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AF - 38611� City of Fridley, Minn. BUILDING PE�MIT nate: dune ]1, 1965 �o �r; Bob LeMeire �� E. 0. I+�ortenson Const. Co. �,y� 6521 Clo�rer Place N. E. A� 598 South Smi.th LOCATION OF BUILDING Na 6�2� stseet C].over Place N. E. p� ��t Lot _ Block Coraer Lot — Inside Lot Sewer IIevatian .� Addition or Sub-Divisi� Setback Sideyard Foundation IIevation ��s� '7857 To be Used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft Uu. Ft � Front Depth Height Sq. FL Cu. Ft " Zj►pe of Conatruction F�� Cost �l� ��• � — To be Completed � �torm damage repair In consdderation of the issuance to me of a permft to canstruct the building descrit�d above I agree to do the I�P� work in accrordance with the drescrlptton above set Porth and in campliance with efl provisions of orrlinances oP the dtq oP Fridley. � �-� ^� . ,� In c�deratton oP the payment of a fee oP � 10 •� , permit �ta hereby granted to E. 4. MortensoII �nstr. Co. to construct the buflding or addition as d�cribed above. This t is granted upon the expresa conclition that the person to whom it is granted and his agents, e�5nployees an worl�nen, in all work doae in, around and upon safd buildiug, or anypart thereo� shall conform in sII respecta to the or8inances of Fiidley� Bdinnesota regarding la:ation, conatruct%n� alteration, maiatensnce, rePair and moving of buflainge within the dty ]imfts and thia pernnitt may be revoked at any time upon violation of aas► oP the P�visions oE eaid ordinancea. Allen Jensen 8��8 �r n NOTICEs 11�s perm[t doa eot eerar ths comlraeli�, tmta0alton �er �rrMeO, plumbie9. On 6allee, aw�e m watsr. B� wn to ae� tln Boitdie9 i�ter ter s�P+►+ia P�emks 6or t6as ihnn. P APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME �[� ,� � .� / / � � �'Z � BIiILDER � [�. ��,�� ji/�i � � r� �nnx�ss�.�'� � � �o�� .c� �f Ann�ss �9'� �e� � �� %� LOCATION OF BUILDING No. Street Part of Lot � LOT BLOCK ADDITION OR SUBDIVISION Corner Lot Inside LOT Setback Side•Yard �_ SEi,1SER ELEVATION � FOURDATION ELEVi�t9°ION Applicant attach to thia form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPT�ION OF Bt1ILDING � �� ,��1f9 �r � To be us as : � � � / � � ,e J2 �,� �o � / O � ,� U �/� C�/�° �f z o� C.¢ �' �� ,��11��..��.�'ront DePt � eight Sq. Ft. Cu. Rt., Fraat Dept � Height, � Sq. FC. . Cu. Ft. Tqpe of Conetruction ' Estimated CDSC %� �9 � To be camdpleted The uaderaigned herebq makes appl�.cation for a permit for the work herein apecified, agreeing to do all work in strict accordance with the City of Fridley msdi�a�nces and rulings of the DeparCment of Buildinga, and hereby declares that a11 the facea and representations stated ia Chis application are true and correct. (Schedule of Fee Coats can be found on the Reverse Side). r'"� � � .s., � _ � HOTI.DING PER1�T ��'EE SCHF�LR.E SE�. The Inspector of Buildings�s'hall� before ieauing any permit for ehe erection of any building or atructure, or for any addition to any esfsting buiid- ing or atructure, or for any alterationa or repa3ra to any exietiag huilding or structure, upon application therefore, require the payment by the applicant for such permit of�fees to the amount heYein below set fotrth and in the m�naer herein_ provided to-wit: 2.1. For any such permit for the erection.of any fire,praof building, other than a garage, warehouae, factory or grain elevator, or for the erection of aay fire�proof.addition, for aimilar occupancq, to any existing building, shall be at the �tate of $1.40 for each one thousand cubic feet, or fract9.on thereof, in such cubical �ontenta. 2.2. " For aay such permit for the erectiou of any fire-proof gara�e, Warehouae, factory or graia elevator, or for the erection of anq fire-proof add3tion, for si.milar occupancq, to aay existing building eha11 b� at the rate of $1.25 for each oae thousand cubic feet, classified as "fireproof" by ��ection 502 of the Minneapolis Building Code. HOUSES � 2.3. For any such permit for the erection of any non•fireproof building, othe han a garage, werehouse, factory or grain elevator, or aay nau-fireproof addition, for similar occupancy, to any euisting building - permit $1.00 for each one thoueaad cubic feet. GARAGES �- _...___. 2.4. For aay such permit for the erection of any non-fireproof gar8ge, warehouse, factory or grain elevatoz, or for the erection of anq noa-fireproof addiCion� for s�Lmilar occupancy, to any existing building or for each such buildiag or addition - ninety cente ($0.90j for each one thousand cubic feet or fraction thereof, in the cubfcal contents t�ereof with the minimum of $4.00. For the purpose of camputing fees for building permits, the cubicaZ coaCents of any building or addition to a un3form beight throughout by multiplying the graund area covered from a point six (6) inches below the floor line of the basement or. cellar to Che average he3ght of the upper surface or to the average height of the roof aurface of the main gable of a pitched roof. ' 2.5. For regai.ra or alCerationa to an existing structare, the fee ahall be a he rate of $3.00 per each Five Hundred Dollars ($SQ0.00)-ar fraction thereof in the coet of all proposed work. 2.6. In no case ahall the fee charged for�any permit as aet forth in Section 2 be lese than $4.00, �"`` " , �1 e� � � �. � � 0 � � r 0 � ' 0 �� _ � �� O � � 0 W U H W � J F= � � �� d ., � � M� � � M � �� "$ � � 3'° � ° � ��d� � ~ � � M�� a '� � o ,� � �u�� a�� ea�;aa � � x � t° a; � ~M y 3 �'� � .� ��G � ��° a� � � �,3q y �� c �, " � � � � ��v � � �a °' v �' � � �� w ��O a � ��m I � ~ I � i � � 8 8 8 z3 �o �o �c cc+ � . : : g . ' g o � � � � � � � .�� ,� � � � Q a ��•� $ � i�i v � � � m , �� a�caa � � I � ► � �� `V � 1 I °� � �I I � � i� i � � � � � d � � � � � U y � I � � 0 � o o � e �� 1G :? E� W �1 �C I r► w g � g g g o :ri m �o c� � 0�0 : : � � . g � ti � � � � � � � � � � � �� o �� o�� "�a � � •� � � � � � �� a � �� Z a° z � a m 3 � ! I I � v► e i ri• g g � g 0 o ec co n ~ � � 67 M Ol O w � �, �� °� d x � � � � m � � � �x �� 0 N M � � �� w � O w 0 O 0 � � � aLI �1 f'0 � � � S 0 � P w � � � O d � � w � 7 � � o �� mW �, m � M M � � � a 0 '�O � � d � � � � � .� y�� V � � � � � � z �o � � I '� U � .� U � � J� ��t � �I ( F y� � M\ I � 1v � N M M 8 � O Lp�, � �O !d 1C � o � � � � �ill� � � I I I � . � � � �� .. �� a.. ��1 v ~ k Q G ��aa� �� 0o E� v v a w � � � �� o � � � � � � � � �,� � �°� G� � � � � � � 0 & 1� � , � ti 6 � i 0 � a � t < � W � •-� �v � � � � � � � i � w I � � � � J � .r � � � � �o � � �� R ;;.s� , , , . � , .. _ . . 0 f � • H��T L�SS ��.,aLC��llo�vs n►:E�,��z�r��f:r.�r ��i� �,�;�,�� _�-it�a; -- ��-_`�" .�.�� _ MINNFA�°ul.ls. t�tNN. --- -- ---- ---- --- -- - - --- -- ---- --- -- - — • �leatherstri s --- � A.S.H.V.E. ---- — -- __ ---_ _-_--- —_ -- -- - J—._� _ , P �� Construction Na. V I lnsulation _ . , Guide ','�ndc�we I Doors I Reference I Out. Wall Int. Wall Ceiling iio�f 1'loor _�'_ Itiind Hov✓ Applied a - - - �. es rlo Ye Nu i 9'_, ---- - , � _--�s i, EL� Ro;�rn ; L.ength �;- �X�idth :=-- '? Heiaht C� --FL� ! Td.�nm Len��h y�Jidth Height Windo.vs and Goors--Crackaqe and Area T � Windows and Doors—Crackage and Area � �Y�JUt FieigEt Ko. ot Llneal (t. Area � � VVldth t[night No. ot Llr.eal tt. Aree 10. of pa�e of PRne IIRhPa o[ crack aq Yc. p7o. of pane ot pane Ilghte of ctBek eC. (t. i � i�a � f, 1F, V, �_ _ I °�' ,. �, w , Q*; �.� + �. — -- � � ..' � ' ,—�i ; �`,� a _., � � � Coef. Btu —±-� ' `^ �' �O � Ur C�oef. D�V ln6lt��ation � , .�- F'' , � �; ; ,-� — a', , -� a°�, . a� � ,, . � P ------ — �y• Infiltration. ;, ,� ------ - (J�dSS , i y1f � , �M. . � c, � `� �j�837 T o ..- ,�' �� ^ �" . d - -- ----- �— i— —"'--_' .�—_' _ F.xp. wall � � G '� ;�" F.xp. wall ---- -- =-�- � - --- - - — -- .'Vet exp. wall— — --- — � '� � �'' ,,;, . �� `Net ezp. w;�ll -- ------- - Int. ea�all � u�►P. wall � ?�` � — ------------------�--- , �eiling r �' � . Ceilin$ ° Flcur ' r `7 ` ?. ` Floor `--- i Tutal �tu. . ^ �__ _. Total Btu. u � , Rrquired sq. ft. E.D.R. or sq. ina. W.A. L.�ader area y`� �� C� Required sq. ft. E.lp.l�T. or sq. ins. W.A. Leader area '�' FI.� -- —� Room � l.ength Width Z Height %� �ry.l I�oom � Length Width �feight Windows and Doors—Crackage and Area Win�3ows and Doors---Ceackage and Area Wldth Helght rio. o[ Llneal tt. Area WMth Heleht No. ot Llneal tt. AreB No. of pane o[ Dane Ilghte ot crack eq. tt. No. ot Fane ot pane IlBhte ot crack e4- tt. � _ .-� .�:� ;, p � L r r �l Inbltration Glaaa ---- - Exp. wall �i ' ��' � tiet exp, wall i Int. wall . . . ` l:eiling " Floor d s+ a - � a COEE. BtLL � �'; ��. � �, _._.� -r — � � i /� Infiltration !. . �` '� ' ; -x-- e.� `� .`° �i �:, �> Glass --- r� � � e�,� � �fA , • Ji s. �� i61, ..' .� � .=> � ' c1- f !.� � Tota! Bcu. --- __ . _-.� -- Required sq. ft. E.D.R. or �a. ine. W.A. Leader area i� � _ FI.l_` RcK;�� Length Width Height Windows and Dooss—C�ackage and Area Wldlh IIeIKht CIn. nf Idne�al t4 Arra ----� No. ot pane of panr Ilgbte ot rrack a!r - - -- -'--- � � �s � �../ T � �,.� � . �_.�.� �_" �' �� . � <F� "' .��__� ' fv+-, Coef.l Btu In6ltratioa Glaea � -- - - - F.xp. wall _ ._____._.__�__�._ __.... __ __ �_. ., Net e�p. wall Int. wall ____:.__._ l'eiling " Floor � � Total Btu. it�qwrrd aq. (t. F..D.R. at nq. ine. W.A. Lcader area Exp. wall - Net exp. wall ` lIIt. We�� Ceiling i Floor Total Bt�. Requirsd sq. ft. EL1.R. or A .r C� A' L -ft � � irss. W.A. L.cader area Fj.I R�am I Length Widlh Windowa $nd Uoors--Crad_kage and Are3 — T Vl'tAtn Hnlght Nu. ot Llnent fL Area No. I of aene of t�ene IIg1�tTot crneK ea. tt. '.�� Heigh¢ __ _1 __ _� Coef. Btu In6ltraeion Glass � � Exp. wall ,. ___ :__� ____ .�.----_._,.._��__ ____� � --- -------------- Nct �xp. wall — �- A VIM. wall Ceiling Flo�r 7�otal Bty. Required aq. ft�E^D,R. �r aq. ine. WA. Leader �rca SUBJECT City of Fridley AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r � � � �• COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. , _ " r ; " ; � , � t ��"1 � CITY HALI FRIOLE� 55432 NUb18ER RE�. �---�� '' 612-571-3450 s�aF�S JOB ADDRESS 6521 Clovex Place NE 1 LEGAL LOT NO. BLOCK TRACT OR ADOITION OESCR. 22 Clovex _ Le�� Addi.tion 2 PROPERTY OWNER MAIL ADDRESS David Linton 6521 Clover Place NE 3 CONTRACTOFi MAIL ADDRESS 5ame 4 ARCHITECT OR DESIGNER MAIL ADDHESS 5 ENGINEER MA►IADDRESS DATE I PAGE OF 5/4/92 / / ' 21317 R RLMA! � � '�= �VPROVED BV SEE ATTACHED SHEET 571-7431 ZIP PHONE UCENSE NO. Z�p PHONE LICENSE NO. ZIP PHONE LICENSE NO. 8 USE OF BUILDING Res identia,l 7 CLASS OF WOHK � N� p ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroo� Dwelling (24 Squaxes� 2nd Laye� 8 CHANGE QF USE FROM STI PU LATION S TO Roo�ing can b_e 2nd lay�. but nat 3x'cl. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZO� AUTHORI2ED 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. I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAL AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEF PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. _ TUR F CONTR T R OR UTHORIZED AGENT IDATEI r, 9 q � �% i G, � ,� �1�� \ �i ... __ .....� .��.., �.� u ncw� � � ATE� i' �. I STALLS IATION �1�2%2 AIT FEE $31.OQ CU. FT. OF LOAD �GAHAGES SURTAX Y e 6�i SAC CHARGE Fa.xe �C $1.27 TOTALFEE $32.91 D THIS IS YOUR PERMIT J�'�-iZ r�w [ ) �DN I l �-'�R [ l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Appli�ation Effective 3/ 1192 Construction Address: �.S`�� t � l o�e. ✓ f�1 Q C e. . Lega1 Description r°to2 �. C�(� r,�c� L�� ►� Ce d�� fr� Owner Name & Address: DGt �� Q w. ��Rc�� Tel. #�? I- 7� 3 1 Contractor: � � � � MN LICENSE # Address: Te2. � Attach to this application, a Certificate of Sun+ey of the lot, with the proposed conslruction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: �� E DESCRIPTION OF IlVIPROVEMENT Length i.ength Length e ��n� Width Height Width Height Width Hgt/Cn � � �� Corner Lot [] Inside Lot j] Ft. Yd S�back Type of Consiruction: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Sq. Ft. Sq. Ft. Sq. Ft. �,�-� Side Yard Se�backs Estimated Cost: $ /02 %� .° �' (Cost on Back) Ft x $ _ $ � ''1 DATE: � �y �' a- APPLICANT: W. TeI. # 5 7�-? y 3 � Permit Fee $ � /. � Q Fire Surchazge $ �� % State Surcharge S �, ` SAC Charge $ License Surcharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: $ ,�� . °i / CITY USE ONLY Fe� Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not N�essary [ ) BUII.DIN(i PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing germits for the ere�tion of any building or sbructure, or for a�► addition to any existing building or structure, or for any alteration or repair to any existing building or stiucture, u�n application therefore, require the paymeut by the applicant for such permit of fees to the amount herein l�low set forth and in the manner herein provided to-wit TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $2i,001 to $SO,Oi10 $50,001 to $100,000 $10(},001 to $SOO,OW $500,001 to $1,000,0� $1,000,001 and up FEES $15 (Minimum Fee is $15 �lus surcharge) $15 for first $500 plus $2 for each additional $100 or fiaction 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,Q00 $252 for first $25,000 plus �.50 for each additional $1,000 or fraction ther�f, to and including $50,000 $414.50 for first $50,� plus $4.50 for each additianal $1,Q00 or fracbion thereof, to and including $100,000 $639.50 for first $100,()00 plus $3.50 for each additional $1,(�l0 or fraction thereof, to aad including $500,000 $2Q39.50 for the first $500,000 plus $3 for each additi.onal $1,OQ0 or fraction thereof, to and including $1,�Q,000 $3539.5� for the first �1,�,000 plus $2 for each additional $1,000 or fraction �thereof DRIVEWAY DEPRESSION ESCROW _ (Concrete C�rb Stre�ets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 f�t times $13.50. Alternate "B" : Removal and replacement of cutb and gutter and install a 3 foot wide approa.ch with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for constin�ction will be issu� a minimum of 24 hours from the rime 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 l�ation of the foundation once it has it has been constructed will be required before proc,e�iing with the framing. ti rn rn c0 � c � � O > U � W Z O H F ; C'J � Z W U5 O Cu U � Q c7 Z � W I--� _� Q � � �z �z � � � Z [C O �U � `� � � [t Z �a Z. 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LAKE ST. MINNEAPOUS, MN 554Q&2998 6121824-2656 ; - %/r�% n� a�na�RCONOmoNn�c &rrlar Tbae7LinCitiea Si� /9.i0' ORSAT TEST RECORD 1072 PAYNE AVE. ST. PAUL, MN 55101-3892 s, Zn�2-Zaas ;.--- ADDRESS � �� .C�,�� ,� _ CITY; " �� OCCUPANT OWNER� /%.�/.Q �i7„C�•r� DATE HTG. INST. ��'—��INSTALLED BY ��/��y�j �� . GAS LINE BY �.SL/ S�/s� 1 TYPE OF HEAT: GA FA C�HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN MAKE ,�'��!� � MAKE MODEL �� O� C,.�p-�Li � MODEL SERIAL �7�� °3� ��' MAX. INRUT � c� � MAKE CONTROLS MODEL THERMOSTAT ( • HEAT PLUG VENT VALVE �l/� KINR °`? �'' �' '' ;'��r`,, CONVERSION °� � � �_ 1 , OF BURNER SIZE 7'� � OF LINER � �y�• SIZE NONE LIMIT_ _�...C�� DRAFT HOOD REGULATOR LIMIT SETTING �4C7 � CHIMNEY CONSTRUCTION FAN SETTI NG ��Ga�a�--�� , DRAFT �/�� S�'P� T EST TAG� ,S,�s�l� PILOT TYPE �� LIGHTIN6 TNST. �,,� ,7 PILOT MAKE PILOT MODEL PILOT TIMING PRESSURE " � S�� PERCENT COZ � ' % � DATE TESTED � /O -� � INPUT CFH � PERCENT 02 - � STACK TEMP.�PERCENT CQ � G',�� NAME OF TESTEP, � � ��- sue�etT P . City of Fridley 2 9 7 5 6 A7 TME TOP OF TME TWINS g � I L D I N� P E R M I T r ; � RECE . � ; v _ COMMUNITY DEVEIOPM�NT DIV. �y f � � � PROTECTIVE INSPECTION SEC. ��O � . . i.-_- w;/'�',.� CITY NALL FRIOLEr SS��Z NUMBEP REV DAT@ PAGE OF APVROVEO BY t �� 612-571-3450 910-Ft5 6/23/99 � � lOB ADORESS 6521 Clover Place NE t LEGAL LOT NO. BLOCK THACT OR AODITION SEE ATTACNED oesca. 22 Clover Leaf Addition SMEET 2 PROPERTY OWNEF MAIL ADDRQS$ 21P PMONE 571-7431 3 CONTRACTOF MAIL ADDRESS Z�P PMONE LICENSE NO First Choice Exteriors 2405 Annapolis Ln N Ste 240 Pl outh 55441 4266 4 AiiCHITECT OR DESIGNER MAIL ADDRESS ZIP PFIONE LICENSE NO. 5 ENGINEER MAII AOORE$S ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADOITION ❑ ALTERATIpN �x REPAIR O MOVE O FiEMOVE 8 DESCRIBE WORK Reroof house and gara e(25 S) Tear-off• Reside house and arage; Windows• Soffit & Fascia 9 CHAN(iE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. TYPEOfCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL. PLUMBING. MEATINCa. VENTIIATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. fT CU FT. AUTHORIZEO IS NOT COMMENCED V�!ITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO fOR A PERI00 OF 120 DAYS A7 ANV 71ME AFTER WORK IS COMMENCED NO OWLG. UNITS OiFSTREET PARKING I HEREBY CERTIfV THAT I HAVE READ ANO ExAMIN�O TMIS APPLICATION STAILS GAFAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISION$ OF LAWS yALUATION SURTAX AND OROINANCES GOVERNING TMIS TYPE OF WORK WI�L flE COMPLIEO r WITH WMETHER SPECIFIEO HEREIN OR NOT. TME GRANTING OF A PERMIT 42 085 21 .O4' DOES N07 PRESUME TO GIVE AUTMORITY TO VIOLATE Ofi CANCEL TME pEqMl7 FEE SAC CMARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- STqy CTION OR THE PERfORMANCE Of CONSTRUCTION $573.05 Fire sc $42.�8 ��„ `o^ �� PLAN CMECK FEE TOTA� FEE �� vr License SC $5 0 $641.17 S�GN4TUpE0� �AACiQFOAAUINOAl2EDAGENT �DATEi WI�EN PROPEC�!/' OATED 7M1S IS YO 6;�/ �C y Y / � l p � �� S�GNnTUAEO�OWNEp��O�NNEpBWLOEN� �D�iEi � G �NSp - � ��E �[ ] ADDN ALTER �� [l Construction Address: Legal Description: Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 /(p BUII,DING PERNIIT APPLICATION �� J n� �� 1 e c, o� @ � r�d ► a�w � Y 32 ��J� Owner Name & Addressn�� '.�() �JC��' �� r, `�iP� /�'�/(� 4'i SY 32^ Tel. #�j� �� 3� Contractor: �< r� C � rP �t� C�r � v � S MN LICENSE #�� Address: �tD�i � � Gcnc�� 5 � . �/ ��►'�`�P � YL� I� �✓Hv�� Tel # ��3''%� 1 � e Attach to this application, a Certificate of Survey of the lot, with the proposed. construction drawn on it to scale. DESCRIPTION OF IlV�ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECB AREA: Lengt� Width Hgt/Ground Sq. Ft. oT'i�R: -� /�C� � �� `s � �� -�cs '� �j �� //�'� 'e � � lNiJaL�� Construcrion T � ° � Estimated Cost: $ �� ,, — f Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �a �- APPLICANT: � p,4� Tel. #�3 ' 1�( f�3 Permit Fee Fire Surcharge 5tate Siircharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIOIV5: ��/�� CITY U5E ONLY � ��. �� U /�- �� / $ � �. �_� Fee Schedule on Reverse Side � �, ,� $ �,�. �� .001 of Permit Valuation (1/lOth%) � $ �d . � � $.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 [ J Not Necessary [] �.. , t . BUII..DING PERNIIT FEE SCHEDULE The Chief Building OfFcial shall, hefore 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,�0 $25,001 to $50,(�0 $50,001 to $100,�0 $100,001 to $500,(�0 $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 $SO,Q00 $643.75 for first $50,(�0 plus $7.00 for each addidonal $1,000 or fraction thereof, to and including $100,000 $993.75 for first $1�,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 fracrion 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 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. 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. a :::s - m.�'� z;;-a'�1 i3 --ce� .:;:.-� r �'- . .-. � . ..a.�- _-.r .y�._.,'s� 'i.'� �`:.�; '�R"t+f�jcj^�� ) 5';a�.�,+k'� �,r:,. _ _ �; �� ,. - - . . � - .. �A ... . - ,� . . .. � .,. � `° 1 � n�i 1� � NI I � � 1 O O O N � c � 7 C � a� � U � W H � � W a �0 z V � U LI" N � � G � Z Q � Z m � J a � � LL Z O F= V J a a a � Z O U W � a W Z Z a� W Q � J � 0 y � � � Z u. c�v "O � � M �C�OIi � � w \ ` � � m 0 � J H O �-- w H � C .� N L Y 3 d � w � n. W w c 0 � a �o N Y G .o d a� s N C .� d 'o C 7 m � � � .� �I C_' • % v � � � � d h � 01 C m �_- � � H � w a � � � N U a�i � N W � � `� � 1 �\ ' ''�G � Q d � � U C9 Z m � � J a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0 0 r: sr ui r� � i: ti o i: o 0 0 �ci �� Z I I I I I I I I I� I I I 0 - z v N } .� � � � `� .� LL � U � c � c �II � � � � F Q m � � x Z m c �o �� W , > � • d � � pj C '� C ` .� ;� .m .N f a OD `� n� m�� H 2 2 �� N j,L �- C] 0 � � ►_ � � � � LL � � �� V C� r�.. m rN � 0 Y � J N . � � � � �l0 � f0 �C l9 � � � � a ZOmmU�v��C�(9m � � � vJ _/ w ta o � Z � c H � w m 0 � T t Of 7 � � m m W > Z a c� f� Q � � O � H J Q � � Z � Q � � a Q = W `o O � � � m Z o V- ¢ 7 C � (p o > aO o \ C � �.' Q � � � � � J Of � � U O � � m c�''o !� 0 L1J 0 � Y Q m Z O O z F- z > Z � O U Q cc w J m H 0 Q Q O � z 0 U w � U � � � w a 0 W 0 � � a w m J Q 2 � � Q Z 0 � � m 0 U _ CIlYOF FRtDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSTfY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 October 2, 2000 Dave Linton 6521 Clover Place NE Fridley� MN 55432 Re: Final Inspection at 6521 Clover Place NE Contractor: KCJ-Mr. Rooter Dear Mr. Linton: A plumbing permit was issued on April 11, 2000, for the above noted address, to install a gas water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVE,�ENSEN BuilcJ�+�lg Inspector