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I�►�III�TDER ��l'GINEF.�.IN1� Ctl►. �,�N�.
EIVGI NEERS �ND SURrI'�Y�RS
L.AND evav�.v�Nq 901L8 TESTiWO �
61VIL d. M1JNIGIOAI. flNO1NEBRINQ I.AIVO PLANRIiNO
6418�56T" AVENVE N.
NtINNEAPOl.15 2T, M�NN.
KE T- 3637
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YVE HEREt'llf GlRT1FY T�iAT T►ti�S 1� IA TRUE M1D CORRECT I��PRES£NTl�T►OW 0� A SURYEY 0� THE Bt3tJN�AR►�� OF THE
I.pND A�tSVE OESCRIB'ED ANO 4F 7�11E IOCATiON OF AI.L BU��L��NGS � IF .�1Y, TuEREBN , Rt�1� At1 v'IStBt�E Et�tRoA,CMMfNTS,
i� a,NY, Faor� aaa� swo u�NO. td11N�EC� �.NGtN1EERING CO., INC.
ont�D �r►us..._..,.e r,�Y � - �'EPTE("1B£.� �,�.ti��g
ENG�wtE ct� aN� S�}JRv a5G=,
.,. - c."' �r�` . C .`�"� b • , � ,F�"r �`'����' riL.J�1e..�r.,,
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City of Fridley, Minn.
BUILDING PERMIT
N° 6023
nate: � '+ �"'°°
Owner: � der _ /
�
Address Address _.._
+LO TION O UILDING
No. �� Street P Lot
Lot ..y�_�'�_____ Block �� Addition or Su visio �
... � .
Corner Lot — Inaide Lot �. • Setback Sfdeyard
_ -��--- . —�_
Sewer IIevation — — Foundation IIevation
DESCRIPTION OF BUILDING
T Used �
P'ront � Depth _.���Hefght � Sq• F`k �!��Cu. Ft,��S.�����
_ Front Depth FTe�ht �Sq. F't. ___—�_ Gw. F�k y
Zj►pe oP Construction _�� `�.,,.��� Es� Cos� ��....�-'�_"To `�e Completed
���"�
In consideration of the 3ssuance to me oP a permit to construct the building descrlbed above, I agree to do
the proposed work in accordance with the description above aet forth and in compliance with all provisiona of
ordinancea of the dty of Fridley.
�..
In conafde�tion. of the paqment of a fee of $.� , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express conditlon that 7he person to whom it is granted and hia agents, employees and worl�en, in all work
daae in, around and upon said buildittg, or any part thereof, shall conform in all respects to the ordinauces of
F'n1d1eY, M3nnesuta regardfng lacation, construction, altera.tion, maintenance, repair and moving of bufldiuga
within the dty ]imits and thia permft may be revoked at any tune up� violataon of any of the provia�tona of said
ordinancea. �,, __
Bwtldin8 Inapector
NOTICE:
Thb psrmh d�s not cowr �hs coe�trneNen, te�}all�loe fee rriein�, ph�mblee, oa 6eMtee, a�w� o� wahr. B� sun fo ss�
tln Bn(IdinB lesp�etor far aparal� psrmhs h� t6a� ti�m,
� =� ` -'- � �
l � 4 E .�
APPLICATI0�1T �OR BUI�D�NG PEi�ST
C�TY O�' FItZDLEX� MTNNESOTA
�mer's Name Bu3lder ���± � C //�� '� :
6���- .�� ,
Adclress- ------- - - Address . ���'i' e
LOCATIDI�T OF BUI.i�DING
� ,
Noa e��� �street ��� � �'���� Past of Lot
� �� ��G����
Lo� �� �81ock � Ad i�� r S i�aion�
�
Corner Z,ot Ins i�e Lot � Setback�S iale-Yard � 1� f�
sEWE� ELEVATION FOUNDATION ELEVATTOL�T
Applicant attach to �this �o�m Certi�icate of survey of Lot and
proposea building location.
DE�CRIPTYON OF' BTJILDING
To be used as o `�j�+�Y+.�
�'ront�Depth � He3ght �
�7�s r 1.• �r�L• rt•
Front_____,___Dep•ch �ie ight
Sq. Ft. Cue F�.
lype o� Construcition � � Eatimated Cos�
lo be Completed ��
i
The unders3.gned here�y makea application �or a perm3t �or �he work
herein specified, agree�.ng to do all work in �strict accordance with
the City of Fridley Ordinances and ruling o� the Deparf�aent of euild-
ings, and hereby declases that all the facts and represeni:a�ions
s�cated in this application are true and corr�ct.
DATE d� U ��� SIGNATtTT�E � �� �
.. .. � _ .
c des� m �
(Schedule o� Fee Costs c�n be raund o� the Re rae Sid .
.. . =_w �",
n
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�t�
�vYLnaN� P��m=� r� scr�nv�
Sec�:ion 2. The Tnspector ofc Buildin�s -shall, befor
pex�ai•� �or the e�ec��.on oi any �uilding oac struc�ure
acidi�tion to any ox�.s�in� building or atruc�twce, ar f
or �epa�.rs �o any oxist�.ng build�.ng or struc�ure� up
��re�or, require the pay�nent by the a�plicant for s
rees �o the amount horein below set �Eorth and �.n the
px�ov�ded to-v�ito
�.ssuing atiy
or �or any
�r any alterat�lons
n application
ch permit of
manner herein
2.1. For- any..such p�rmit for the erect�.on of any fire-proo� building,
ot�er than a gaTCaga, warehouse, factory or grain elevato�c, o�c �Eor the
erec�ioa of any i3ra-p�oo� acldition, �or similar occupancy, to any
exis��ing building shall be at the rate o� $1.�0 for each ono thousand
cu'�ic �eet, or �rac�tioa thereo�, in such cubical con�tents.
2.2. For any such porcn�t �or the erec�ion o� any fire-proo� garage,
wa�ehouse, �Eactolcy or gra3,n elevato�c, or �or the erection or arly sire-
proo� addition, 10� sir��i.lalc occupancy, �o any existing bui].ding shall
�e at the ra�a or $1.25 ior each one thousand cubic fe��, classiriec7
as "�ireprooi" by Sec�ion S02 of tYae �i�.nneapo7:is Huilding Cac�e.
FiOUSES
2.3. For any auch perm3.�c for the erection o£ any non-fireproof build-
�.ng o�her than a garage, warehouse, factory or grain elevator, or any
non-�ixe��coo�E addition, for s3milar occupancy, to any exis�t3.ng building
Persmit $1.00 for each one.thousa�d cubic feet.
C1�2P1GES
2e�. For ariy such �e�cm�.� fcor �he �recfiion o� any non-fireproof
garage, warehouse, �actory or gra3n eleva�or, or ior the erection of
any non-�ireproo�c addi�ion, for sint3.lar occu�aricy, to any existing
bui].d�.ng or for each such bui].ding or additione l�inoty Cen�ts gor each
one fihousand cub ic �eet or fcraction �hereof, in the cubical contentB
thereof. wi�h a min�nvun o� $9,,00.
�'or �he pu�pose o� computing� fees for build�.ng perm�.te the cubical coa-
tert�s o� any building or addition to a unifo�n h�ight throughou� by
multiplying �he grownd area covered :�xom a point eix (6) inches I�elaw
�the �loor 13ne oy the Taasement or ce11a� to the average height og the
upper sur�ace or �a 'che average heigh� oS the roo� surface of the main
ga�le of a pitched �roof. �
2.5. For repairs or.alte�ations to an exi�ting structure, the �ee
shalZ be at the ra�te of $3.00 per each Five F3undred Dollars ($500.00)
or �ractior� �hereor in �he cos� o� a],l propos�d �vork.
2� 3n no case ehall the see charg�d �or any pesn�it a� set fo�th in
Sectioa 2 be less th� $4.00. � ��-� -� �
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�I�C��153`'ROMS HTG. & AIR COND.� INC. 1ob NamP
�sb� 4410 Exeeleior �nlevard, Minneapolis 16, Minn. �,
�Z6 H6AT LOSS CALCYLATIONS Job Address �
Weatherstrips A.S.H.V.E. Construction�No. I Insulation —
Guide
Windows I Doors Referenee Out. Wall Int. Wall Ceiling Roof F1oor I ICind How Applied
Yes—No Yes—No 19_
� Fl•��=�� ��: ,., Room � Length -� =� Width -� Height ;r- Fl.� �. �, Room Lengt6 � Width �� Heigh�'
Windows and Doors—Crackage and Area _ Windows and Doors—Crackage and Area
�Vidth Helght No. ol Llneal ft. Area- Wldth HalBht No. o[ Llneal it Ares
No. o[ pane o[ pane IlBhte o[ crack eq. ft. No. ot pane ot pane lighte of crack eQ. tt.
� l - _ �� � � . �, L�, � �� �T �i �a t g�P � � �� � � �
€�
_ -- - ; �, � °. � ��' �' � � p � � 6�
__ i � ;
Coef. Btu . Coef. Btu
Infiltration � �' �=,^,a � �` '"�' �� Infiltretion � � �;,� � � � °� �
Glass � � �� �� _�* �" ;� c� Glaaa � �.a �,`�� 9 �2 ��
Eap. wall _ '�' - Ea�i. wall � _ �' "�' 4;
Net ex wall � � �
P• � F- ��, � �� '' �` _ '� Net eap. wall �? �i � �' �, i" � ,P E� ?. �
Int. wall In� wall
Ceiling �, `�' �' � Ceilin8 � �' ,� `�= �.� . � .�'
Floor Floor
Total Btu. �'�� �'' �' � Total Btu. _<�' �`� h
Required sq. k. E.D.R. or aq. ins. W.A. Leader area � Required sq. k. E.D.R. or aq. ins. WA. Leader area
F7.� -_-,.._ Room ( Length Width Height = F7.1 � ra �r, Room I Length �� Width �/' Heig�
Windows and Doora--Crackage and Area Windows and Doors—Crackage and Area
Width Helght No. oL Lineal ft. Area Wldth Hetght No. oL Llneal tt. Area
No. of pane ot pene Ilghte ot crack eQ. tt No. ot yane of pane 1lghte o! crack eq. it. -
� � �' ',� ci c-✓ �I � � f � /� c� � r�r � /� : � f� �' ...
COOf. _ 8�11
Infiltration � � �=� �, � �? �-»
Glaaa �' �' �; r_, r ,� �
Eap. wall �,� � � �' ,�'
Net exp. wall ,�° ; a � ,� �» � � r�
Iat. wall
Ceiling f''° _ �,f' %� �' ,,,a ,� � � �
Floor
Total Bm. � �� ��` �
Required sq. ft. E.D.R. or aq. ias. W.A. L.eader area
� FI. d�, ,� � ,�, Room � Lengt6 � ��' Width � �� Height �'
Windows aad Doors—Crackage and Area
Wldth Helght No. ot Llaeal tt. Area
No. ot pane ot pene Ifghte ot crack sq. tL
n �,
.r'r�`�, �/' � � . 4 .� .� . : . -. /�
COef. Btu
Infiltration �f ^° �=,`��a � ' ,�
, - nn -
Glaaa ;' F <_r ;.
Exp. wall �?� �` � -- �„ �� ' ,P
Net exp. wall 1 i =� `+ � � , � � � ,::»
�_
[nt. wall
Ceiling A , ' "�'`� ! � S �!`�
�
Floor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
�
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� � �
In6ltratioa
Glasa
Eap. wall � 1,�, � -- c¢
Net esp. wall ��
Int. wall
Ceiling ,��
� ��
Floor
�fotal Btu.
��r;� ra �` �
Nt°a! �' � H='
1�: ,,,r_ a ;t' ,�t; r.a
" r'.h`� � �C �° ���
Nued aq. k. E.D.R. or aq. ins. WA. I.eader area __
�.� � �..a o Room I
Windowa and Doora—C
WtdtA Helght N
oI pane ot pane II
� �, � � �:
�� � � � �!
Inhltration
Glass
�. Wa1� �r`a' � ° R-j ��
Nec eup. wau 4l /
Int, wall
Ceiling �' �� , s �? �
Floor
Total Btu.
� Width
and Area
neallt. Area
, crack eQ. tQ
� � � �
Height
Coef. Btu
�
c-;a , P
�� �,-�5`�
k ' m
—�
��
k. E.D.R. or sq. ins. WA. L.eader area
� r�
�� �
C�ppR� (��IS�ROMS HTG. & AIR COND.� INC. �1ob Name
�S6' 4410 Fxselsior Boulevard, Minneapolis 16, Minn. �,_
z6 HeA'� L08S CALCYLATIONS Job Address '�
A.S.H.V.E,
Weatherstrips Construction No. I Iasulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How Applied
Yes—No I Yes—No 19_ I
F7.� ��� �, �� Room � Length �`� ,� Width ;" 1' Height �; ,(�Fl.) ,�-;".� � � Room Length �.� Width � Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vldth Helght No. ot Llneal t. Area Wldth Helght No. ot Lineal ft. Area
No. of Dane of pane Ifghte oL cracB eq. ft. No. ot pane ot pane ligbte o[ crack aQ. tt
_�y- �,^ �. —s �° _ r�`, � � � �°
�� �i"�, � c� / `�' � � � -_
� Coef. Btu Coef. Btu
Infiltratioa � c�� ":' a �' ��_ �:�' �'? ��r8tI0I1 /' � '� ' �� � ,� ��
WBSS �j �ill ��.,, �i Q'P �� ��, ,F:1 WBSS // �' '=�c � t �' �� ;�'r
Exp. wall �'' � � � � �`' Eap. wall �'�- `°_� : � � �-
� ;� , <, �
Net exp. wap �v° � �' s' ��" �;� ^ ,= ��� <� ^
Net eap. wall Z . f' � �' �' � °3 c� � / �
Int. wall Ip� �,`,a��
Ceiling � i �.. � `.� �` cl,' � � � �`� � Ceiling
Floor Floor ;�+ � � � ,�� ,�4`'�
Total Btu. ^ f � � �' Total Btu. � � � �' � ��
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area ` Required sq. k. E.D.R. or aq. ins. W.A. Leader area
�F1.� ��. Room ( Lengt6 �,c� Width ,� � Height �� �,� Room I l.ength Width Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
Wldth Hetght No. o[ Llneal !t. Area Wldth Helght No. o! Lineal [t. Area
No. ot yane o[ pane llghte ot cracB eq. ft. No. o! Daoe of Dane IIBb� ot crack eq. [t.
� �� �� � [� � � i� �; �
Infiltration � �; �
Glasa
Exp. wall ,� r,i��, `� � _ �� r� �
Net eap. waq � �
Int. wall
Ceiling
Floor ��' �;,. "
Total Btu.
Coef. Btu
bf � � "r � � In6ltratioa
�4 � � - � ° Glasa
�p. v,►�u
�=' E� P�? �� r�' Net eap. wall
Int. wall
Ceiling
% '� � a' � � Floor
- f�''' , r`' �� 7'otal Btu.
Required sq. ft. E.D.R. or aq: ins. W.A. Leader area
B�'�FI.� i�� � a G�* Room
Windows aad Doors—�
Wldth HelBbt
No. ot oane ot vaae
Inhltration
Glaaa '
�p. Wau � G r�. � � �
Net exp. wall
Int. wall
Ceiling
Floor " `�
Tbtal Btu.
�j Width
and A� rea
ieal ft. Aree
crack ea. it.
ft. E.D.R. or sq. ias. W.A. L.eader area
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sue�ecT � PERM13123
City of Fridley
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r —
� � RECEIPT NO.
� ; L____�_ COMMUNITY DEVELOPMENT DIV. ��� a
r � � PROTECTIVE INSPECTION SEC. �
1 ; �
1� � /""1 � CITY HALL FRIDLEY 554$Z NUMBER REV. DATE PAGE OF APPROVED BY
----� ' '•' s, 2-sso-saso
910-F15 $ � 75 � �
JOB ADDRESS 255 Craigbrook Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. � 9 6 CraigWay Estates 2nd SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
John West 255 Craigbrook Way N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Leo Sanders 7813 Jackson Street N.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
�
7 CLASS OF WOFK
❑ NEW ❑ ADDITION ❑ ALTERATION OX REPAIR ❑ MOVE ❑ REMOVE
e oESCR�BE ��s`�a 11 drai n ti 1 e .
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. Y�Z�iI ���@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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 OFFSTREET PARKING
i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAiiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �� �600 .�O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISION� OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9 � 6O
STRUCTIO OR THE PERP MANCE OF C STRUCTION. �
PLAN CHECK FEE TOTAL FEE
� $10. 40
SIGNA RE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI W EN PRO E V ATE THIS IS YOUR PERM IT
SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP ATE�'���
' - r - +_� _ _ !
� ' '. • •A�PLICATION rOR RL•SI'DL'NTIAL., ALTL'RATION, � � � •
OR AllllITION.IIUILDING �'LRI�iIT
' CITY OF FRIDLEY, hIINNESOTA • .
� �� � � BuYLV�x • , � c ��.��� � � .
OWNER S NAl�i� • .
ADDRESS : ` � ` � ADDRESS • ' '� , � , �/ �-- '.
� . .
NO:. � STREET: �
. , . . � �
IAT : BLOCl: • � C� � ADDITI01� :�,� �� � _-��
. CORI�TER LOT:, INSIDE I.OT: _ SETBACK: SID�Y�D:
pppli�cant attacr. �o this for� Zt�o Certificates. �f Surve .of L�ot and.proposed . . •
building location dzAwn on these Certificates. � .
Ta Be Used As :
HESCRIPTION�OF BUILDING
- Fron� : Depth • � ' Height • : �
et: .Cubic.Eeet: . � . -I
. . . Square Fe , �
' . ' � Front:� _Degtii: • Height• _ .
�_ . � � Square Feet; Cubic Feet: " �� '
. Zjtpe of �Construction: �,��� �'� Estimated Cost:��,/� � ��� � .
To� Be Completed: �'�, • � �"' 7 S • • '. " .. •
�• The undersigned hereby makes applicativ��for a permit for the work herein
specitied, agreeing to do all worlc in strict accordance �oith the Cit}• of
' Fridley Ordinances and rulings oi the Department of Buildings, and her�by
declares �thne all the facts and representations stated in this application
8re true and corrcct. •• �
' � . . . �. . . � • • , ' ��
' SIGNATUItE : ' �� �' �
• pATE: � _ , .
�(See I�everse Side For Addition�l Info�ation.)' . .
. ;�� � �, � . . ' . . . , � � .
' ' : - r ��, .��� ' .. . . . .
. � � � �� ° . �� • � • . .
^ ��� � . ., . . � • .. s � -
�� • � � �.
13U1Lll1N� t'.L•JN�Il! r1�L• ���icLUr.�
l
• i
S�CTION 2. Tlie Inspector oi Buildinfis shall, before issuing permits for the
eXection ot any building or sCructure, or for any addition to any existin�
building or structure, or ior any alteration or xepairs to any existing
bui.lding or structurc, upon app�ication thereforc, requixe the payment by the
applicant ioir such _pennit of fees to thc air.ount hcrein below set �orth and f�l
the manner lierein provided to-wit: . , •
UP�FOr.M BUILDIrG COD�: �►pe 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, i.n such cubical �ontents. Type 3& S-$1.85 for
eacl� one thousand cubic feet. • �•
�IDDTTIONAL INFORI�IATION
.For the purpose of ;:omputing fees fox building permi.ts, the cubical contents
of any builcling or addition, is determined by multiplying�the ground area
• covexed from a point six (6) inches below the floor line oi the basement �
ox the cellax ta the average heiohts of the upper surface or to the average�
height of the•xoof surface of the ma.in gable of a pitched roof.
• For repairs.or alterati�ns to�an existing structure, the fee shall be at the
° rate of $3.00 per each five hundred�dollars ($500.00) or fraction thereof in
the cost of all proposed work. •
�� � in no case shall the fee charged for any, permit as set forth in Section 2 be
� less than $5.00. . � • �
�
VERIFICATION OF'FOUNDATION
0
e
NOT�: Permits for construction coill be issued.a minimum of 24 hours fxom the
time of application, to allow for proper retriew, of the proposed strucfure and.
• of the construction site. . •
A Certified Survey of the lot, sho�aing the location of the foundation, once it
has been constructed, will be requixed before proceedin� with the fraina.ng.
. . CERTIrICATE OF�OCCUPANCY •
Application for a Certiiiczte of Occupancy shall be made ten (10) days pxior
, to the use or occupancy of any structure for whi.ch a buildin� permit has been
issucd; and said structure shall not be used ox occupied until a Certificate
�'•� of Occupancy h�s been issued.. , _ ••
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sue�ecr P
City of Fridley � 15 41'7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. �
� �ti: � -�-
r � � PROTECTIVE INSPECTION SEC.
t �
� � /�"1 � CITY HALL FRIDLEY 5S4$2 NUMBER REV. DATE PAGE OF APPROVED BV
�"'""� � ��� 612-571-3450 910-F15
8/27/79 � �
JOB ADDRESS 255 Craigbrook Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ],9 6 Peasson's Craigway Esta.tes 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John West 255 Craigbmok Way N.E. 571-7408
3 CONTRACTOR MAILADOHESS Z�P PHONE LICENSENO.
Viking Home Improvement Co. 4832 - 2�t 5treet N.E. 560-3794
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
RPSICIP.T1't,].d�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install soffit and facia
8 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONINO.
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 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
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 HEHEIN OR NOT. THE GRANTING OF A PERMIT S�BO. OO $. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STR CTION OR THE PERFOR ANCE OF CONSTRUCTIO . $%. SO
� PLAN CHECKFEE TOTALFEE
�8.�0
SiG TUAEQFCON7RACTORORAUTHOR12EDAGENT IDATEI WHEN PROPERLY V�DATED THIS IS YOUR PERMIT
/
� ' ° - � _� .l%f . �' �
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BIDG INSP �pT
CITY OF FRIDL•EY • -
APPLICATION FOR RESIDENTIAL BUILDIPdG PERMITS
. � (P�ew, Alterations, Additions, or Repai'rs) . ,
P � .
. `
� OWNER: �°'� BUILDER: -��/C �� � �o �
�,� �
ADDRESS: �,� ,� � � L� AUDRESS: �7'D.��— ���5 %�� .
TEL N0: 5���°�%�D � TEL N0: --�� �����
- ST�T NO : �� � STRE
, LOT: � f BLOCK:
Construction Location
;T: �,� s �c� � — -� - - � 1� g'
/ ' �. . ' �
�b ADDITION : �l��G�i�� f ����� � �
• Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certi£icates of 5urvey of lot and
proposed buildi.ng location drawn on certificates to scale.
. DESCRIPTIO�d OF CONSTRUCTION �
�'i �� r��'' Front: � Depth: Height:
Squa�e. Feets C�bic Feet: '
Front: Depth: Height:
Square• Feet: Cubic Feet:.
' f�� 1�.�+✓T N, ►�,.,. . C�0 .
Type of Construction: Estimated Cost: $��� �—
7.b Be O�mpleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $� $
. , SEE REVERSE SIDE OF SHEET .
7�e undersigned hereby tnakes application for a pezmit for the work� herein specified,
agreeing to do all work i.n strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct. ^
DATE: �-,�7- %� SIGNATURE ;
5tipulations:
���A``' `j • '�� �U
• �� s�b
�Uf�
,�,_ '
�
. BUJLDI(JG f'ER��IIT f=EE. SCHEDULE� ,
S�CTION 2. T}iQ Ins�,�ector or 13uilding� shallr before issuing permiL•s for �he erecLion
oi any Uui].ding or uL-ructure, or for any additiion to any exis�ing building or strucL-ure,
. ox for any alteration or repair� to•any exi�ting bui.lding ar structure, upc,n application
'therefore, require the paymen� by tlie applican� for. sucl� permiL- of fees to. the amount
herein beJ.ow set forL-h and in the manner herein provicled L-o-wit; �
N�P7 CONSTRUCTTON: 5ingle rami�.y IIomes and Garages: $�.00/1,000 cubic Leet. .
PL71t� CH�CY.: 25 percent of bui.lding permit fee.
D12IV�WAY D�PRLSSIOII: (Concrete, Curb Stxeets Only) �' •
' Alternate A: Reinoval and replacGment of concrete eurb and
qutter only; Driveway width plus 6 feet x Y1�.75
-. Alternate B: Removal and replacemr.nt of cancrete curb and
� •� gutter and install a 3 foot�wide approach with �'
� .- 6 inch depth; Driveway width �plus 6 feet x$17.85 '
• . �DDI T IQNAL I NFOR�IAT I ON
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is d�termined by multiplying the ground area covered from a
, poznt sir. (6) inches below the floor line.of the basement or th� ce].lar to the
average heights of the upper surface or to the average heic�ht of the r.00f surL-ace
of the main gable of a pitched roof. �
For repairs or alterations to an existing stn�cture, the fee shall be at the rate
of .$3.00 �er each five hundred dol.lars �� ($500.00) o"r fraction thereof 9n fihe cost
of all proposed work. . , �
Tn •no case shal.l t}�e fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge. . •
��Z ' : � � � � 1 �
" NOTE: Permits for construcL-ion tvill be issued a minimimn of 24 houxs from the time
of application to allow for proper review of the proposed structure and of the
cons�ruction site.
A Certificate of Survey of the 10�, showing the location of the foundaiion once it
has been constructed c,rill be required before proceeding with the £raming.
� _�ERT I F I CATE OF OC��J NCY ' �
' Application for a Certificate of O.ceupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building peYmit has been i.ssued; and
sa�d structure shall not be used or occupied until a Certificate af Occupancy has
been issued.
�
.
• ' � `
. • � '
0
sue�ecr RMIT NO.
City of Fridley � 17 2 6 3-
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
' � R
� � •
� ' COMMUNITY DEVELOPMENT DIV.
� LV � �
r � � PROTECTIVE INSPECTION SEC. /D %��
1 = �
� �'���1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�----� • •�� 612-571-3450 910-F15
9/26/83 � �
JOB ADDRESS 255 Craigbrook Way N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDIT�ON SEE ATTACHED
DESCR. ]_9 6 Pearson's Craigway Estates 2nd Addn. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Janet lniest 255 Crai. brook Wa N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Mortenson Home Im rovement Mad'so -
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
s.' d
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
ro f
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roaf can be 2nd layer but not 3rd. Install ridged galvanized valleys.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. ASPh3�-t
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING S�. FT. CU. FT.
AUTHOFiIZED 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 OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
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 $`$OO y�`.SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`1S.00
TR CTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$15.50
SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATE---=� WHEN PROPER ALIDATE THIS IS YOUR PERMIT
��
SIGNATUREOFOWNER�IFOWNERBUILDERI IDATEI BLDG �NSP �pT
CITY Of FItIDLCY
NPPLIG11TI0:� FOft RCSIOL'iJTl/'w I3UILDliSG PCiLiITS
(I�ch�, Alterations, Additions, or Repairs)
Ot�r�ER: �� � ��
ADJP. S : � /�,� [,Q� , ,�' ���
TEL A0:
. �� S�-
STIiI�T NO:
STItEF.T:
Effective Aug. l, 1981
't3UI LDER : �?v
ADDRCSS: � �� .�' � _ ���
TEL t20: ��/ ��6 �%
Construction Location
L07': BLOQC: ADnITION :
Corner Lot: Insidc Lot: _ /\ Setback: Sideyards:
�L.���
Ap�licant attach to tl�is form two Certificates of S�rvey of lot and
p:oposed building location drawn on certificates to scale.
DESCRIPTIO�� OF COi�lSTF:UCTIOW
Front: Depth: Height:
Squarc Feet: Gtibic Feet:
Front: Depth: Height:
Square Fe�t: C13bic Feet:
Rype of Con: truction : �, Estimated Cost: ��
Zb Be Nr.�pleted:
Alt. A Alt. B
Proposed Drivevay �iidth If New Openinq Is Desired: $ $
, , S�� PF.VF:1Li: SIDi OF S}IE�T .
19ie unde�rs'igned hereby mal;c� appliclticn for a per�it fcr the �:ork herein specified,
agreeing to do .all v.ork ir, strict accordance ��ith the Ci�}� of I'ridley Ozdinances ei�d
zulii�a� of tlie Department of Duilclings, and hereby declares that all tl�e facts and
represes� t.Ztiens' stated �n this appLication�re true and correct.
D.�TE: so�/ � D � SIGNATUI.�.:
Stii�ulations : �
f / S� ��
s�
I��
�
y ,. �
�
•�?���7!'_�f-l�"��� _ � I � • - '
The ChieP Building Official ahall, bePore issuing permits for the erection
of any building or structure, or Por any addition to any existing building
or atructure or for any alteration or repairs to any existing building or
structure, upon application therePore� require the paymeat by the
applicant for such permit of fees to the amount herein belrn+ aet tortb and
ia the manner herein provided to-xit: ,
Sotal Valuation
#1.00 to �500.00
�501 to �2,000.00
Fees
=10.00 (Minimum �15.00)
a10.00 for the first a500 plus �1.50
for each additional a100 or fraction
thereof� to and including �2,000
�2�001 to �25�000 �32•50 for the first a2�000 plus �6.00
Por each additional �1,000 or fraction
thereof, to and including a25,000
�25,001 to �50,000 a170.50 for the first �25, 000 plus
��.50 for each additional �1.000 or
fraction thereof, to and ineluding
�50,000
�50�001 to �100�000 a283.00 for the first a50, 000 plus
�3.00 for each additional �1,000 or
fraction thereof� to and including
�100,000
�100,001 and up �433•�0 for the first �100�000 plus
�2•50 for each additional �1,000 or
� fraction thereof
Plan Check: 25 percent of building permit fee.
Drive�ay Depression Escrov: Concrete curb streets only.
Alternate "A": Removal and replaeement �f curb and gutter only -
DriveWay width plus 6 Peet times �13•50
Alternate aB": Removal and replacement oP eurb and gutter and
install a 3 foot Wide approach �ith 6 inch depth - Driveway width
plus 6 feet times �15.75
•, � �. .. .�
Permits for eonstruction rill be issued a minimum of 24 hours Prom the
time of application to a11oW Por proper revieW of the proposed structure
aad oP the constructioa site.
A Certificate oP Survey of the lot, ahoxing the loeation of the loundation
onee it has been eonstructed vill be requfsed before �roceedinR rith the
framing.
- , �
�
G
MINDER.EN�INEER.INC�r CO.,INC.
ENGI NEERS AND SURVEYORS
�.wN� avave�nNo
CIVIL i�. MUNICID/►L QNOIN[ERINd
6418-SGT" AVENVE N. ,
MINNEAPOLIS 21. MINN.
KE 7- 3637
�!'r�i���d��i�� 1�� �S ���1l�
CA R L BEN/VE T T CONST. C0.
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LANO PLANNINO
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��.�4�" �� B�K 6�PEARSQN.S'CRr�IC�WAY ESTATES � Nd ADt��O�l.
�
��li� HERlO'if � ClRTIFY TNAT 'rN�s �S A tRUE IWO CORRECT R,EPRESENTI�TION OF A SURvEY OF THE BOUN�NRIES OF TNE
UWD AQOVE OpS�QI$ED AN� � OF 7NE LbCATION OF ALL BUII.DIN6S � IF {WY, THEREON , AND A1.1 VISl6LE ENCROACHMENTS�
�F �w,r, FROM dRON SIUO U1ND.� MINOER E�JGtNEERING CO., INC.
or►�o TM�s_� or� os S� _MBFiQ � n�o.���y ENa�N a .,N� av a
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BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of � any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,�1 to $25,0�
$25,001 to $50,000
$50,001 to $100,�0
$100,001 to $5�,000
$500,001 to $1,�0,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $SUO plus $3.05 for each additional$100 or
fraction thereof, to and including $2,0�
$69.25 for first $2,�0 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000 �
$391.25 for first $25,000 plus $10.10 for each addirional $1,000
or fraction 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 including $100,000
$993.75 for first $1(K1,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $5�,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT E5CROW
(Concrete Cbrb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
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.
VERIFICATION OF FOUNDATION
A Certificate of Survey of � the lot, showing the location of the existing foundation will be required before
proce�ding with the firaming. New Houses Onlv
NEW
ADDN
ALTER
[] CITY OF FRIDLEY �� �� �E� e 4/1/2004
[ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
� �„J�%v �.S
Legal Description:
Owner Name & Address: �'t? � i17B Z.`1�i � c e�.� S C� � a� I. # 7G3 S�� 7S�l�
Contractor. �'e� A a 11�rr ����'�'i h�' MN UCENSE #
Address: �SS �ra'o� �v ��IC ' �F ��., r��� . �I,C� ���/3� Tel. # �/����7�-�' -7Sy�
Attach to this application, a Cert�cate of Survey of the
bt, with the proposed constructuon drawn on it to scale.
DESCRIPTION OF IMPROVEMENT — O I���
�
. �
LMNG AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft T
r —�t
DECK AREA: Length � Width � Hgt/Ground Sq. Ft `"/���
OTHER: ��.�p ���sr�� �or�rin � Gc.r� �.�w�� �� � ����Z�� j ► �I�
ry x /3--_�_ �-- ��, _ _ , .
Construction Type: fiVO�a � _ Estimated Cost: $� X �;i `1,3. DD � _ � ��7�•l��
Driveway Curb Cut Width Needed: Ft + s Ft = Ft x� _$
DATE: d% APPLICANT: Tel. #'_7/�—�}/'� 7S�i�
Call (763) 572-3604 for Permit Fees if ma ng in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
,�
$ Fee Schedule on Reverse Side
$ 10� . 65% of Permit Fee
$ .001 of Permit Valuation (1/10th%)
$ �-(, �� $.50/$1,000 Valuation
$ $1350 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 [ ]
$ ? � STIPULATIONS:
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 iJNIVERSITY AVENUE NE
FRIDLEY, MN 55432
,63) 572-3604 FAX: (763) 571-1287
: 255 CRAIGBROOK WAY NE
: 033024430031
: PEARSONS CRAIGWAY ESTATES 2
: LOT 19 BLOCK 6
: BUII.DING
: RESIDENTIAL
: ADDITION/ALTERATION
-�
\
PERM N0.:2004-01161
DATE ISSUED: 07/21/2004
VALUATION : $ 8,576.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI-IE
2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 10' X 6' THREE SEASON PORCH ADDITION AND A 14' X 13'
SCREEN PORCH.
APPLICANT
JOHN & VERA, WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
C�l:'/►1�:7
JOHN & VERA, WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, NIN 55432
AGREEMENT AND SWORN STATEMENT
This pemut becomes nu11 and void if work or construcrion
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
[ hereby certify that I have read and examined this
application and laiow the same to be true and correct. AIl
provisions of laws and ordinances governing this type of worl�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
Bldg Insp
BUILDING PERMIT FEE
PLAN CHECK FEE
FIltE SURCHARGE
STATESURCHARGE,VALUE
TOTAL
PAID WITH CHECK # 5179
�d I „ e.
� SEPARATE PERNIITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
167.25
108.71
8.58
4.29
288.83
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
r631572-3604 FAX: (7631571-1287
: 255 CRAIGBROOK WAY NE
: 033024430031
: PEARSONS CRAIGWAY ESTATES 2
: LOT 19 BLOCK 6
: BLTII.DING
: RESIDENTIAL
: WINDOW/DOOR REPL
PERMIT N'b��2004-01905
DATE ISSUED: 10/18/2004
VALUATION : $ 7,766.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317
OF TI� 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPEI�TINGS.
REROOF DWELLING (19 SQ) TEAR-OFF, AND INSTALL WINDOWS WITHIN EXISTING OPENINGS.
APPLICANT
MARK WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
� ./�I �I:
Ma� wa�s
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and l�ow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or locallaw
re�nstruction or the performance of constquctio�n.
Bldg
BUII.,DING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
PAID WITH CHECK # 5245
�:.> C a '
SEPARATE PERMITS REQUIItED FOR WORK OTI�R THAN DESCRIBED ABOVE.
153.25
7.77
3.88
164.90
N� [ l
ADDN []
ALTER [ )
Construction Address:
Legal Description:
Owner Name & Address:
Contractor.
11 ��:7�_�
GARAGE AREA:
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
s� �+� ► g_����,� �� .,�� � � 5 � � �
# 7Lo3 � 7</— �5��
MN LICENSE #
Tel. # '7G3 — 7��� �Sf�r/S
Attach to this application, a Certific'ate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
DECK AREA: Length Width HgUG`ound Sq. Ft
OTHER: � _ S - , �
�Q I`d(3� /,9 �'9P��! w � o�� �ar?� � . ` �- � - ,
V ° �
Construction Type: � i 4�G%G�7S' Estimated Cost: $� .`� ��� � ='� = �
�Ga �:°°] �7 � �o
Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$
�
DATE: `�� � � � APPLICANT: Te�• #
Call (763) 572-3604 for Pennit Fees if mailing in application. Fax to 763-571-1287 ff using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ � E o Fee Schedule on Reverse Side
$ � � 65% of Permit Fee
$ , .001 of Permit Valuation (1/10th%)
$ o $.50/$1,000 Valuation
$ $1350 per SAC Unit
,$ $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 [ J
� �1
STIPULATIONS:
�
BUII.DING PERMYT FEE SCHEDULE
The Cluef Building Official shall, before issuing pernaits'� for the erection of any building or structure, or for any
addidon to any existing building or structure, or for any alteradon or repair to any existing building or
structure, upon applicadon therefore, require the payment by the applicant for such pernvt of fees to the amount
herein below set forth and in the maziner herein provided to-wit:
3
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 $5�,0�
$5�,001 to $1,000,0�
$1,000,�1 and up
�� °'
$23.50
$23.50 for�first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.W for each additional $1,000
or fracdon thereof, to and including $25,�
$391.25 for first $25,000 plus $10.10 for each additional $1,�0
or fraction thereof, to and including $50,000
$643.75 for first $SO,OQO plus $7.00 for each addidonal
$1,000 or fraction thereof, to and including $100,0�
$993.75 for first $100,OQ0 plus $5.60 for each addidonal
$1,000 or fraction thereof, to and including $5�,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,�0 or fracdon thereof, to and including $1,�0,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fractio�n thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate �
Permits for construction will be issued a minimwn of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATIOl� OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
ti
CITY OF FRIDLEY
' 6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
(763) 572-3604 FAX: (763) 571-12�7
ADDRESS ,
PIN ,
LEGAL DESC .
PERMIT TYPE ,
PROPERTY TYPE .
CONSTRUCTION TYPE .
REPRINTED ON 11/19/2004
255 CRAIGBROOK WAY NE
033024430031
PEARSONS CRAIGWAY ESTATES 2
LOT 19 BLOCK 6
HEATING
RESIDENTIAL
ADDITION/ALTERATION
PERMIT NO.: 2004-02137
DATE ISSUED: 11/19/2004
R610�
VALUATION .
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A:
# A/C UNITS 1 VALUE OF APPL OR WORK 0
# FURNACES
# GAS RANGES
APPLICANT
CHANGING CLIMATES INC.
PO BOX 491056
BLAINE, MN 55434
(763)434-2485
OWNER
MARK WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and conect. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
ganting of a permit does not presume to give authority to
violate or cancel the provision of any other state or local law
regulating construc�n or th�erfor�ance of construction.
Bldg
1 # GAS DRYERS
0 VALUE (FOR MINIMUM CALC)
HEATING PERMIT MINIMUM FEE
FURNACE SHELL/DUCT WORK
GAS RANGE FEE
GAS DRYER FEE
AIR CONDITIONING FEE
HEATING REPAIRS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
GAS PIPING FEE
TOTAL
PAID WITH CHECK # 8969
0
4000
0.00
35.00
0.00
0.00
25.00
0.00
0.50
10.00
70.50
0
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ADDRESS
PIN
LEGAL DESC
CITY OF FRIDLEY
6431 LINIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX:
: 255 CRAIGBROOK WAY NE
: 033024430031
: PEARSONS CRAIGWAY ESTATES 2
: LOT 19 BLOCK 6
571-1287
PERMIT NO.: 2004-02272
DATE ISSUED: 12/13/2004
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUG°I'ION TYPE : ADDITION/ALTERATION
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE.
# INSPECTIONS 1
APPLICANT
MARK WATKIlVS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
OWNER
MARK WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORI�T STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and conect. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating�construction or the performance of construction.
Applicant Date
Bldg Insp Date
STATE SURCHARGE, ELEC FLAT
ELECTRIC FORM FEE
ELEC PERMIT FEE - MIN (RESI)
TOTAL
��YAKA l� Y�KMI l � li�llUll(�U rUK W UKK V l ri�K l HAN ll��(;K1J3�U At3UV�.
0.50
1.00
20.00
21.50
�
CITY OF FRIDLEY
6431 iJ1vIVERSITY AVENUE NE
-�' FRIDLEY, MN 55432
(763) 572-3604 FAX: (763) 571-1287
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
: 255 CRAIGBROOIC WAY NE
: 033024430031
: PEARSONS CRAIGWAY ESTATES 2
: LOT 19 BLOCK 6
: PLUMBING
: RESIDENTIAL
: ADDITION/ALTERATION
PERMIT NO.: 2004-02273
DATE ISSUED: 12/13/2004
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A HOME OWNER DOING WORK
PH 763-5747546
# ELEC WATER HEATERS 0 VALUE OF FIXTUREIAPPLIANCE 0
# NEW FIXTURES (E7QST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
MARK WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
OWNER
MARK WATKINS
255 CRAIGBROOK WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not.commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced
I hereby certify that I have read and examined this
application and lmow the same to be true and correct. AIl
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit cioes not presume to give authority to
violate or cancel the provisions of any other state or local law
regulatingconstruction or the performance of construction.
Applicant Date
Bldg Insp Date
0 # GAS WATER HEATERS
0 # GAS RANGES
0 VALUE (FOR MINIMUM CALC)
0
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
1
0
300
0.00
0.00
0.00
0.00
0.00
35.00
0.00
0.00
0.00
0.50
35.50
0
0
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BUF�NING APPLIANCE PERMITS
COMMON VENT; VENT CONNECTOR AND COMBUS710N AIR VERIFICATION
Vl/hen replacina an existina furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
�
The venting system is plastic/PVC and meets all current codes and m�nufacturer
specifications including sizing, length, number of elbows and terminatidn.
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This dbes
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( )
When installinA a new ventina svstem, the undersigned hereby verifles that
it is a listed assembly and meets the current codes and manufacturer's�
spec�cations. This does include AGA-GAMA Category I Central Fum�ce
V�nting Tables for fan assisted and natural draft appliances. � Yes ()
IS the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent ar�d vented
separately as per current codes.
No ( )
No ( )
Yes ( ) No ( )
A�pliance Tvpe and SizelCommon Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Tdal Btu Input
Common Vent Type Vent Height Diameter � inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describe)
HEATING CO:
Signecl By: Date :
FEB-24-2006 0i:27P Fl�M:
.��
.. . j;�
......... - --
rr• . D���,�,1
:.�, � Ixispections
'Ib3-572-3604
���
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ONVNF.�t1 -
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Date Rec'd:
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P1�CIN2:
�,urrwu�r:_' K1ine Corp. � — .
ccrn'ACr P�� � DBA: Praciir.�l Systems .
srnrE�.�c��^ 4342B Shady Oak Road _— --- --srA� �
,��5;� Hopkir�s, MN 55343 —r---��
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p�R M516�.655 �na pesm
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� x .05 � L�D �
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s Numlxr o!' fnccut�s ��"15.00,� ��5,00 6 S��_
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• THLS L5 AN ApPUCATIC�N FqR A PERMIT Nf�T VALtD UN'f1L PROC�
� tba# ttt� wor3t w'�1 be in
I l�r,reb'Y el�A1Y fot a bw'ldipg p�� aud 1 aek�nttwtcdg,e that �he infnrmatioa above is eompIr�cs �d ar.carpte;
• ConiornaaACe with tha tudiagnas ae f�eogr��a�f �e�nd�.vQrflcFs �ot tu�strsrt=•wi hou�A pcnaie rl�a� t t�h�� �+'��l�bc m accardd�with th�
�� nat.� P�'�n byt aaly aa app�r,a�on which s reviey► and app�oval vf� �7�
. appro�red plan !st tba cas�all w� �° _ lA r� ._,, r �!"� , e ue /'~ �e��` �� �U(lJ --
' SIdNA'NRE OF
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�n4idin� Inspec#ions Dapartimeat :
b431 Univtrsity Avei�ue NE, Fridley. MN 5543Z
763-572-3604
FA�C: 7G3-502-4�77
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