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Date:
Owner:
City of Fridley, Minn.
BUILDING PERMIT
►I�� P3°�*',�
N°
Builder _.---•-------._...._ .
Address .--••-----_. _:�-��---�::._._..__.__-------T_._.___
LOCATtON OF BUILDING
No. _�L':.._��=° --•�--- Street �'..:_?�: . - :�� ....:..�.a�`�.....-------------._.._......_ Part t ----•-;-------_...._.---.. ._.._.._.----- ---
� �
� �......_.......� Addition or Sub-Division ..� `
Lot ....__ . ....................... Block .---•---••-�---- �.--•--------.......:.. Sideyard ...�._....,�..� :.._�...
Corner Lot ....._ ...................-•--..... Inside Lot ....._.....��............ Set}iack .-----� � ,� . __...........------........
Sewer IIevation
F'oundation Elevation
DESCRIPTION OF BUILDING
To sea as •
"� - - A. /� �°
•-----� -._..... _ Front ----�� �p� --��1-.. Height _....�.. Sq. F� �� Cu. F'�� .��....��
--- • -� -• - - -.�!�. -- �.._... on .._�.. Depth ..�... Height ....x""�.!��... Sq. F�. ."���._.. Cu. Ft ..�r?'..�
..� /ry
Type of nstruction ....F��.,��'J.'�..... Est. Co ---.� ...,�j'�. .�f�'.�To be Completed ....._._-----.--- .............__._.._.........
/
� THIS PERM17 p ���1��
�r ---_.`�T AUTHORIZE VIp�AT
14N '1Pd'1' P,�;I . ;� I-E LAI`�p
EUILDi�'dG �;�.�T;-;:�rlONS. �OVENANTS AND
In considera.tion of the issuance to me of a permit to construct the building described above, I agree to do
the propased work in accordance with the description above set forth and in compliance with all provisions of
ordinances oE the city of Fridley. _
In consideration oP the payment of a fee of $. .._ --_:.--•------•--. Permit is hereby granted to...-------.._....-------
_._._ __........_..�..—_.._.._...._._._ to construct the building or addition as described above. This peravtt is
t&e express condition that the person to whom'it is grantecT 8nd his agents, employees and workmen,�'u► 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 location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at ahy time upon violation of any of the prnvisions of said
ordinances. �"" .�7.e!a .-.--�,
BUIl(�lAg I173pECtOP
NOTICE:
This permit does nof eever fhe eonsfrueiien, inslallafPen fo� wiring, plumbing, gas heaiing, sewer or waler. Be aure to see
the Building InspeNor for separale permifs fo� these hems.
�`` 4 '�"�
, `
�_ . . 4�
.e _ ._ "'�' — _
OW2181"8
�aT698
��scgs�vx � evi�n�� r�a�
� CITY Og FRTDLEY, MINNFSOTA
� i��- ,
...��,.� �--
LOCATION OF BIIILDING
- �. _ �...
No. % < <� 3treet� � ,,_,,,,,Pert of Lot
/
Lot_ Blacls . _� Add3.t3on or Sub.D3v. �
_,�
�
Corner Lot In�ide Lot�_S�� Back e3 .� Side-Yard L,,�. �",�__
SEWEB I?Li,�;VATION � F'aUNDATIDN ELE�iATION •
Appl3cant attech to t}�i.s form Certificate of Survey of Lot and proposed bui].ding
loca.tion.
DESGRTPTION OF BtiII� ]NG
To be used as:
F4�o�t Depth � � Height
�• 1' LI�-_��� w VLL• 1' {�• �t/' /���
' , F�ont ,v� � Depth Height f �
5q. Ft.��l: ,_ Ft._�� ��
� ��
_ .� � �' `��
Type of Constructian •�� Tst�oated
� �-
• •1
s -
The underaigned hereby makes application for a permi.t for the work here3.n egecifi�l, -_
agree3.ng to do aLt �rork in str3et accordance wit e C3ty Ordinances and rulin� a� '
the Departanent of Bui7.dings, and hereby decleres tha a11 the f�cts and representa-
tivns siated 3n this application er� true an c ect. _
DAT� � � � � - � � SIGNATIIRE
,
(A Schedule of Fee coats can be found
/'1
R . . a
Reverse Side.)
P`'�
` BUU.[LDING PERMIT FEE SCAIDULE
�
Section 2. The Inspsctor of Bu3ldings aha7.1, before ia�uing arny perm3:t
Yor. the ereation of any building or structure, cr Por any addition to
any egi.sting bu3.:ldia� or structure, or for an� alterationa or re�.r�
to.auy exiating_bu3lding or struvture, upcn a.ppliaetion therePor, r�uire
the payment by the applica.nt far such perm3t of fees�t,o the amount�herein
beiow set gorth and in the manner here�.n.provided to-wit:
2.1. For any such permit for the erecti.on of an�r f'ire-proof building, other
�Chaa a�arage, vTarehou�e, facior�► or grain elee�tor,_or Por the erect�on of
aqp fireproof addition, Por similar occupanc�r, to a� exiating hu3.lding �
shall be a.t the rate of .$]..1�.0 for ea.ch one thousend cubic feet, or . f5raction �
thareaf, 3n suah oubic�.]. content�.
;_ .
2.2. For ang such perm3t for the erection of any fireproof �are�e, ware- :
house; factory or grain elevator; or for the ereotion of..any. fireproof
addition for similsr occupancy, to a� existing buildin� ahe11 1� at the
rate of �1..2� for e�.ch one thousand cub3c feet, cle.ssified as "fisaproofn
by 3sction 502 of the Minneapolia Buil.ding Code. �
OUSk'�
2.3. For ang auch permit for the erection of any non-fireproof building
other than a garage, warehou�e, factor� or,�rain elevator, or ar�y non�
fireproof addition, for aim3lar occupancy, to any exiating bv�Iding. '
Perm3.t $1.00 for es.ch one thousend cubic feet.
GARAGES ..
2.4. For a�y such perinit for the erection oi' any nor�fireproof gara�e,
werehouse, factory or grain elevator, or �or the erection of any non-
. fireproof e,ddition, for eim3lar occupancy, to arry existing building �r
for each such building or addition. Ninety Centa for each one thoueand
: c���.feet_ or f`t�etion thereof, 3.n the cub3cal. contents thereoP rai.th a
n+�r,�t,�„+�► of �l..00. ° . _ _
Far tlae purpoae of aomputing fees for bu3.ld3n� permits the cubicel contents
o�' eny building or additiun to a uniforin hei�ht throughout by �7.tiplying
the ground a.rea covered from e point six.(h) inches balow the floor.line of
the basement or cellar to the aver��e height of the upper surfaae or to the
aeerage he3ght of the roof surface of tk�e main gable oF a pitehed roof.
�
2.5. F'or repa.irs or alterations to en exiating atructure, the f�e shall be �
at the rate of $3.00 �or each F3ve Hundred Dolla� (�500.00), or fractiori
thereof in the eost of all proposed work.
2.6. In na-case shaU. the fee ch�rged %r a� permit es set forth in
Sec't�.��� 'be leos than �,..�.
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TYPE OF EXP05URE No. HTM °! Btuh °` Btuh °� Btuh °� Btuh or ��h or ,.Bt
Length I.ength Lengt Length Length I.ength�
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ly Infiltration a . ,
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13 R.eserve Capacity if Desired ' ,. ' �;: ;:
14 " Front � � .� 'i Ci �°`" � : �
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Exposed � b
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� 17 Watm Floors
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� A liances 120U / Z o�e3
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21 Total Btuh Gain 1.3 �
" 22 Btuh for Air Quantities
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City of Fridley SUBJECT PE� .� n �1
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� e� ��
r
� � RECEIPT NO.
� ; L ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � `�
� � �
� _ �'�'1 � CITY HALL FRIDLE� 55032 NUMBER REV DATE PAGE OF ApaaOVEO Br
�----�: `.� 612-571-3450 910-F15 7/12/96
� �
JOB ADDRESS 170 Craig Way NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oESCa. 6 2 Pearson's Craigway Estates SHEET
2 PROPEHTY OWNER MAII ADDRESS ZIP PHONE
William/Jill Discher 170 Craig Way NE 571-1547
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Sam.e
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Reroof House & Garage (24 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY 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 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAiiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PEHMIT $1,980 �.99
DOES NOT PRESUME TO GIVE AUTHORITY 70 VIOLATE OR CANCEL THE pEfiM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OFi THE PERFORMANCE OF CONSTRUCTION. �62.Z.rJ Fire .SCi �1.98
PLAN CHECK FEE TOTAL FEE
$65.22
si tv aE CON' ACTOAOAAUTMOAl2EDAGENT ionTEi WHEN PFiOPERIY ALIDATED THIS IS YOUR PERMIT
' � ��/��r
SiGNATU OF WNEAdPOWNERBULLDER� IDATE� ��d BL �NSP ppTE
NEW
ADDN
ALTER
il
�l
[l
ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Z
Effective 3/1/96
Legal Description: U "
Owner Name & Address: ��)! (,�'G�� � �S
� CC � U�p�. Tel. #_ �i71 /Sz/ 7
Contractor:
Address
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTHER:
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
�n� Width Height
�n� Width Height
�n� Width Hgt/Ground
.
� �f ��M,A�? _ � 02 t% �'S.�P �
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion� Date:
`,
Sq. Ft.
Sq. Ft.
Sq. Ft.
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ 09�j(� aU
(Cost on Back)
Driveway C�trb Cut Width Needed: Ft. + Ft = t x$ _$
DATE: - � b APPI,ICANT: .
� � Tel. #` i%—�$e/�
Permit Fee
Fire Surcharge
State Surcha.rge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Gharge
TOTAL
STIPULATIONS:
$
�� � �S�
� �• ��
$ . C'j
$
$
$
$
$
$
� �� aa
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valua,tion
$900 per SAC Unit
$5.00 (Sta.te Licensed Residential Comractors)
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
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $1�,OQ0 plus $5.00 for each additional
$1,.� or fraction thereof, to and including $500,000
$2887.25 for the first $500,�0 plus $4.25 for each addirional
$1,000 or fraction thereof, Yo and including $1,0(�,OQO
$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)
Alterna.te "A" :. Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternaxe "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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applica.tion to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
NEW []
ADDN []
ALTER [ ]
Construction Address:
Legal Description:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
,, , �
II
(763) 572-3604 Bldg Insp
(763) 571-1287 Fax
Owner Name 8� Address: L�,.S� �P� �`i' ��� � � V)�j�C� Tel. #��t�.�,��-1����"(
Contractor: �j-C� � MN UCENSE #
Address: Tei. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on � to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft.
Length � Width Hgt/Ground Sq. Ft
Construction Type: 'I(�Q�� Estimated Cost: � ��%' ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �-I � APPUCAN . r Tel. #������
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ � �1 a 2�
$
� 3 � �f�
� I.��
$
$
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1450 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Consenration Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ t11 STIPULATIONS:
� �Z.(a�
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 applicaxion therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the m�nn.�r herein provided. to-wit:
TOTAL VALUE
$1 to $500
$501. to $2,000
$2,001 to $25,000
$25,001 to $50,000
$SO,QOl to $100,�0
$100,001 to $5�,000
$500,001 to $1,0�,0�
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fra.ction thereof, to and includ.ing $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,�
or fraction thereof, to and including $25,Qfl{l
$391.25 for first $25,0� plus $10.10 for each additional $1,000
or fra.ction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and includi.ng $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to a.nd including $500,000
$3,233.75 for the first $500,0� plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,0(� plus $3.15 for ea.ch additional
$1,(}� or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv '
MAR-14-2006 01:52P FROM:
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Building x«�ci,►� sy.%'
�ispectians R�S��N7'�A.L AP�'LICA�`ION Dat����� : � /� D
�63-572-3604 CI�°Y i�� �`�D�.•�Y�
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DBA: Practical Spstems
43428 Shady Oak Road
HOpkir�s, MN 55343
952-J33-18G8
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STAI'E�71P
. PF�t M5168.655 tbC per'�a
it fee is a minimn� �i�1�.00 or S% ot tbe total cost �p to 5500.00, witicb�e�d' is grest�, fot ths
improvameat; i�ssraltarion or replacemeac of a resi�deatitial fix�ure, exelud'u�g the fixturts• i'm� should �le�t oa�y the eoat a{l�bar
ti
i,abor cost uuder 5300 - 515.04, Labor cost bc�aeen S3U0 to SSOG = cost of Iabor _�,�
x.OSc��
F`OR PROJ�r3 wH'�t� iJ►�OR SxGEF�S ssCO� FE�S ARE BASED on sti o.DU Y�c t�Xi'uRg. �JCCtxr waERS NO�. �crtf�: t�iG►Te r4 r U.
, �of �►cH a�a.owa �o: a v M a n�.: V s�t�sru �
�P�t lnstatl�d • �; ��� MODF1,' S�ZF��iV _ --
� MOpE�: �.
"�G: CuiS x.+►�3Gfi�oY�h S�o.00
. ��� FfR,EpLr►C� t8a5) 315.00 � G�,�, 510.00
_AtR TO AIIi &�CWINCEEK S15 Fll(.EPLA�E (►�OC�D) S'+S•� � UMTH]'R Sio.oO
. �pll,$R S3S DO _Ftl�CE �35,00 I+OOL }�►TBlC S3S.Oh
�IBY LWER #2000 GAS [1RYER S10.00 '—VEM'B.A'PGR S1S-QQ
'�n�r wo�uc s�aoo �"'��ta�
. �.r��i L� ir 11 Ri i � i
rernu� ree � ,___�__�-_
Surohnrga ��—+���`
TQTAt DUE s ..,.— --�
Numb�r af f�ct�ues
Numbcr of fixnues
Number of fnccuros
Number oi �ixtures
�10.00 � 51v.4v = �;
�1S.00�x SiS.QO � S;
�j.�0 x SZS.00 � �
�35.04 x S35.Oa' �'
St�e S S_
Twt�i o i�
• 'tN1S I5 AN APPUG+'tlS�l FOR A PERMl7-1�►1�T V�D t3N7lL PROCE�SSED �
I hrrab'Y gpAlY for a build'mg g��mit ead i ackro�++lcQge thac Th� information above is c�mplete aud accvrnte; that tha vrork wi13 be in
ovnfar�enr.e �t ith t�e ordinettccs e�d wdes of tt�e Gity ef Fridtay utd wittt tht Mint�esota CAbS1riiGCi0t1 COdEt; tbst 1 tutdcr5ta.'�d thi3 is
iitalioa fo�r a it z�nd �vork is not tv stert without a poxriiit; tbat dle work will bc in aceordance with the
na� a pctmic but ouly an aP� ��'
�bv� �� ��� �,e a p�v whicb raq�uir�s revie'w sud approvg] of pLans•
StGNATURE OF APP41�. `rv�, � �� �►� PRiI��T N�k
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.
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City of �'ridiey
Suilding lnsr,ectio�s Dept�rtmeat .
6431 Univicesit�� Avei�ur N�. Fridley, MN 55432
763-572-36U4
FA.Y: 763-SOZ-4977
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