AF - 38539BUILDING PERMIT
Vil.l.age of �ridley, Min.n.
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N° 2123
�¢5
Date� .. .. .......... .. .............
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Address . ..f . �.M1�?� . .,�t�'."'�.�i� •�r:'�1? . . . �':�� Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOCAT[OI�I OF BUILDING
� � ,�:.
No. . .�*.�:� �j� . . . . . Street . . .� =�; t ?�� . . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . ..
Lot . .... . �: �'.. .. . Block . . . . �. .. . . . . .. . Addition or Sub-Division . :"� R`�����.`.'�`�� '� �'�
Corner Lot ............ Inside Lot . .. .. . ..... . Setback .����. Sideyard ��.�...''�r.. � ..............
DES�CRIPTfON OF BUILDING
To be Used as:
b
. . �;,;!'.��4.'.�f . . Front .�� �.
- y��
Depth . � . �. . Height ��. . .
.................... Front ........ Depth ........ Height .... ...
��
Type of Construction ..,:�� �''`:`.� Es�t. Cost ...`'.��'.'"��.�...1�.... .
Sq. Ft. ........ Cu. Ft. . ...... .
Sq. Ft. . .. ..... Cu. Ft. ... .. ...
,�r < ,,,r•-9c! :��+
To be Completed; ' . . . . . . . . . . . .
In consfderation of the issuance to me of a permit to construct the building described above, I agree to do
Ehe proposed work in accordance with the description above set forth an in compliance with all provisions of
ordinances of the village of Fridley. ^�,.
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........,.t .,�{,, .+�:d°.'�r . ,;...,. ...
..�con ideration of the payment of a fee of $. . . . . . . . , permit s �hereby anted to . . . . . . . . . . . . . . . . . . . . . . . .
��'.� .✓. '. .... to construct the building or ad dition escribed above. This permit is granted upon
the express condition that the person to whom it is gra.nted an his agents, employees and worl�nen, 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 loca.tion, construction, alteration, maintenaace, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon olati�o �an of the rovisions of said
ordinances. JA �r► /� J��
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NOTICE: ,
Thts permit does not cover the construction, instailation or alteration for wiring, plumbing, gas heating,
sewer or water, Be sure to see the Building Inspector for separate permits for these Ptems.
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City of Fridley, Min�n,
BUILDING PERMIT' �F ��
. N •° ��
Date: � �' .,�I..._�'�`�j V _ ...._.._._..____
Owner: ..���"�:�Q ���°,'���[ _�►� Builder ..,c ,�� ��' .M
Address ���. , �' � , .6� ���!?�1''.--�+r+�—.--.��-�.._....._
'�' Address __..---- -
LO�ATION O BUILDING
No. �G�%��a__. Street ��.�G.�fi�C.�!'.�.+� � .
.:!._..._..._..___.__._..... Part of Lot
Lot .....- .....:.....:._......._.:.:.... Block
Addition or Sub-DivisIon
Corner Lot ....------ .............._........ Inside Lot ....._..---.-.--.._....---_........ Setback ....._.._........._.....---..._........ Sideyard
Sewer Elevation
To t� v �:
s �
-----�-- •--_ ...:f."�..�.'ji------•
Foundation IIevation
DESCRIPTION OF BUILDING
Front .�..��---- DeP't1� �= - Hei ht .i��,�............ .
�. -� g . sq. Ft. `�!���?..
-- ._.._......-� •- �•- ----- �--..._.._....--�--- -• Front ....._......._...._.. Depth ........... Height ........... ............
.
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Type of Construct�on .... .......__..._......._..--�-•----....�._....._... Est. Cost..:--�d- ���-...� .................-........ To be Completed
cu. r�t. '��.�.�?.r�
cu. �c. ....._ ............:_..
In conaideration of the issuance to me of a permit to construct the building descrlbed 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 dty of FricIIey,
In consideration of the ����
Pe.Yment 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, azotmd and upon said building, or anY Part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repau. and moving of buildings
�� �e• atY limits and this permit may be revoked at any time upon viol.�on of any of the provisions of said
Bwlding Inspector
NOTICE:
This permh does nof cover tt�e eonstructioa, inatallaHoa for wirine, plumbfng, gn heatfng, sewe� or water. Be wre fe aee
fhe Building Inspedor fo� separots permNs for these kema.
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APPLIGATION FOR BUILDTNG FERMIT ;
CITY OF FRIDLEy, MINNE30TA ;
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Owners Neme •
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LOCATION OF BiiI ING ''
No �� 3� Stree� ��=�= �� Part of Lot �
�� glo� bddition or Sub.Div.
Corner Lot�,Inaida I�ot_ Set Ba.ck 33de-Yadrd
g��g Q,Eyp�p� _ FOUNDATION EI�VATION
1pp13cant attach to this form Certif3cate of Suutiwwey of Lot and proposed building
location. �
DESCRIPTIOIV OF BUII�UING
To be used as:
��� Front � � Depth °�'� � Height � �°'
___�
�j,. Ft. Cu. Ft.
FroAt Depth Height
Sq. Ft. Cu. Ft. ��
T3rpe of Construction
��/���. � � I�:s'timated Gost �-� �
�-.
To 'be completed �" f`°� d �
3'he underaigned hereby makes application for a permit for the work here3.n apecified,
agree3ng to do e11 work in strict accordance with the C�.ty Ord3nances and ruling of
the Department of Buildings, and hereby declares that all the facts and represents-
tions atated in this application are true and c�ec�.��,�� ���� �,�
DATE ,_ _�_,_._
SIGNAT�E
(A Schedvle of Fee coeta can be found on the A.everse ty�de. )
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BIIILDIlVG PERMIT FEE SCF�IDIILE
Sect� The Inapector of Buildings shall, before issuing any perm3t
for the erection of any buiZding or structure, or for any addit3on to
any existing building or structure, or for any altera.tions or repairs
to any e�cisting building or structure, upon application therefor� require
the payment by the applicant for such permit of fees ta the amount herein
below set forth and in the manner herein prov3ded to-wit:
2.1. For any such permit for the eraction of an� fire-•proof building� other
than a gaxage, warehouse, factor�r or grain elevator, or for the erection of
a.n�r f3seproof addition, for s3.mi.lax occupancy, to any existing building
shall be at the rate of �1.40 for each one thousand cubic feet� or fraction
thereof, in such cubical contents.
2.2. For an�► such permit for the erection of any fireproof garage, ware-
hous�, factory or grain elevator, or for the erection of any fireproof
addition, for�similar occup�ncy� to any existing building 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.
H0.- USES
2.3. �or any such pe.rmit for the erection of an
other than a garage, warehouse, factory or grain
fireproof addition, for s3,mi]+ar occupaiac�y, to any
Permit �1.00 for each one thousand cubic feet.
GARAGFS
y non-fireprocf building
elevator, or any non-
exieting bu3lding,.
2.4. For any such permit for the erection of an�r nor�Pireproof garage,
warehouse� factory or grain elevat.or� or for the ereotion of any non�
fireproof addition, for aimilsx oc+c,�a.pancy� to any existing buildin�
for each such building or add3tian. Ninety Genta for each one tho
cubic feet or fraction thereof, 3n the cubic�7. contenta thereof with a
minimum of �4.00. �
For the purpose of computing fees for building permits the aubic.�7. contants
of eny build3ng or addition to a uniform heignt throughout by multiplying
the ground area covered from a point s3x.(6) 9.nches below the floor line of
the basement or cellar to the average height of the upper surface or to the
average he3ght of the roof surface of the ma3.n gs.hle of a p3tched roof�
2.5. For repaiss or alterations to an existing �tructure, the fee s'hall be
at the rate of �3.00 for each Five Hundred Dolla�s ($500.00), or f�action
thereof in the cost of all proposed work.
2.6. In no case sha11 the fee charged for aqp permit a.� set forth in
Section 2 be less than �L,..00.
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sua�ecr PER
c;ty of F��a�ey 30928
AT TNE TOP OF THE TWINS g U I L D I N G P E R M i T
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� `� � _ COMMUNITY OEVELOPMENT DIV. � �� �
r � � PROTECTIVE INSPECTION SEC.
1 .t �
� 1 /"'1 � CITY NALL FfiIOLE� SSIJi NUMBEp REV DATE PAGE O� AVPROVEO BY
���-��' �'' 612-57�-3450 s�aF�S 5/9/00 / /
�oe nooRess 5036 Clearview Street NE
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oescR. 26 6 Carlson's Summit Manor South Addn SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE
William/Eleanor Schultz 5036 Clearview Street NE 572-8227
9 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Advance Home Products 3770 West Broadway, Robbinsdale, MN 55422 521-9211 2332
4 ARCMITECT OR OESIGNER MAIL ADDRESS 21P PMONE LICENSE NO.
S ENGINEER MAIL ADDRESS Z�P PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW 0 ADDITION O ALTERATION �] REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Reside House; Soffit & Fascia
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
�efore covering. Provide soffit ventilation to meet the State Building Code.
TYPE OFCONST. OCCUPANCV GROUP OCCUPANCVLOAO
SEPARATE PERMITS ARE REOUIfiED FOii EIECTFICAI, PLUMBING, FIEATING,
VENTI�ATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTMOR12ED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO fOR A PERIOD OF 1� OAYS AT
ANY TIME AFTER WOpK IS COMMENCED. NO OWLG. UNITS OFfSTREET PARKING
I MEREBY CERTIFY THAT I MAVE REAO ANO EXAMINED TMIS APPLICATION 1 STA��S GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of �AW$ ypLUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIEO @
WITH WHETMEFi SPE FI MEpEIN OR NOT. TNE GRANTING OF A PERMIT W 7 f 3OO �3 . 6S
DOES NOT PRESUM T GIVE A MORITY TO VIOIATE OR CANCEI TME pEqMIT FEE SAC CHARGE
PROVISION OF AN T ER S A E OR LOCAL LAW REGULATING CON-
ST UC ON F TH 'P OR E O CONSTRUCT�ON $153.Z.'r� F re SC �7.30
PLAN CHECK FEE TO AL FEE
.J-�- ���� L3c e C $5.0 $169.20
$�GNOTUpE O� ON'FACiOp OA AUTMOp�2ED OGEN1 IOATE� HEN R P VALI� �� HIS ���� � —_`
V V
S�GN4IUAEO�OWNEA���OWNEpBU�IDEp� �OAfE� Bl0 �NSP ����E
�w [ ]
ADDN
ALTER
Effective 5/10/99
� � CITY OF FRIDLEY
[� SINGLE FAIVIILY AND DUPLEXES R-1 AND R-2
BUII�DING PERMIT APPLICATION
Construction Address: �0 3 6 — C��ulr �c� €�w �"/ �t� � ��
Lega1 Description: 5�, �,.�
Owner Name & Address:
Contractor:
i'�I��uw� d- �
Address: � 5 � �d -- Ie�OPt7`— - /"S�oa�fG.a
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTI�R:
� � ����,�
Tel. # .5� 7a - 02� �
MN LICENSE # 0?�3�
Tel. # sa,- 9a��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construcdon drawn on it to scale.
DESCRIPTION OF IlMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
I.ength Width HgtlGround Sq. Ft.
Construction Type: J,� .°�, -- ��, f d- , x� Estimated Cost: $�Dd. ac�
Driveway C�rb C�t Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: �' -�' ov�J APpLICANT: ah �t 5'�2vs7`P, �� Tel. ��oZ� �oZ//
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � S3 e ��
$_ �. � o
$_ 3 � fo.�
$
$ Seoa
$
$
$
$
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CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit 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 [ ]
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official sha.11, before issuing pernuts for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon 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,(}00
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,0�,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,OOQ plus $14.00 for each additional $1,000
or fracdon 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,Ot�,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ctiub Streets Only)
Alterna.te "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $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
Permits for construction will be issued a minimum of 24 hours from the time of application to alloev 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 ii has been constructed will
be required before proceeding with the framing.
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