S1lLL FUFI FILFA
'T'�1'�AL (� VALII� ..._ _.__ .
U VPJ�UE (1/R) =
�uss�n► �ooF �ar�u ��su��ow
_- _ . . __._ . _ ._._. _ _.. . _ _ --- _ _ .
SHEE-T�UC�C
INSUlAT10N
STill AIR F1LM
TZ5`T/�L R VALU�_ �-
U VALUE (11R) :_
VA4J�.�93 �O(AIF TFIiBU �RA�II�IG
ii IFAC'�'(9R
_ .. ._ __.._..
-- - --.
1
_-0.850
1.17fi
�t R-AC7'OR
--- _--p.bBU_
0.000
___.�.�_
_..---
�.C�-
---- -�i7b-
0.850
5.176
0.30U �
-------(5.3f1(i �
R FAC3'i)IFi
_ __ _----...__
b.s1�
0.560
-- ---�c�fa� Afi� �1t3�-- - - -
ROC)F1NG
PL.`l�N1�OD
SHEET If+15UTATION
FUaF�f�:R
SHEE-`TR�(:OC
irrrF:.aioa Ai�� � �+ �,a
l.i7T'AL F� 1/At . ;;
UVALUF_f1/6�; , ,
-... .... __b.61 tl-
_.. _ ._. _..
i.7
0.562
R FAC'!fON3
__ -__ .._.__�:s��
U.560
____Q:810_
_ _ .. .
�.:�-
0.562
R FAC'�fOFl
- — _ -----
a.1 �o
o.�o
_.- O. I8(l
__. _.._-fo.--aiti �
_,._._._. -
_ 1 . �l
_._ __p.58t5
_ o.-si o
26.406
li.��
PA(3E 2 OF 4
1iw�� � �� �riii�r a"�-a�ti3 ia��i3g..�►`dii:oo�
s�cr�.a� u �wc�aw
THHIY CJ11+f17L.�NER IFIRMNIN�
_ .... . _ _ _ .
_ ___-..
--�t'�- - -fi AtR-FILM
ROOFIIVG
Pl_YWUOD
SNEE�i' INSULA710N
WSUL/•1l"1�11V
SHEETROCK
IiYTERIOR E11R FlL1v1
T�StAL Fi 1/F�i.O�..___ ._. _ .....
U VALUE (11R) �=
2 PANE / LOW-E
_ _ _ _IIVI"ERIQFf AIFi �(L1+A _ .
FINISH FLUORINC;
UNDEF3L}1YAAEiVT
�U�3F=LOOR
f=LOQR JOIST
SOFFfT PLYWOQD
F�CT�RIOR A1R f-lLM
--
_
7 AI.. _
U VALUE (1JR) =
THRU CANXdLEVER INSULATIIDIN
_ _ _ __.__ _ . _ _
ll.l :11i C�L+±:(�I:117 �.T.7i7:1 �I i: Ct�
TF#RM�D �UCKLD�IDER IAdSULATNON
� !Fde1l�'1"C1�i
_. _ -
0.540
0.7$b
10.i1q0
3$.OW
_ __ ---a.$60
0.810
- -c-�-.�_.
O.p20
�i FACTOR
_ _ ___.. .._ _...... -
0.
2.100
---- -. __.b.84Z1..
_
�.:�6O - -
i�.74t� _ _ -- -
--.. .. _. ___... .._....
0.470
--._.. ._..__p.��0
_.__...._._...--- -----
�.
0.052
R FACfOR
II�fT�FilO�f/UF1�1I.M _. _....____ _ __. _..__�.9�..
FINISH FLOU�iING 2.100
UNDERLNYMEIVl" -..-_ __.__�.�40"
�SUBFL4tJR 0.960
INSUI.ATION d+�.C�—_ --
soe--Frr �vwoc�D ---------�:a�o_
F?CT'EWOR AIR F11.M ----_--b.1=1U-
l"O'�ALfi-1lACU� _Y ._ _..._..— ---___._ _._--�.�._.
U V�U� (1�) = 0.020
I�lTEFR�QFi AIF� FlI.M _
C�-1N15H FLU(�I�Wc;
UNDERLAYMENT
SUBFIQOR
f'LOO'R JOISi
518" SHEF?ROCK
STII.I.. AIR f-7LM
YO�'AL R Vi�LO�' �_. _ _
U VAL.UE (1JR) -
_�. . . _ �bR Al�t .. ��.. .
t-INISFi ROORING
UfVDEFtL11YMF_IV T
SUBFLUUR
lNSULA1lON
5j8" SH�EiRC7C.�"C
S11LL AIR f"1LM
1"OY1�1L F3 VALIJ��._ �_ .
U VALUE (11H) =
R F,A,GTOR
__ _.. _ .--___ -
.920
-- --�.58p �
_ _ _ _ ....--- - -
0.�3'�.�
�. .
p.413
H FAGTOR
--- _ _ - -.. _. _. a��i�_
O.WO
O.Wd
O.OW
8. ..... _
_ _._..__
0.920
.4
0.413
�::�nae 3 or d
CITY OF FRIDLEYINSPECTIflN DIV, Effective On January 1;1993
Fridieu�MN 55432 NE APPLICATION �OR POWER PLANTS AND HEATING, COOLiNG, VENTILATION, ''� �%����� (�Lj �
Y
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AfVp DEVICES
1 � _ � �
Residential
Fumace Sheil and Duct Work, Burner —
Also Repiacement Furnace
Gas Piping
C`—l�j `�� i I'�(Cr �� ��ti%c,S_t
Gas Range
Gas Dryer
*Air Conditioning — Atl Sizes
All Others/Repai�s & Afterations (LIST ON BAC�
1% of Value of Appi(ance or Work
Cammercial/tndustrial
1% of Valus oi Appfiance or Work
JOB ADDRESS , %� J [; f�F S iy,�• y u' i� .y /1/ �
The undersigned hereby makes application for a permit for the wark herein
Rate 70TAL specifled agreeing to do ail work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the tacts and
$ 20.00 $
� :�ei
$ 10.00 $ l�
$ 10,00 $
$ 10,00 $
$ 10,00
State Surcharge
TOTAL FEE
$
$
$
$ ,5D
�.�.. �2C�
MINIMUM FEE FOR ANY HEATING/COOLINGN�NTILATION
REFRIQERATION/AIR CONDtTiONiNG PERMI7 IS �15.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Cendftioners can not be placed in a side yard wlthout
written permission trom adJolning property owner.
representations stated in this application are true and correct,
� O� c 7 ,1993
OWNER p 0 lY f) � v �� �li'fj,' /G /� i✓
BUILDING USED AS L, / l/ / N C .A l'1 I-�I
ESTIMATED COS7' PERMIT N0. :�' i�� -^
� • � :�� •; : ;
No, of Heating Units 1 Circle One (Steam) {Hot Water) arm Afr
Trade Name ��' C�i %�f Sfze No.
BTU /3 � o c o Hi' EDR
Fuel /Y�J? F, �� Total Connected Load
Burner Trade Name Size No. ' �U
BTU HP EDR �� �i '
� ' � ���;f'
HEATING COMPANY /I o M� o w i1I �� ✓
Signed By %/�� �_-�� � Tel No, �� � � d � $ 3
�t�
� Q
Approved By,��f . Rough—in Date Flnal Date � /
FILL OUT BACK SIDE FOR STACK VERIFICATION ON L' '��/ ��
REPLACEMENT FURNACE
CHIMNEY AND STACR V$RIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or_deterioration Yes () No ()
3. Has no foreign objects lodged within Yes () No { j
4. Is securely supported Yes (-j No ()
5. Meets all current Code requirements for
size and total BTU's connected ! Yes () No ()
6. Has total heating BTU's of �
_ All other BTII's � �
" TOTAL BTU's
Remarks
List Alterations Beinq Done•
e
HEATING COMPANY
Signed By
Date
�
sue�ec. PE
City of Fridley 29841
AT TME TOP OF TME TWINS g � I L D I N G P E R M I T
r
� .
� �
� i y.._.._ COMMUNITY DEVELOPMENT DIV. �/��
r � � PROTECTIVE INSPECTION SEC. ��
i____ A���"' �'� CITY MALL FRIOLE� SS�32 NUMBEp AEV D�iE v�GE O� �vnnOVEO 8r
L '� 612-571-3450 910-F15 7/g/99 � �
JOB ADDRESS 123 Chesne Wa NE
t LEGA� LOT NO. BLOCK TRACT ON ADDITION SEE ATTACMEO
OESCR. 2 Chesne ACres SHEET
2 PiiOPERTY OWNER MAII ADDFESS ZIP PHONE
Donald & Geraldine Carri an
3 CONTRACTOF MAIL ADDRESS ZIP PMONE LICENSE NO
Owner
� ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
p NEW O ADDITION O ALTERATIpN QX REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof house and garage (28 Sq) Tear-off
9 CHANGEOFUSEPFOM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPEOFCONST OCCUPANCVGROUP OCCUPnNCrLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTiiUCTION 20NING SO. fT CU FT
AUTHORIZED IS NOT COMMENCEO WITHIN 60 DAYS. OR IF CONSTRUCTIpN
OR WOf1K IS SUSPENDED OR ABANOONED FOR A PEFiIOD OF 120 OAVS AT
ANV TIME AfTER WOFK IS COMMENCED NO DWLG. UNITS OFfSTpEET PARKING
1 HEREBV CERTIfV THAT I HAVE FiEAO ANO EXAMINEO THIS APPLICATION STALLS GARAGES
ANO KNOW TNE SAME TO BE TRUE AND CORRECi AI.L PfiOVI$IONS OF LAWS VALUATION SURTAx
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIED
WITM WMETMEf7 SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT 2447 1. ZZ
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqM1T fEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- C
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION �3. Z:J F1 I'
PLAN CHECK FEE TOTAL FEE
�5�) NATUAE O� COAN"�7AC1OQ Op AUTMOA�ZED �GENT �O�TE� ME PR EpL� VA IDATED THIS 1 VOUR PERMIT
V "—/�+"� �..0 , � V ^� > I
S�GNS7uaE O� OwaEQ��F OWNEQBU�LDER� iDATE� BIOG �ti5� ��°fF
� -
NEW [ ]
ADDN
ALTER
Effective 5/10/99
[ � CITY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
L.egal Description:
n�1
U`� �
�- �.tD
�
i ,
Owner Name & Address: � ` Tel. # ,s � / — 0 � $ 3
Contractor: MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlVIPROVEMENT
Length � Width Height
Length _ `¢�� Width ��� Height
�
Length Width Hgt/Ground
C'�� _.� _i�:�
Sq. Ft. _
Sq. Ft. _
Sq. Ft. _
� 8'
Construction Type: L,�/-a-aY.f Estimated Cost: $ � n,%�j�! �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: aj � APPLICANT: oU ' Tel. # � % �--0 � � 3
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �j� „��`.
$ o�- S
� / ��
$
$
$
$
$
$
$ � c4�. ��
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Pernut Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 [ ]
• • r
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 application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$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 $1,000
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 $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, 000 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.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing.
Buildir�g
[nspections
763-572=3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
�ATE ((��.3�� 7 YOUR E-MA[L ADDRES3
iITE ADDRESS Iv�� �$v�V� 4':1`?
iHIS APPLICANT IS: ❑ OWNER �ONTRACTOR
PROPERTY OW1vER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
Permit No.: �t; -t��o
Received By: /
Date Rec'd:��,
ADDRESS: 3 r Wc. CITY l��0�� Vt STA I tf'!� ZIP �� d
PHONE: %C� % ��v �
NAME: i-�wu��t w���-. Co�ne� �b ��
STATE LIC� i���-Eo ( EXP DATE ,�I ��� �
ADDRESS: �-{a(� � I�o�q �r CfTY Y I f I S STATE±1�rUZ[P �
PHONE 76 � 7�� i�. S79 C� FAX 7� %�C. b��� I �
PROPERTY TYPE
0
PERMIT TYPE �
❑
I•� � 114'//�! �:+Z�ZiJ��
❑ GARAGE/SHED ❑ WINDOWS
F[NISH ❑ ROOF ❑ DRAIN TILE
❑ SIDiNG ❑ OTHER
O SWIMMING POOL
TYPE OF WORK: I � �W `-�ADDITION
_ 1 ❑ MAINTENANCE/REPAIR � REMODELiNG
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT_
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDIlVG
❑ Vinyl
� Aluminum
❑ Other .
TH S� WID?H �J HEIGHT ��� � Sq. Ft: `dJ
❑ HOUSE & GAR.AGE
❑ A7TACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
WWDOWS
IN EXISTING OPET�IINGS ❑Yes QNo IACATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF \
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of swctural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDI7"IOAIS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing swctures
and proposed projecL
2. Two sets of construction pians
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�� ���.(E�j ([JSING THE 1997 U.B.0 FEE SCHEDULE)
TOTA JOB ALUATION $—�0a-`-=`' OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Swchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$ �Z�o, `�S
$ ! 7 , ��
$ . S�'
$ � 5(r
$ j , G;G:�
$
$
$
$
$
� J /
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the tota] job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks oavable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT[L PROCESSED
lations
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 applicatio for a permit and work is not to start without a permit; that the work wil] be in accordance with the approved
plan in the case of all work whr re ' a�d approval of plans.
SIGNATURE OF APPLICAN - PRINT NAME ��"sh�w I��'tir`. �e� DATE �V 3�% 7
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permifs for the erection of any building or
structure, or for any addition to any existing building or structure, or far any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such pernut 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 addirional $100 or fraction, to and
including $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000 $643.75 for 15` $50,000 plus $7 for each additional $1,000 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,�00
$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 including $1,000,000
$1,000,001 and up $5,608.75 for the lg $1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Pernvts for construction will be issued a muumum of 24 hours from the time of application to
allaw for proper review of proposed structure and of the construction site.
A Certifica.te of Survey of the lot, showing the location of the existing found.ation will be
required before proceeding with flie framing. New Houses Only
City of Fridley
Buildi.ng Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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A N'.�eA �ouNTY
Phon¢: GReenwood 3-$352
ARLEIGH C. SMITH
Registered Prufessional Engineer and Lana Survzyor
� 2030 L-ast Wayzata Iioulevard Wayzata, 1V�innesota
p�AT oF su�vEY
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OF PROPERTY OF.. ��%—'-..1 L i.i----l.-=._ L. �J �. �::: %_t.� ----------
described as follow� .__ '�— �� -"'- � ------ � r✓.L�". � :, �i 3Z
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Scale: 1 inch=_J.�? —feet.
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CERTIFICATE OF LOCATION OF BUILDTNG
I hereby cei•tify that on�!.! b.1— '`� , 19��� 1
made a survey of the��l location of the building
on the above described propert�� and that the location
of said building is correctly shown on the a e plat.
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CEk3'TIFICATE OF SURVEY
I hereby- certify that orLM.Py �l , 13�0 I
surveyed the property described above and that the
above plat is a correct representation of said surv�y,
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Building PLUMBING Permit No.•
Inspections COMMERCIAL APPLICATION Received By: (��_
763-572-3604 CITY OF FRIDLEY 1�at���[�i: ��
DATE �- U� �� YOUR E-MAIL ADDRESS
SITE nvD�SS 1 a� C�n �S n� u � Q.�a
TENANT SUITE NO.
PROPERTY NAME: � � �
OWNER/ ADDRESS: I a 3 �1r, es n�o �,, 1 �)„ � ci �r � o� � p.a STATET��iZIP��a..
TENANT pHONE: 7 i0 3- 5y/- Da k3
CONTRACTOR NAME: �
SUBMIT A COPY OF STATE LICENSE # D LO L% ��,�� - P I�YJEXP D E J a O
YOUR STATE ADDRESS: �'�. �. (3 � X ��-{ 1 1 f� � e CITY � � STATE�NLIP 1✓" 5�ay
LICENSE WITH pHONE �% �oi " 5 oa- � a a� � FAY �'J'�o7' � d� `�
APPLICATION
PERMIT TYPE � 1NSTITUTIONAL �fULTI-FAMILY ❑ SWIMMING POOL
❑ TOWNt�OUSE ❑ COMMERCIAL/INDUSTRIAL ❑ OTHER
TYPE OF WORK' ��W y( �PLACEMENT ❑ ALTERATION/REMODEL
. �.
DETAILED DESCWPTION OF WORK �� ��,�t �_ � �l � ct,Z� e,r 1�� �� ci� I I
FIXTURES: (INDICATE TOTAL NiJMBER OF EACH)
CLOTHES WASHER FLOOR DRAINS _ RPZ VALVE URINAL
DISHWASHER GAS PIPING BACKFLOW PREV. 1 WATER HEATER
DRINKING FOUNTAIN GREASE TRAP ROOF DRAINS _ WATER METER
FAUCET HITCHEN SINK _ SHOWER _ WATER PIPING
FLAMMABLE WASTE TANK LAUNDRY TRAY SLOP SINK _ WATER SOFTENER
LAVATORY SWIMMING POOL _ WATER CLOSET
Total Job $ ��-� V All fees are based on valuation, including the cost of labor and materials.
Valuation
Permit Fee $��- /� (1.25% of Job Valuation / Minimum fee: $35)
Surchazge $ Valuation X .0005
Total Due $ y�3,� � D Make Checks Payable to: City of Fridley
THIS 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 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 requires review and approval of plans.
NAME OF APPLICANT 1• M L���-O K.�-a� ���o�l�' S K DATE J^O� v�
SIGNATCIRE OF APPLICANT �� .�Qn ,f1�v ,(��F. ���
PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley Building Inspections llepartment
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977