AF - 38610sue�ecr PERMIT N
City of Fridley 4142
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
�
� � COMMUNITY DEVELOPMENT DIV. R CEIPT NO.
� � �-� 9/z�
i 1 V ������� ��
f � � PROTECTIVE INSPECTION SEC.
i1 = �
-_-_ A �/"��,,, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L �� 812-560-3450 910-F15 6/8/77 � �
JOB ADDRESS 5132 Clearview .S'tY'L'Et N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEEATTACHED
DESCR. 1$ 6 Caxlson 5ummit Ma.�r South Addn. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Michael Ziegler 5132 Clearview Str�t N. E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Re 33.C�0I1't].a,�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C.� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Reside house
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. �.SOIlI.'te
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
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 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 LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLtED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �`SOO �•SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON-
STRUGTION OR THE PERFORMANCE OF CONSTRUCTION. � $7•5O
PLAN CHECK FEE TOTAL FEE
y�8.0�
SiG TuREOPCON7RAC7� OR THORI AGENT IDA7E1 WHEN PRO ERLY VALIOATED THIS IS YOUR PERMIT
r� ��.�-� t� �� � � , �,�� � �.�� � -� -
S GNATURE OF � NER IIF O' R BUI RI ID TEI BLDG INSP DATE
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CITY OF FRIDLEY
° APPLICATION FOR RESIDENTIAL BUILDING PERMITS
� �NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
. . �
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OTr�PdER: ��/ _��]/,% -/ � I _ �-� BUILDER: �C���'1tiSL.�
Address : �13 0� ., ���'j^//��'/p� �% Address :
Tel. No.:
��30� Street: � /�i(� %"(�l� (.4� � ^
No. ��� . � �
�
LOT: �� BLOCK: �_ ADDITION: �/q�ISO/T/ SGtiJ7I%i/� �O ,
CORNER LOT: INSIDE LOT: S;TBACK: SIDEYARDS:
Applicant attach 'to this form Ztao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. .
DESCRIPTION OF BUILDING
To Be Used As: '
� -
� ���"ront: Depth: � ' Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: �/1 j f'i%O/ ��(,��, Esti.mated Cost: $��Q.�(�
7.b Be Completed: �_c� l, ������
Alt. A Alt. B
ljroposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict 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. See reverse side for additional information.
� �
DATE: � SIGNATURE:
Stipulations:
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BUILDING PERt�IIT FEE SCH�DULE
SECTION 2. The Inspector of Buildings 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 repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete G�rb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
�9D�ITIONAL INFOR�IATION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point si.x (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 $7.50 plus $.50 state surcharge.
VERIFICATIO� OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
consi:ruction site. .
A Certificate of Suxvey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CtRTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (1G) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
��
sue�ecT pE .
City of Fridley � 14'719
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � ECEIPT NO.
� `L ______ COMMUNITY DEVELOPMENT DIV. ���
r � � PROTECTIVE INSPECTION SEC.
� �
(-___ ��'�',,� CITY HALL FRIDLEY 55432 NUMBEH REV. DATE PAGE OF APPROVED BY
1 J\ si2-58o-3a5o 910-F15 5/22/78 � �
JOB ADDRESS �132 Clearview Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �]_$ 6 Carlson`s S17IIII[►1.'t M3IlOY' SOU'�1 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Micha.el J. Ziegler 5132 Clearview Street N.E. 566-7924
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
��.
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof structure
9 CHANGEQFUSEfROM TO
STIPULATIONS
Install ridged galvanized valleys. This can be second but not third
roof .
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCllPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. ASP�lc1�.'t
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONINO SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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 OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STAL�S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX
AND ORDIIJANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $SOO yfi. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVI�yIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- $`7,SO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �
PLAN CHECKFEE TOTALFEE
". �`8.0�
S� � REOFCONTRACTORO UTHO�ZEOa NT (OaTE� HEN PROPE LY VALIDATED THIS IS YOUFi PERMIT
s—a��7�'° �1�� ��a-��°,
SIGNATUREOFOWNE II OWNER I DERI IDATEI " BLOG.INSP pATE °
. �
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CITY 0� f=1t11)LCY , ' .
' /�('f'LIC�TIUI� fUft I2L"SI))(:�lTI/1L �U1LD11�1G f'C121�1ITS .
' (�'�L'W, �LTER/1T1UfJ�, IIDllITIOfdS, Ofi Rcrnirzs) ,
. .� , � .
, . �:
o�:�i�R: � , � l3UILDrIt:
Address : `e ��02 ��I� � / l(o Address : �
Tel. l�o.: ��"��'o��
1Jo. : Street : �
. �
LOT: �� BLOCY.: �p ADDIT70P�: l.�-'t�j(}�LI� �����11�1.-�,� �1�1� �y'Z� �i
.
CO121d�:R L�JT: �_ IIJSIDr I/JT: SLTL'l�CY.: SIULYI�RDS:
�PP�icant attach �t� L-his i�rm `l�ao Certi{i.cates of 5urvey of Lot and proposed
bui_ldinq locatian drar�n on these Certiiicates. .
DESCRI PTIOi'd OF BUI LDI l�G
To Rc Used A :
Front: Depth: . �
Square Feet: Cubic Feet:
Height:
I'ront: � Depth: � Height:
� 5quare reet: ' C�ibic Feet: '
Type oi Construction: �s a . EstimaL-ed Cost: $�(�( .•d� _
7.b }3e Gomplei:ed: �n—�—� � Alt. A Alt. B
Proposed Drivetvay lti'id'�► If l�etia Opening Is Desired $ $
(S�� T'1:VE::SE SIbE OF SHEET)
The undersigned l�e�-ei�y makes application for a permit for the w+ork l�erein
specifS.ed, agrceing.to do all �:ork in strict accordance with the City of
Fxidle�� Ordin�,nces and niliilgs of the Dcpari:r�ei�t oi l.;uildinc;s, and hereby �
deelares i:h�t all tlie facL-s a»d re��resenL-ations stated i�i i:his applicat-ias� .
a�:e true yid correct. See xeverse si.de or aclditioi�al inio�niation. `
DAT�: � "- o�..�,"' % � STGI�A'rURI::
Stapulations: � � , ,
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BUILDItdG PER��II1' FEt SCi�EDULE
SECTION 2. The Inspector of Buildings shall, before issuing pexmits for the crection
of any building or sL-ructure, or for any addition to any existing building or structure,
or for any alteration or repairs to any existing building or structure, upon'application
theretore, require the payment by the applicant for such ��crmit of,fees to tihe amount
herein below set forth and in the manner herein provided to-wit:
NEW CON5TRUCTION: Single Family iiomes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of buiZding permit fee.
DRIVEWAY DEFRESSION: (Concrete C�zrb Streets Only)
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 c.�urb and
,qutter and install a 3 foot wide approach caith
6 inch depth; Driveway width plus 6 feet x$17.20
• ADDITIONAL INFOR��IATION
For the purnose of cor:�puting fees for building perm?ts, the cubical contents af any
building or addition, is determined by r.�ultiplying the ground area covered from a
point six (6) inches below the floor line of the basesnent or th� cellar to the
average heig:�ts of the upper surface or to the average height of the roof surface
of the �ain gable of a pitched roof.
For repairs or alterations to an existing structurP, the fee shall be at the rate
of $3.00 ��er each five hundred dollars (5500.00) or fraction thereof in the cost
af all proposed work. ,
In no case shall the fee charged ior any peYmit as set forth in Section 2 be iess
the.n $7.50 plus $.50 state surcharge.
��R� F I CATIO� OF FOUNDATIOfV
NOTE: Perm_ts for construction will be issued a miniraum of 24 hours�from the time
of applicat�cn to allow for proper reviec� of the proposed structure and of the
cons�raction site.
A Certificate of �unrey of the lot, sho�tiing the location of the foundation once it
has been co�sti-ucted will be required before proceedir.g with the framing.
Cr2TIFICATE OF �CCUPANCY
Appiication for a Certificate of Occupancy shall be made ten (10) duys prior to the
use or occu_�ncy of any structure for wl:ich a building pexlnit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
�
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SUBJECT PEF,� O.
City of Fridley 18 3 2 5
AT THE TOP OP THE TWINS g U I L D I N G P E R M I T
r
� � R .
r ; L__�__ COMMUNITY DEVELOPMENT DIV.
� � PROTECTIVE INSPECTION SEC. / ����
' i '
' /�"1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BY
!"'-"� � ,�� 612-571-3450 910-F15
2/18/86 � �
JOB ADDRESS 5132 Cleaxview
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 1$ 6 Carlson's Summit Ma.nor S011'kl1 AC�Clii. SHEETttACHED
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
Michael Ziegler 5132 Clearview 572-1890
3 CONTRACTOF MAIL ADDRESS ZIP PHONE LICENSE NO.
Ariel R�todeling 5744 West Moore Lake Drive 571-9531
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PNONE LICENSENO.
8 USE OF BUILDINO
RES 1CZeI1'i:lt�.
7 CLASS Of WORK
O NEW �J ADOITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 2Q' x 6' Addition tp DHrelling
9 CHANaEOFUSEFROM TO
STIPULATIONS
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�, . �t �,� ,,�,
i��LiFf�p�".�����,,; ,� r f� ,�. ,. � , ,�°`.6 �, �.��:����� ��r;��«.�� �=��'
P���.. , � �- , °.
�-- d"1 p I g�t ,�^� j� � g ¢y�ry� (� �p ry ry�
R�Q�` �'��r,� j�`-�p� °+n1�� �,�`' Z � S P�,y �p 6�IE�a�t � g����,J.y �E�S.! �i�61.�t311:\k� C�E`Y�' .��'i��� d�,
� � �' � �e�� ° r��',
V �.
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� �y�.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEfi 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 LAWS VALUATION SURTAX
AND ORDINANCES CiOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3 � OOO y51. SO
WITH WHETHEH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 38.50
RUCTION THE PERFORMANC OF CONSTRUCTION. $
� PLAN CHECKFEE TOTALFEE
4 $40. 00
SIGNATU E FCO RA O ORAUTNORIZEDAGENT ID ei : ��-�jIEN PROPERLY VAL A ED THIS I VOUR PERMIT f.
[ V V
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEi L G INSP �p7
NE�; [] City o.* Fridley Effective 4/1/84
A�nt+. [] i R-1 AxD R-2 �
pLTER. [ Building Permit Application
Construction Address:
0
Legal Description: �-01�' � /� �j�-��� {a �°�� � l$oh'� SL�,�vi i1.,�, ��=
owner Name s Address :'`� ��-� +2- � � ��'°�r` �°e-1� Tel . 0 5� 7���� l c3
Contractor: �t. � 7�{=✓�LOC�I�.0 I vt T�1. # S 7l ''�/s3l
' s i�� ��,�1 ��� ' �� �� 1�
Address:__ _�
Attach to this application, a Certificate of Survey of the
lot� with the proposed construction draxn on it to scale.
DESCRIPTIOH OF IMPROVEMENT
� S�
LIVING AREA: Length �-c� � Width �� Height � Sq. Ft. � Zo
GARAGE AREA: Length Width Height Sq. Ft.
DECR AREA: Length Width Hgt/Ground _ Sq. Ft.
OTHER:
Corner Lot [� nside Lot [] Ft. Yd. Setback Side Yard Setback _
Type of Construction: r-t-� u� Estimated Cost: $���_C� � _,
Approx. Completion Date: � � _
Proposed Driver+ay Width If New Opening Is Desired:
DATE: �� I� ��
�
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
1FOTAL
STIPULATIONS:
Alt. A Alt P
� $ $ -- ---
See Back Page for Explanation
c
APPLICAKT: _ Tel . �i ��7/ � `�S_3j
CITY IISE ONL7 ,
$ 9�� � Fee Schedule on Reverse Side
$ � 25� of Building Permit Fee
S ��,.�_ 5.50/$1 �000 Valuation
3 �— �425 per SAC Unit
$ �—' Fee Determined by Engineering
��/ Agreemer,t Necessary [ ] Not Necessary [ ]
B (J
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BIIII.DING PERMIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of ar.y
buildins 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 applicatio n
tt;erefore, require the payment by the applicant for such permit of fees to the ateount
herein below set forth•and in the manner herein provided to-xit:
Total Valuation
=1,.00 to �500.00
�50�.0o to az,000.00
Fees
�10.00 (Minimum Fee is a15.00) �'
$10.00 for the first �500 plus �1.50 for eaeh
additional �100 or fraction thereof� to and including
�2,000.
52�001.00 tc 525,OOO.QO �32•50 for the first a2�000 plus $6.00 for each
additional �1�000 or fraction thereof, to and
including �25,000.
�25�001.00 to a5C,000.00 5170.50 for the first $25,000 plus �4.50 for each
additional �1,000 or fraction thereof, to and
including �50,000.
550,001.00 to $100�000.00
�100,001.00 and up
�2R3.00 for the first
additional �1,000 or
includinE :100,000.
�50,000 plus $3.00 for each
fraction thereof, to and
�4?3.00 for the first a100,000 plus g2.50 for each
additional �1,000 or fraction thereof.
DRIVEiiAY DEPRESSION ESCROH
(Concrete CurC Streets Only)
Alterr.ate "A": Removal and replacement of curb and gutter only - DriveWay wi�th plus
6 feet timec $13•50
Alternate "B": Reaoval and replacement of curb and gutter and install a 3 foot wide
approach With 6 inch depth - Driveway uidth plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Pernits for construction xill be issued a mir+imum of 24 hours fro� thE time of
application to allow for proper revieu of the propose� structure and of the
construction site.
A Certificate of Survey of the lot, shoWing the location of the foundation once it
has been constructed will be required before proceeding r�ith the framing.
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CHIM�JEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined , �'
., ,
2. Is free from rust or deterioration , Y ��
3. Has no foreign ob jects lodged wi thi n �s`��� �
���
4. Is securely supported '
e �)
� 5. Meets all current Code requirements for size and
total BTU connected
6. Nas Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
��
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. �,e �� ��
/�
� ��C ���� �p
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No ( )
No()
No ( )
ao()
- ->
" Yes _ ��)1, No ( )
r�'�� � � /
Canpany �'�, �.,
��� � � ' ��j. �_! %%d' �r' ��
Signed By
i �,�,�3 h � � �
A��d �.
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e
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S/,3� C��-���,�e��.r a�
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FffAT lA6S CALLt1LAT101�1S DEPARTMENT OF INSPECTION
Weathentrips Gu�� . Conuruetion No.
W� ( Doori Refereaa Out. Qlaq lnt. WaU Ce�in� Rooi Floor Kiod
e o 19
Fl.� Room Len�th WideA Heiaht Fl.� Room � 1
Windows aad Door�—Cnckage and Area Windowi aad Doon--�n
tv�ain N•�sA� Ho. ot Llawl ft. An� w�a�e a.trse i�to.
Ne. ot wee et yane Il�ht• o[ enek �0. fl. 1�fo. ot �n� ot y�n� 11�I
_ � /v 2 ti 1 / J �
Ia6ltration
Gla�a
Esp. wall
'Net e�p. wnU �
Int. wall
Ceilin8
Floor
Total Btu.
Required aq. ft. ED.R. or sq. in�. WA. L.eader area T �
Fl.� Room Length Widch Heiehe �
- �/indowa aad Doors--Crackage aad Area
wiace Bet�At Ne. e! l.tn�a! !t. �ru
Na et oans o[ pa� IIrnN ot erack b. t�
� l
3�r �
Esp. wall
Net esp. wdl
ln� wall
nequ�rea ,q. r�. v.ic. ot p. m�. w.n. I.�:aaer area
Fl. R�om LeaQt6 Widtl:
Q/indows aad Doon�raek�Qe and Area
wlaen B•I�et No. et Llw. [l. I►na
1ie. et ysns et paas Urbt� �t araelc �a. (t.
�
.` Ia6ltration
8�11
vsY I
Glu� 0 �D
Etp. wall
Net e:p. waU ' /2
lnt. wall
c��rpg s O 6
Floor p
Total Btu. ,[
Requued sq. h. ED.R. or p. is�. WA. l.eader area
�
]o6ltratioa
Cdau
Esp. wall
Net ezp. wall
Int. wall
r
� �'`��--�
�
/�TCjy .��3�y/
�APOLLS. IY�Q�CV.
IaW�tioa
—,,.— liow
Width
�nd Area
npl tf. �rd
crack �a.ri.
Ceiling
Floor
Total Btn.
Required iq. ft. ED.R. or �q. ms. WA Leader area
Fl.I Room I 1.eaeth width
Windows and Doori--Cnckage and Atea
Io6ltritioa
C•iw
Esp. wall
Nlet e�. wdl
Int. wall
x�nired p. k. ED.R. or �q. ins. WA Leader area
F7. ' Room I Len�t6 �►i�l►
Window� and Doon�raeka�e aod Area
, wall
esp. wall
�
h. ED.R. er p, ia, al,A. (sader aiea
_�.
&u
.
suedecr PERMIT N __
City of Fridley � 13 9 2
' , AT THE TOP OF TME TWINS g � I L D I N G P E R M I T RECEIPT N.
�
,�
� ; L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � y��/
� _ �
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""'�"� ,'� 612-571-3450 910-F15 6/10/92 / /
JOB ADDRESS 5132 Clearview Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 18 6 Carlsvn's Summit Manor South Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Michael Ziegler 5132 Clearview Street NE 572-1890
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Sam�
d ARCHITECT OR DESIGNEH MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILAODRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Resi den ti..al
7 CLASS OF WORK
0 NEW � ADDITION ❑ ALTERATION f� REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Rexoo� Iiouse & �axage (22 Sc�uares� Tear�o��
9 CHANGE OF USE FROM TO
STI PU LATIONS
Underlayztient z�4ust compl� titith. the 5tate Building Code,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
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 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE fiEAD AND EXAMINED THIS APPLICATION �- STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL HE COMPLIED $1,166 .�`a SS
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29.00 Fire SC $�..I.%
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$30.75
SIGNATUiiEOFCONTRaCrOa AUTNORIZEDAG r �DA7Ei HEN RO L VA ID ED THIS IS YOUR PERMIT
' � -f�-9� - -,� �L� � --/� - � �
SiGNATURE OF pWNER iIF OW UILD IDATEI BLOG INSP �ATE
�w [ l
ADDN [ ]
�-�R [ l
Construction Address:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUP'LEXES R-1 AND R-Z
Building Permit Application
�
S� 32 C�P��'�/r� � .
Effective 3/ 1192
Lega1 Description:
Uwner Name & Addres.s: /rl��q����9��` .�'/,�Z. Cl,Priw��el. # ��2 ��la
Contractor:
Address:
MN LICENSE #
Tel. #
Attach to this application, a Celti�ficate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTiON OF IIIRPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Widt6 Hgt/Ground Sq. Ft. --�
OTHER: J� G�v� ���i-�a� �—f'Q . 7�a'�' l�
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard S�backs
Ty� of Constiuction: q,s��-t'� Estimat�i Cost: $ //��
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
.
DATE: � � � ° � � Z APPLICANT: �� �� Tel. # S- � 2 --� � f a
Permit Fee $ � �- �' ��
Fire Surcharge $ ,� ,� �/
State Surcharge $ � ��'
SAC Charge $
License Surcharge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ ���' ° �
STIPULATIONS:
�„TY USE ONLY
Fe� Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$7� per SAC Unit
$5.00 (State Licensed Residential Contra.ctors)
Alt. "A" or Alt. °B" Above
Fee Detemnined by Engineering
Agreemern N�essary ( ] Not Necessary [ ]
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 bnilding or structure, or for any alt�eration or repair to any e�sting
building or shvcture, 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
$10(?,QOl to $5�,000
$500,�1 to $1,000,�
$1,00(},001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 pins $2 for e�ach additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction ther�f, to and including $25,Q00
$252 for first $25,000 plus $6.50 for each additio�l $1,000
or fraction ther�f, tv and includiwg $50,000
$414.50 for first $50,000 plus $q�.50 for each additional
$1,000 or fraction the�eof, to aad including $100,000
$639.30 for first $1Q0,000 plus $3.50 for e�ch additional
$1,000 or fra�tion thereof, to aad including $500,000
$2039.50 for the first $500,�0 plus $3 for each additional
$1,000 or fra.cbion thereof, to and iacluding $1,000,000
$3539.50 for the first $1,�,000 plus $2 for �ch additional
$1,000 or fraction �thereof
DRIVEWAY DEPRESSION ESCROW
_ (Concrete Curb Slreets Only)
Alternate "A" : Removal and replacemem of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alternate "B" : Removal and replacement of curb and gutier and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet time.c $15.75.
VERIFICATION OF FOUNDATION
Permits for consiruction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the praposed siructure and of the construction site.
A Certificate of Survey of the lot, showiag the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE [: ` r� I� C1 �v YOUR E-MAIL ADDRESS
srrE AnD�ss s" I 3� C 1-z,� ��,e, _.,� ,� %�J c,
1'HIS APPLICANT IS: � OWNER
PROPERTY OWNER/ NpME: � �,�g ,�
�N`�T ADDRESS: S I 3'� e,� �p,r �- v CITY
PHONE:
CONTRACTOR
Permit No.: ° 4��� '� '�� � I
Received By:
Date Redd: � � � � � :
��� ��
SUBMIT A COPY OF STATE LICENSE # O� 3 NCf O EXP DATE 3" O
YOUR STATE LICENSE ADDRESS: I� S�v b c'1b � �Av � CTCY?� rc L� �t STATEWIKLIP S'S3ng
WITH APPLICATION pHONE i fe 3- �(�3 ^ C' f b o FAX 7 t,. 3- a11� 3-��i 3_3
PROPERTY TYPE
❑ TWO FAMILY/NEW CONSTRUCTION
PERMIT TYPE
0 BASEMENT FINISH 7.�OOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTI�R
O SWIAM�IWG POOL
TYPE OF WORK:
DESCRIBE WORK BEING DONE:�� :� �:«.e, t5 u-�i' o I�,
SIZE OF IMPROVEMENT
riuivBEx oF sQu�s o? s�'
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SmING
O Vinyl
❑ Aluminum
❑ Other
WINDOWS
IId FJQSTING OPENWGS ❑Yes ❑No
OR FOR NEW OPENIlVGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WW�W TO BE INSTALLED
LENGTH
0 HOUSE & GARAGE
❑ ATTACI-�D GARAGE
0 DETACI-�D GARAGE
OSoffit
❑ Trim
❑ Fascia
IACATION OF WINDOWS
NUMBER OF
HEIGHT
BASEMENT REMODELING SUBNIIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of strucwral members to lse used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
,ADDITIONS. & PORCHES SLBMIT:
I. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 199 U.B.0 F�E SCHEDULE)
TOTAL JOB VALUATION $ o2S� I.� i� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
� Erosion Control
� Patk Fee
Sewer Main Charge
Total Due
$ �"3 •2S� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ ol .� .001 times the total job valuation
$ �, 3� .0005 x Permit Valuation Minimum $.50
$ S.C`� U $5.00 (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21 =$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ _ l Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applicarion 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 re uir r�Ie and approval of plans.
SIGNATURE OF APPLICANT �/'��y PRINT NAME r« H/�'+ e 3�'� DATE �i a�'O b
Page 2- Building Residential Application
BiJILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, 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 FEES
$1 to $500 $23.50 (Minimum Fee is $23.50 plus surchazge)
$501 to $2,000 $23,50 for 1� $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fracrion, to and
includin $$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 includin $50,000
$50,001 to $100,000 $643.75 for 1�$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 $500,000
$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 includin $1,000,000
$1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certifica.te of Survey of the lot, showing the location of the existing founda.tion will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Depariment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977