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�Y� -�tERE�Y ',Lkt�,l`tFY. 'I'�lAT TR1� iS A'tR1il Mta' CORIxEGT' "t.�PRESEMTATICl1� qF A� S�URY�Y��t3f TNE �OC1N�A�R1�5° � TH� `
tiA�lO i.��l`E D� 3� LAi@� U �! I R O�'�'! 1� C G C A i l O i t t ; O� 1� t. L B 1 J� t� O l 1� t G S, I F A� 1 1 d", ? H� R� O R 1, P 1 t� I Q l�+ t t. V I� 1� l:� E N C R O A t F i M� N l' Sa`; . �' I
1� ANY, FROM' 4R, oN , Sf�10 tAt3t�r. .y� t`�r{� -�'j R:� /� t� �pt /� . ;
ONT4k 'TU}�—�.r-.- pw�f o�-_ �I,t/''/T�G P kJD.t�15 .J�c lY.i t YV V E(4 �1� V I Iv �� 15,.1 N W CQ.9 ��G . - . a I
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City of Fricll.ey, Minn..
BUII�DING PE T N� 5 o i~
���,.�
Date: � """"' �-. � �°`'
x �
Owner: �i�� � Builder �..-- —
Address �'_" � °� <'' � Address � '�
�, �.. LOCATION C�� BUILDi1VG
No. � �r .,i� Street _ � . '�'�'°� •%` `' ! — Part . Lot t ,,�
Lot �__ Biock dil3on or Sub-D visi ?"� r�.�. � -�'�
�n�'�"�.�_ ✓
Corner Lot � Inside Lot � Setback Sideyard ._.��
Sewer IIevation
Foundai3on IIevatfon
DESCRIPTION OF BUILDIt+fG
To ��! Used�', � 4 Front ��r s�.. Depth � Height �. Sq. F't. � ~ Cu. Ft a� ,�
� ,�i
n Fr�nt Depth �- �' H'ght ��.�; Sq. F� r Cu. Fti. �`'"'�`
_ ._ F u bn. � � . ���R"�3' ...�,� , �'�iu�
�e of �Onstruction ES�. Cost _ To be Completed ^
In consideration of the fssuance to me of a permit to construct the building describerl above, I agree to do
the propased arork in accordance with the description above set forth and in compliance with all provisions oP
ordinancea oP the city of Fridley.
��
In consideration of the payment of a fee of $�,�,�—�"�� ., permit is hereby granted to
to construct the building or addition as descxibed above. This pexznit is granted upon
tlae express condition tlnat the person to whom it is granted and his agents, employees aad worl�nen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesuta regarding location, construction, alteration, maintenance, repair and moving of buildinga
withiu the dty I3mifs and this permit may be revoked at any time upon violation of any of the provlsions of said
QYdiIIAIINP.�. _ ,,�,� .,�
+, �
r�
��a.; •%.��'�uilcling Inspector
NOTICE: �
T6is peneit do� net eover fhe eonshueHoe, inafellaHon io� wiring, plumhing. eas heatteg, sswe� or water. Be sure to ses
�hs Building Iwpeetor for ssperate permits Por f6ese itenn.
�, 4 /""�
— ---- - — ---
� _ "�' _ _ i.—� _ . �l
' � _ —y4
APPLICATION FOR BIIILDINa PERMI'r
CITY OF FRIDLEY, I�IIlJNESOTA
Owner's Name �'�! Lt� �� r �C /d�} Builder r` � I�j�'`D �Z, � / j /� /�-
_ �
. ...
�d.drese �f �" � ��? � �� � Address � i— L' S' Z c. y_ �f �c
No.
LOCATI4N OF BIIILDING
of Lot
Lot H1o�k � � Addition or Subdiv3aion
Corner Lot Inside�I�t Setb�.ck Side-Yard
SEWER ELEVATION FOUNDATION ELEVATION
�pplicant attach to this form Certificate of Survep o� Lot and proposed build3ng
locat3on.
DESCRIPTIQId OF BUILDING
To be �aed ae:
Sq. F't. Cu. Ft.
�
v . Ft. Cu. Ft.
T�pe of Construction Estimated Coat ��� � __
To be Completed � �����-���
The underaigned her�by makes applica.tion for a permit for the work herein specified,
agreeing to do all work in etr3ct accordance wiih the City ardinances and ruling oi
the Department of Bui].dings, and hereby declares that all the facts and representations
ste.ted in this appl3ca.tion are true and correct. ,,f" �-
>
DA7� ��' "' •� � � �. SIGNgTURE � `'� -
(A Schedule of Fee Costa can be found on the Reverse Side.)
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HIIII�ING PERMIT FEE SCF�DIII�
Sectioa 2. 7.7ae Inspector of Bui].din�s ahall, t�fore issuin� e�Y parmit for the
erection of ex�► building or atruature, or for e�y addit3on t,fl e�„q �d.stia6 bu�ld-
ing or struc�e, or for ar�p alterations or repairs to e�y �xistin� buildi.n8 or
structure, upon appliaetion therefor, requise the pe�qment by the e,ppl3caat for
such perm3.t of fees to the amount here3n below aet forth and in the meaner h�e3a
provided to-wit:
2.1. For s.n� such permit for the erection of er�y f3r�-proof bu3ldin�� other thaa
a gsrage, warehouse, factor� or gra3n elevs,tor, or for the erectioa of eay fire-
prooP add�.tion, for aimi].ar occupehc�, to any exia�in� bui7.ding sh�.l. be at 'the
rate of �1.40 for each one thousand cubic feet, or i�act3on thereoP' in suoh
cubical contenta.
2.�. For any snch perm3t for the erection of �y f3reprooi gerage, varehouoe,
factory or �reiu elevator, or for the erect�.on of e.ny firegroof addition, �or
aim3lar occupancy, to a.ny existing buildin� ahell be a,t the ra.te of $1..25 ��'
ea.ch ane thouaand cubic feet, classiPied aa "firegraof" by 3ect3.on 5�2 of the
Minneapol3s Building Code.
: t 1 �:
2, 3. Eor an,y such permtt for the erect3on of anar non-fireproof building o'�he�t'
than a ga.rage, warehouse, factor� or �s3.n �levator, or any no�-fireproo�
addition, for �similar occupaney, to auy exiet3ng buildi.ng. Perm3.t $]..00 tor
each ono thousand cubic feete
GAR.AGES
2�1�, For any such perm3.t for the erect3on of ar�r non-fireproof gar�e, wax'ehouae,
factory or grain elevator, or for the erection of any nor�fireproof addition, far
sim3].ar occupancy, fi.o any existing building or fbr ee.ch euch building or addition.
Pdinety Cents for ea.ch one thousand cubic fe�t or fract3on thereof, in tbe cubic�l
confi.ente thereof with a m�.n���+ of �4.00.
For the purpo�^ of computing ieea for building peiomits the cubic�a7. conten'te of a�,y
bu3lding or a.dd3.tion to a uni"orm height thx�oughout by multiplying the ground eY'es
covered from a point aix (6) inchea below the floor line of tbe �.s�nent or aellar
ta the average height of the upper surface or to the avera�e he3�ht of the roo�
aurface of the main ga.ble of a pitched roof.
2,5, For repa3ss or altera.tions to an ex3sting etructure, the f�e sha17. be et the
rate of �3.00 for each Five Hundred Dollars ($5�a00�, or f'ract�.on thereoF 3n the
cost of a11 propoaed work. , . .
2.6. In no case shall the fee charged for any permit ae set forth in Section 2 be
less than �4.00.
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CRONSTROMS HTG. & AIR COND.� INC. Job Nam� �/��'���� .�'���'� ��%�C �
�S6 4410 F.xeelsio� Boulevard, Mlnneapolis 16, M(nn. . ,,
�e ' N6AT LOfS CALCYLA7'IONS Job Addre � �� �= � ��
A.S.H.V.E.
Weatherstrips Guide Constructioa No. I � Insulation ',
Wiadows I Doors Reference Out. WaA Iat. Wall Ceiling Roof F7oor I Kiad How Applied
Yes—No Yes—No 19_
Fl.� ,�+ Room Length ��+' Width ��' Height ,� Fl.� Room Length �"�' Width ,�'��:' Height
Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area
�Vldth Helght No. ot Lineal [. Area �f Wldth Height No. 01 Llneal it Area
No. o[ pane ot pane Ilghte ot crack eq. [t. j No. of pane ot pane IlBbta of crack eQ. [L
� � � � � �' ��f � � � �
Coef. Btu Coef. Bcu
Infiltration �
Glass ,� ,
Exp. wall �; .
Net exp. wall ��' ��
Int. wall
Ceiling �,,:r ,,t �t" ;� �
Floor ,�!_ �`
Total Btu.
Required sq. ft. E.D.R. or aq. ins. WA. L.eader area
Fl.� Room) Length j'Width e�,n�Height
Windows and Doors---Crackage and Area
Wldlh HefghL No. of Ltneal it. Area
No. ot Dgne ot pane llghts ot cracB ep. f�
s� � '�' �.'i�
Coef. Btu
Infiltration
Glaaa � � f �
Fap. waU
Net e:p. wall � � ,� ,�
Int. wall
Ceiling ,,* �p � �
,
Floor �
Total Btu.
Required sq. ft. E.D.R. or aq. ias. W.A. l.eader arca
,�/ Fl. Room � Length � Width /I'"�1' Heighc .
Windows and Doora—Crackage and Area
Wldth Helgbt No. ot Llneal tt. Ares
No. ot Dgns ot pane Ilshts ot cnck sa. tL
�
Infiltration ,,� �
Glaaa �!'
Eap. wall /► :
N�� esp. wall �
Inf wall
Ct�ng !'s �' �,
}� loor �'
Tbtal Btu.
Required aq. k. E.D.R. or aq: it�a.;`W.A. Leader area
Infiltration
Calaas
Eap. wall
Net eap. wall
In� wall
Ceiling
Floor
Total Btu.
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Windows and Doore—Crackage and Area
Wldth Seight No. o! Ltneal ft. Area
o[ yane of pane llgbte of crack ea. tt.
� .+i� ;6.+' � .
�
Infiltration
Glasa
Eap. wall
Net eap. wall
Int. wall
Ceiling
Floor
Total Btu. �
_ I Required sq. k. ED.R. or aq. ins. W.A. Leader area
Fl•� �'9,�"i�' . Room I Length �2 Width ,
Windowa and Doora—Crackage and Area
Wtdt6 Helght No. o! L1nea1 ft. Ares
No. ot pane of Dane Ilghts ot craak sp. tt
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�,(� Net eap. wall
In� wall
�� Ceiling
-Floor
�i! j� 'foEal Btu.
:q. k. E.D.R or aq. ins. WA. I.eader area
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City of Fridley
r aT T� ror or rN� TwiMa
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�'L-""--� GOMMVNITY DEVELA/AfENT QIV,
� �` � M10T�CTIVR w1�CT10N O<K
` i r--- � GT1/ MAI.L sIU01.`Y �M�
4.�_.�.� �.�! N�'6�0•3�p
J�D Aaal@SS
ner
Contractor
Rind of Bui
Comp etion :
53-8t�-s-915. 51
•ue�ccr
lli7 N. E. Craig Wa�r
Kidylo X. Czichra�r
�111NNE�.�SCO
Frame
5-10-71�
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PLUMBIiVf PERP1IT APPLICATI�id
-� ioa � v
Ad ress
�dc' res s
Use
��°`�
��� f�1A���1E � d � AV�I�IIE
Res. MPLS., M9N{�.
io.00
Plumbing Fixture Rates: N0. RATE TOTAL
Number Fixtures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg. x$3.25
Elec. Water Heater
Gas Fittin Faes:
lst 3 Fixturea
x $2 . 00
x $2.00
-�—_�
' Additional Fixtures x $ .75
� I
IGas Range-199,000 BTU x $5.00
Repeirs � Alterationa
See IDescription; Install Grill �ode 5 00
s
S tate Surcharge � �� V"�' �:�� � � ���, _ ����. . 50
�
� TOTAL FEE $ 5.5�
!The undereigned hereby makes application for a peranit
for the work herein apecified� agreeing to do all work .
in atrict accordance with the City �rdinances and rulin
of the Department of �ui7.dinge, and hereby declare that
a11'th� tacte and representationa atated in thia
application are true and correct.
�-s �:`:�� � , P�`�.�-d �.
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��7
sue�ecT PERMI .
City of Fridley 18355
�
� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � CEIPT
' � ti.------
COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC. � � �7
� � O
� � �
� � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�'""� � ,�� 612-571-3450 910-F15
3/27/86 � �
JOB ADDHESS 147 Crai.g Way N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCH. 3 2 Pearson's Craigway EstatJes SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Kirylo Czichray 147 Craa.g Way N. E. 571--8464
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Lakeland Brick & Stone Tnc. Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRES3 ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW X ADDITION ❑ ALTERATION ❑ REPAIR � MOVE O REMOVE
8 DESCRIBE WORK
Construct a 15' x 14' Addition to back of dwelling
9 CHANaEOFUSEFROM TO
STIPULATIONS
� �` �IA��I�G
�efore digging �a�� ►ocal uti►ities 'SEPARe4TE PER�ITS REQ[�I��p F�R
TELEPH'ONE-ELECTRIC - GAS Etc. �/IRI�VG' P-�EATIIOIC�a PLU�I�IIVG A�lp �����
itEC�tJI�E� �Y l�`�
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI Fr�2
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPEWDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WOHK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GApAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S��2rJO y�`4.63
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. .}`HO. SO
PLAN CHECK FEE TOTAL FEE
$20.13 $105.26
SiG u OF Tf7ACTORORAUTNORIZE rvr tDaTE� WHEN PROPERIY VA ATED THIS IS YOUR PERMIT
� - �a
ATURE OF OW IIF OWNER BU DERi IDATE� BLDG INSP ATE
NEh (] City of Fridley Effective 4/1/8b
A�Dt� . [ L R-1 AAD R-2 �
pLTER. [•] Building Permit Application
Construction Address: � �"� � � A-� Q' � �`f °'Vl � �. �j � �_�L-�f
. � -c
Legal Description: L �'� � � � �-r�.�, 2 ���,cd,,z G ��, *q � �� � srq r-e __�
Owner Name s Address : E� ��� �-o C� e" �-�2 e2 I� Y Tel . i �'% t Zi ���
Contractor: �.F}G2�?�A �� �12�°�� �C S� ��� � Z In �, T�l. i 5 7/ Zi�!-� �
Address: ���' C/� �,��_ � �cf
T
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draxn on it to scale.
DESCRIPTION OF INPROVEMENT
LIVING AREA: Length /.%�j- . Width � Height �_ Sq. Ft. � �v
GARAGE AREA: Length Width Height Sq. Ft.
DECR AAEA: Width t/Ground Sq. Ft.
� � �. _ � � '
OTHER : �d. � i
� � ��� . ',, � � .y a
Corner Lot [ ] ns3de Lot � ]
e �v�- �,�,—i�—�-�—
Ft. Yd. Setback
Type of Construction: � 0 � �� f' � 1`� 'W1 �—
Approx. Completion Date: � � � FrZ`/ �
Proposed Drive�ay Width If New Opening Is Desired:
DATE: �2 ��i
!
Permit Fee
Plan Check
State Surcharse
SAC Charge
Park Fee
SeWer Main Charge
��
STIPULATIONS:
Side Yzrd Setback
00
Estimated Cost: $
�� ��
Alt. A Alt B
a � __�
See Back Page for Explanaticn
APPLICAhT: v '� � _ Tel. 4 ��7�����
CITY OSE OA1LY .
��:� ,�
$ � :_
�„�,�,� Fee Schedule on Reverse Side
e1
� c�t� ��� �� 25� of Building Permit Fee
E -„
$ � �.-�� 5.50/$1,000 Valuation
3 `� a425 per SAC Unit
$ "� Fee Determined by Engineering
� �
Agreement Necessary [ ] Not Necessary [ ]
� I � s i`,�
-�'�
BQILDING PERMIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of ar.y
building or structure, or for any addition to any existing building or structure, or
for any alteration or rep�air to any existing building or structure, upon applicatio n
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:
ToLal Yaluation
11.00 to �500.00
�501.00 to �2�000.00
Feea
510.00 (Minimum Fee is �15.00) �
�10.00 for the first �500 plus �1.50 for each
additional �100 or fraction thereof, to and including
�2,000. •
32,001.00 to $25�000.00 a32•50 for the first a2,000 plus $6.00 for each
additional �1�000 or fraction thereof� to and
including �25,000.
525,001.00 Lo �50,000.00 �170.50 for the first a25,000 plus �4.50 for each
additional �1,000 or fraction thereof� to and
including �50,000.
550�001.00 to $100�000.00
S1Q0,001.00 and up
a263•00 for the first
additional � 1 , 000 or
including �100�000.
�50,000 plus a3.00 for each
fraction thereof� to and
�y33.00 for the first �100,000 plus �2.50 for each
additional �1�000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROiiI
(Concrete Curb Streets Only)
Alternate "A": Aemoval and replacement of curb and gutter only - Driveway Width plus
6 feet times S73•50
Alternate "B": Removzl and replacement of curb and gutter and install a 3 foot Wide
approact: With 6 inch depih - Driveuay width plus 6 feet times �15.75
VERIFICATION OF FOUNDATIOH
Permits for construction Will be issued a minimum of 2u hours from thE time of
application to a11oW for proper revieu of the proposed structure and of tre
construction site.
A Certificate of Survey of the lot, sho�ing the location of the foundation onee it
has been constructed will be required before proceeding With the framing.
� a-
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