AF - 38038City of Fridley, inn
B�JI�DING PEI�MIIT N� 5 0 2 8
Daie: _�G'�' �` � �
, �� � ,' /� '� R ,{ ,i �
Owner: �..� �,,.L�'�u�l.� ,,�'��.� Builder .���- — •--'��,�+'
Address � �� Addr�'"� ,
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LOC�44ilOiV OF Ui DIIVG
.
No. .� Street �,�„��.a.�i,�G.� ...._.. .� ' � part, �f.<: t _-- ; --�-`
Lot ��.__ Block � '�Additi�ub-Division ._l �,
Corner Lot _. Inside Lot _ '�''� Setback �we'�.—� _ Sideyard ��__�"�� � �
Sewer Elevation � Foundation Elevation
DESCRIPTION OF BUILDING
To–��• � _ �
f Front ��� Depth =�� �Height .�.._ Sq. F't. ��� Cu. Ft� .S�"`
� : � Depth .«�� ��` Height .���, Sq. F't. �� Cu. F't. �
, of Construction :�''�° ` F.st. Cost .��=-,�,.�-:�� � be Completed _.._
Ea consideration of the 3ssuance 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 dty of Fridley.
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Ea considerai3on of the gayment of a fee of $� , permit is hereby granied to
to construct the building or addition as described above. This permit is granted upon
ithe express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part thereoP, shall conform in all respects to the ordinances of
Fridley, Minnesota, regarding location, construction, alteration, maintenance, repair and moving oP buildinga
within the city ]imits and this permit may be revoked at any time upon viola#aon oi any oE the provisiona of said
ordinances. a . ,
Building Inspector
NOTICE:
T6is permit does not cover the construetion, tnateUattoe for wirine, plum6tne, gas heaHeg, sewer or watea Be sure to see
ths Bu(Wieg Inspeeror for separat� psrmite for fhese items.
i'�` 4 �""�.
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_ - _ _-- s-:"
Ownera
Addresa
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APPI,ICATI�N FOR BtTIJ�DZNG P�iNIIT
� cz� oF �mLE7t. MIl�3oTA .�
_ ��1
F �- /
No �� � Stree'� ��, , ¢7 � ` ,� : � ��Pert of Lot ��, �' y
..� �
• , � ��,� � ��
� � ' � ,,��� ,������ � �'� /�
%ot _�,=,. ffiock . � � Ad.d3tion cr Sub.Div ,�'� . .,._._._,��� __ ,
Corzisr Lot= s�.de Lot�Set Back _ �' � S3de-Y�rrd �� �i=w � � �� _
SEi�. FLEVATION F'aUNDATION ELEVATION
Applicant e.ttacb to thia form Certificate of S�uwey of Lot and propos� building
locatioa.
DESCRIPTI016 OF BUII�ING
To used ass
�, � �.�- ��� : Fro�t , ��� �� Depth ,�_ �_,�::_�3�t `�
;-i
Sq. Ft. �� �� ,�f_,., Cu. Ft.
� ',�� ;;_-�-�; . �� �iont, �� � , Depth � � Height �
Ft�.
Type of
To be
'
.m � -;, y
�
ted Cost -=�� �''�' "� ' �'' �,
�_.......�._.— -- �.
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The undersigned hereb�r makee application for a permit for the work herein apecif3ed,
ag►reeing to do a11..�tcrk in striet accordance with the City ardinances and ruling of
the Depart�ment of Bu3ldings, and hereby decl:�.res� "" eSl e facts end repreaenta-
tion� stated 3n this �ppl3cation are true d c6rr ct. ���
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DATE ',f ' ,�� ���' � F�' SIGN�TURE � �' � ,� . F, _ '� ,�
,.. �
(g Schedule of Fee costs can be found or�� Reves'se Side.)
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HIIILDIlJG PERMIT FEE SCI�DULE
,� Secrtion 2., The Inspaec�tor of Buildings sh�7.1, before 3ssuing ar�y perm�:t
for the ereat3on of.any buia.ding or att�-ucture, or for any addition �
aay e�tat�ixig building or structure, or for any a].terati.ons or repaire
to.any e�dsting buildin� or.�tructure, upo�n application therefor, requ3re
the �yment by the applicant for such perm9.t of fees to the amount herein
bs3or� aet forth and in the manner herein proeided to-wit:
2.1. For an�r such permit for the erectian of a� fire-proof build3n�,.other
thaa a garage, warehau�e, faatory or grain elevator, or for the erect3on of
aay flreproof addition� for similar occupanc�, to sx�+ existing building
slaaZ�. be at the rate of .�]..L�O for each one thousand cubie feet, or fraction
thereaf, in euah cubic�.l content�.
2.2. For eng such permit for the erection of auy fireproof �are�e,.ware-
house, fa.ctory or grain eleva�tor,- or for the ereation of any f'ireproof
addition for s�.m3lar oeQUpancy, to an� exieting buildin� eP�elJ. be at tl�
rate oP �1.2� for each one thoueand cubic feet, cla.esified sa "fire�roofn
by �ct3on 502 af the Minneapolis BLtilding Code. '
0� USES
2.3. For ariy such perm3t for the erection of aay non-fireproof building
other than a gara.ge, warehQUSe, factory or graf.n elevator! or an,y non-
f3reproof add3tion, for aimilar occupancar� to any exiating bu3lding.
Permit �1.� for each one thousand cubic feet.
GARAGE3
2.4. For any such pernnit for �he ereation of any non-fireproof garage�
warehouse, factory or �rain eleaator, or for the erection of any noa-
fireproof addition, for simi].ar occupancy, to any exiating buildin� �r
for ea.cb. �uoh bui7.ding or Qddition. Ninety Cente for es.ch one thousand
cubic feet or fre,ction thereof, 3.n the cubic�l contents thereof with a
mir�3mum of �/a..E30. - .
For the purpose of computing fees for building germits the cubical contents
of an�r building or eddition to a unifo�m he3ght throughout by multiplying �.
the �round area covered from a point six.(6) iaches be7�ow the floor line of
the basement or cellar to the average height of the upper surface or to the
average he3�ht of the roof surface of the main gable oi a pitched roaf.
�
2.5. For repaira or alterationa to an exiating structure, the fee shall 1�
at the rate of �3.00 for each Five iiuradred Dollaac,4 (�+500.00), or f�action
thereof in t}ae cost of all proposed work.
2.6. In no.-c�,ae sha11 the fee charged for an,y permit as set forth 3n
Secti�n-2" be less than $L�.�.
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MiNDER�NGiNEERiNG Co.,INC.
ENGI NEERS AND SURVEYORS
1�►NO 9VRVEYWO SOIL9 TESTINO
CIVIL �, MUNIGtPAL ENOINEERINO . LANO PLAKwfINp
6416-SfeTN AVENUE N.
MINNEAPOLIS 2l'. MINN.
KE '�- 3637
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WE HEREBY CEtLTIFY TNAT THIS IS A TRUE AA1D CORREGT REPRESENTATION OF A SuRVEY OF 1'HE BOUNDARIES OF THE
�IWO ABOYE OESCRtBED AND OFTH� LQCATION OF ALL BUt�DINGS, IF A1�lY, tNEREON,'ANO' A1.1. V1516L� 6N[ROACHMENTS,
IF ANY� FQOM ORON SAtD IAND. MINDER ENGINEERING CQ., INC.
OpTED TNIg QI►YOF ���''� ��•��5 � EW61*t R AtJD SURVEYORS
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I-�£A7°�LUS� CALCULATIONS DEPAftT'MENT
�eatheratrips A.5.H.V.E. Construction ;
Guide
Windows I Doors Reference Out. Wall I Int. Wall I Ceiling
Yes—No Yes--No 19
� Fl.� ,�'s �/ Room � Length ��- Width�3 � Height �=
Win owa and Doora—Crackage and Area ,Z� °
Width Height No. of Lineal k. Aree
No. of pane ot pane lights ot creck sq. ft. Z Z
.�J �a � 6 � '
0 .�°° � =? � �� ��
Coef. Btu
Infiltration �,� �� �� ,M ��
Glass �' i „�� °� � �
Egp. wall o D
Net esp. wall °' ^ ,+�,� <� _ _ � ,�
Int. wall
Ceil.or �SC � � e°Q ��r � �
'Total Btu. �' ' �',�.�
Required sq. Ft. E.11.R. or sq, ins. W.A. Leader area
� FI•� � Room � Length,/'/9 `� Width�! � Height�� f
Windowe and Doors—Crackage and Area /,o-°
Width Height No. of Lineal ft. Area
No. of pene of pane liqhts of crack eq. fc'
� � � � � /' �,n ,�'� .��: .S� I I 6
�' �,�, f�
Coef. Btu
In6ltration �/..� �'O , ,� � ,
Glass �?,� ,�� ,� �' _�
Ezp. wall �
Net eap. wall �Jd �� �
Int wall .
�� .�� � �D
Ceil. or floor ,s+� �?' ,J,� ,,,*���
Total Btu. �' , ,�
Required sq, ft. E. D.R. or sq. ina. W.A. Leader a ea
/' Fl:� ��°Fs Room � Length ��'= Width �'e�' -.p Height �=
Windows and Doors—Crackage and Area /" °-
Width Height No. of Lineal ft. Area
' No. of pane of pane lights of crack sq. ft.
�J� �' �? —� � e� �� �� . �°
.�° � l� / � � �.°���° G � `-
� -� �
� Coef. Btu
lnfiltration ,� a� � ' � �.� � � � � � ��i
Giass �.�` S� � � � �
F�p. wall D � �e
Net eap. wall �. ,� ,�p � �
Int. wall
� � �� ����
Ceil. or $oor �,� �' �� � �1 �j
Total Btu. ,�!� � �
Required sq.k.E.D.R. or sq.ins. W. A. Leader area
D.56 .
p«�A WM.. P� Or'..�.��
a ��erJ`� C�,�� �� ^ � �d�'��,
OF BUILDINC� �r;�° ,,���,� ��� , MINNEAPOLIS. MINN.
Vo. Insulation
_ I Roof I Floor Kind I How Applied
� Fl.��`/.��� Room � Length a/'� Width �//// Height �
Windows and Doora—Crackage and Area �^� �
Width Heisht No. of Lineal ft. Area
No. of pane oE pane lights of crack sq. h.
� � �� � � .� g
CoeF. Btu
Infiltration � � �°,� ,e�
Glasa � �' ,�� �,� ,�p
Exp. wall � � � g
Net eap. wall �- W �� A�
Int. wall
�� ' !'� ��� �
Ceil. or $oor �^� , ,� �
Total Btu. `��
Required aq.ft. E.D.R. or. sq. ina. W.A. Leader azea
� Fl.� ����� Room � Length �� Widthb�'� Heigh :
Windows and Doors---Crackage and Area �°
Width Heighe No. of Lineal k. Area
No. of pane of pane lighu of crack sq. ft.
� �� /'� �'�. �',` s'� � � I �'
Coef. Btu
Infiltration �,t �,,�` ;'fi+ � ��
Glesa � ��� � � N�� � �`°
Egp. wall �
Net eap. wall �'�,� �� � � �
Int. wall
�,/'� �� ,�6�
Ceil. or floor �� v.� �� ,� �
Total Btu. ��� �
Required sq. ft. E.D.R. or sq. ina.W.A. Leader area
� Fl.��,��/ Room � Length;/'� Width �.!'� Height "'
Windows and Doors—Crackage and Area /� =
Width Height No of Lineal k. Area
No. of pane of pane lights of crack �. k.
-�r �
!i �-'S�' � ��`.+ � �/D. ,� • Q�
� 3�0 � �` A �
�
Coef. Btu
Infiltrarion � � ' � p �o�
Glaes �<� ,°� � � ��
Esp. wall � �+,
Net. egp. wall •� �� _ � �i �
Int. wall
%��' �� ��'FC
Ceil. or floor �Z'�° �'` ,� � � /
Total Btu. �'� ��' �
ftequired sq. k. E.D.R. or sq. ins. W.A. Leader area
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��'s-. :1�.'!� 0 -irY ¢
s�J
HEAT�LC� CALCULATIONS DEPARTMENf OF BUILDINGS MINNEAPOLIS. MINN.
V@'eatherstrips A.S.H.V.E. Conatruction No. lnsulation
Guide
Windows ( Dooss Reference Out. Wall I Int. Wall I Ceiling I Roof I Floor Kind I How Applied
Yes—No Yea--No 19
� Fl.����,�s�! Room � Length ��= Width ,�' Height � r�i' Fl.���� Room � Length y�r Width � Qr Eieight ?6
Win ows and Doors—Crackage and Area �% Windows and Doors—Crackage and Atea �o °
Width Height No. of Llneal &. Area Widch Heisht Na of Li�eal k. Area
No. of pane o( pane lighta o( crack sq. ft. No. of pane of pane lights of crack �. R.
� �= /�—' � /� /�— I�
In&Itration
Glass
Egp. wall
Net esp. wall
Int. wall
Ceil.orodoor
1'otal Btu.
'� • '
��
��
`� � �� � �90 I
Required sq. k. E.11.R. or sq. ins. W.A. Leader area �
� FI.� ��,�� Room � Length � Width �-- Heig
Windowa and Doors—Crackage and Area �@
Width Heighc No. of Lirreal k. Area
No. of parre of pene liqhts of crack sq. R' —
,,� `-'� �� ./� r i" �
Coef.l Btu
Infiltration ' 4'i �
Glass .�O
Eap. wall ./ �
Net egp. wall .� O
!nt wall
S"� ,��
Ceil. or floor � �
Total Btu. � � ° °
Required sq. ft E.D.R. oraq. ina. W.A. Leader
d Fl.�'����Room � Length�'�- Width� �=° Hei;
Windows and Doors—Crackage and Area ��
Width Hei�t No. of Lirceel ft. Area
No. of pene of pane lights of crack sq. k. °�
. _ � � e e/ h .3'
�
�
�
� � � Coef. Btu
Infiltration � - �
Glasa �� � �
F�p. wall ��
P
Net egp. wall � _ . ��
Int. wall
� �� � ��
Ceil. or $oor � . , "�` � ��
Total Btu. ' �
Required sq.k.E.D.R. or sq.ina. W. A Leader area !!� ��
^ n°� -�/ ���, � � � � � � �'�� � � -�
eo
Coef.l Btu
Infiltration �
Glass
Esp. wall
Net esp. wall � ��
Int. wall a �� �
Ceil. or floor ��� �
Total Btu.
Required sq.ft. E.D.R. or. sq. ina. W.A. Leader azea
Fl.� Room � Length Width
Windows and Doors—Crackage and Area �
�
� I � Coef. Btu
In5ltration
Glass
Egp. wall
Net eap. wall
Int. wall
Ceil. or floor
Total Btu.
Required sq. ft. E.D.R. or sq. ine.W.A. Leader area
Fl.� Room � Length Width Height
Windows and Doora—Crackage and Area
Infiltration �
Glass
Exp. wall
Net. exp. wall
lnt. wall
Ceil. or $oor
Total Btu.
Required sq. k. E.D.R. or sq. ins. W.A. Leader area
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Weatherstrips A.S.H.V.E, Coastruction No. I Ins tion
Guide
Windows Doors Reference Out. Wap Int. Wall Cxiling Roof F1oor I Kind How Applied
Yes—No Yes—No 19_
Room Lengt Width e%'l�"'"` Height F7.� Room Leagth Width "'` H
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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 �
� �
� • COMMUNITY DEVELOPMENT DIV.
� Ly �'�����
r � � PROTECTIVE INSPECTION SEC.
' i '
� �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE
�----� � �`� s�2-5so-3a5o 910-F15 5/5/77
JOB ADDRESS 104 Craig Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
oescR. 11 2 Pearson's Craigway Estates
2 PROPERTYOWNER MAfLADDRESS Z�P
Robert H. Engler Jr. 104 Craig Way N.E.
3 CONTRACTOH MAILADDRESS Z�F
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
MAIL ADDRESS
� ADDITION
8 DESCRIBE WORK
Construct a 14' x 14'6"
9 CHANGEOFUSEFROM
� 14060
IECEIPT NO, r.,
PAGE OF IAPPROVED BV
� �
SEE ATTACHED
SHEET
PHONE
PHONE LICENSE NO.
PHONE LICENSE NO.
ZIP PHONE LICENSE PIO.
❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
addition
ro
STIPULATIONS porch.cannot be heated unless it meets the ¢yl¢�� energy requirements.
g�A'� pERMITS REQ�3iREfl � Fi�t 1��. `
H�►�nr�. �.����:�� ��� s��v�. . VIR�R�iINC
B@tote dt�ng caii I�I �t��t�ei��
1F,I.EFHONE - EtECTRIC - ;;aj;,. tr.�.
REQUtRED BY Lo�1�
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �od Fr�
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
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 COMMENCEO. NO. DWLG. UNI
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �-
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED. $2 � 2OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCA,� LAW REGULATING CON- �`13.20
STRUCTION OR THE PERFORMANCE OF CON�1„'RUCTION.
(DATEI
IDA EI
OCCUPANCYGROUP OCCUPANCYI.OAD
SO. FT. CU. FT.
OFfSTREET PARKING
STALLS GARAGES
SURTAX
$�..10
SAC CHARGE
TOTALFEE
$14.30
D THISa�S YOUR PERMIT �.._
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
�NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWPdER: �' ( �e C� � L3�I� ��,�'/,e�' 7R..gUILDER:
Address : ��y G'� � [ �'�„ � �`y� {�1 �' Address :
Tel. No.:
No. :_](�, � Street: �''�.� 9� ta.9 �y�'
LOT: �] BLOCK: 2� ADDITION: � AQ��S ��G�u�q-�1 � i�'b''�
CORNER LOT: INSIDE LOT: Y SLTBACK: SIDEYARDS:
Applicant attach to this form �ro Certificates of Survey of Lot and proposed
building location drawn on these Certiticates.
DESCRIPTION OF BUILDING
To Be Used As:
�s
���' h, Front: ��' Depth: �� �o �� Height: P
Square Feet: �Q� Cubic Feet: ���,�
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ��� %� � Estunated Cost: $,'�'� �� � ��%
To Bc Completed: ��'� 77 Alt. A Alt. B
Proposed Driveway Trlidth If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHE?;T)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City o�
Fridley Ordinances and rulings of the Department of Buildings and hereby
declares that all the facts and representations state tl� application
are true and correct. 5ee reverse side '��� ddi i �"inf rdia on.
.o ,-� � �
;�
DATE: o� �� � 77 SIGNATURE: a
Stipulations:
� � � rv�
,�, � 22 0� X
� �2 �� �
� N� �f� � C�.� c,r s�
�', � o�oe � = t`� � "� �
���//O�o y
.1�1,� �
�'� 1(1^�'l� �"�5 `•j'H � �.c� �. n, C, `f �� C� u i'2rz. m„�
,
�:
,=
��
BUILDI(dG PER��IIT FEt SCHEDULE
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 CON5TRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete C�trb 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 rep�.acement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
��11 i 1 �' � �
For the purpose of computing fees for building germits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or th� 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 repaa.rs 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 $.50 state surcharge.
_�IERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimiun of 24 hours from the time
of application to allow for proper review of the proposed structure and of the �
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CI�RTIFICATE OF �CCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
�'�
'�
�"!
AGREEMENT
`
Ys
, owner of the property
].ocated at ��� a J. � � have no objecti.on i:o the
City allowinq the constrnction of a D�, C� to be
located at �� G{' C'(� j�.�(q. .�� without �the required
certificate of survey that the City ordinarily requires for aIl new
const,ruction.
Signatur
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c�ty of Fr�a�ey
AT THE TOP TME TWINS g� J � L D I N� P E R M I T
� �•572 36�MUNITY OEVELOPM�NT OIV.
� � �: ----•-
r � � PROTECTIVE INSPECTION SEC.
� . �
� : �"'1 � CITY MALL FRIDLE� SS�32 NUMBEN
�--°�'� �'' 612-57�-3a60 9�aF�s
JOB ADDRESS 104 Crai Wa NE
t LEGAL �OT NO. 9LOCK TRACT OR AOOITION
oesca. 11 2 Pearson's C
2 PROPEfiTY OWNER MAIL AOOR�S$
Robert Engler
� CONTqACTOFi MAIL ADORESS
Giertsen Co 860 Decatur Ave N Golden Vl
d ARCMITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL ACDRESS
8 USE OF BUILDING
Residential
OAT6
10/13/98
21P
ZIP
vAGE Oi
/ /
PMONE
PHONE
PHONE
8226
�OV O
!�
�VVaovEO er
SEE ATTACMED
SMEET
LICENSE NO
1796
LICENSE NO.
LICENSE NO
7 CLASSOF WOFiK � N� p ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
B DESCRIBE WOFK
Reroof house and garage (25 Sg) Tear-off
9 CHANCiE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPB OF CONST.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITMIN 80 DAYS. Oii IF CONSTRUCTION
OR WOiiK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS A7
ANY TIME AF7ER WORK IS COMMENCEO. NO DWLG. UNITS
1 MEfiEBY CEATIFY TMAT I HAVE READ ANO EXAMINEO THIS APPLICA710N
AND KNOW TME SAME TO BE`TF1UE AND CORRECT. ALL PROVISIONS Of LAWS ypLUATION
AND OROINANCES GOVERNING TNIS TVPE Of WpRK WIIL QE COMPUEO
WITH WHETMEii SPECIFIED MEREIN Oii NOT. THE GRANTING OF A PERMIT �ZZ�FZ
DOES NOT PRESUME TO E AUTNORITY TO VIOLATE Ofi CANCEL TNE pEqMIT FEE
PROVISIONS ANY ER STATE OR IOCAI LAW REGUTATING GON-
STRUCTIO ME RFOfiMANCE OF CONSTRUCTION �7�F.7S
� ��� �� PLAN CMECK FEE
Licen C
S�GNATUNEOF�ON'AACTOpOAAUTMOpIjEOOGENT IDATEi N �
S�GN4TUAE �� OWNEp��� OWNEA BU�LDEA� IDATE� B G�NS�
SQ. f T
Of FSTFI
STALLS
SURTAx
$1.07
SAC CMI
Fire
TOTA�f
).OD $82/,�9
OCCUPANCYLOAD
CU FT
f PARKING
GARAGES
$2.14
r
NEVV I ]
ADDN I l
ALTER [ ]
ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
�
Effective 1/1/98
��� ��
�� ��
Owner Name & Address: �� �� ��6 C�L Tel. #
Contractor: GY ��.i�'��"a,� � MN LICENSE # �71�
Address: � � � d'-���k-2- �z/� �' G �l�i�..� Tel. # �{°G �'-� � �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIP'TION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width HgdGround
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �� �J � `� � � �f Estimated Cost: $ �/ ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �l�/��� APPLICAN'T: Tel. # 5��� ���"
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� �s
$ ��
$ /- C��
$
$ ��O
$
$
$
$
� � �
- �
CITY USE ONLY
Fee Schedule on Reverse Side
.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
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] 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 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 $1,000,000
$1,000,001 and up
FEES
$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 thereof, to and including $25,000
$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, 0(}0 or fraction thereof, to and including $100, 000
$887.25 for first $100,000 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 iust $1, 000, 000 plus $2. 75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $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 tunes $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 ttie framing.
*
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