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AF - 38658� � Village oi Fridley, 1Vlinn. � `� �� BUILDING PERMIT �� - � �_ Date: . ..�. �. .. �. .�.'� . .. .. ..... .. .... Owner . . a . . . . . . . . . . . . . . � � �� Builder . . . . . . . . . . . . . . �� `�� .. . Address s`�. lP. �?. . .� �. .� . . . . . . . . . . . Address . . . . ��. �.�,��?;��`'� . LOCATION OF BUILDING No. l.� �?. .�.�. Street . ��-�. . . . . ' . . .. . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . .. . . . . . Lot ! � . . Block . . . . . . . . . . . . . . . . . . Addition or Sub-Division . ��°s��!�. . . . . . . . . . . . . . . . . . � Corner Lot . . . . . . . . . . . Inside Lot . .`�. . . . . . . Setback .��, . . . Sideyard ! l�'./ . . . . . ��o� �� % DESCRIPTION OF BU[LDING To be Use�� . � . /� �� . ��: t�:l : . ?'� . Front . . /. . � Depth .� . . . . . Height,� � �� Sq. Ft. � �"' ` �Cu. Ft. . . . . . . . . '1 ��, g� 1� i G�� : ��:f�`"� F ont . �?: .'". Depth �' � . Height . . Sq. Ft. . . .�?� Cu. Ft . . . . . . . . . '��. . . . � 0� / ype of Construction . . . . �:�'�� . . . . . Est. Cost . �. .��' . ��. . . . . . . . To be Completed . . . (�. . . . . . . . . . . �� Z � �� = /� � ��' In consideration of the issuance to me of a permit to construct the building described above, I agree to da the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. �� - �3:� . .. �„�. .�t :�? . .. .. . .. .. . .... ' . , In consideration of the paymeni of a fee of $..��., permit is hereby granted to ...��'.�4`�:`��. ......................... 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 worl�en, in all work done in, around and upon said building, or any part thereof, sha11 conform in a11 respects to the ordinances of Fridley, 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. n �-' NOTICE: This permit Joes not cover fhe construction, ins�l�,i,4ioec� or ai4eration fo� wiring, sewer or wa4er. Be sure to see the Building Inspector for separate Ae�mits fo� these � - _, �, � . Rfl<iP'�°'_i.:s�ll. � � '�„�h�'��.. , �. � 1�/ � � Y �� iR� � � �— -.�� . � �� a . �.. �,ti �:. .�w :�� .� , ,, oy � � n n � � � ' ' � �, �� -�:!e�-�, � �, �= �� C � Ot C � � � > � �� t�� _� �� ! �. � � �� i m � o � � � � W � N W � J !"� � d p�, �' � a � � d � � �� M ��V � ��3�� w � o'� o��°� �� a c�uH� '� ay � A�'aa �� M y 3 0 ;c w $�`G .�,c'� � � �y � q A y �f.' d O i� �" �„� � � � ��°� a�, �'y�a, � ��:: w L�,� p U �� I � � ; I � ( � � � � 8 8 8 3 �o m � � � : : g . . g .� S � � w � � � a a �� PG w � ��o�� waa � � � � � � � W � � a ,��aaa� � � a� .. 1 , a� b �� I � � �I � � I I � � � � � � i 00 � e '� i � ! � o � � � � � �) 0 «! » » 8 � 8 8 8 �:�mm� � H� : : � S ' $ � � : « � � g � � � � � ' d �� d � ��°�� .�aa � � .� � � � a � � �� a� � .fd � � .� F W � x a° �� . z ; � i� � a i i � I ° o�a i U 3 � � «+ 'd w O I I I I I ' I � � � � $ 8 � 8 a o oe co � M � � t�7 tt7 w S � �s �, �a s� N x� u � � � � � � � � o v� x A�� 0 N M WW � � w � O w O O A � � . I� � z �( � � B � �e t� � � I � 8 � � � w �fn '� L� � � ti� �� 3� �� M � � ' 0 � a 0 b � �� OaC � � 0 � p� . �� N� � � �' � � � I � •� U .� U E+ (%� O � � .� �� ( �! o °� `� H ,� o � ,�,� N M N � g � � . � � o'� � � �� n � • �� ' �� w . . �� «� ��s Q~ � a � v M� �� M � � ��e� o� � v v � � �� o � � � � � � � � �I � w � � � � � � � � 0 � � � � � � � � � W i 0 � M � t t � W � ��t . w r � � 6.� ... i . . � � '� �' c . i�� • ' � a ,�.. .� , - y � � . ,. . . . � � Qt ,• �� _.. _._. .�i� r' , ; , � ' r. � . . � � �,� . HEAT LOSS CALIi.iLA'CYOh!S [)EI'AR"1'R1E �T O� II�?;�s�I:C:�f':O�' ��MIN�J�HLa�::°MIMN. \�'eath�rst►i a � A'.�.E�.��.�. ' I`�� Insulation p II Construct�on c�. Guide `_ iVindows Doors ReEercnce � Out. Wall Int. �`�all t'eilin� C2oof Flour i Kind How Applied ��Ps—r�� I Y�S-=r�� ;� ��--. i ^ — :__ - = —_- ---_ _ . -:- -__- _--' '- - — _— —�-- �� __�--! -- —� —_ _—. � ! 1�1.� I��H>�� j L�•n�tk�� fr -1�lirlih �, I leight�'- ' f�L� f�oom l.englh i1�/idth He�ght , _ : _ _..__ _� ---- W�ndo�vs an�i U-�oro l:rackegr an�l r'1rra Windows and Uoors-Crackage and Area \Yidth Hrlgr.t rvo, t Llnesl (t. dree ^ �6'lath Fielglit No. uL Llneal tL Area No. nt paue ot �ane liqnt� oC crac k Tsq. tt. Nu. ot ana o[ ur.r If hte of cr6ck Bp. IC• - �_L_�_�_—� �.� �(:oef. 1n61tralion °'. �'•, �� r. - - - — --- --- - ----- - - = --�- _ -- - -- Glass �� Exp, wall � .,�', r-'r -- ---' � !',fet exp. wall �----�-• ,�;° ---+, r, � Int. wall + eihng --- ---- ' • f-1 ou � . - .____. �fota� Btu. � F�equired sq. @t. F.[3.F2. ar sq. ins. W.A. Leader area F1.� �--- --- --- 6�oom � Lengeh ' �'idth Windows anc� dloors—Crackage and Are� Width }iel ht No. pI 1Jneal !L Area Nn. o( pane u[ D9no Ilghte of crBCk sq. tt. B '1 i -- — — % � e fi S � f � � .0 � . 1n61trati�n � ^ Glaes + � Exp. wall � '' �._ �'Vel exp. w�,ll -------- ,�. , Int. wall . "�—^ ;� P 'f '� f 4 :�, �� ..� _, ��, �I�� : I !our '-- , _ " Total Btu. - .�. _ Rrqwrrd sq_�t. E.D f3. cr aq_ina` W.fV._I�r,�Jer are; F11_ ------ t��m I Leneth Width -- '171'�ndowe and I)ours l.iackage and Ar� � -�-- N��a1n ►ln�gi;i- �No. or I.�os$! GL�. No. 1 0( pane � of ��nnr r Ilgt�t� n[ rre< k a.� It Infilt►ati�n Glasa i IExp. wall � Ncl �x�i. wall `-- -- Int. wall -�-�_-_. C.eiling ------ ------ I loor ^ i�.`Id� �tU. `� �equired aq. ft. E.D.R. or t Btu _� '� �,a .:'. + ��; �9 ---�,� =- o , t' :: Hz;gh� Coef. Btu c� ^ ' �;1 .�! � ,7 6 4 :.P, ' ( , ('�� 1 �. -�-- -F�-►. i {eight ^ r s`� �,rl �' -�o 1 �. � u r � i (' , Coef. Btu ins. W.A. L.eader area � � � �� . " '� .. �r_-� � , " - �� ` ,,, _ , � ----� _- - , In6ltratio r A � - } �, ' • °+ -- -..- _--i---- =- -- --- (',la;,� - —� .- r �- --w . p ' Ea��. wall �-- .-�°° __ - --- � !'�e[ ex�. wall ---- r � � ry---r- Int. wall °�- ; ,,� Ceiling ------ ---- -�-� ---- -- F'toor �_--------- — Tota► Bt�a. FLequirecl sc7, ft. E.D.R. or sq. ins. W.A. l.eadec area Fl.I Room I Length Width �'6ndows and Uoors—Crackage and Area � No. uf c� A o[ pane llahta oif crack�l ec;� tt. ln6lUalion _ Glass Fa},. v.d�� Idet esp. wall � Int. walt Ceiling ----- -- �Ioor_ '___ Tora�.l 1��u. ^Fiequiecd �y. it. E�..Li.l�. nr �q. ine. VN.Q►. l.tader araa -- -Fl � ---- Ruo�r� l l.englh Width, IY °�^ -"° Windows an�i i7uora--'�rac:kage and Arza � R'Idth Halght �No. ct Llz.cal !:. Aree �^Nu._I oI pane _ oP Trr.a � IlgAle o[ crerk sa tt- � ---l---l---- — co�F Infiltralion � � Glasa--- J- — — Ex�,. �tiall -------- — � Net exp. wall �nt. wall ---- Y.. ' l`�ilinR F�unr ' Total �tu. Required aq. ft. E.D.R. or aq. ine. WA. Leade� area Btu Heigh�► l �eibl� r � Btu HOUSE HEA�ING TEST RECORD ADDRESS � � � �� L � � � � �� APT. FLOOR CITY SUBURB �} � � /� � OCCUPANT � OWNER � � s HEAT LOSS DAT HT� ST. GAS CO. METER BADGE SOLD BY �� 1' �� INSTALLED BY o� Eleetrical Work By Gaa Line By �� TYPE OF HEAT GA FA =� HW STEAM SPACE HTR. UNIT H�R. OTHER � dGAS DESIGN CONVERSION MAKE ?' S l�F" MAKE OF BURNER Model � �/'3� �/ Model ' Serial � � � �- � ` � � Max. BTU Rating INPUT �� e°� MAKE OF FURNACE Model CONTROLS �,�� THERAA05T T P�d 4 Heat Plug Vent Size Valve �� KIND OF LINER �% ��-9� SIZE�NONE Limit �'� �D �� Draft Hood � �=+-> � Regulator �� Limit SeHing —T�� Fi Iters Size Q��%1 �%> Mumber �. Fan Setting � G tt' `f Z� Chimney Location Inside � Outaide Pilot Type Chimney Construetion � � Pilot Make � ° �-A � Pilot Model Smoke Bomb Wiring �� Pilot Timing ��- � Draft Test Tag � L.W. Cut Off �� Door Pressure Lighting Inst. � Pressura Pereent CO2 Date Tssted � a � Input CFH L e� � Pereent O �� Company Testing 2 C P e Staek Temp. �`� c Percent CO _ �� ° Name of Tsster Form 235 sue�ecT pE City of Fridley o i 9 9 4 5 ' ` AT THE TOP OF THE TNlINS g U i L D I N G P E R M I T R EIPT NO. � � `y ______ COMMUNITY DEVELOPMENT DIV. f � � PROTECTIVE INSPECTION SEC. 3a (�� _ � ' �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""� � ,�� 612-571-3450 910-F15 6/12/89 / / JOB ADDRESS 6578 Clover Place N.E. 1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �-4 CI.OVPrY' Lea� Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE John Atkinson 6578 CloSrer Place N.E. 574-1153 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDHESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residenti.al 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (2� Squares) 8 CHANGEOFUSEFROM TO STIPULATIONS Roo£ can he 2nd layer b.ut not 3rd. Install ridged galvanized valleys. t�ew m�� ot {�ar=oi�s and replace�►�nt �o'i�, On ali ers of 15 Ib. ie1t, State Code requires that 2�aY ��t 2,� inches mopped together, be installeor ��e � �f �� up from exterior wa11 1ine, approved underlayment membrane. SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCV LOAD VENTILATING OH AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. 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 8E COMPUEO $1,450 �`.�T3 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $35.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKfEE TOTALFEE $35.73 SIGNATUREOFCONiRACTORORAUTHORIZEDAGENT �DaTEi �� WHEN PROPERIY ALIDATED THIS IS YOUR PERMIT SiGNATURE OF OWNEP iIF OWNER BUILDERi IDATEI BLDG iNSP � � � Ol+T � [l � [ ] �T� [ ) R-1 AND R-2 Building Permit Application Effective 5/1/88 Constniction Address: if� �� ',,�'�,`'�i`'' �^� �,�!"� : � Legal Description: Owner Name & Addre.ss : �� Q �h ��' ��-� �°:� A �� r� P� ' '�` �:� � �.?;;� � °� r � � � Z�el . # ��'"�'m„� �-=��' Contractor: �. # Address: Attach to this application, a Certificate of Suzvey of the lat, with the piro�osed oonstruction drawn ari it to scale. Ei�sr�+; �JW •;� •)� �„��.��i�.,i�,� LTVII� AR�: Lerigth Width Height Sq. F't. CAZt�GE AR�: I,ength Width Height Sq. F't. D�C[c AREA: I.ength Width Hgt/Ground Sq. Ft. o�t: � � �� n�� SGi�+t�t � Corner Iot [] Inside Ivt [] Ft. Yd Setback Side Yard , Setbacks , Type of Canskruction: � .�y�i �� Estimated Cbst: $ E: �," _ � �,, --E�.. �,- Approx. C�pletion Date: / ��tl Propo�ed Driveway Width If New Openir�g Is Desired: Ft, $ $ Width + 6' See Back Page IaAZ�: APPLICANT: �. # ��'�++; t Fee State Surcharge SAC Ct�arge Driv�way Esc�.�„i Fark Fee Sewex' Main Criarge • V• .�'1��$ : $ �. d� $ �� e � � CITY UBE �iII,Y Fee Schedule on R�everse Side $.5o/Sl,000 valuation $575 per SAC Unit Alt. nA" OY' Alt. nBn 1�bOV2 Fee Determined bY �ngineering Agr�ee�aertt Neoessaxy [ ] Nat Nec�ssaty [ ] a I � �� .SG c,� �� / J'',p�1 t.� �� ::�1� � �,_ �:�;�Y�4 :�:�: : �:i�+� �� The Qzief Builcling Offici.al shall, before issuing �*�+�;ts for the erec.�tion of any �; � ding or stn�re, -or for arry addition tA any existir�g building or structurn, or for any alteration or repair to any existir�g building or structure, upon application therefore, require the paymer►t by tt�e applicant for suc3� permit of fees to the amaunt iierein belaw set forth ani in the marvier herein prwided to-wit: Z�0►I'AL 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 �+a. $15 (Mini�nn Fee is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fractio� theteof, to airl including $2,000 $45 for first $2,000 plus $9 for each additional $1,000 or frackiari thereof, t� ar�d iricluding $25, 000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to ar�d including $50,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to arid iuicluding $100,000 $639.50 for fizst $100,000 plus $3.50 for eac� additional $1, 000 or fraction thereof, t.o arid includirig $500, 000 � $500,001 t� $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction th�reof, to and includirig $1,000,000 $1,000,001 arid up $�539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof � D�tIVL�iY L�PRESSI�T ffiQiOW (Caa�crete�Curb°Streets On1Y) Alternate ��A�� ; Re�naval arrc� replac�rnnt of curb and gutter only - Driveway width plus � 6 feet times $13.50. Altetnats ��g�� ; R,e2noval ar�d repla�znent of cutb arid gutter and install a 3 foot wide approach with 6 inc3� depth - Driveway width plus 6 feet tiu�es $15.75. Pern�its for c�ru�.iaaz application to allcw f construction site. •)' -•�u r� • r, wi].1 be issued a m�*+��m+ of 24 hours fraon the time of or praper Yeview of the praposed stn�re ar�d of the A Dertificate of S�zvey of tl�e lot, showing the locatian of the frnu�dation orx;e it has it has been constYUCt.ed will be required before proveeding with the framing. �, sue�ecl IT N O. City of Fridley � �. � �� 6 AT THE TOP OF THE TWINS B� I L D I N G P E R M I T r � � RECEIPT NO. � ; y ___�_ COMMUNITY OEVELOPMENT OIV r � � PROTECTIVE INSPECTION SEC � 7(��i � � � � � , � �� CITV HA�L FRIDLEv 55032 NUMBER AEV OnTE PAGE OF APPROVED BY �"'"� � �'' 612-571-3450 9�0-F15 3/27/97 � � JOB ADDRESS 6578 Clover Place NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],/{ Clover Leaf Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Atkinson 6578 Clover Place NE 574-1153 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO Minnesota Exteriors Inc 8600 Jefferson Hwy, Osseo, MN 55369 391-5514 2877 0 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION �7 REPAIR ❑ MOVE O REMOVE B OESCRIBE WORK Soffit/Fascia/Gutters 9 CHANGE OF USE FROM TO STIPULATIONS SEPAqATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV 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 60 DAYS, OR IF CONSTfiUCTION OF WORK IS SUSPENDED OR ABANOONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WOHK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `P4aOOO �Z.00 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMIT fEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $87 � 25 Fire SC ��F. OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FE TOTA� FEE License C $ .00 $98.25 SIGNATUREOFCON'AACTORORAUTMOAIZEDAGENT �DATE� N P RLY V IDATED TMIS IS YOUR PERMIT . • 3- - SiGNATUREOFOWNEAi�FOWNERBU�LDER� IDATEI p ip qaTE NEW ADDN ALTER [l [] [� ConstrucdonAddress: Legal Description: Owner Name & Address: Contractor: / Address: �/�/f%)�.� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R 1 AND R-2 BUILDING PERMIT APPLICATION Effecrive 1 / 1 /97 r� / Tel. # J�� ;�,�� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type. �-� Estimated Cost: $� - � (Fee Schedule n Back) Driveway Curb Cut Width Needed: _ Ft. + 6 Ft = Ft x$ _$ DATE: `� �' APPLICANT: n Tel. # ��T Permit Fee Fire Surcharge s�� s��nazge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � ��. �� $ - G� $ �- �� $ $ � � $ $ $ $ $ � �� CITY USE ONLY Fee Schedule on Reverse Side �1 of Permit Valuation (1/lOth%) $.so/$1,0(}0 valuation $950 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 [ ] .� � ._ � BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the paymern 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 $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up �� $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction tliereof, to and i�cludiag $25,Q00 ., . $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for fust $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $1Q0;000 $887.25 for first $1�,000 plus $5.00 for each additional $1,D00 or fraction thereof,.to and including $500,000 $2887.25 for the first $500;000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,0�,000 $5012.25 for the first $1,000,�0 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (�oncrete �rb Stree�.s Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once tt has it has been constructed a�ill he required hefore Proceeding with the framing_ sue�ecT PERMIT NO. City of Fridley 2 6 91 � AT THE TOP OF TFIE TININS g U I L D I N G P E R M I T � � � COMMUNITY DEVELOPMENT DIV. R�EI�� O. iLy �� / f � � PROTECTIVE INSPECTION SEC. �� j � `-_-- w ��,.� CITY HALL FRIDLE� SS032 NUMBER REV DATE PAGE OF APPqOVED BY L J� 612-571-3450 910-F15 7/30/98 / / JOB ADDRESS 6578 Clover Pl 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 14 Clover Leaf Addition SNEET 2 PROPERTY OWNER MAIL ADDRESS tIP PMONE John Atkinson 3 CONTRACTOR MAIL ADORES3 ZIP PNONE LICENSE NO. Halek Roofin _ d ARCMITECT OR DESIGNER MAIL ADORESS ZIP PHONE IICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADOITION O ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOHK R roof ho se n 9 CHANOEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATINf3, �PE OF CONST. OCCUPANCV (iROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONING SQ. fT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTpUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION STAIIS GAFiAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING OF A PERMIT 3 2O 1. 17 DOES NO SUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CMARGE PROV NS O ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST CTION THE P RFORMANCE OF CONSTRUCTION F�Y'2 SC Z.3�F PLAN CHECK FEE TOTAI. FE — c�.9'�' SIGNATUR OF CONiRACTOR OR AUTMORIZED AGENT IDATEI P OPER IDATEO TN S VOUR PEFMIT .-r r � �' S�GNATU�iE OF pWNEQ i�F OWNER BUILDER� IOATE� BLO �NSP f�6TE NEOV ADDN ALTER [] [] �] ConstructionAddress : CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION Effective 1/1/98 �� b�� Legal Description: � Owner Name & Address: �p h v� j� �� t �• � C� Y� Tel. #� Contractor -� f'} �� G lC � o� F t MN LICENSE #�� f� Address: �o Z 5 � ��+- ��- �L • Tel. # .S 3 S �- ��.3 S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. �� LIVING AREA: Length GARAGE AREAs DECK AREA: OT'HER: DESCRIPTION OF IlVIPROVEMENT Width Height Length Width Height Length Width � Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. ��. S� . Construction Type�� Estimated Cost: $ r--- °� � 3� +��? �(Fee Schedule on Back) Driveway Curb Cut Width Needed: F� 6 Ft = Ft x$ _$ � DATE: 7 ^ �d�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ % �/� 7 5 $ �a 3�( $ •I7 $ $ �' - � C� $ $ , � CITY USE ONLY Fee Schedule on Reverse Side Tel. # .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.� Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL S'TIPULATIONS: , $ �3�� BUII.,DING PERMIT FEE SCHEDULE The Chief Building O�cial shall, before issuing permits for the erection of any buildino 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 apgli�ant for such pemut 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 $5(�,001 to $1,000,000 $1,0(�,001 and up FEES $21 (Minim�tm �ee � is $21 plus surcha'rge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 � $62.25 for first $2,000 plus $12.50 for each additional $1,�?0 or fraction thereof, to and including $25,0� $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 � . ��, $887.25 for first $100,Q00 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1, 000 or fraction thereof, to' and including $1,000, 000 ' $5012.25 for the first $1,000,000 plus $2.75 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 $13.50. Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed 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. r U � � ? 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N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 August 16, 2002 Mr. John Atkinson 6578 Clover Place NE Fridley, MN 55432 Re: Final Inspection at 6578 Clover Place NE Contractor: Fignar Plumbing Co. Dear Mr. Atkinson: A plumbing permit was issued on Ju1y 16, 2002 to install a water heater and three plumbing fixtures at your address. A final inspecdon, conducted on July 16, 2002, noted the following correction that must be completed and a reinspection called for according to Section 4715.2800 of the State Plumbing Code: Provide combustion air to the water heater, a minimum of 10 feet from any other vent. The pernut fee that was paid covers the inspection to make sure the work was completed according to the Codes. Please contact us to set up the reinspection so we can final out the permit. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh o �' N .-i � � c- �� . C' o. . �w..�� V � w .. 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(. ) oN.kr) sa,� :;, �pa�fnbaa aa�y�u► paddo�sa� pue pa}�oddns �(#aan�as si pue ..4: _� �� 'suo�ru�sqo `�ao�}��ou��ap `}s►'i:r wa� aa�} si pue �auiw�ka uaa�'s�y 6u�uan :;-.. . � =; . ' a4� le� sa�uan i(qa.i2y pau5is.aapun ay� ` - . . ua4M _ ' _: �� : : ► : : i�� _ri� ��; :• �� / � ��riri� a3Ntl(113�! 38 ��IM N011b�l�dd�d 3Hl ?JO S3�Mdl�dd`d JNIN2�f18 �3t1� JNl�tild32! N3HM NI a3l�l� 391Sf1W M0�38 3H1 .. 1082 Payne Ave. St. Paul, MN 55101 651 /772-2449 G�►S d110RK ORDER STANDARD b HEATING � 410 W. Lake St. Minneapolis, MN 55408 612/824-2656 & AIR CONDITIONING A Blue Do�: Service Co. EQUIPMENT INFORMATION LAST � �'/ fW �4 � FIRST TYPE �� ADDRESS ��%� �� ' � � � � °� MAKE �' - f'��"�� CITY `'� �' l� 1�� ZIP `�.�� MODEL`�S"�,,�t�v�3G�(� HM PH� � � � � i`' �"�.��WK PH SERIAL `��v � �- d ;� a �� TECH �'��'� �+ � �' � DATE ; M � '�" �' '� INPUT �`� ' � � � f � CO2 (�e S % 02 �� ,S� % CO � % NET STACK TEMP ORSAT TEST RECORD METERED INPUT�rj�,,� �� Cf�1_ CHIMNEY TYPE LIMIT SETTING �_� ° FLUE SIZE PILOT OUTAGE � sec CONNECTOR SIZE ? � TOTAL CHIMNEY INPUT �� in. � in. ��a� btuh ` �- � CIIYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 • FAX (763) 571-1287 • TTD/it'Y (763) 572-3534 I`lovember 21, 2005 Mr. 8� Mrs. John Atkinson - 6578 Clover Place Fridley, MI`i 55l+32 � Subjec� Glover Place Dear Property Owner. PW05-060 This summer, dirt material was placed without a°Land Alteration Perrnit° from the City on 6578 Clover Place. I am sending this notice to the 6568, 6578 and 6588 properties on Clover Place. City Code requires a permit and a grading plan to review current drainage patterns. Please remove ALL material and restore the disturbed area to prevent erosion onto adjacent properties and the City's storm sewer. lf the work is not completed by December l, 2005, the issue will be tumed over to the Code Enforcement office for resolution. Code Enforcement has the authority to write citations. In 5 years with the City, 1 have always been able to resolve land disturbance issues with properiy owners without citations. If you cannot meet the deadline, please call me to discuss the matter at 763-572- 3551. Sincerely, ,•;•e�� , Layne Otteson PE Assistant Director of Public Works � � Building pI,UMBING Permit No.� � p Inspe�tions RESIDENTIAL APPLICATION Received By: � 763-572-3604 CITY OF FRIDLEY �ate xec'd: ��; �'�� DATE�(�� YOUR E-MAIL ADDRESS � SITE ADDRESS �f THIS APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY N,e,r,�: � .� L g • OWNER/ TENANT �D�S' CITY STATE zrn PHONE: CONTRACTOR Nq�: �j��r��Lu�ib/a�t SUBMTT A COPY OF STATE LICENSE # � EXP DATE YOUR STATE ADDRESS:�'�o� °� ��eN �'t7L !'i19� CITY_(�i�i°� STATE�ZIP LICENSE WITH pHONE FAX APPLICATION PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ 1�w Q�2EPLACEMENI' DETAILED DESCRIPTION OF WORK �',�,��c� (f�� or�e �.-�,PFTry-�,. s�2e �^ �— PER MS 16B.665 the gerr�it fee is a minimum_ of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation_or replac�ment nf a residential fixture excludin the fixtures. This should reflect onl the cost of labor , g t Y � -- : . ._ Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PR4}ECTS �Vi�EitE;�&:E3C£�Ei3�$�96�AREB/�SEI3 ON $10:00 PER FIRTEJft�� XL`EP'f Wi�RE NOTED. FIXTURES: -(Il+tDICATE'FO'F�:a' _�- NUMBER OF EACH BELOVI� � BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING �ve�oc»ruc�,rsE) SWIMMING P�L WATER SOFTNER ($35) _ CLOTf�S WASHER KTfCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER _ OTHER 1..,� _ � , . � ; � � �-� �- �� . . . �,.�,.� ` , � ' �' �€,� � � � �� , � � �p , �� F€�� . .,. _ . „ _..:. . . � � . . .. `� r�_ �� Permit Fee $ . (7� Number of fixtures @ $10.00 x $10.00 = $ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMTf-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 application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which reyuires review and approval of plans. SIGNATURE OF APPLICANT PRINT NA11rIF/AC/�Pl�a,.L�[�'�,Sr°'T/ DATE � o7fT � �. ;A r:... �� .. , , . � __, a ..�� ,,: ..�_.�� i:,� �'� �� ' ; v �i�� u - _ _ ..�. F. � �.� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977