AF - 38577i
Village of Fridley, Minn.
BUILDING PERMIT �°• 19 2 6
Date: ���i.�� . .�� . . . .�. . �� . .. . . ... .
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Owner�''lJ��: :�:°v�..t��.-�:'g'• •��'��^li�. .. Builder . . .�;r:ts.�-.'�`.x�.�::�.+t . . .... . . ..... . ...... ....
Address 1�� � . . ��` �: j� f�'r� � . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
� ... ...
LOCAT[ON OF BUILDING
No. �' c7.':7. . . . . Street . . R��c G:� :� . ���'�c�r,�.�.� .•:'�d•�1. . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot . ./!�.`�... . . . . . . Block . . .�,�.�. . . . . . . . . . . Addition or Sub-Division �:��€�:�`:�:'�?�: ��: :": �!:!fi.�.'. �.#
.
Corner Lot ... ..... ... Inside Lot ........... Setback ........... Sideyard . V�.:�,�.�l�i�:�:�:'�r.........
DESCRIPT[ON OF BUILDING
To be lised as:
�_,�..�'� .a,� r��y�. . . Front .�,� . . . Depth ,�.`�r. .. Height f..�9.n"�.q'" Sq. Ft. . . . . . . . . Cu. Ft. . .. . . . . .
f
..................... Front ........ Depth ........ Height .......� Sq. F't. ..... G,u. F'� ........
Type of Construction �,:r�4-r•+:�,"'...... Est. Cost ... .��i .�:.:"�..... To be Completed .�,�d%t'.�.�:..V.��
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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 village of Fridley.
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-- ... ..... --- — ----
in consideration of the payment of a fee of $..'�:"" , permit is hereby granted to+�I't*r.�� ��..�..
,e.-�: �'�� �;°.�'�w.•��C ..... to construct the building or addition as described above. This permit is granted upon
the e�cpress con on that the person to whom it is granted and his agents, employees and worl�en, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
F'ridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon,violation of any of the provisions of said,
ordinances.
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� ;,r:.�.. :..,r.. ..:�r'Jr�s �ti: nuilding Inspeator
- -- _ �.
N071C�:
7his permit does not cover the constructton, installa.tion or atteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see� Building Inspector for separate permits fo�ese items.
�-' �--�
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City of Fridley, Minn.
BUILDING PERMIT
Date: April, 22� 1968
�r: Larry Gass 8��, Chuck's Const. Co.
�o
Ag� 5087 � Clearview St .,e,d�s 3800 Hayes St . N�E .
LOCATION OF BUILDING
No. 5087 s.�t Clearview St. N. E. p� of Lot
Lot - 12 __ Block _�� Addition or Sub-Divisian . Summit Manor Addn.
Coraer Lot w Insfde Lot — Setback � Sideyard
Sewer IIevatian
Founda.tion IIevation
� r � 3�
9686
DESCRIPTION OF BUILDING
To be Used as:
Ritchen Remodel �nt —. Depth Height ._._ Sq. Ft Cu. FL
Front Depth � ITeight _.._.. Sq. Ft Cu. F't
Z�ie of Construction Frame ��^_��896 .00 __ To be Completed
In consideration of the issuance to me of a permit to cons the building descrlbed above I agree to do
the proposed work in acc�rdauce with the description abov�s t and ffi co�p Q�� thc�a'11 proviafona of
ordinances oP the dty oP FridleY• / ! „9 / 1���,Yd //
In camsfderation of the payment oP a fee oP $ 6. 00 � permit is hereby, gra,n,ted ta Chuck � s Cons t. Co .
to construct the building or addition as described above. Thia permit ia granted upon
the express condition that the peraon to whom it ia granted and his agenta, employees and worlmien, in all work
done in, around and upon said building, or anypart thereoE, shall conform ia all respecta to the ordinance� of
FrlaIley, Minnesota regarding locat3on, conatructfon, alteration, maintenance, repair aad movfu� of buildings
within the dty ]im�tts and thia permit may be revoked at any time upon vi tio �_�,of the provisions of sa�d
ordinsnc�a. �
� O�ficial
� � � �? sufla�ng
LT n Ga.ste and
NOTICE:
� 'flds psrmit doas aet eevsr t6s eontlrasNon, ira�llafioe h� rrtrtee� Plumbing, ga haNee, mv�r e� wahr. B� mn te a�
tha BniWi� losptato� for mparat� p�mHs hr t6as t»m�.
.� . .
AP'FLICATIvBi FOR SUILDING PERMIT
CITii OF �"'RIi)LEY, MIYd�SOTA
,:-.::;� . �
' � . � . ,i. . . B�LDER ��.����+� ����
OWIVER 5 _ _ .
AU$RESS ��; � �.� ,, 1 � ,' • ��D$ESS �� O �9��'�� !��
� • . LOGA�'�.ON�.�. BjJILDIt1G' .. � ..�,. . . � : ,
•. , •. , . . .. , �: x:� �. . . ; ,,.
NO.��STREL�T � -- �� „�.�:; � . .
LOT� - BLOCK . .�S ADDITION OR SDSDIVISION ��ra�.��
. . . CORT�R LOT � " . , . IN3IDE LOT . . � . .. . . � ' SETBt�CR. SIDEYARDl�': �.s�
SEWER ELEVATION T�P OF �T�'OaTING � � � '� � � y
Applicaat attach to thia form Two Certificates af Survey af Lot sad proposed
building �loeat3.o#� drawa-�on �thes.�,�extificates. , �
. . . . � . . � . . ,,-; ..
.,l ,E �� � . DESCRtP�I4N 0� BVILDIIITG. : . • , ' ; � .. .
. � � ... . �. . . .
. .n • � .
To Be tlsed As�s • ... . . , �•,t` � , � .. .
� Fropt . „r,_ Dep! HeighC ��
.. �: . , • Squa�e..�eet. � ' _ Cubic Feet . ...
: � Fzoat � Depth � BeigYit : �.
.. ,. .� . ,••_
Squsie�feet Cubic FeeC -
, . � . . ..,��s �
Type of ConaCruct3on '�-�'��9 Est�tmated Cost. . ��� .�-
r----
To Be Campleted
�d
The uadersigned hereby makea appiication for e permit for the work herein
specified, agreeing ta do all work in strict accordance with the Citq of
Fridley Ordinances aad rulinga of the Dep�rtment of Buildiags, and hereby
declares that all the fact� and representatioas atated i�t this applicatiotn
are true and correct. �
DATE _ _ � � �^�- _9IGNATURE '��� _ � _ � _
(Schedule of Fee Coats can be found on the Reverse Sidej.
- �
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� BUILDING PERMIT FEE.S�HEAULE
• SECTI6N���2.� The Inspecto� of Buildings shall, befere iesuing permi'ts �or
the erectfon of �ny bui�dit�g or structurQ, .or fot..anq- ac�c�t�ian to eny
exiating structure or buildittg, or for aay alter�ti.on or repairs to any
existing building or:'stt��t�sr��.upaa applicaCion therefose, require the
the payarent by the applicant�for sueh permit of fees to the amount herein
belaw set forth and in the mauner he�i�i provided to-csit: �
�..,:•�. --. .� � -° . .
,,c . '.i ;"d=.: 1°"
.• °Dniform Duildia� C�e; Type 1, 2-, 6 4- $�1.75 for each ome Chousand cubic
,,f��t. -or fractiireof, in eucli cubical aontenCa, e�3 8� S- $1.50 �or
.. �....
-. . .�. `�acfi one� theusaad �cubic feet.
. . . . �. �.. - .. :, _
. . �..�. � ,. . .
� '' F�r the �ur�ose �i:,ct�putiag fe�"s :#or �uildin$ pera►�ts,' t'�� cubicel
conteaes of any building•or'addition C• a u�iform height throughout by
nn�ltiplqi�g the grcund area c.over.ed fr�m a point ais (6) inches below Che floo:
liae •f tbe basement or��the c�llsac to �he everage height_of,_the uppQr surfaca
or eo the average height oi the roof surface of the imain��gable of a
pitched roof. :
-.� "'�For repai�s�or alterations�to an exi$ti,ng etrucCure,.the fae shall.be at the
r�te of.:�3,00 per each five•hundYed.'doliars ($500.00) or fraction thereof
- . • in ttie coet ef all" propo�ed work_._ .
.. ....:
• ;,�..:, , . ,
: �n no case°-stusll the "fee chaicged far anq permit as s�C forth �� SecCicn 2 be
lea�, tt�ar� ..$5 . A0. tl ... . .
NSSSD G�u�ec�ia�u Gi�,a,kges based on, locat�,en- Area 1'or �2. '�
, �; ..� • � � . .
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SUBJECT P MI O. �
City of Fridley � 146'71
' ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T RECEI
r
� � COMMUNITY DEVELOPMENT DIV.
1 j L �����_�
� � PROTECTIVE INSPECTION SEC. q/ y7�
1 . �
�� � �"�'1 � CITY HALL FRIDLEY 55432 NUMBER HEV. DATE PAGE OF APPROVED BY
""� � ,�� 612-560-3450
910-F15 5/4/78 � �
JOB ADDRESS 5087 Clearview Lane N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7,2 5 Carlson` s SL110IIL7."t 1KdilOr SOtl'�l SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James H. Zabel 5087 Clearview Lane N.E. 566-4109
3 CONTRACTOR MAIL ADDRESS 2�P PHONE LICENSE NO.
$ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
RL'S1CZC:i1't].1�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 14' x 12' Addition
9 CHANGE OF USE FROM TO
STIPULATIONS �y�� Sp� for 2"x 8" floor joists shown on plan is 14 feet.
Provide more detailed plan by May 17, 1978. Provide 8 inches minim'�t atti.c
insulation.
, 1NAR����
�5;�}�FtA� P'ERMITS REQUIRED FOR 1Nl�RI�G, �efore digoi►�g �!i It���� �t��i���s
HEATING, P�.U1�81iVG AtVt� �fGNS� TELEFN�f�E�Ei�C1�,3�-���t�
���������� �'� ��
TYPE OF CONST. OCCUPANCY GROUP OCCUPAN Y LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. �OOd FrdI��''
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION 168 3,360
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $S��-48 $2.57
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 13.44
STRUCTION OR THE PERFORMANCE OP CONSTRUCTION. $
� PLAN CHECK FEE TOTAL FEE
$3.36 $19.37
Si uR• FCONianC o THORI Dn NT IDA7E� WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
��J � / — " � 8'�� �-a4C► IODU�/ ��'i � / 0
SIGNA7UREOFOWNE ERBUILDERI IDATEI BLDG iNSP DATE
�
CITY Of� f=ltillLEY .
AP!'LTCP,TIOi� FOft (ZGSIllf=P�TI/1L L'UILDItdG PEf�MITS .
� ' (I�[:W, /1LTLRnTiOfd�, /IL�i�IT10(JS, OR RCf�J�I(ZS)
; . '
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ov��1�cR: `��/`l�'J' ��E'L �viLUr•.�z: ��Ym� '
, --
Address : .�Q� ��/��!//�� Address : �
. , Tel. t�o. ��o (o - �/C3�.
No. ___- ==`�-� Street : 1��.1� J��¢� �iU� �� � -
r,oT : / a �r�ocr.: �� �nDZTiora : �F�-2.lSo �J S �um r� � T �u <<-�
COi2IQER LOT: ITISID� IAT: � SLTBI�CY.: SIDL'YI�I2nS: ____
�nn�i�ar�t attach i:o L-his form 4�ao Certificates of Survey of Lot and �roposed
bui_lding locatian drawn on ttiese Certificates. •
DESCRIPTIQI'� OF BUILDIriG
:
�0 33e Used 11s:
�j � � �U'
�,(i/Q/Br �0/�i Front: '%`7 DeptYi: �� � Newc3ht: "
5quar� Feet: � Cubic Feet: .3_3� �
I`ront: � Depth: - � Hpight: - — —
' Square 1 eet: , Cubic Feet: �
7.j�ge oi' Construction: �OC'� � fr �21�m� -- Estin►ated Cost: $ ��"—
• � 7't�
7Cb Be Completed: l.l.�►'lSL- / 7 Alt. A A� �. B
Proposed ,7ri`�eway Widt:h If t1e�a Opening Is Desired $ S
(S�� l'.�VERSE SID� OF 5Hi:�'T)
The unde�signed l�ereb�� makes zpplication for a permit for �che Frork iierein
sp�c:ifa.ed, aqreeing to �o a21 t.�or}: in strict accordance �ai -L� the City of.
FX�dley Urdina�lCGS ci]1C� rU�.111CJS of l�he Lcpartment oi ruilding ., a�id }iereby
deelares that all tlte facts and re���'esen�.�tions sta'�ed i�: i�his a�plicat:ioi� .
�% ' Ax� true anc3 carrcct. See rev�rse side f�r acldiLional iui-orniatian.
v
D�T�: �� 3 / 7�iGt��mvr.r•.: _
S�i.pulatioais: � 1.�. 'jl� '
O�J��/ a,rp° ,u.•- " ' ��'°'` ��� 3,3�
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BUILDING PER��7IT FEt SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any bL�ilding 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
tharefore, require the payment by the applicant for su�h permit of.fees to the amount
herein below set forth and in the manner herein p.rovided to-wit:
NEW CaNSTRUCTIbN: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Onl�)
Alternate A: Removal and replacement of 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 foo t wide approach with
6 inch depth; Driveway width plus E feet x$17.20
{11 � � �..= ,,
For the.pur,pose'of computing fees for building permits, the cubical contents of any
builr]ing or addition, is determined by multipiying 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 �r to the average height of th roof surface
of the main gable of a pitched roof. �
For repairs or alterations to an existing stru�ture, the fee shall be at the rate
of $3.O�J �ier each five hun3�ed dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATIO� OF FOUNDATION
NOTE: Permits �or construction will be issued a minim�n of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certi.ficate of Survey of the lot,�showing the location of the foundation once it
has been constructed will be require�3 before proceeding with the framing.
_C�RTIFICATE OF �CC 1PANC'v
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupsncy of any structure for which a building permit has been issueds and
• sa:i.d stxucture shall not be used or occupied until a Certificate of Occupancy has
been issued.
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CONS � ilf�N SITE.
CAL1: FOR A L INSPECTIO�VS,
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CO►dSTRUCTiON StTE. -
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Cp�LL EOR A1-1� �E 1NSP�C�►ON.�.
FinallnsPect�o�s of a11 trades
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Page 1 of 4
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EXTERIOR ENVELOPE AVERI�GE "U" COMPUTATIQN �
OWNER: V�% ,�G�'�� G. DATE. __��/��� � � 7
SITE ADDRESS : ��0�' ��4/P!//t�./ O!�.PHONE :_�IG G' 7 I O.Q
CONTRACTOR: �+ C�• F ' � I,� � e
Dv�� � �
Determine working square footage of each f „,�-�`il
,�q � � 3 0
1. Total exposed wall area...... wV sq. ft. x .17 = �
2. Toal roof/ceiling area ......
sq. ft. x .05 =
Total exposed wall area above floor =
a. Total wal windo area ................................. �j �� �
b. Tota doo a ea ....................................... /
c. Total s iding glass door area .........................
d. Total fireplace wall area .............................
e. Total• wall �raming area (average 10�) ..................
f. Total rim joist area ..................................
g. wall area above floor ..........................
h. wall area above floor .......................... _ '
i. wall area above floor ..........................
j, wall area above iloor ..........................
Total e�cposed foundation area =
k. Total foundation window area ............... ..........
l. Total net foundation area above grade .................
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section)
f� S� `
cl . [J Z X uUn •�`� - 7 1 �
b. X nU° _
c. X "U"
� d. X "U"
e. �Y�i'r g ��U��
f . .2 ro. t� X "U"
,o� _
, �% _
g• ��./� X ��U�� 'O� _
h. X "U" _
i. X "U" _
�7.0�
b
.�, Z
J� X uU�� —
k. }� nUn =
� . �a X „U„ . e �(6 = . �t, �
�
3 . ............................. Total = ___,
�
` � �
{
I ,�
If item #3 is the same as,
or less than item #1, you
have met the intent of
SBC 6006 (c) 2.
i
�F�terior Envelope Average "U" Computation Page 2 of 4 � .
Total exposed roof/ceiling area =
m. Total skylight area ............................
n. Total roof/ceiling framing area (average l00)...
o. Total riet insulated roof/ceiling area........... �.-'
Determine "U" value for each roof/ceiling segment
m. X ��U�� _ - .'
n. X "U" _
o. X "U" _
4 ........................... Total =
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6�06 (c) l. •
Alternate Building Envelope Design
To utilize the total envelope syst�n method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
l. + 2. _
3. + 4. _
0
e
u
WALL SECTIONS
NOTE: Use lOgo of opaque wall area for
. frame construction
WALL
FIG. �l
. � „ -\ u
� - • , ,�
b � �� �� � '
3G. #3
FRI�iE T 7ALL �
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.�-_-----u .
4. - -_ �
� • •
Page 3 of 4
Construci:ion � ' R-Value
l. In�terior air film 0.68
2.
3.
4. �
5. '
6. Extermr air film . 0.17
Total
1. Interior air film 0.68
2.
3.
4.
5. �
6. Exterior air film 0.17
To tal
1, Interior air film 0.68
2.
3.
4.
5. •
6. Exterior air film 0.17
� Total
� 1. Interior air film 0.68
'J: - � � 2. � .
. �.: . • 3 .
4.
5.
6. Exterior air film 0.17
. Total
, . . � a . r ,• � ` a
` � �
t. ` r..ry
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FIG. #4 - k ' � ' ` ;. i�r � �
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�� ` � �� � ,i
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NOTr'.: Indicate type, "R" �value, depth and
placer.►c�nt of insulation.
�.
ROOF/CEILING
��ented
�IG. �i5
LJ `J � .
Heat f low
up � � � •
4n�1t,�.�!`I��j�,c��'�1i::�w;...rc_'�V�(�'e,f,�tii�'J'^.�..G���J .
� }:eat flo�a up � . ; •vented
. FSr,. #5 . . .. . . � - . . � .
: . . . � � 1 �' . 1 `=✓ " u
. ° ' �:
• _ NOt?--V�h'TF.D • � ' . • . .
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, ' • � f lOUt Up - .. ' � . ,
. .; . . ,. .
TTr,. �7 � • • • �
Page 4 of 4
Construction R-Value
1. Interior air film 0.61
2. .
3. '
4. Exterior air film (still) • 0.61
Total
l. Interior air f ilm 0.61
2.
3.
4. Exterior air film (still) •0.61
Total
1. Inside air film 0.61
2. .
3.
4. �
5. Outside air film 0.17
Total �
Note: Use additional sheets if more space is
needed for details and calculations
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i�
� �
• COMMUNITY DEVELOPMENT DIV.
� VV � � �
r � � PROTECTIVE INSPECTION SEC.
1 � �
i--_-� ��"" �'� CITY HALL FRIDLEY 55432 NUMBER REV DATE
i 612-571-3450 910-F15 5/11/83
JOB ADDRESS 5087 Clearview Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. ].2 5 Carlson's 5unffiit Ma.nor South
2 PROPERTYOWNER MAILADDRESS Z�P
Jim Zabel 5U87 Clearview Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P
5ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER MAILADDRESS Z�P
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION � REPAIR
8 DESCRIBE WORK
Reroof dwelling __
9 CHANGE OP USE FROM TO
TIONS
PAGE OF
� �
P .
_ 17134 �
�y� 5_
APPROVED BV
SEE ATTACHED
SHEET
PHONE
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
� MOVE ❑ REMOVE
Roof can be 2nd layer but not 3sd. Insta.11 galvanized valleys.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFiMIT BECOMES NULL AND VOfD IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �'
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-�700
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yti`ZS.00
IDATEI
� -//-��
OCCUPANCY GROUP I OCCUPANCY LOAD
S�. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$.85
SACCHARGE
TOTALFEE
$28.85
D THIS IS YOUR
f
�IT1f Of fRJOLtY Eifective �►u9. 1, �9s1
APPLJUT1Qi FOtt RESlOCNT1/1� BUILDli1G PLRi�1lTS
(Nc�,r. Alterations. Additions. or Repairs)
��
ONNiR: _ �///� �.��= L
ADDP.ESS: S� �� ���-2����
--
TEL A0: ' .� % � - � 7 �' s '
• - —
BUILOER: � •
ADDRLSS:
TEl N0:
� Constrvction location
• iTR�T NO: ��� � 6TREET: ��� Ff� vr�w
,
LOTt 1IAOG: ADDIS'IOI�I s
___�
Cozner Lot: ._______ In�iae L�t: ��ctbacts � Sideyarbs:
J1p�liear�t attach to tl�is fo� !tio Certificates of S1�rvey ei lot ar�d
pzoposed buil�]ing locatian ezavn on tertificates to seale.
. -
OESCRIPTIO�t OF CO►�iSTP.UCTJOri
� ���' Front: Depth: Height:
� 6quare Fset: Q�bie Feet:
��,A Front: . DeptAs 8ei9ht:
6quar� Fest: Q�bfc Peet:
��
7ype oi Cbrstruction: �� ��l�f�----
-.-_-__.�
1b B� Cbr.,plcted:
Esti�ated Coste = � � � � �
1►lt. l► I►1 t. B
pzoposed Drivc++ay iCidth Zi New Opening Is Desireds =' �
, . 6EZ Rs.VER:E SIDE OF SHi�T
. �
Zi�e undercigne8 Aereby �nal;es applic�tion for a per�it icr the ��ork hereir� specified,
sgreeing to 1!0 ,all vezk i�, 6triet accozdsnce vith the City of Fridle�• Ozdi��ances ana
suli��9� of the Dcl�.�str+ent of Duildingt, and ?�ercby dec]azes t},e�t all t]�e facts ana
zepre6cnt�tiens stated ir� this appiica -
�°, �
�17'Et r l� � f SIGNI►TUJ�s�
btipulations: �
�� �����
�� �
�� � � � � ��
�� ��.�
,,� .
�
DUTLDING pERMIT !EE 6CHED�LE
The tnapectoz oi Duilainqs sh�ll, Deiore issuing pczmits toz the
�r�ction of •ny �uildinQ oz atsv ctuze, os ior •ny addition to any
�:i�tiAq buileiAq oz strvctnse, os tor any altezation oz tepaizs
to any •sistinq Duiidinq os atsuetuze, opon •pplieatioa th�sefose,
s�Quiz� the payaent �y tAe applieant toz sueh pezmit oi iees to the
•�ouat a�reia D�lov set iozth •nd ia the sanaer ?�ezein piovided to-vita
9'0?71I. V11L[)l1Ti�1
:1.OD m =500.00
iS01 m :2,000
tz,00i eo s�s,000
i25,001 to 550•000
�
!gS
jlO.00 !lini�n� Fee S15.00 plus surchszge
f10.00 !oz the lizst iS00 plus S1.S0 foz each
•dditional f100 oz fzaction theseof, ta ar�cl
including :2,000
i32. SO ioz the iizit S2.OG0 pius 56. 00 foz each
addi tional S1.000 cz ftaction tAerecf, ta and
ls�elua.ing t25, 000
i170.S0 !oz tht fizst S�S,000 plus Sa.50 tcr
each additional 51,000 oz izaction thereof, to
ana tn�iyai�g tso,000
iSO, 001 to t100, 000 i?63.00 tor tAe tirct i50, C00 plus S3. 00 for
each •ddi�ionsl 51,000 oz izaction thezecf, tc
ane incivainq Sio�, o00
tloo,00i .�a yp t043.0� toz tbe firat 5100,000 plus 52.50 ioz
each additional 51,000 oz fraction thezecf
pI.�W G�OC: 25 percent ot building permit �ee
DRIVt3,tAY DEpRESSiDN ESQt�h1: Goncrcte Q�rb 5tseets �ly
111teznste 'J1': Relaov�al and zeplaceloerrt of cvzb and quttez only
Drivevay vidtA plus 6 feet s�13.50 �
111ternate 'B's Ra�oval and tep2scw�erit of cu=D ar�e quttez and install � 3 foot
vide approach vitA 6 inch depth
Drivevay vidth plus 6 teet x i15.75
VER]FICATION OF FOUNDATION
Pera�ita toz constsvctian vill De issued a �eini�++tian of 24 houzs izao the time of
application to allov foz propez reviev ot the proposed structuze ar�d of the
const� ction site.
71 Cezt3ficate of �rvey of t?�e lot, showing tAe loeation of t}�e foundation once it
l�as been oonstrvcted vill Le tequired before roceed_ in� with the irami,r�Q�
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4
sue�ecr PERMIT .
City of Fridley _ 19 8 7 8�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � CEIPT NO.
� ; y ____� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 3
1 ` �
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBEF REV. DATE PAGE OF APPROVED BY
�.---� • •�� 612-571-3450 810-F15 5/5/89 / /
JOB ADDRESS 5087 Clearview Stxeet
LOT NO. BLOCK TRAC.T OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. 12 �j Summit Manor South Addi£i.on SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
James Zabel 5087 Clearview 5treet N.E. 572-8705
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Cities Home Improvement Co. 5841 Ceda.r lake Road, St. L�ouis Park 55416 591-033
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USEOFBUIIDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION � REPAIR � MOVE � REMOVE
8 OESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYC3ROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, 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 PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET 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 IAWS VALUATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`rj�OOO $2.50
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 CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $72 � OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$74.50
SIGNATUREOFCONTRACTORORAUTHOR12EDAGENT IDATEI WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
` ,h � .
SiGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP �1l.T
I�1 [ ]
�1�N [ ]
AL'tER I l
Construction Address:.
r�; � Descriptian:
0[vr�er Naane & Address::
�ntractor : � 77 �S
�are�:.�8�/ �
City of Fridley
R-1 AI�ID R-2
B�uilding Permit Application
.�'087 �.:G UC�.�tf
(�9 7� /�, � S , �� �aa, �a.
/ '
� ��
� /�iPe �.crF �
� ls�� .�..r� ..�,L�o,�s
Effective 5/L88
Tel. # ���- �TO�
Tel. #���� ��3L
�a�/�
Att�c�ii t� this �pl ication, a Certif i�cate of Suvey of the
lat, with the poroposoed aonstruction draa�mm on it to s�cale.
I�'.SatIPPI�i OF Il�'ROVF�MEIiTl'
T.TVT11: ARFA• j�,an� W1�1 HP.1C�lt S�. Ft.
C�RAGE ARFA: I�enyth Width Height SY�. Ft.
DEQt ARFA: Lengt Wi Hgt/GrOtmd 9q. Ft.
Q�:. ���� �
Gbrner Lot [ l Insi� Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Qonstruction: Estimateol Cost: ���`� �'
Approx. Comp7. etion Date :
Al� A Alt. B
Prop�s+ed Driveway Width If New ' g Is Desi : S �
Width + 6' See Back Page
L�iTE : ��/ Ap Tel. #��v� O 3�3.�
(TTY OSE �Y
Permit Fhe S /�� �d I�ee Schec'�l.e on Reverse Sicle
Si�ue S��arge � � .�� 5.50/51,000 Valuation
SAC (�arge S 5�5� per SAC Onit
Driveway Escrvw � 1�.� '�," or �,l.t '�" Ab�ve
Park Fee S Fhe Determir�ed by F�gir�eering
Sewer 1Kain Charge � Agreene� Neaessary [] No� Neoessary [ l
� s ���
S.L'�UId9�I�:
-- . _ .�
=: 1 . �. �, ' �+�+v 4 �+� ��:i��,l�
�e C'�ief 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 belaw set forth and in the manner herein pravi.dec] to-wit:
TOTAL VALUE
$1 to $500
5501 to 52,000
52,001 to $25,000
�25, 001 to ��i, Q0�
i "��
S15 (Minimtm� Fee is S15 plus surcharge )
$15 for first 5500 plus S2 for each additiona]. 5100 or f raction
there�, to and including S2, 000
S�i.S for f irst S2, 000 plus S9 for each additional �1, 000 or
fraction thereof, to and including 525,000
�252 for first ��5,006 plus �6.50 for each acTditiona7. 51,000 or ,
fraction thereof, to and incluc3ing 550,000
550,001 to $100,000 5414.50 for first 550,000 plus 54.50 for each additior�al 51,000
or fraction khereof, to anol including 5100,000
5100, 001 to $500, 000 S 639. 50 for f irst �100, 000 plus S3. 50 for each additional $1, 000
or fracti� thereof, to anc7 including 5500,000
S500,001 to 51,000,000 52039.50 for the first 5500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including 51,000,000
51,000,001 a�d up $3539.50 for the first 51,000,000 plus $2 for each additional
51,000 or fraction thereof
D�VE�ATAv D RF_�RT[�N F_Q1_{M�T
�Concrete Curb Streets Only)
Alternate °A": Renwal and replaaement a�f cvrb and gutter only - Driveway wic7th plus 6
feet times 513.30.
d �ti: E4" '�`` • .
Alternate "B°: Ranwal and �eplaae�ie�t.;.,a£�:°�r���'ai�d��gutter ancl install
appr�ch w�.�� �.� �.n��.d��t}�i 1Drs�'��y �-ic�ti�,.��`�5 f�t i�es $]�5.75.
' vl� ,!�'•�'�� y a'�li�.y ��.�Q�• ��x�+.i
' • n h1 L. 'ii 'C.4R �:���.. ,�1
: , ,. i {�.. S.- ' v ,�q:, :R�ll1+,�'i�...
, . '.6�, �},�:VER�r�rFi`c'iiAi�ON OF F�mTnN
a 3 foot wide
Permits for construction will be issued a minimtm► of 24 hours f rom the time of
application to allaw for praper review of the proposecl structure and of the oonstruction
site.
A Certi.f icate af �uvey of the lat, shawing the locati� of the foiuidation once it has
been aonstructed will be required before prooeeding with the fraaaing.
�
SuBJEG�
c�ty of F��a�ey 3 i 712
A T T N E T O P O F T N E T W I N S g � I L D I N G P E R M I T
r �
� � COMMUNITY DEVELOPMENT DIV. �q/���.� o/� IPT NO.
j � v � PROTEC7IVE INSPECTION SEC. ■ �� J��
� �
� _ �
l-__.�; r���,'� CITY HALL FFiIOLE� SS�3Z NUMBEP pEV DATE PAGE Oi AVPROVED BY
L 612-571-3460 910-F15 3/30/Ol � �
JOB ADpRESS 5087 Clearview Street NE
t LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACMED
oesca. 12 5 Carlson's Summit Manor South Addn SNEET
2 PROPERTY OWNEq MAII ADORES$ 21P PNONE
Tim/Mary Zabel 5087 Clearview Street NE
3 CONTRACTOR MAIL ADDRESS 21P PNONE LIC NSE NO
Signature Installations 22811 Poppy St, Oak Grove, MN 55070 612-490-180�
a ARCNITECT OR OESIGNER MAIL ADDRESS tIP PMONE LICENSE NO.
20187747
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION �I REPAIR O MOVE � REMOVE
8 OESCRIBE WORK
Reroof House & Garage (26 Sq) Tear-of�
8 CHANGEOFUSEFqOM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PIUMBING, MEATING,
VENTI�ATING Oii AIR CONOITIONING.
THIS PERMIT BECOMES NUIL ANO VOID If WORK OR CONSTRUCTION ZONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�iITMIN 80 DAYB. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERI00 OF 120 pAYS AT
ANV TIME AFTER WOfiK IS COMMENCED. NO DWIG. UNITS OFfSTHEET PARKING
I MEREBY CERTIFY TMAT I HAVE iiEAO AND EXAMINED THIS APPLICATION 1 STALLS GAflAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF lAW$ yq�UpTION SUR7A%
ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETMER SPECIFIED HEREIN Oii NOT. TNE GRANTING OF A PERMIT �2 s 659 $1 . 33
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CHARGE
PROVISIONS OF ANV OTHEFi STATE OR LOCAL LAW REGUTATING CON• �$3 � 25 Fir SC y+2 . C C)
STR TION 7 E P ANCE Of CONSTRUCTION
P�AN CMECK f TOTA FEE
Lic e C $5.0 $92.24
S�GNATUAE OF CON'FACTOA 0�7 AUTMOAIjEO aGENT i�atE� MEN ROPE LIOA MI�YO PERMIT
S�GN4TUaE O� OWNEp��� OWNEpBW�DER� �O�iE� 8� �p5o � r��
N� [ ] Effective 1/1/2001
ADDN [] . CITY OF FRIDLEY (763) 572-3604 Bidg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Construction Address: ���� C I��� � i r e�v S I"'
Legal Description:
Owner Name 8� Address _� 1 r-` ���, �c�e ( Tel. #
Contractor: 5� q ria��� � �c�e--� �-�l GY�S MN UCENSE # ao r� ��1 7
Address
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Te�.#_��Z- 3�-i7g'�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
i % -?� r�o�- �-6 n /� .,�� �
Sq. Ft
Sq. Ft.
Sq. Ft
Construction Type: Estimated Cost: $
v °� � � /
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE:3 '�^ a� APPLICANT: Tel. #����3� 77y,�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ �� •�S� Fee Schedule on Reverse Side
$ �? � � .001 of Permit Valuation (1/10th%)
$ /<�� $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ � C� � $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 SCAEDULE
The Chief Building Official shall, before issuing germits 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,Q00,000
$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,�0
$69.25 for first $2,000 plus $14.� for each additional $1,000
or fraction thereof, to and including $25,Q00
$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.Q0 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)
Altemate "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
Pemuts for construction will be issued a minunum 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. New Houses Onlv
Building
Inspections
763-572-3604
DATE p( bU(�7 U�j
SITE ADDRESS �V p
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
�
i � �,
Permit No.:��� �P��
Received By:
Date Rec'd: ���—� �
YOUR E-MAIL ADDRESS �jSCI�,'�d@ Q/�Q`,� DC • C.CiiY\
��. i��L _ ���
O OWNER �CONTRACTOR
ADDRESS/:w ^ � ', CITY STATE ZIP.
PHONE:_ULI O' ' � OI — � � �-
NAME:
STATE LICEN5E #
ADDRESS:
PHONE
❑ SINGLE FAMILY/NE�
❑ TWO FAMII VMRW �
Renewal By Andersen
1920 County Road "C" West
Roseville, MN 55113
License #20130983
651-264-4777
❑ BASEMENT FINISH O ROOF
❑ DECK p SIDING
i�xsT
— I ❑ IVt,Ai1v7
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVFMFNT
OF SQUARES
G�Rw c
PROPOSED S1ZE:
PROPOSED HEIGHT:
u HvU3E ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
'ATE ZIP
O DRAIN TILE
O OTHER
BASEMENT RFtupDFi IN 1R1�"IT•
l. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
S1DING
❑ Vittyl 0��� FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Al{Illllp4til t9.DDITIONS a�t�r`ucc cr ta�err.
O Trim
O Other 1. Site Plan/Survey showing the existing strucque
0 Fascia end P�Po� P�l�-
WIN--�W-� 2. Two s�ts of construction plans
IN EXISTING OPEIVINGS OYes pNo LOCATION OF WiNDOWS 3. Energy Calculations
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCI.UDIIVG THE COST OF LABOR A1�TD MATERIALS:
(USING THE 199� U.B.0 FEE SCHEDULE)
TOTALJORVAI.i1s'rinive �,�,S7Q _ �___�______
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surchazge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
a `� �-• � J See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ �J • .001 times the total job valuation
$ �.[ e l Q .0005 x Permit Valuation Minimum $.50
$ 6 (7 $5.00 (State Licens� Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= Rx$21=$
$ $450 Conservation Plan Review
$ Fee �termined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
e r�� --,� r -- - -
TH1S IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building �it and I acknowledge that the information above is complete and accurate; that the work will be 'v
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Cades; that I understand this is not :
permit but only an application for a�rmit and work is not to start without a permit; that the work will be in accordance with the approvec
Plan in the c�se of all work wh�requires review and approval of plans.
SIGNATURE OF APPLICANT '�v W� n� v� /".. �I� NAME��.
� n�So If`'> DATE
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