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1�i�TDER +�TC►IATEEI�INGr CQ.,Il"�C.
ENGI NEER� AND SURVEYt)RS
IwND aueavevwo SoEI.� TEBTINt3
CI�ftL Q�t, MtJNIG10AL ENOINEEfitNp LAND PLAhfNItJO
6418—b6T� AVENUE N.
� � MINNEA(�OU9 'tf, MINN.
KE T- 3637
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N!E HfiRE81f �ERTlFY THRT THt5 �5 A'i'RUE AND CBRREGT REPReSEhlTATIpN OF l� SURYEY OF THE BUUNDARiES OF ?HE
LANp A�GY� Q�S�Ri6EC ANa QFTHE LDLA7t8N OF ALL BUILQttJGS, I� W3Y, tHEREON , AND P.l.l. VISIBLE ENCROAGHMENiSa
i� �w�, FQOM iiR oN SAID LAND. �MINDEf� E�IGINE�(2lNC� CO., INC.
� . pATE[1 'CN�9 , "' DRYOF,,,,,, �e����a�r ti.o.��g9 �.� �. , � .
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City of Fridley, Minn.
/ 1
BUILDING PERMIT N� s�54
Date: ��! �—fS��
�
Oo¢aer: Builder � �
Address Address _.._..
LOC TIO OF BUIL ING
No. _����.�� 3treet _!�� art o t
Lot ���_ Slock ���� Addition or S-Divfsfon
� ,� e�, � / �
Coraer Lot _ Ina4de Lot _. SetUack _�L...—�_ Sideyari ��i �I �
Sewer IIevatiws _.._ Foimnda.tion IIevation
1 DESCRIPTION OF BUILDING
T V �
FY+ont �_. Depth ��� Height ..�.� Sq. F't ���� Cu. F'��!���
t_.�.� Depth �I�eight _.�� Sq. Ft' ,'�,�' " G�. FL��,y.�
Type oP ction Faat. __T..__ To be Completed
In consideratton oP the issuance to me of a permft to construct the building described above, I agree to do
� P�P� work in accardance with the description above set forth and 3n compliauce with all provisions of
crrdinanoes of the dty of FrYdley. ��,�� !�' c�
� �.
In camaiderat[on of the payment of a fee oP $�� permit is hereby graated to
to c�natcuct the building or addition as described above. This permit is granted upon
'Che express condition ttiat thepereon to whom ft ie granted and hie agents, employees and worlunen, in all work
dane in, around and upoa safd building, or any► thereo� shall c�onform itt all respecta to the orclinances of
0
FridleY, �esota regarding lpcation, constru on, alteration, ma3ntenance� repair aad moving of buflaings
wTthin the dtY 7imits end 'this peranit may be revoked at any ttrne upon violation of aay oP the provisiona oP ea�d
ordinaaces. - –
Building Inspector
Nonc�
'IYs permh dess aet cerer ths conatroeHoe, ImtalFrtien Ior trtrtn0, P�+�uB. 6p 6e�8, ��* or wsts�. B� wrs to as
da Bui(dteg lesp�etor for uparaf� p�rm6s foe t6as itMU.
�
At'PLICATI01� FOR gUILDING PERI+�IIT
CITY OF I�'RID%BYs MIl+�NESO'TA
� . . - : ,� - � �r � �� ' �' . - it�ii _� ,� , . �; � ��
-.,y � :.�r�x^.��-..�a�,�.�:..,.,
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LOC�TION OF BUILDING
�o• o�a � Srreetl� G�/ Part of Lot
L ./�.t�
,�� / ^
Lot B1ock�Addition or Subdiviaioa G�,�'
� �
Corner Lot�`rneide Lot SetbacYc ��'`�; Side-Yard /D �
�
SEWER ffi,EpATI0A1 � FOUN�ATION ELEVATTON
Applicant attach to thia form Z'wo Certificates of Su�vey of Lot aad proposed
building location drawn on �hese Certificates.
DESCRIPTION OF BUILDING
�
To be used as: ' j�_ '��'�,'���' �
d�
i
Front Depth__�Heigh� �� �z
Sq . Ft . /�. �,h_Cu . Ft . 9�d�� .
�� ' Front Depth Height
Sq.. Ft. Cu. Ft.
Type of Constructfon EatimaCed Cost �
� To b2:.Completed
7.'he undersigned hereby makes application for � permit for the work herein
� specified, agreeing to do all work in strict accordance with the City of
�ridley Ordinances and rulingg of the Department of Buildfngs, and hereby
declarea that all the facts and representations a,tated in tt} ie applic tion
are true and correct. � ,���� °
DATE ���i s.v � e , '7 /� /.� � RT[2NATl1At�! �� �� , e i �'I"4� �6/i � �
(Schedule of Fee Coets can be fouad on the Reverse 83de).
�r, r � �
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BUILDING PERM[T FBE SCHEDULE
Section 2. The TnspectoY of Buildings eha11, befose issuing any permit for
�he erection of any building or structure, or for any addi�ion ta aay exist-
ing building or structure, or for any alterations or sepaira to any existcing
building or sicructure, upoa application therefor, require the payment by iche
appl3cant for such perm3t of fees to the amount hereia below set,£orth a�d
in �he maauer herein provided to-wit:
2.1. For aay such permit for �he esection of any fire-proof building, other
than a garages warehouse, factoi'y or grain elev�tor, or for the erection o�
any fire-proof addition, for similar occupaacy, to any existing building
ahaYl be at the rate of $1.40 fo� each one thous�.nd cubic feet, or frgction'
�hereof, in such cubical contents.
2.2. For aay such permit for the erection of any fire-proof garage, warehouae,
faetory or grain elevator, or for the erection of any fire-proof additioa,
for similar occupancy, to any existing building sha11 be at �he rate oi $1.25
for each one thousand cubic feet�, clasaified as °1fireproof1° by Section 502 of
the Minneapolis Building Code.
�OUSES
2.3. For �ny such permit for the erection of Pany noa-fireproof building other
than a gara�e, warehouse, factory or �rain eleva�or, or anq noa-fireproof
additioa, for similar occupancy, to any existing building - permit $]..00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erectioa of any non-fireproof garage,
warehouse, factory ar grain elevator, or for the erec�tion of any noa-fireproof
additiox�, foz similar occupancy, to �.ny existing build3ng or for each such
building or addition - nine�y cents ($0.90) for each one thousatid cubic feet
or f�action thereof, in the cubical contents thereof with a minim�mn of $4.0�.
For the purpose of computing fees for building permfts, the cubical con-tents
of any building or addiCioa to a uniform height throughout by mul�iplying the
ground area cover.ed fram a poiatc six (6) inches below the floox line of the
basemeat or cellar to the average heigY�� of the upper surface or to the
average height of�the roof surface of �he maia gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fee sha.11 be
at the rate of $3.00 per each Five flundred Dollars ($500.00) or fraction
thereof in the cost of a�.l propoaed .work.
2.6. Irn no case sha11 the fee charged for any permit as set forth in
Section 2 be less th�n $4.00.
., . , ; _.
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MINDER ENGINEERINC� CO. INC.
ENGI NEERS AND SURVEYORS �
u�No euavE,r,Na 301L� TlJTINO
C1VIL fr, M�JNICIp/� @WpINEERINO LANp D(.qNNIN�
6418-SGTM AVENVE N.
MINNEAPOLIS 2?. MINN.
KE 7- 363T
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' HEAT LOSS CALCULATIONS DEPAR�NT OF BUILDINGS `
Weatherstrips A.S.H.V.E, Construction No.
_ Guide
Windows Daors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kind
Yes—No I Yes—No 19_
; Fl.� `; . * k t ; � �.Room � Length i k� Width � ` ' Height ; � 4 Fl � ;�,� �' `A � �,� Room � 1
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Windows and Doors—Crackage and Azea Windows and Doors—Cr�
�Vldth He1Bht No. of Llneal Y. Area Wldth Helght No
No. o[ pane of Dane 11Bhta ot crack � eq. ft. No. of Dane of pane IIB
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Infiltration � '�' �� _ � �'a
C,lass �'� A; � s"� r �"� a
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Eap. wall � -� ::y' ��'
Net exp. wall :;f : _� �.°�n �, � ._g: �
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Ceiling �..,�
k � `�
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Floor �` � �- � t{ :� � �,��,��, � ,e' r. � {� .
Total Btu. " ,y:. ,�, µ�°°'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
; F7•� �; .'a a y,; �,.� Room � Length �� d� Width .9 � Height r?;
Windows and Doors—Crackage aad Area
Wldth Hefght No. o[ Lineal It. Area -
No. of pane of pane lighte o[ crack eq. it.
�- ,t ", ?� '�e� „ ' � "d
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Coef. Btu
Infiltration � '`;�'' " � � � �' t
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Int. wal)
Ceiling -
Floor ?� � r � � �•�°:,-,� � �; "� '< � �
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Total Btu. ; � �` � �.� : {
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area `� -
� FI '-; ,,�n "�' �� Room � Length ��' Width �:� Height �°
Windows and Doors—Crackage and Area
Wldth He1gAt No. o[ Llneal tt. Area
No. ot pane of pane Ilghte ot crack eq, fG
3 ' �� H.='� 4 ! � f�
Inhltration � � � : '�-
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Exp. wall 3;� „P' s �;
Net eap. wall �}� .s. ��
Int. wall
Ceiling �.
Floor �`'�^ '�' '� ;' �+ � �'
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. L,eader area
Bhl
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Infiltration
Glasa
Eap. wall =� �3 �
Net esp. wall
Int. wall
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MINNEAPOLIS. MINN.
Insulation
How Applied
i ' �3 Width
e and Area
Llneal fL Ares
of crack eq. Lt.
.'
Bttl
Floor °" " �, � �' ��' " "� � �, '-
i. ��° � V<
Total Btu. N`. 'a .:,x�
Required sq. k. E.D.R. or sq. ins. W.A. Leader area
j Fl.� '�' p f;:�� Room � Length a� Width �+ .�- Height ��
Windows and Doora—Crackage and Area
Width Helght No. o! Llaeal ft. Area
No. of pane ot pane lighte ot crack eq. ft.
i;r. � `r
;:,� �;� ;.� �,: � �: � �
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Coef. Btu
In6ltration �",� � ; .���� �,; ��
Exp. wall ;,�._2�`` �
Net eap. wall
Int. wall
Ceiling �
Floor ,, � �" �' a,
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7'otal Btu.
t.i':'� `.�,
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Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
y Fl.� '`' �, �� �"�;�� Room I Length „°.�'> Width
Windows and Doors—Crackage aad Area
Wldth Helght No. ot Lineal [t. Aree
No. ot pane ot pane Ifghte of crack eQ. it.
'�, ,��a- C: �'$. j � .':-< *'� ' a'°"°
�
In6ltration
�895
Eap. wall ,;;'
Net exp. wall
Int. wall
Ceiling @.,,,
Floor �*�'
Total Btu.
ft. E.D.R. or sq. ins. WA. Leader ana
�
Btu
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HEAT LOSS CALCULATIONS DEPARTM�NT OF B�JILDINGS
Weatherstrips �•S.H.V.E. Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind
Yes—No I Yes—No 19_
Fl.� ';d �;. ��; ;`� Room � Length x��• Width .�� ���° Height ��. FI.� Room � 1
Windows and Doors—Crackage and Area Windows and Doors—Cr,
Wldth Helght No. o[ Lfneal f. Area Wldth Helght No
No. o[ pane aY pane llghta o[ crack � eq. ft. No. ot pane ot pane lig
. .,. � i'°.� ..r 1.' � is . �b �.:-..
Coef. Bm
In6ltration � �"' - ':'' �
�,,z ", �,,
Glass �' e �, �=�, �' ���
Exp. wall E, ;�' �`: +,�^
Net ezp. wall :' �°.'' �< �,, ;�
. -
Int. wall
Ceiling .._..,�
Floor �` ' `' ; _ . ; �,, -, . 7' �: s g' a �
-r
Total Btu. �y ' �
�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area a J
Fl.� Room � Length Width Height
Windows and Doors—Crackage and Area
Wldth Hefght No. o[ Llneal Lt. Area
No. ot pane ot pane ]lghte of crack eq. ft.
�
Ia6ltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
uired sq. ft. E.D.R. or sq. ins. W.A. Leader area
Btll
Room � Length Width Height
Windows and Doors—Gackage and Area
Wldth Helg6t No. ot Llneal tt. Area
No. ot De.ne of Dane 11g6te ot crack eq. ft.
�
Infiltration
Glaas
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq, ins. W.A. I.eader area
BtU
��
a = e- -S
iVII1VNFAPOLIS. MIIVN.
Insulation
How Applied
� Width Height
: and Area
,lneal ft. Area
of crack eq. tt.
Btu
Infiltration
Glass
Esp. wall
Net esp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.I Room ( Length Width
Windows and Doors—Crackage and Area
Width Helght No. o! L1nea1 [t. Area
No. of pane ot pane lfghte o! crack eq. ft.
Infiltration
Glass
Eap. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.� Room I Length Width Height
Windows and Doora—Crackage and Area
Width Hefght No. of Lfneal ft. Area
No. ot pane ot Dane ttghte ot creck ep. tt.
Infiltration
Glass
Eap. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader ana
Btu
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City of Fridley
AT THE TOP OF THE TWINS
i �
� �
� ; v ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
{, .-_-� � "' �,� CITY HALL FRIDLEV 55432
�' 612-571-3450
SuBJECT
BU ILDING PERMIT
NUMBER REV. DATE PAGE OF
910-F15 n /i /stn � �
JOB ADDRESS 160 Craigbrook Way N.E. �
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 1 7 Pearson's Craigbrook Estates 2nd
2 PROPERTYOWNER MAIIADDRESS ZIP
Edwa.rd Ahrens 160 Craigbrook Way N.E.
3 CONTRACTOR MAILADDRESS
Justen Roofing Route #1, Big Lake
4 ARCHITECT OR DESIGNER MAIL ADDqESS
5 ENGINEER
6 USE OF BUILDING
Rt� � ]. C�P.ri'tl�.�.
7 CLASS OF WORK
o NEw
8 DESCRIBE WORK
Re.roof house
9 CHANGE QF USE FROM
, STIPULATIONS
MAIL ADDRESS
❑ ADDITION C� ALTERATION
TO
ZIP
ZIP
PERMIT .
�O " 15634
R EIPT NO.
9 � /�
APPROVED BV
SEE ATTACHED
SHEET
571-2984
PHONE LICENSE NO.
428-2506
PHONE LICENSE NO.
PHONE LICENSE NO.
❑ REPAIR ❑ MOVE ❑ REMOVE
SE
PERA�E PERMITS REQUiRE� �OR �fl���
�-{EAT1CdG. Pl�l��l81�VC �ND SIC1Vao
TYPE OF CONST.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, 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
I HEREBY CERTIFY THAT I 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 COMPLIED y�`]_ � 2OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $9.00
PLAN CHECK FEE
i `
GNATURE OF CON'R R AUTHORIZED A T D E
OCCUPANCY GROUP OCCUPANrv LOAD
SQ. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$.60
SAC CHARGE
� � WHEN PROPERLY
. �
SiGNATURE OF OWNER UF OWNER BUILDER� � IDATEI 9�oG INSP
Al FEE
$9. 60
iIS IS YOUR pERMI
,-
� ' a�rr�c�:
ADDRESS:
TEL �d0:
.
CITY OF f'kTDLEY •
At'('L1CA'� IOi�� l-QR (tCSIDLNTI/li. C3UILUIPJG f'ERf�1ITS
(�Jevt Alter��tiuns, i�ddil:ions, or lZ�pairs)
� �c��� � ,a ����s • .
�
�UILDER: .
ADDR�SS: . �L� .' •
TEL tJO: �� -- ��(J� .
��/ -v��lc�� ' '
�nstruction Location
- STRT�T NO: ��, STR1��T: �..�-i'Il0 ��-� �� W r'f'`� �
T�OT: �
� ELOQG: _� AUDITI02d: �F �q�So� S �,���.8�c�,� �Sc�1-i�S
Corner Lot: • Inside Lot: Setback: ����
S9.d�yards :
Applic�.nt attach to this form t-wo Cer�i�icafies oi Suxv�y of lot and �
proposed building location dra�•m on certificates to scalee
DESCRIPTIOId OF C����TRUCTION � � .
i��QO� �l$�rront: � Depfh: aieight:
Squaie Fec-�: C�,ibic I'eeta
0
Front :
Square� Feet: �
�P� � i3eight:
Cl.�ic Fe�e�:
T��pe of Cozzstxuctiora: �� _ � Estima�ed Cost: $ 1��.v�
ib Be Cbmpleted: _�, � q • . �
��r
.'
• - _ . Alt. A Alt. B
Pxoposed Driveway Width If New Opening Is Desired: $� $
. . .. SiE R���RS� SIDE OF SH�ET
T'ize unde.rsigned hereLy makes applica�ic�n for a p�rmit �or uhe work herein specifiedl
agrecing to do a11 work i.n stric� accordance witli tlie City of I'ridley Ordinances and
rulii�gs o.i thc: Depari:m��t o� Buildings, ai�d llercby decl�xes tliat all tl�e �acfis and
re�.�resent-�tians stated �n L-his applic� ' ' ' '
pA���� � J� Q STGi�?1�UF�:
� ---
St�ipula�ions :
. ��,�5�
��
� �'. ��
. --` ..
• l;1.11 i_1id 1'�l� I`t_ii�'tl 1� I'L'l:. .:t.iIL1JUL,t: , •
---- - - --....;-_.....�r_.__.._._—__ _
,�,J:C�'701•� 2. 7.'Is� 7n�.:J���ctoY. or: n«�.�.a;_,��,��.; ::lir�l.l, l�ef.c,res i:;:;u:!>>�) l�enni�s, !'o�. t!�c erc:cLi.on
Uf �iny l�ui.l.cl:i.t�cp �a: :,�a.t�c:t:uror o�: l:c„- ��ny ,a:lcl�.t_�,_,t� t:u ai�y cr.i:.;ci�u� )�iii.lai.ncJ ur :�i:r.ucLure,
, cix° f.o�- �iny �ia.t:crcit.im.i oa: r.cl.�ai.r.:� tc, •ai;y c,�:.i.,titacf iatl.i.J.ci3.11cJ �r st.r.uctua.�, uJ�on ar�pl.i.c:a�i.on
Llir.rcic�r.c, i:c�;e�iT-r. tJ�e pciyment• }��f �:1ie ttr,Is].f.c;ant: fc>r: ��i�cl� ��cr.�n�L U� f�e � Lo LZ�c amounL
}icr.ci.n bc].a��� sc:l: for.th �i�,cl ii2 L-li:� !�anneL hca:Ga.ti P�.ovic]c�3 L-c�-wi.L: . • �
11l.l•1 CO'.1,:TRU:;7'IOid: S.i.��gJ.r� I.'auii].y ll�s,e:� anci Gas°aqc:s: S�aO�/1,OG0 cub5.c tcc�.
PI,At� Cti];CY.: ?,5 ]�c:a�c�iiL of bui.ldi��g t��er.�ni.t fce.
ll�ZTVEI•?:,1' 17�1'RL•'5S�C)tai LCcx:crcLe, �ur.b �t�-ceLs O��ly) ' '
• 111�:c:�:n��i:e T.: l:^rnoval �ind zr.pl,�:cc.mer►L• of conr_�ei:e cuzb and '
ytat.ter ��a1.�j; l�r_ive��ay tva.dt•}i plus � feet x Y.�5o75
� iiZt�rnafi.c l3: R�':mc�va3. und 1"Cj7J.c1Z'f'i1lC:]iL• oi roncreLe curb and
. . _ � gutcex' and insta].). a 3 toot t•�ide approach �aii:h ''
' . 6 i.r,cYi cIr_ptli; Dr�_vcvtay width }�3.us G feeL- x$1.7e85 �
. /�1�j)TTlQi'� I.. IP �'�i ���liYlcr�
F'or .t�-�� pur�s� �S: coMpui:�_ng ices fox bui7_da.ng pe�r,iit�, tlic� cubioal G`Oi1LG'11L-s of any
}�uildi.nq ar ac�di_L-ion, i.s c�etel-mined by mu).i:ipl.yiny i-3ie cJreund.area covered f:rem a.
poi.�ii: si�: (G) ii�ch��s belv,•, ilze floor li.ne oi tlle b��semeaet or th� c�llar 'L•o the
avcxac�� }icighL-s ai th�� u�?r�er. surf_ace az Lo ictie ���erage Iiez,iht oi ihe rooi sur�ace
of i:he raain c�able of a}�itch�d r_oof.
Fox re��a7 �:s or al.terations -�o an exa.st:ir�y struci:ur_e, the S-ee shail be a� the rat�
oi $3.00 re�- each �ive hundreci dollars �� ($5U0.00) c�r frae�ion tl7ereoi zn the ,ca�t
o� aJ ]_ pxoposed work. . •
xn •rio case. sl�al.� '�:he Lee chakged for a:zy per.mit as set ierL-h in Sect:ion 2 bv 1.ess �
�haia $7050 plus $,50 stai:e sLU-cliargeo � �
� � .�! � � � F T��. T T o ` _�2�_._�_ � � �n i v _
NOTE: Perm3.is �ar construction �•�ill be i�sued a niinimum ai ?_4 houzs �r.om the ti.me
oi rtp�Zication to �llo�v �or ��ra�er review of t}ic� 1 r..o,�:�sed structure and of the
construction si.te.
7�, Cc:rtiia.cate ot Sui-vey of the lot, sl�owi.ng the lccata.on o�' the ioundatio;� once it
ha� 3�een consi:nzcted wa.11 be required bc iore nr.oce�dincJ ;ai�� the �z�ming.
.��'I I � T C:ATE aF �C�l� 'C' . .
Applicat:ion Lar a Certi�icate o� Occupancy shal.l be mad� t.en (10) da�'s priox i.a the
u�c �� uccupai�cy ot ariy structurc for taiiicli a�;uilclitiig },�c�znit ]ias be�n �ssued� and
said �i-xucture sl�all �io� be used or occit��ieci un�il �-� Cer�C-.i:��.cate of Occu�,�a�icy has
been i�ssued.
. + . .
0
0
sue�ecr PERMIT NO.
City of Fridley .---�����"�`��'
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T 213 4 9
r
; ` RECEIPT
COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIYE INSPECTION SEC. L� �� ��
� �
� _ �
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBEP REV. OATE PAGE OP APPROVED BY
�----� • •'� 612-571-3450 910-F15 5/21/92 / /
JOB ADDRESS 160 Crai�gbrook Way NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. �- 7 Pearson's Craigway Esta.tes 2nd SHEET
2 PROPERTYOWNEFi MAILADDRESS 21P PHONE
William Dombrowsk 160 C a' S72-2478
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAII ADDRESS 21P PHONE LICENSE NO.
8 USE OF BUILDING
Res iden ti,a 1
7 CLASS OF WORK
�J NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O FiEMOVE
8 DESCRIBE WORK
Construct a 12' x 16� Storage �hed
9 CHANGE pF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, rrPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO S0. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEHEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED $1,034 $. �j2
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- $2'], OO Fire SC �`�.. �3
ST 10 OR THE PE FORMANCE OF ONSTRUCTION.
� �-- ��/� PLAN CHECK FEE TOTAL FEE
$28.55
S ATUREOFCONTRACTORORAUTHORIZE AGENT �DATEi WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
SiGNATURE OF OWNER iiF OWNER BWIDER� IDATEI BLOG �NSP DATE
., ...,.. �...... ....... .. . ........._...., . ..:�:..v.,.,...,_, . ,.... ... , . . h...:i1. i._Y :,:i8:�......... .. ..... ...... . ....... ... .. . . . . . ..i.. . ,.,.... .. ,.. . . . . . . .., . .. ,.. .. ... . ... .. _ . .� . .
NEW [ ]
ADDN [ ]
AL'r�t I l
Constiudion Address:
Legal Descriptioa:
Owner Name
Contractor:
CITY OF PRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
' a ��� ����' -���d� �r/�
Effective 3/1/92
MN LICENSE �
Address: � Tel. �
Attach to this application, a C,ertificate of Suivey of the
lot, with the proposed coa�truction drawn on it to scale.
DESCRIPTION OF IIV�ROVEMENT
LIVING AREA: Length i�Vidth Height
GARAGE AREA: Length Wi�h Height
DBCK A1�EA: idth Hgt/Ground
OTHER: - ��� �� ,.1d .�� % � �' � ,�
Sq. Fk
Sq. Ft
Sq. F�
Corner Lot � inside Lot j] Ft Yd Setback Side Yard Se#backs
Type of Conslra+c�ion: _� ��g, �imated Cost: $ 0 � � ��raQ�.�
Approx. Compietion Uate:
(Cost on BackJ
Driveway, (�ui� Cut Widih Needed: F� + 6 Ft = Ft x$ _$
DATE: � -�� �� APPI.ICANT:- a��/�1��Z �Li����°l�G� Tel. #
Permit Fee $ � �� �Ci
Fire Surcharge $ �. D 3
5'tate Surcharge $ � J�2.
SAC Charge $ �
License Surcharge $ `—�
Driveway Escrow $
Park Fee $ `--
Sewer Main Charge $ `�
TOTAL $
2Q�,�"S�
STIPULATIONS:
�ITY USE ONLY
Fee Sche�ule on Reverse Side
.001 of Permit daluation (1/lOth%)
$.SO/$1,000 Valuation
$700 per SAC Unit
$5.00. (State Licensed Re�sideatial Contractors)
Alt. "A° or Alt. °B" Above
Fee Determined by Engineering
Agreement Nec�ssaiy [ ] Not Neces.Sary [ ]
�7�
BUII.DING PE�IIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or strucfiu�e,
or for any addition to any existing building or stivc�e, or f� any alteration or repair to any exi�ing
bailding or structure, upon application therefore, require the paymern by the applicant for such p�rmit
of fees to the amount herein below se$ forth and in the a�anner herein provided- to-wit
TOTAL VALUE
$1 to $500
$SOl to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$5�,�1 to $1,0�,0�
�1;�,0(�1- .�d..�� - ._ ____
FEF,.S
$15 (Minimum F� is $15 plus surcharge)
$15 for first $500 plas $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plos $9 for �ach additional $1,000
or fraction_ thereof9 to and including $ZS,OOQ
$252 for fir� $25a000 plus $6.50 for each additional $1,000
or fiaction thereof9 to and including $50,000
$414.50 for first $50,0� plus $4.50 for each additional
$1,000 or fraction thereof, to and including $i�,�0
$639.50 for first �100,00Q plus $3.50 for each additic�nal
$1,000 or fraction ther�f, to aad including $500,000
$2039.50 for the first $500,� plus $3 for �ch additional
$1,OW or ftaction thereof, to and iacluding $1,000,000
$3539.SQ for the first $1,000,000 plus $2 for e�ach additional
$1,000 or fraction �thereof
DRIVEWAY DEPRESSION ESCROW
(Conctete Gtirb Streets Only)
�
Alternate "A" : Removal and replaceme� of curb aind gutter only - Driveway width plus 6 feet times
$13.50.
Alte,�nate "B": Removal and replacement of curb and gutter aad install a 3 foot wide �
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for co�ction 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 coa�niction sit�e.
A Certificate vf Survey of the lot, showing the l�on of the foundatioa once it has it has l�een
consttuct,� will i� required before proceediag with the framing.
3TTMATE FOR :
WIL.LiAt� DOMPROWSK�
1�� CRAIGL�ROON.WAY
F R I DLEY, M�I 554: ,�
61� �7��-�478
Estimate From
� • ' �
��vi CENTRAL AVEhIUE NE
FRIDLEY, MN 5�4�1
�HQMEe tEi�) 579.-8689
�/��/g� ESTTMATED PY : LDG
DESCRSRTiON
llELxVERY CHAROE
1 /�" 4�X8 �F'LY CDX �'LYWO
AGENCY 8Th1G'—ORQ
SN I IVGLES F T gE RGLASS ►�0—Y R
�1IST WHTTE .
ShI00TH HARDBl7ARD S i D T NG
7�16���'�'dX1��
GRIMED OUTSTDE CORNER
1�" #�i1�XL
8' X7� STEEL GARAGE DO[]R
WHiTE RIPBED
�X8-1�' GREEN TREAT
2X8-1�' GREEhI TREAT
3/4" 4' X8' CDX F�LYWOOD
�8/�4SF't�IV RATEO
MX4—iE�� �TD+PTR SF�F
�X4—B' STUD/STD+RTR G�dADE
OTY TO
ORDER
1
A
9
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4
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187—����fi i�� SF�EC ORDER STD TRUSS 7
4/1� ��# �' OC
187—��13 1:=:' SF�EC ORDEFt 5TD �TRUSS , `
�F/ 1= EhID FRAME
�
UNIT
�'RICE
�4. ,.�i�D
8. 49�
�. C�9�
4. 79*
. 38
1�9. 99
8. i�
i►z�. ��
�5. �8�
3. �9�
1. $�*
140 ,��
18. �8
�'AOE 1 OF �.
ESTIMATE �
17�N38
� '
/ � � �
�
l �
� .�°'` F'RE—TAX
�� TOTAL.
r
This is an estimate. It is given only for general price information. Th(s is not an offer and there can be no legally bfnding contract
between the parties based upon this estimate. The prices stated hereln are subject to ehange depending upon tfie market
conditions. The prices stated on ihis estlmate are not firm for any time period unless specitigally written otherwise on ihfs form.
The avaitabllity of materlals is subJect to inventory conditions. MENARDS IS NOT �ESPON$I�LE FOR ANY LOSS INCURRED BY
THE CUSTOMER W HO RELIES ON PRICES SET FORTH HEREIN OR ON THE AVAILABILITY OF ANY OFTHE MATERIALS STATED
HEREIN. All informalion on this form, other than price, has been provided by customer and Menards is not responsibte tor any
errors in the in(ormation on this eslimate, including but not Iimited to quantity, dimensfon and quality. Please examine this
estimate carefully MENARDS MAKES NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE THAT THE MATERIALS
LISTED ARE SUITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE CUSTOMER. BECAUSE OF WIDE VARIATIONS IN
�
EXTENDEd
F�RICE
;,'_4. 50
�?. 9`
vl. �'1
:�63. 4�
13. 68
iE9. 99
1 �.�.� . 56
ci. �4
91. E8
14. 36 '
74. ��
i�t�. it�
��. i�
1, 034. 75