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City of Fridley, Minn..
BUILDING PERMIT , �� o
;. �1T. 4982
.... ,/ � � ,�'
Date: ..�.�""' p� �__:�"�..Le�._ ._._._.._..�� y �
1 �. ' v
Owner: ....._. �.. ---��_. :��� �'�'; �Builder _.......-----...._..__-�- � ._.---_. ..._._.___..._.__.-----_.__._�..._._
.._. ...... __.. __ �. . .... ��.,.-�.
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Address ...----•---- � � � . ,.��Z: ' � ' _ + Address ��- . _ .. �
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---_..__.�___.._..__.____..
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rL0 ION OF BUILDING
rro. �l.�..!�---�--- street _..�,.�'.'.-_'�,� .�- �`�,��'�a
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Corner Lot ....----- ........... _...... Inside Lot ...��--..._.._........ Setback ....�� ----------....... Side .. . �°°�..--...._.....--------......
Sewer IIevation
Foundation IIevation
DESCRIPTION OF BUILDING
To �ie Used • �
r
--,�.i -------�� �J-.�----.. ... Front�.,�.�..._. .�/�_.. Depth ..�..�.�. � Height ..._r:'�''..__�Sq. Ft. I..._:���Cu. Ft����
--...� ...�.../........_.........._.. Fro �_... Depth ..��.� eight .. /' � 4• �{ • { ��`'
- -- ._... �S Ft .... _... ...f/ Cu. F't: . .- �- --- -- ��
',,/� A,ry
e of Construchon ._. .� ����� �~''!J _..--.-- To be Completed .....------------......_..._-•.-----.
.�t=�` --- ... Est. Cost........
In consideration nf the issuance to me of a permit to constxuct 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.
In consideration of the payment of a fee of $��..._._....�..� ....., permit is hereb
Y �'anted to...._......----�-�-•---.........-�---�-----�-�---•-----..
_.____�. .. ___. _.____.__...._....._. 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 workmen, in all work
done in, around and upon said building, or any part thereof, sha11 conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
tvithiu tt►e city limit� attd this permit may be revoked at any tim� u� 'olation gf any of the provisions of said
ordinances. ..°''" ,�° � /
Building Inspector
NOTICE:
This permR doea not cover the eonstruNion, installation for wiring, plumbieg, gas heating, sewe� or water. Be sura to see
the Building Inspecto� for separate permfts for these i�ems.
i�, 4 �"`�
- _ _., - __, � •� -.±
..��„� r
0
Owners �1
Address
APPLIGATI�N FOit BU[ZDXAIG P�MIT
LOCATION
No. ��� �� Si�ree� ��'7-e�l� /.�i�.� ,/_ art of Lot
Lot ,_�,_H],ock��( = dit3on or Stiib.Div.
� �" �
Corner Lot__Ine3de Lot�Se� Back �� 3ide-Yard /'�►f .�.,_
SEWER ELEVlTION FOIINDATION ELEYATIOld
gpplicQnt attach to thi� form Certific�.te of Survey of Lot and proposed buildiag
1oca.tian.
To be u�ed as a
, f .
sg,. �t.
Type o�
�.
Ft.
DESGRIPTION OF BUILDTNG
� ��
��,�' . �
�
� ���
ted Cost �% � � �,,,�;,
To be campleted � �- � �
The undersigned hereby makee appl3cation for a persa� or work herein sgecified,
agreeing to do all Work 3n �triet accorda.nce w °°`the City Ord ces and r�].ing of
the Departanent of Build3.n�e and hereby dec3�ase t t all the f cts and repreaents-
tions atated irl th3� appl.icat3on are �true and ec .
DAT�_. � � ' ...� �- � a SIGN�TURE
(A Schedule of Fee costs can be found o�a��s� e Reverse Side. )
�
� . .
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_`�~�..
`-.
.�
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0
, '
HIIILDING PERMIT FEE SCI�DUI.E
Section 2. The Insgect�r of Buildin�s shall, before i�suing any permd:t
for the erection of a.ny bui].fling or structure, or for e�ny�addition to
any exiating b�xil.d3ng or atrueture, or for any a].teratione or repairs
�o:any axiet3ng 'bu3lding or structure, upon application there�or, require
the peyment by the applicant for such perm3t of fees to the amount herein
beiow set forth and 3n the manner herein prov3ded to-wit:
2.1. For any such permit fox the erection of any fire-proof building,.other
th�n a garage, werehouse, factory or grain elevator`, or for the erection bf
anx.f3r�proof add3�ion, for simil.ar occupancy, to ar�p existing buildin�
sha11 b� at the ra�ts of $1./.�0 Por each one thouse.nd 'cubic feet, or �fraction
thereof, in such cubical contenta.
2.2. _For any such permit for the erect3.on of any fireproof �arage, were-
hous�, fsctory or grain elevator; or for the erection of ang fireproof
addition for similar ocaupancy, fi.o aug existing building �hall be at the
re�te of �1.2� for e�ah one thousand cubic feet, classified as "fireproof° ._
by Sectioa 502 of the M3nnea.polis Bu3].d3ng Code.
l��� �
2.3. For anyr sucb permii for the erection of any non-fix°eproof building
othe�t� tY�,n a garage, warehouse, fac�ory or gra3.n elevs.tor,• . or ang non-
fireproof addition� for �imilar occupan�y, to any ex3sting buiiding.
Permit �]..QO for each one thousand c�.bie feet. -
GA'R�1GFS � �
2.4. For any such perinit for �he erection of ana► norN-fireproa£ �erage,
warehouae� fac'tory or grain elevator, o� for the erection of any non-
f3reprouf add�.tion, for similar oecupancy, to amy exiating bu31d3�tg *r ,
for each such building or addit3on. Niaiety Cents for each one thousand
cubic feet or fraction thes�eof, in the cubical contents-thereof with a �
min3mum pf,�4•00.
�� For the purpose. of computing fees for building �rmits the�cubicaZ contents �
of any building or addition to a uniform height throughout by mu].tiplying
the ,ground area covered fY�om a point six. (6) inc�ies below the floor line of
the basement or cellar to the anerage height of the upper surface or.to the
aeerage heigh'� of the roof surface�of the main gable of a pitchad roof.
2.5. For repairs or alterations �o an existing s`tructure, the fee shall be
at the rate of �3.00 for each Five Hundred Do11a,r,�,g ($500.00), or fraction
thereof in the coat of all proposed wortc.
2.6. In no caae ahall the fee°charged for any perm3t as set forth in
Secti�n �"be less than $4.00.
_ �"1 �
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� .- ' _
�•se ��q . , _
f�'I' I.OSS CALCUL.ATIONS DEPAf�TMEN� OF' BUILDtNCS
�/eetherscrip� A'�' •�• • Conatruction No.
_ Guide
Windocve � Doors Rcfmrenee Out. �/all Int. Wall Ceiling [doof Floor
ea— o Yes—l�lo 19_
m
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MINNEAPOI.IS. MINN.
Insulation
How Applied
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sue�ecr PERMIT_1V.0._ __
City of Fridley
AT THE TOP OF THE TWINS 2 2 4 6 9 �
; ` BU ILDING PERMIT
RECEIPT NO.
� `y __�� COMMUNITY DEVELOPMENT DIV. I� 3V
r � � PROTECTIVE INSPECTION SEC.
� _ �
( /"'1 � CITY HALL FHIDLE� 55432 NUMBER REV DATE PAGE OF APPHOVEO BV
�-"'� � �'' 612-571-3450 910-F15 5/3/94 / /
JOB ADDRESS 146 Craig Way NE
t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 8 2 Pearson's Craigway Estates SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PFIONE
Rick Rubalak 146 Craig Way NE 572-0159
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PNONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASSOFWORK NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
�
8 OESCRIBE WORK
Construct a 12' x 16' Sh d
9 CHANOEOFUSEFROM TO
STIPULATIONS Shed must be kept at least 3 feet from the side or back lot lines or
off from any easement. Maximum height 14 feet. Shed must be securely anchored to the
ground by either putting it on a foundation or tying it down with anchor ties.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY IOAD
SEPARATE PERMITS ARE fiEQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONINd S�. FT. CU. FT.
AUTHOFiIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEfi WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPIICATION 1 STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W3sOJL �1.53
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING cor,- 63.00 FIre SC �3.0%
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �
PLAN CHECK FEE TOTAL FEE
67.60
SIGNATURE OF CONTRACTOR OR AUTHORI2ED AGENT IDATEI w Y LIDATED THIS IS YOUR PERMI
�.� � �R�l " ���'�-� --��-��
SiGNATUREOF WNERi1FOWNERBUILDEf71 1DATE� 8 G iNSP naTE
NEW ( � Effective 1 / 1 /94
ADDN j) CITY OF FRIDLEY '
ALTER (� StNGLE FAMILY AND DUPLEXES R-1 AND R-2 � l b3O
Building Permit A�lication
Construction Address: ': `� � �',�c�.�����___ --- ----- -- ------- -- ------
Legal Description:
Owner Name & Address: �,��'(��,bC�,�,i� ��, C� ,.�� �,�,� Tel. # S�,-(�\��
Contractor: (")�.�, nQ � MI�1 L[CENSE # -�4�;-13�5361 �s`��
Address:
Atta.ch to t6is application, a Certificate of Survey of the
lot, with the proposed conshuction drawn on it to scale.
Tel. #
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length �dth Height Sq. Ft
DECK AREA: Length Vf�idth Hgt/Ground Sq. Ft.
OTHER: 1 �� �-- � 1a, � \ „
Corner Lot [] Inside Lot j] Ft Yd Setback Side Yard Setbacks
Type of Construetion: (,t, o��� � C�c�.�..c' Estimated Cost: $`�- �.�CU`l �.
Approx. Completion Date: J u�p �. t4
(Cost on Back)
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: � �� �� �t APPLICANTt � L� '��Q� Tel. # Si �.• O l � �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� ������
$ �- � �
� /- S 3
$
$
$
$
$
$
� �%C�D
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Penmit Valuation (1/i0th%)
$.SO/$1,000 Valua6on
$S00 per SAC Unit
$5.00 (State Lic� Residential Contracto�s)
Alt "A" or Alt� "B" Above
$450.00 Canservation Plan Review
Fee Determin� by Engineering
Agreeme,� Neoes�y ( ] Not Necessary [ ]
BUILDING PERMIT FEE SCHEDUL-E
The Chief Building Official shall, before issuing pe�mits for the erection of any bui(ding or structure,
or for any addi6on to any existing building or strucdue, or for any alteration or repair to any existing
building or structure, upon appiication 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 $SOO,OQO
$500,001 to $1,000,000�
$1,�00,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $S00 plus $2 for �ch additional $100 or
fradion thereof, �to and including $2,000
-$45 for fiist $2,000 plus $9 for each additioaal $1,000
or fraction thereof, to and including $25,000
_$252 for fust� �15,U00 p��s $6.50 for each additional $1;000
or fraction thereof, to. and including $50,000
$414.50 for fir� $50,(�lQ plus $4..50 for each additional
$1,000 or frdction thereof, to .aad including $100,000
$639.50 for first �$100,OQ0 plus� �3.50 for each additional�
$i,000 or fraction thaeof, tn and inciuding �$500,000
$2039.50 for the first $�O,Q00 pius $3 for each addit[onal
$1,000 or fradidn thereof, to aad iacluding $1,000,000
$3539.50 for die fust $1,OQ0,000 plus $2 for each addifioaal
$1,000 or fractioa th�eof -
DRI'VEWAY DEPRESSION ESCROW
(Coacrete t�ufi Streets Only)
Alt;emate "A": Removal and repla.cement of curb and gut�er only - Driveway width plus 6 feet times
$13.50.
Alteraate "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 construcbion will be issued a minimum of 24 hours firom the time of appiication to allow
for proper review of the proposed stracture and of the coastruction site.
A Certificate of Survey of tfie lot, showing the locaiion of the foundation oace it has it has been
consiructed will be required before proceeding with the framing.
Znx6n
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3��° T-I-II PAN�L
'Le'WQOd SID��IG
an q." ���'�oM ��,�
ZII � �W
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p�ioNP� ;� �
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SuBJECT
City of Fridley 2 5 6 7 4
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � RE T NO.
� ; L ���__ COMMUNITY DEVELOPMENT DIV. _
f � � PFOTECTIVE INSPECTION SEC. Cj�i%e� fl
� . � d i.� 1
' � �'��� � CITY FIALL FRIDLEV $$43Y NUMBER REV DATE PAGE OF APPROVEO BY
�""� � �'' 612-5��-3a6o 9�aF�s 11/10/97 / /
J08 ADDRESS 164 CRAIG WAY NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ({ 1 Pearson's Craigway Estates SFIEET
2 PROPEf;TY OWNER MAIL ADDRESS 21P PNONE
Dean Althaus 164 Craig Way NE �
3 CONTRACTOR MAIL ADDRESS 21P PMONE LICENSE NO.
Wayne Brekken Construction 3836 Harriet S, M ls., MN 55409 823-9128 4978
4 ARCHITECT OR DESIGNER MAIL ADDRESS LIP PMONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
8 USE OF BUILDING
Residential �
7 CLASS OF WOIiK
❑ NEW ❑ ADDITION ❑ ALTERATION [� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (35 Sq) Tear-off; Insulate above roof deck
9 CHANOE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OGCUPANCV LOAD �
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IP WORK OR CONSTRUCTION ZONIN(i SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN BO DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTEii WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GApAGES
AND KNOW TME SAME TO 8E TRUE AND CORREC7. ALL PROVISIONS OF LAUNS VAIUATION SURTAX
AND OFiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2.919 � L.�FC
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEFM1T FEE SAC CMARGE
PROVISIONS F ANY OTMER STATE R LOCAL LAW REGULATING CON-
STRU 710N R TNE PERFORMAN _ F CON UCTION. �7�F.7S Fire SC �2.92
PLAN CFIECK FEE TpTAL FEE
�� — � � � License SC $5.00 $84.13
�SIGNATUREOF ON'FACTOAO ti1UTNOAIIEDAGENT IDATEI FIEN PROPERLV VA ATED THIS IS YOUR PERMIT
�" „n //� � I
SiGN4TUAE OF pWNEA i�F pyyNER BUILDEN� IDATEI � „��
. B�OG i Sp iE
rrEw
ADDN
ALTER
[]
[l
[�°�
ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�;
Owner Name & Address: __%��� �v ��°���-�s-s' Tel. #
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1/1/97
NIN LICENSE # ��%�
Tel. # �.� �/ �'�
Atta.ch 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
`C C'�C) �"`� �� S J � ✓L
Sq. Ft.
Sq. Ft.
Sq. Ft.
,�� sv�- ��� � i�� v� �d��' ��' � �.
Cor�struction Type: ���(� t� F Estimated Cost: $ � �
(Fee Schedule n Back)
Draveway C�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: — � — �' APPLICANT: Tel. # r� .� � % / , � '
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � �
� a. 9�
$ /- y�
$
$ �- G�
$
$
$
$
� ��/�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 per SAC Unit
$S.QO (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 $25,0(?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 $100,000 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 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.
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 it has it has been constructed
will be required before proceeding with the framing.
, -�.
SUBJECT
City of Fridley 2779 4
AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T
r
� � O.
� ' COMMUNITY DEVELOPMENT DIV.
' j L � / �
r � � PROTECTIVE INSPECTION SEC. C��
1 . �
� _ /"'1 � CITY HALL FRIDLEv SS432 NUMBER i1EV DATE PAGE OF APPROVED 8Y
�����'�'� �'' 612-5�i-3a5o s�aFis 9/15/98 / /
JOB ADDRESS 146 Craig Wa NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNEO
oescR. g 2 Pearson's Crai a Estates SHEET
2 PROPEFiTY OWNER MAIL AOORESS 21P PMONE
Rubalak Same
3 CON7RACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Gates Roofin 4640 %imines Ln P1 outh 5 442 5 0-0
4 ARCHITECT OR DESIGNER MAfL ADDRESS ZIP PMONE LICENSE NO.
5 EN(iINEER MAILADDRESS ZIP PMONE LICENSENO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ,❑ ADOITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (28SQ) Tear-off
9 CHAN(3E OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPAqATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, MEATIN(i, �PE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DA'�S, 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 OFfSTFEET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TIiUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUAT10N SUpTAX
ANO OFDINANCES GOVERNING THIS TYPE OF WOpK WILL BE COMPLIED $2, 399. OO �1 . ZO
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR �OCAL LAW REGULATING CON- �](�,.75 F� 2 SC �Z.�FO
STRUCT N OR TH E�ORMANCE OF CONSTRUCTION.
Q G PLAN CHECK FEE TOTAL E
� �'� �'c� � �p Licen SC $5 0 $83. 35
G ATURE OF CONTPACTOF OR AUTMOR12E0 AGENT IDATEI N OPE r A IDAT HIS IS ��IT
V
SiGNATURE OF OWNER��F OWNER BUILDER� IDATEi B NSP fipTE
- �
N� I l
ADDN [ ]
ALTER I ]
ConstructionAddress: �
Legal Description:
CITY OF FRIDLEY
SINGLE FAMII�Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
��
�1 ,��
�' ��
Owner Name & Ad ress: �b�(,�, Tel. #
�
Contractor: � Q.� �o �-t �,� MN LICENSE # L� i3
Address: ���,� �C�l�,i,�S �'� Tel.# a��0'�6�3
� 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:
DESCRIPTION OF IlVIPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length � Wid�,h Hgt/Ground Sq. Ft.
Construction Type: �r (o�� + ��G� � o�d� Estimated Cost: $ �J �9
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �� t� APPLICANT: �J� ��j Tel. # �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� �S�
$ 6
$ � �U
$
$ SS vv
$
$
$
$
$ �.� .�.�
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 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,Q00
$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
$1,000 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 $1,00O,OOQ
$5012.25 for the first $1,0(}0,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alterna.te "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.
� _ .
�3uilding
Inspections
763-572-3604
SITE ADDRFSS /
THIS APPLICANT IS:
BUII..DI�TG
RESIDENTIAL APPLICATION
CITY UF FRI]�LEY
PR��ERTY OWNER/ f N,d,ME:�
TENANT I ADDRFSS:
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROFERTY TYPI+J
PERNIIT TYPE
YOUR E-MAIL ADDRESS
J� .
�CONTI2ACTOR
��— The Home Depot A.H.S. Inc.
sTA� �tc 3200 Cobb Galleria Pkwy.
anDx�ss: Atlanta, GA 30339
PHONE '763-542-8826
❑ S`Il�tGLE
❑ revo FA License #20268257
❑ B.4SEMENT FINISFi ❑ ROQF
� DECK 0 SIDING
❑ SWIlvIIvIIIJG
z�rE oF woiuc: o �
o�
DESCRIBE WORK BEING DONE:
SIZE OF IIvlPRflVEMENT
NUMBER OF SQUARE,S
GARAGES
PROPOSED SIZE:
PROPOSID HEIGHT:
SIDING
0 V'myl
❑ Aluminum
❑ Other
�
LENGTH
fl HOUSE Bc GARAGE
0 ATfACF1ED GARAGE
❑ DEfACHED GARAGE
�Soffit
❑ Trim
❑ Fascia
�iTi'INDOWS
IN E3ffSTII�TG OPb'NINGS OY� DI�To LOCATION OF WII�DOWS
OR FOR NEW OP£NII�iGS-DESCRIBE SIZE OF
OPENING CHANGES 8c "
TYPE OF WIIJDOW TO BE INSTALLED NUMBER OF P
ALL FEES ARE BASED
TOTAL JOB V.
Permit Fee '
Plan Review
3urcharge
Fire Surcharge
License Surcharge
5AC Charge
�urb Cut Escrow
�rosion Control
?ark Fee
>ewer Maan Charge
Cota.l Dne
Permit No.: ��'")f'I� �
Received. By:
Date Rec'd:
�
LTTY STATE ZII',
■ �� i �
■ • M.i�;
BASENI�'NT REMODELING SUBMlT�
1. Existing Ficaor Plan
2. Proposed floor plaa
3. List of stiuch�ral members to be used
FOR NEW CONSTRUCTTON INCLUDING DECKS,
ADDTTIONS. & P01tCHES SUBMfT•
1. Site Plan/Survey showiag the existing slruch�res
and proposed project
2. Two sets of conshvction plans
3. Energy Calctilations
VALUATION, INCLUDING THE COST OF LABOR AND MA
(USING THE 1997 U.B.0 FEE SCHEDULE)
)N � �, �� OCCUPANCY TYPE
$
$ f�°l. ��°
$ 1 . C�
$ �.�
$ ,� . �aD
$
$
$
$
$
See Back Page for Fee Schedule
6S% of Building Permit Fee
(.0005) times the total job valuaxion — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contra.ctors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payabie to: Citv of Fridlev Attach
TEIIS IS AN APPLICATTON FOR A PERMTf-NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I aclmowledge that the information above is compleie and accura.te; that the work will be in
:onformance with the ordinances and codes of the City of Fridley and with the A�innesota. Consiruction Codes; that I understand this is not a
�ermit but only an application for a pe ' and work is not to start without a pe it; that the work will be in accordance with #he approved
>lan in the case of all work ch requir r view andapproval ofplans.
:IGNATURE OF APPLICANT , RINT NAME � .� l�
�
Building
MECHANICAL Permit No.: S� �>
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Date Rec'd:
DATE �a►��, O S YOUR E-MAIL ADDRESS
srrE �,nnxESS to C ' W A .�'c. .
THIS APPLICANT IS: O O �jCONTRAC7'OR
PROPERTY Np�: �,h�.c,.�,��e S O� Ci�C. � cN`�
OWNER/ ADDRESS: �A iM� CITY STATE ZIP
TENANT PHONE: �lA 3— So o� — 1310 S
CONTRACTOR �p��y NpME: ,
CONTACT PERSON �.. :� �e tir � s�2 a o�
SUBMIT A COPY OF �
YOUR STATE STATE LICENSE # �_er�_.. n �w� ���p`TE
LICENSE W1TH pDDg�g; ' Ci�Y STATE ZIP
APPLICATION (763) 754- �X so .
PHONE
,
PERNIIT TYPE �MGLE FAMILY ❑ TWO FANIILY O TORfilHOUSE
� ��r �LTERATION/REMODEL
TYPE OF WORK:
.
DETAILED DESCRIPTION OF WORK '� t1s'� .A1��.� ��-� -�g �, '� qa'O'�'e'
PER MS 16B.665 the permit 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 replacement of a residential fixture, excluding the fixtures. (T his should reflect only the cost of labor )
Labor cost under $300 =$I5.00. Labor cost between $300 to $500 = cost of labor ���=�x .OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (II�IDICATE TOTAL
NUMBER OF EACH BELOV+� ,�y� � MODEL: L4i �1��R/�/ SIZE/BTU
EquipmentInstalled . MFG: /�` SIZE/BTU
�G; MODEL:
MFG: MODEL: SIZE/BTU
A/C $25.00 FfREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00
AIR TO AIR EXCHANGEER $15 _FIltEP1.ACE (WOOD) $35.00 NEW GAS GRII.L $10.00
BOILER $35.00 ._FURNACE $3i.00 _GAS tJNIT HTR $10.�
CHIIvDVEY I,INER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $1000 GAS PIPING $10 00 VENTII.ATO
� �_ ,
j .._ z� �Y ;� ',!{��;
� ,e_ � . .�...� 4 �� � � 2� �..be � ri' �'td. A��n����, �ll- ,�I .z,.' i��3��✓c'?� 515;.. ...�., ��.• W�,
� �� � r ;. ��
... ,.
u �
�.. _, .: ,. _ . ,. ,: .� � . . . . _ .. . . . . . . . ;� .
.. ... _.. . _ _
� "" " � � J " . � , � Number of fixtures @ $10.00 x $10.00 $
Permit Fee � ,5 $ ,�
Surchazge $ .50 Number of fixtures @ $15.00 � x $15.00 = $ 'i�
1"OTAL DUE $ 15� ��b Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Total = $—�
TFIIS IS AN AFPLICATION FOR A PERNIIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge 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 w' requires view and approval of plans. �
SIGNATURE OF APPLICANT r PRINf NAME l, rl'�► 5 A D D DATE 1 al ��t e S
� , � � «t � ���«G Nsr,�� � � �� .��. . ,�` �.i � ti '�'�'�'""�� `� V;` e t ��"�Y 5��t��a�.
C;�ty oi r r�aiey
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
...
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC �
❑ NEW HOMES/ADDITIONS ❑ EXISTII�G HOME ❑ MAKE-UP A!R
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below) .
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. N�tlara]. Gas or PropanellFGC Chapter 3 with Iv�T Amendments •
2. 1Vlak�up Air (5ee note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Cha.pter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooli.ng load per room
a
a. Required on new constru.ction IMC 1346.0312 "
5. Ventilation .
a. Per MN Energy Code 7670 or 7672
6. Duct Design per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
�- /b�, �5J
Bwilcling
Inspections
76�-572-3604
DA'�E �� C�
srt� �nnxFSS /tl (o
TFItS APl'LICAN'T IS:
PROPERTY OWNERI
�ENAN'T
CONTRACTOR
SUBMTT A COPX OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERIVIIT TXPE
TYPE OF WORK.:
BUILDING
RESIDENTIA.L APPLICATIUN
❑ ovv�
STATE LICENSE #�
.4nn�ss:5f��i r
rxoz� l�5f y3 `.
❑ SINGLE FAMiLYINE
❑ TWO FAMII.Y/NEW
❑ ADDITION
❑ BASEMENf FINISH
❑ DHCK
DESCRIBE WORK BEING DONE:
STZE OF IIvIPROVEMENT
R.QOFIIYG
NUMBER OF SQUARES ��
GARAGES
PROY03FA SIZE:
PROPOSID FIEIGHT:
SaDING
❑ Vi�l
❑ Aluminum
❑ Oth�
WINI?OW3
IN EXiSTII�TC� OPEN"IIdGS QYes CINo
ORFORNEW OPENINGS DfiSCRIBE SIZE OF
OPENII�TG CHANGES 8c
CI'TY OF FRIDLE�
�COUR E-MAIL ADDRESS
rn�r ��c
�
i�
F.
CTION
[ON
GARAGE/S:
R.00P
SIDING
y�
����
Permit -b/ -
Receiv d SY_
Date R c d: g/� a�
s�r .� E z�
EXP DATE ,T�/ � �Ca i
CITY !�' _ TATF/�ZIF�l���-
❑ DRAIN TII.S
❑ OTHER
❑ SWA�Il4IIN(� POOL
ADDTI'ION
CE/REpAIR REMODELING
e�v d� �d �e%o� �
LENGTH WIDTH
❑ HOUSE ONLY
❑ HOUSfi & GA.RAGE
❑ ATCACI�D GARAGfi
❑ DETACi�D GARAC�E
USoffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
Ft.
BASEMEN'�' ILEMQDELI ' � � SUBMIT:
1. Earisting Floor J 3 i
2. Proposed floor � � n
3. List of strucWr I � iembers to be used
FOReJSW CONSTRUCT � Q INCLUAING AECI{S,
�►DD�ONS Rc PORCF� ; iUB14ITf:
1. Site Plan/Surve hawing the existing structures
and proposed p � : xt.
2. Two sets of coz : uction plarts
3. Energy Caicula i �s
........... ... L�.......,....�..,
ALL k'EEES ARE BASED ON VALUATION, INCLUDIl�TG THE COST OF LA.BOR AND MATERIA 1 S:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ c� %�D, OC.� OCCUPANCY TYPE _
Permi2 k'ee
Plant Review
Fire Surcharge
Succharge
License Surcharge
SAC Charge
C�ub G�t Escrow
Erosion Cotttrol
Park Fea
Sewer Maffi Claarge
$ �7, Z� See Back Page for Fee Sched.ule
$ � 65% of Buildimg Permit Fee
$ 3. 9 S -001 timas the total job valuation
$ / �j' �— .0005 x Pernut Valuation Minimum $.50
$ � o U $5.00 (State Licensed Residential Contractors)
$ 51550 per SAC Unit (Plans to MWCC for detarntinati >)
$ ft+6ft= fix$21 =$
$ $450 Consanration Plan Raview
s Fe@ Determinea by Engineering
$ Agraement necessary ( ) Non Necessary ( )
� D..�j . M�ke checks payable to: City of Fridlep Ai t c
THLS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSID
I heisby apply for a building permit and I acknowledga that the infornnation above is complete and accurate; zat the work will be in
conformance with the ordinances and codes of the City o£ Fridley and with the Minnesota Conslruction Codes; th� t_ undezstand this is not a
pernnit but only an application for a petmit aud work is not to start without a permi� that the work will be in acc� �� �ance with the approved
plan im the case of all wozk w' requir eview d approval of plans. �/
SI(iNATURE OP A.PPLICANT � .,e ' PRINf NAME b��% V" f/"'`/�J DATE ��`7/D�i
Building PLUMBING Permit No.: tx�S -�a5
Inspections � RE+ SIDENTIAL APPLICATION. Receivec� By: �
763-572-3604 CITY OF FRIDLEY D�'d! A 6�
DATE YOUR E�vfAIL ADDRESS
SITE ADDRF.SS �aw�L a�.s �wwt�/ .
�s arpLtcaNr ts: o ownrEx �:otv�xa,croR CharlesBrenda McDade
PROPERTY N�: 146 Craig Way Northeast
��R/ ,,,��: Fridley, MN 55432
TENANT �TATE ZIP
� pxor�: 7635021365
CONTRACTOR N,�: •
SUBMTT A CQPY OF STATE LICF,I�ISE # C% E7� DATE
YOUR STATE ADDRESS• J7 i I CITY �' � /1 STATE� S��O�
LICENSE WITH pHONE — �/03 FAx —
APPLICATION 9 '
PERMIT TYPE �STNGLE FAMII.Y ❑ TWO FAMII.Y 0 TOWNfiOUSE
�rYrE oF woxx: ❑ �w � ���c�
DETAILED DESCRIPTION OF WORK %
� PER MS 16B.665 the permit fee is a minimum of $15,00 or 5°/a of the toYal cost up to SSOO.QO; whichever is greater, for the
impro�ement, installation or replacement of a residential fixture, excluding the fixtures. (T.his.shoul�r.eflect only.the cost of labor )
Labor cost under $300 =� 15.00. I.abor cost between $300 to $500 � cost of labor x AS =
>FOR�R�JF,CTS WE�RE I.ABOR EXCE�S�3UO;FEES ARE BASED ON $10.00 PER FlXTURE; EXCF�3"sW�xEA(J:'I�E�.-FI�CT�:�-.(II3DIG�TE TQTAL
NUMBER OF EACH BELOVi� '
BATH SINK/LAV _FU)OR DRAIIVS SHOWER WATER PIPIIJG
_ BA1i37'UB _ GAS PIPING �EmcmLC�) SWIlVIMING POOL WATER SOFINER ($35)
_ CLOTHES WASHER _ KITCHEN S1NK WATER CLOSET � BACKFLOW PREV. ($1�
_DISHWASHER =LAUNDRY TRAY ,LWATER FiLATER ($35) FOR lRRIGATiON
_ WATER METER OTHER
�- .
- `" l :�;
. .. , „ . .v...: _ � . - ... . . -- .
Permit Fee $ Number of fixt�n�es @$10.QO x$10,00 =$
Swchar e .50 Number of fixtures @$15.00 x$1 S:DO =$
TOTAL DiJE $ Number of fixtures @$35.00 � x$35,00 =$ 3S.Oo
.. . State Surcharge = $ .50
Total ° $
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building pernait and I aclmowledge that the information above is complete and accurate; that t6e work will be in
conformeince with the ordinances and codes of the City of Fridley and with the Minnesota Consttuction Codes; that I understand this is
not a pernut but onty an application for a petmit and work is not to start without a permit; that the work v�ill be in accordance with the
approved plan in die case o 'ch ' e eview and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME_ JC. /i/O/�ION�i DATE � d O
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977