AF - 43182-�-
�IINDERENGINEERING CO.,INC. �
ENGI NEERS AND SURVEYO_RS
�..NO evaveY�NO SO�LS TESTIN�
CIVIL 8r. MVNLIGIOAL ENOINEERINO LANO PI..ANNINO
6418-56T" AVENVE N.
MINNEAPOLlS '�'f, t�/IiNN.
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WE HE6tEBY CERT�FY TNAT TNIS I$ A TRUE ANO @ORRECT REDRESENTATION OF A SURYEY OF THE BOUNDARIES OF THE
LRNO ABOYE OESCRIBED AND OFTNE LoCATION OF ALL DU1lD1NG5, IF ANY, TNEREON , AND ALS. VISIBLE ENtROACHMENTS,
,F AN,"r, FItOM CRON sNO u�NO. MINDER ENGtNEERING CO., INC. �
P , ry�
pATED Tn�S - p�,YOF °� � – �.0.�75`-� �n1G�1J1��Rg AND SuRVEYOR� .-
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City of Fridley, Minn..
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BUILDING PER.MIT N° 410 9
Da�: ---._...�-----.�.�-.-��--.-------.---__.._.. �� ��,� �� �
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Owner: .............--�-----�---•----�----�---..........._....... _.__..__.....__..._....__....._...._.... Builder .-- •-----_ . _ a __
Address
Address
.sLO TION OF BUILDING
No. -------_��J..�.. Street .._._.. .... _......._ . ... ....... .. _.....��I._...�............_.............. Part o I.ot •-----------_-•-•_--•.._...._......._..---...._...__.._._...
.... ....... Block ------......- -.-- -- --._--- Addition or Sub-Division ...�--��i�!l--•-- . .. .
Lot ...............� -. -- ..._..._.--��---- -
Corner Lot .....- ..................._........ Inside Lot ...._�..........----........... Setback -��--��---�- - Sideyard f�....-..._'�..�..........._..
Sewer IIevation
To be Used as:
�� - - �------ .....
��t�a����..�. _ ............. .. ..
Tyge of Cons tion
Foundation Elevation
DESCRIPTION OF BUILDIiVG
�Q''' F �+ ,t � q' —
6 '
Front�./.._....�...._� Depth e��.`°.� Height .f..fj!.� Sq. Ft ��i�.---� Cu. F't�._..}��
Front ��..'_�Depth �_�_°.� Height ��:.•.�..q Sq. Ft �.i�. Cu. F't.��
..................................................... Est. Cost.....�..���.�...�......_........ To be Completed ...................._............._.....----.......
In consideration of the issuance to me of a permit to construct the uil ' g d ri above, I ee to do
the proposed work in accordance with the description above set fort co an with ovisions of
ordinanc�s of the city of Fridley.
..�.----.... . _�.._..---_..._...." . __._.._...._....... __.._.._.__�..�_...._..__.._._
In considera.tion of the payment of a fee f$..�.-- -..._._.�_../..�.., permit is hereby granted to....._ .............---•-_---....._.....------•---....._.
_.__..�.__..._------------_........---------.. to construct the building or additian as described above. This, permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding lceation, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinanc.es. .�- � 6i � �y
Building Inspector
NOTICE:
This permh does not eover the eonsfrudion, insfallalion for wiring, plumbing, gas heaNng, sewer er wafer. 8e aure fe see
the Building Inspector for separafe permits for these ffems.
.:.�
APPLICATION FOR BUILDIlVG PERMIT
CIZ`Y OF FRIDLEY, MIlVNESOTfl
�� �•• � �
Owners Name �-�.. � Builder � �-' �'4:�,�''� �",��� � ��i��;� .
Addreas '-� � ..� � `; ; Address �= �; � �' ����.��-��. � �'��� �
+...
. . , .� . ... ..,..
LOCATION O� BUILDING . ...
No. � � �a . Street � - �' . �' . Paxt of Lot ' ;�
Lot � � -: Block i� .Addition or S�a.b.Div.,��'1��� �.�/ � �'�"�o���f
. � /.. ` �' rl✓�T� =�
Corner Lot Inside Lot '�° � Set Back, o�� �•�;��-de-Ya'�d `� /�� a����
SEW'EK ELE'�T�i��QN FOtJN'DATION ELEVATIO�I � . _ _ . __ .
Applica.nt.:��tfiac�;`:.ta� th�s fbrm� Certificate of 5urvey of Lot and proposed building
location: .. .. . � :� ... � • . . . .
D'ESCRIPTION OF BUILDING � '.
To be u�ed a.s :
,.-:� , . . �, A "
��.��,�%�.J� �'1' �� ,�..k'.xront .�� � Depth 2�� Height � � ..
. .. • � i , ,,_. _ , .
Sq. Ft. I � �� � • . Cu: Ft. � �� �� � . : . .. . .
� � �
�.%i�.� �". Front �� ` Depth �� � Height� . �� �.
, � .. ..
�. Ft. '��l�.: � .Cu., Ft. '����. _ ..
. �`:. . .� :"'`'.� .. '.. . ' " A
T3rpe of; .Construction � . . �.�i�/�i�=' � FNstimated Cost � � � �"�'�
To be completed 1' �� �' ��� � � ' ' � .
The undersigned hereby makea application for a permit for�the work herein specified,
agreei.ng '�o .do �a31 worls 3.n strict .�ccordance with the Cit�r ardinances and ruling of
the Depar.�rit o���u.ildings; and:hereby�decl8xes that a11 the fac and representa-
tions stated �.n �hi's application� are true and correc
�' �' I N TITRE � �
DATE �-� ...a` G/� �% .� � 5 G A -.�
(g Scl�'edule of Fee costs can be found on the Reve�'se 5ide: )`',: �� �: ..�.���
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BUILDING PERMIT FEE 5CHEDULE
._. .fti., . , r, ...; . ;.i:. x..,. '' •�:�;.i.ii.
��a{� °� g�„ �, � before issuing any permit
�sction 2. The IiispsGtor � of }3ii3l.,lclin sl��. ,,
for the erection o�f�ariy building or structure, or for any addition to
any existing building or structure, or fbr any a.7.terations or repairs to'
, T�,t
�y ex�.st��g b�lding or� st,r,ueture � upon application therefor � req�ire • �� : : � :. •.
__.._._....._:��.-�a�mer��,-�by�- �l��e-��1�=�nt� fo"r su�ch� p�r�t� oi �ee'�� to� "t%e 'a�iourit
herein below set forth and in, the - manner herein provided to-wit :� ,, _,: ��::.�z:.s
. .. ... __.._. ._...M__. _. _. �- .
. .��:... _.._....._ .... .. .... ...._ .. . ._ ..
� 2,1 For any such perrait for the erection of any fireproof buildi.ng,
other than a gaxage� warehous�,.:�a�td�y;ar�gr�3:n elevator, or for the
erection of any fireproof addition, for simila�`"c��euFan�y� to any :�
existi:ng bui.]:di,�?g Sl�all�.;be atwthe_ rate.. of..°�1_...40_ f.c�_.�€�.e��"fxi�_thousand.--_...._-�'�-
""��`"`� cu�ic �ee�,�or fra ction thereof, in such cubical contents. � r,.al
.. � , :� �, .'� . .-. -
---�`- "'�2.`2'�"�"F"or � ariy auc�i �permit for the erection of any fireproof garage, ware- ... ._,�
house� fac�o�yr ..q� ��xain elevator, or. for• the � erectiori `of �ny `=fir.eP�oo� `' �"" � �� �
"""��'" �" addi:�ion' ��for aimilar occupancy, to any existing building sh�a11 be ,at the ._, ,,�:
rate of �1.25 for,i:e�ch one tliausa'ricl� cubic,.feet, cl�..�.s�.fi��•.a�'�f�irep�oofn� :`, :c'.
�-�--- Buildin Code. ;C;
_�'- -- : _ �'b ec�iori...5�� of the Minneapolis g . . . . .. , . ,� .. .- . . .
M � :1 .. ' 1 � ''T; . .. . �,. , . ' . . '.? �. . I. �..�.
� HbUSES + . �
2�3 For any such pe.r.�ai:� ior .�he. e,r�;c�t.i,g�. of any non-fireproof building
�-o_ther,than a garage, iaarehouse, factory or grain elevator, or any
non-fireproof addition, for siLnil�..r occupancy, to any ex3-stirig bui,ld;i��. :•.; �r'�
Permit �1.00 for each one thousand cubic feet.
. . .: =. ..�� ....,..,�;.... .. ._.. . ..___._.__ ....�..--_-_.�.__.
:. . � : -
, - . . _ ... . ._._._...._.. �. . ... �
__....___._GAR.A��S.-�`::._.'._:_-..___..._. ___.. .._._.._..._ :-: .r:
2�1� For any such permit for the erection •f any non-fireproof garage� ,_ .
warehouse, factory or grain elev�,tor; �r-�-for�'the ereaiicsn of B�I�► �iion-"
�ireproof addition, for sim?.lr�,r.occupancy, to any existing building or
----f-�..€a.�.�` ��ich `- bu�d�g--Q��-aci�i���on:-�--�:n�e�ty.. eents fo�.-�aCY���o�ie-� ---... .__ .. ___.._-- =
thousand cubic feet or fraction thereof, in the .cubical .contents thereof _
with a minimum of $4.00. ._..___._._.... ...�.__..._.._..
� - ��t:'
. ..
r. ,..... .
_._.._.._.__Eo�_.t3se.�urpose o�`'co�dpu�ing'f�es--fo�-�bLt�ding permit� �t�e cubical
contents of any building or addition to a uniform height throug�ictut�py... ;�
� _w,...m�ul.ti�l�rin�-t1�.� g�ound �e�. cove�ed -froa� �a •poin� � six . �E�}..in�h��" belota
the fl�or line of the basenent or cellas to .the average. �.Qight pf._t$e,: ,. ;;;_ ;,,���;�
. '� y ��' . `v:p�r `�urface � or to � tkse r ;avera`ge hei�ht f of :the roof s`ux'�f a�e of � :�he �� � s , ,�,
:a �gable �o�'� a pit�cYied�roof.' ' , . _ : : . .
. .� . . . : : .
..:, ., .:. :. ::
.:.,, , ..„. .. .., .._,.
2.5 For repairs or alteratibna �o"�,n existing structure,�the fee shall
-,-� ,;
be at the r�,te of $3.00 for each Five xunclx'ed Dollaxs (�5Q0•40 , or M.;,�vf�.�.
..._._...���-�on_:thQSer�£.3n__�he -co,� �of-a.11 proposed wos�k:° - ._ -°. �.. . __ .,
2.6 In no case �shall� the ��fee cHa.'rged ��fo'r any permit `as set forth�in ��
Section 2 be leas tYian �4•�fl• °.
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ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSII'Y AVENUE NE
FRIDLEY, MN 55432
57Z-3604 FAX:
: 133 CRAIG WAY NE
: 103024120046
: PEARSONS CRAIGWAY ESTATES
: LOT 2 BLOCK 2
. , i .Ai
: RESIDENTIAL
: ADDITION/ALTERATION
571-1287
PERNIIT NO.: 2004-00324
DATE ISSiJED: 03/15/2004
VALUATION .
NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE.
WIRE BATH REMODEL
# INSPECTIONS
APPLICANT
TOTAL ELECTRIC INC
11967 ELDORADO ST NE
BLAINE, MN 55449-7907
(763)786-8484
�� ./��_ •
.
REVAK BRANDON J& GREENWALDT L
133 CRAIG WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or caacel the provisions of aay other state or local law
regulating conshucrion or the performance of construction.
Applicant Date
Bldg Insp Date.
1
�
ELEC PERNIIT FEE - MIlV (RESn
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 12748
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
���
20.00
0.50
20.50
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE oC %
SITE ADDRESS ��
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
_ EFFECTIVE 8-19-09
✓ T �OURE-MAILADDRESS
� i
❑ OWNER �CONTRACTO
NAME: /°� -,�us e?.Vc.�
ADDRESS: � � 3 � A%: , '� �"� �
PHONE:
NAME: P� 4l ��%�;�r �
STATE LICENSE )#
ADDRESS:_��( � � �
PHONE � (� 3 —�1� �`- � �
�GLE FAMILY/NEW CONSTRUCTION
❑ TWO FAMILY/IVEW CONSTRUC7'ION
❑ ADDITION ❑ GARAGElSHED
❑ BASEMENT FINISH �ROOF
❑ DECK ❑ SIDING
❑ SW[MMIIVG POC
SIZE
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDI770N
D AI ANCFIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: C°--
SIZE OF IMPROVEMINT LENGTH WiDTH
ROOFING .''j � ❑ HOUSE ONLY
NUMBER OF SQUARES J �OUSE & GARAGE
GARAGFS ❑ ATTACHED GARAGE
PROPOSED SIZE: ❑ DETACHED GARAGE
PROPOSED HEIGHT:
EXP DATE
❑ DRAIN TiLE
❑ OTHER
Permit No.:
Received By: �,�
Date Rec'd: �' � '
.7'E�ZIP�_
STATE�ZIP.
I�i
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
SIDING FOR NEW CONSTRUC7'ION INCLUDING DECKS,
O Virryl OSoffit ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures
❑ Other ❑ g�ia and proposed project.
2. Two sets of wnskuctian plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS OYes ❑No L�ATION OF WINDOWS FOR WINDOWS – PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES 8c
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
'OTAL JOB VALUATTON $ 4�1,�'1 ��G THE 1997 U.B.0 FEE SC OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surchazge
Surchazge
License Surchazge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ (� I.Z`a See Back Page for Fee Schedule
$ 4- . 65% of Building Permit Fee
$ � .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2000 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$22=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ _�� Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATiON FOR A PERMIT-NOT VALID UNT[L PROCESSED
I hereby apply for a building permit and I acknowledge that the infotmation above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridiey and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a it and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all ich requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME ��1�� ���1 Ll DATE� U
Page 2- Building Residential Application
BUILDING PERNIIT 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 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,OOl to $25,000 $69.25 for 1� $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for I�` $25,000 plus $10.t0 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 forthe 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 Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977