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sue�ecT PERM
City of Fri.dley , 14460 �
�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � ECEIPT NO.
� `L _ COMMUNITY DEVELOPMENT DIV. �/
r � � PROTECTIVE INSPECTION SEC.
I . �
�` i �"�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
""'� � ,�� 612-560-3450
910-F15 � 1 ��� � �
10B ADDRESS � 560 Dana Cou rt -
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �O 2 Harris Lake Estates SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Mr. � Mrs. Born 1 60 Dana Court Fr'dl MN
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Brickner Builders, 1401 Kerry Circle, Fridley MN 55432 574-9871
4 ARCHITECTORDESIGNER MAILADDRESS ZIP . PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
H s
7 CLASS OF WORK '
� NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
9 CHANGE qF USE FROM TO .
STIPULATIONS �
1. Provide City with copy of truss design.
2. No basement floor below 886.00
li-iE CIIY OF Fl�fbl`Y QOES iv�T GU�yRr�NT:.= "r'.
ACGURACY O� l9Ttllil( lOG4T6QN5 AN� EL�'JA�6C:..
Tn14S DATA IS FOR IPJFO+P1iAT10Pa9 PU,:POS�S C1�RfLY :`�°;.:
PERSONS US�I�lG �iT SHOIJL� dERIFY THE IPdFO�:hAATIG� �
pN 111E SIT� ,
S�PERATE PERAAiTS REQUIRED F�R VV�4�ING�
H�ATIRiG, P�.Ut�BIiV(� �ND S�GIVS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. IPIOOCI F a 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 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 VALUi4TION SURTAX
AND ORDINANCES GOVERNING THI$ TYPE OF WORK 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 pERMIT FEE SAC CHARGE D/W I S 6)
PROVISIONS OF ANY OTHER ST OR LOCAL LAW REGULATING CON-
STRUCTION, E�"��THE PERFOR E OF CO TRUCTION. � $37S • OO ��� �
'�' i ( PLAN CHECK FEE TOTAL FEE
. � ��.�!"�'°�.!� �� ��, % / ``� '�' '� 8 . 2 ���
�� ::
� SIGNATUREOFCONTRAC OROFAUTHORIZEDAGENT �DA E) y� N R RLY VALIDATED THIS IS YOUR P RMIT
� � / / A
SIGNATUREOFOWNERIIFOWNERBUIIDERI IDATEI BLOG INSP pA7
CITY OF FfiIDLLY .
APPLICATIOT� FOR RESIDENTIAL BUILDING PERI�1ITS
�NEW, ALTER�TIOfJ5, ADDITTONS, OR REPAIRS)
OWf7ER: �%"/�� '� //f�j/s ��-!'�1= �
�
Address: _ �'AZ�;�c,c,�i,, .
No.: ��� � Street:
� '
BUILD�R: � ����''2U-_ C r
�
Address : � i � 1 ��� C�/l,��(%
Te l . No . : ,�� � � � ,� �/ . .
�.<r3-�+�te,,,/�
LOT: �D BIACK: �- ADDITION: I �'�
� �
CORNER LOT: INSTDE LOT: SLTBACK: f�
0
SIDEYARDS: ��
Applicant attach 'to this Eorm Zt,vo Certii'icates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRI PTION OF BUI LDI NG
To Be Used As: ��^ ���
e
• .S Front: �a �(or� Depth: �� ( Height: 02� �
Square Feet: Cubic Feet:
(„f�%�,��. Front: ��%.� Depth: �•� Height: /() �
Square Feet:
G`ubic Feet:
Type of Construction: �d�.Q ���� Estimated Cost: �
� —
7.b Be Completed: Alt. A A1t. B
Proposed Driveway Width If New Opening Is Desired �_ $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordanca with the City of
Fridley Ordinances and rulings of the Department oi Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse sid.e far r-3ditional inf � tion.
/ // J l /
/ - j G �
DATE : 7 S IGNATURE : '�-� �1'�,' j��'-�%L_'✓��,s,,
Stipulations e ' � ��b � ��
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BUILDI(dG FER��IIT FEt SCHETJULE
SECTION 2. The Inspector of Buildings shall�, before issuing permits for the erection
of any building or structure, or for any additiori to any existing building or structure,
or for any alteration or repairs to any existing building or structure, upor. 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-cvit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) .
Alternate A: Removal and replacement of concrete curb and �
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: R�moval and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
ADDI T IONAL I NFOR�1AT I ON
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point.six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
F'or repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 �aer 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 $7.50 plus $.50 state surchaxge.
VERIFICATIOy OF FOUNDATION
NOTE: 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 been constructed will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until.a Certificate of Occupancy has
been issued.
�
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Page 1 of 4
`' , EXTERIOR ENVELOPE AVERAGE "B" COMPUTATION
�WNER : �,�i")' � �ci��s+'.� .s�` � DATE // � � � � 7
SITE ADDRESS: /�` a /1J��. �-+�� pHONE: S 7�- ����
CONTRACTp ,g ��. ��,�
� ,�, �, _
Determine working square footage of each
1. Tatal exposed w��l area...... /��� Sq, ft. x .17 =���- ��
2. Toai roof/ceiling area . . . . . , _ 2 7 3 sq. ft. x , 05 � _ � � . �,5�
Total exposed wall area above floor =
a. Total wall window area.. �
b. Total door araa "•-........� .................. i°° �
c. Total slidinq glassodoor.area ......................... `�
d. Total €irepl.ace wall area ........ .� �������� ��� �' 3 9• 9
e. Total wall framing area (average 10�).......,.. ••.� �� 9
f. Total rim joist area ........................ �
9- wall area above•€loor....... OI
h• wall area above floar.......••��•����.� ���
i- wall area above floor........•.••�.��� ����� ��
3- wall area above floor.......e.......o..........
Total exposed foundation area = � �
k. Total foundation window area.. ,,,,eO_,,. �0��
1- Total net foundation area above.grade ................. ��v
Determine "U" value of each wa12 segment
(e.g. window, door, each separate wall section}
a. $� 31� X��un . 3�' ✓ � G�, ti`1s
b. � s m 3� x„u„ , S"�� _� 3 m%'1/
�. 3�. 9� X„�„ . 3 q =, S°. /�
a. 7� X.,u„ , 2�/ `� 1�
'� �
e. ���� �%3 X ��U�� ��l _ � ,2 .
f. % � g � ��U„ ,0 J v �, .
g. � �G fl � X ��U�� , � �o L'i �f . �
h. X uUn =
F i , X nUu =
j. X ��U�� _
k. � X
�. g ti X
��U�� �_
„�,,, , y � _
3 . ............................. Total =
�3. �
a 8's` 8",�
If item #3 is the same as,
or less than item #1, you
have met the intent of
SBC 600� (c) 2.
L
e, Exterior Envelope Average "U" Computation
Total �posed roof/ceiling area = � �', 3
m. Total skylight area ............................
n. Total. roof/ceiling framing area (average l00)...
o. Tatal net insulated roof/ceiling area........... �.�
Determine "U" value for each roof/ceiling segment
m. 3j °Yjn =
Page 2 of 4
n. g ojj° -
o. 1 Z. � 3 X„U,. , o� = 3�� I
4............o .............. Total = 7 �'� � .
If total of #4 is the same as, or less than.#2, you have met the intent of
SBC 6006 .(c) 1.
Alternate Building Envelope Design
To utilize the total envelope syst� method, �he values estabZished by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. + 2. _
3. + 4. _
�
� WALL SECTIONS
NOTE: Use 10% of opaque wall area for
frame construction
Construction R-Value
1. Interior air film 0.68
2. �/L,, ,12 D. S'
s. 3 ''ti S iv� .2�
� 4• %i" l�fi/G/l�st !. /
e,.__
)f���3�� �5 �YsVlb�lts Shc�AF�I?, ����L ���d40.s� i�•��
�. 6. Exterior air film 0.17
.� To�� 9. a a-•� I 1
FRAME j�ALL
e ` � � �` v
� — • ..
� � , �-. ' ,,
r'ZG. #3
�� v f .a , � �. 4
. ' o - _ ` , �- ' .
� . �
C• � - ' -! � � b "•
Page 3 of 4
�
�'6 . , .
; ;..•.. .
l. Interior air film 0.68
2 . �a. � � � 0. �! .�
3. � �Z`° ��Ji@/� le •
4 : '��. �' !� s� �� /�� � � I - l Ll
5. ��.��J& �AI������a �`��� A� ���ia'���,e73
6
6. Exterior air film 0.1?
Total � S°, �' ; . a �
1_ Interior air film 0.68
2. ��%,.� on�sv� II
.
s. s'�,' -e� ►. ��
4. �%" ��s� �,� s,� • � g �
s . �EC v wt s sb r r� � � ��e � �g � ,��.,� � � �
.
6. Exterior air film Q,l�
Tota.l /,�. � � ; � OS/
1. Interior ai.r film p, 68
2.
s.��.•' / �p�
4.
5.
6. Exterior ai�c film 0.17
Total � . / ? ° • �°7
. t o . '
.. �� �
=--
FIG. �4,
, :.
NOT�r'. :
r • ' � e.
. � �` �
t.
�� �� � . • � , _ ` .
/l('=— , �� � . : - . � , � .
.�-- `
<
� � . . � ;.
� . � 6 _ ', � It J �
([! = '� . • - • � --- / 1 �
�' ' � • � /(/ � � '
/l( u. t ' •. Q, � /�(
^ �: ` �' �� � .�
� � x y � �tl
�
• /� ( !� r � ��r =
Indicate tyoe,� "?2" �v�],ue, depth and
t'1�,1nnm�»�- .aF -..-..___� _ i. _ _
�
� ROOF/CEILING
� :
'��`5_..�'
�����I �� �:I`; �� � t
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Vented
Page 4 of 4
Construction R-Value
��
� . I 1. Interior air film 0.61
�: � 2 . ��9�.. � � " � 0. ��
� 3. ��3C 36
�?�s_� � : .
(� �� 4. Exterior air film (still) 0.61
��
_�._._�. To�� 31. 6� r , �3
- �, �� . . .
Heat f low
up . .
FIG. a5 � �
'.n,�t,..�-�N- -:ti�,s?1;11�.`e'��•�a��3�c�R^.�Atet
- - - ��
� }:e�t f]:oc� up � . ;•ventedo
. .FIr. #6 .. . .. . .
. _.�� ------.� . �-- :
. � i'
. o�S = ��! �
��p1 �_�oS • ��.0
. .• , : ca a.C3°,i.:^i? .. . _ .. - _ �� •^"'� �
' t�U@:—YL:IL��
. � • � �i�IIt `. � .
' • �ZOW ll�J . .. • .
. ; . • ..
f xr,. �7 _ . .
1. Interior air film 0.61
2.
3.
4. Exterior air film (st�ll) ' 0.61
Total
1. Inside air film 0.61
2.
3.
4.
5. Outside air film 0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
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8431 UNIVERSITY AVENUE N.E.� FRIDLEY, MINRIESOiA 66432
:bruary 13, 1978
Mr. Thomas Brickner
Srickner Builders, Inc.
6245 Ben More Drive N.E.
Fridley, Mn. 55432
Re: Final Inspection at 1560 Dana Court N.E.
Deax Mr. Brickn�r:
TELEPHONE ( 812)571-3450
A final inspection on Februa�y.10, 1978 of the above address noted
the follor,�zing items which must be completed before the structure
can be finaled out;
1. Provide a verifying survey by March 1, 1978.
2. Provide sod in the front and side yaxds by August l0, 1978.
3. Provide a hard surface driveway by August 10, 1978.
We will expect the above items to b�e completed by the scheduled da.tes
when a reinspection will be conducted to detennine c�npliance. If
you have any questions on these items, please contact me at 571-3450.
Sincexely, .
RON HOLDEN
Huilding Inspector
RH/mh
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City of Fridley 2 9 7 6 9
AT TFIE TOP OF THE TININS � � I L D I N G P E R M I T
r
! �' y____� COMMUNITY OEVELOPMENT DIV. RECEIP .
r � � PROTECTIVE INSPECTION SEC. �7��
1 � � «J
� � �'��1 � CITY MAL� FRIOLE� SS132 NUMBER REV OATE PAGE OF AiVqOVED BY
�"""'� � �'' 612-571-34b0 s�aF�s
6/25/99 / /
�oe aopaess
1560 D C r
t IEGAI �OT NO. BLOCK TRACT OR AODITION SEE ATTACNED
DESCR. �O 2 SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE
Sheriden & ar' ri
3 CONTqACTOR MAII ADORESS 21P PNONE UCENSE NO
Renewal b Andersen 350 73rd Ave NE Fr'd
4 ARCHITECT OR DESIGNER MAIL ADDiiESS ZIP PMONE �ICENSE NO.
5 ENGINEER MAII ADORESS ZIP PHONE IICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION � ALTERATION O REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Replace 12 windows in home
9 CHANGE OF USE FiiOM TO
STIPU�ATIONS
Provide smoke detectors in a11 sleeping rooms and on all levels of the da�elling
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
TYpEOFCONST, OCCUPANCVGROUP OCCUPANCVLOAO
SEPARATE PERMITS ARE REOUIREO FOF ELECTRICAL. PIUMBING, HEATING,
VENTI�ATING OFi AIR CONDITIONING
TMIS PERMIT BECOMES NULL ANO VOID IF WORK OH CONSTRUCTION 20NING SO. FT CU FT.
AUTMORIIED IS NOT COMMENCED V�fITHIN 80 DAYS, Op IF CONSTRUCT�ON
OR WORK IS SUSPENDED OA ABANDONED FOR A PERIOD OF 120 DAYS At
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREE7 PARKING
I MEFiEBY CEFTIFY THAT I HAVE pEAO ANO �XAMINED TMIS APPLICATION STALIS GAAAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALl PROVISIONS Of �AW$ yALUATION SURTAX
AN� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETMER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT BOOO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME pERMl1 FEE SAC CHARGE
PqOVISIONS OF ANY OTMEfi STATE OR LOCAL LAW REGUlA71NG CON-
STRUCTION OR TFIE PERFORMANCE Of CONSTRUCTION 153 'rJ
PLAN CMECK FEE TOTA� FEE
S�GNOTUpEOFCON:AGCTOAOpAUTMOA�ZEDIGENT �D�iEi MEN PROPEiiL Al10ATED THIS IS Y UR PERMIT
�sJ� — �r —
S�GNnfUAEO�OwNEA��FOWNEpBUQDEA� iD�TE� B�D �NSo � qart
Prcpaid Plan Check $
Estimated Cost $
CITx OF FRIDLEx
Effective 1/1/99
Receipt # R-3, COIVIlV�RCIAL & IlVDUSTRIAL bQ�
BUII.DING PERMIT APPLICATION � vJ
�� ��
Construction Address 1'S(.oD • Co uY '� . - oi l mN a Zorusig �
I�egal
owrier & Address�j�i-e.�f :d.¢ n. � h�o,.�',�:•Q l�or (� 'rel# Co�a •s'11 • [n�ICo
C�C:I�TRKCIC�R & Ar�rnzF�.� �ev���so�.� b�,, �Y�d� _r ��� ��O • �;3�d I�a . IN. f.� �r�c� I� Tel# C� i a• Soa • y`7 7�
a�'C�11t2Ct �, # Fn� naar �. #
BUII.DING CONSTRUCTION
� oF � �� � e�. �t�� � �.t�t�� -�� ���� � a w;�� ��
` __ 1�.._..,. _ /'n , .. �i,: . _.� _ _.. A r 1_ _ .,. _ _ ,-:� _
OFC. AREA: Length Width Height Sq. F't.
WHSE AREA: I�E.'Il�l Width Height Sq. Ft.
0►�R AREA: L�erigth Width Height Sq. Ft.
\ �k 1y`% '
�pL=� ��f\l�h.CA , L Y� Tel #(pla •BS� • a 85Y Date (L • p�� • Q/ 9
vai.va�oN
sq. F't. x$ cost/sq. Ft. = Valuation $ )
sq• Ft - x $ cbst/sq. Ft. = Valuatian � ) _ $ `�; 00 8 �" ,
sq. F't . x$ oost/sc�. Ft .= valuation $ ) ZO►TAL vaLt]E
���g U� ��� �' ��� � �i- �v �� � �2�.�
�ir Condition�ng ❑ Yes Ll No Fire Pxntectiari Pr�vided Ll Yes L] No
Perforn�ance Hond Amr��mt $' See Reverse for Schedule Received [] Yes' [] No
Pezmit Fee $�Jr.3. �,5 See Fee Schedule on Reverse Sids
Plan Check $ - In Excess of Prepaid Amotuit - See Reverse Side
F� �"�'�a'''' $ � ba . 001 X Pe,rntit Ualuation (1/lOth o)
State Surcha�e $ ,. 6U $.50/$1,OOQ Valuation (See Sched. for >$1 Million)
� $ �'� $1050 per SAC Unit (Plans to N�nTCC for detezmination)
�/4" .` [,r � $ �- !3U
- $450.00 Consexvation Plan Review
Park Fee _ $ Fee Detennisied By Engineering
Spec. Assessments $ A�e�nt Necessary ❑ Not Necessa.Yy.[]
�'i��Y �� $ feet x $13.50/faot
z�vr�,L $ �% . �.f
ATTA H S ATIONS
%��o Y/�� - G�� ��c c' ��"��c����--.�,wr �G ?� �
�o+�-s�+-S �.cL/� c�ov �/�' �v�
�� L .��Y�G,�.,o.k� T,�� ,� �.��i.v
e�---
�
$1 to 500
501 to 2, 000
2,001 to 25,000
25,001 to 50,000
50,001 to 1Q0,(}00
100,001 to 500,(�0
500,(}Ol to 1,OQ0,000
1,000,001 agd up
$1 to 2,0a0
2,001 to 25,000
25,001 to 50,000
50,001 to 100,000
100,001 to 356,000
Over $356,000
BUII.,DING PERMIT F'EE SCHEDULE
$21 (Minimum Fee is $21 plus surchazge) ' �'�
$21 for lst $5(� plus $2.75 for each addn'1 $100 or fraction, to and including
$2,000
$62. 25 for 1 st $2, 000 plus $12. 50 for each addn' 1$1, 000 or fraction, to and
including $25,000
$349.75 for lst $25,�0 plus $9.00 for each addn'1 $1,000 or fraction, to and
including $SO,OQO
$574.75 for lst $50,000 plus $6.25 for each addn'1 $1,Q00 or fraction, to and
including $100,�
$887.25 for lst $100,000 plus $5.00 for each addn'1 $1,000 or fraction, to and
including $500,000
$2887.25 for the lst $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to
and including $1,Q00,000
$5012.25 for the lst $1,000,000 plus $2.75 for each addn'1 $1,000 or fraction
PREP�ID PLAN CHECB FEE SCHEDULE
$29.25
$29.25 for lst $2,000 plus $5.85 for each addn'1$1,000 or fraction, to and
including $25,000
$163.80 for lst $25,000 plus $4.225 for each addn'1$1,000 or fracrion, to and
including $50,000
$269 . 43 for 1 st $50, OQO plus $2. 925 for each addn' 1$1, 000 or fraction, to and
including $100,000 .
$415.68 for lst $100,000 plus $2.275 for each addn'1$1,000 or fraction, to and
including $356,000
$1,QQ0 (Balance due with nssuance of building permit)
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling residential project wluch requires
outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover
all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences,
lighting, water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3% of the
building permit value up to a 2 million dollar project or a$60,000 bond. Actual amounts will be rounded to the nearest
$1�. The City reserves the right to require greater or lesser bond amounts based onunusual circumstances. Projects
with no outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully complet�d. Reproducible "as-built" drawings of all exterior
underground utilities must be submitted to the City Engineernng Dept before the project is considered complete and
the bond released. All bonds will be held over one winter and through the next growing season to insure the survival
of all landscape installations. The City �vill then inspect these properties in August of the year following the initial
planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed.
sua�ecr P IT NO. '
c�ty of Fr�a�ey �32522�°
�
AT THE TOP OF THE TWINS g u � L D I N G P E R M I T
� � RECEIPT NO.
COMMUNITV OEVELOPMENT DIV. f
r j v � PROTECTIVE INSPECTION SEC. ���(.;-�
1 . ,
( � /��'1 � CITY MALL fRIOLE� SS�32 NUMBEF pEV OATE VAGE Oi AVPROVED BY
�----�: �.• 612-57�-3a50 s�aF�s 4/22/02 / /
,
JOB ADORESS 1560 Dana Court NE
1 LEGAL LOT NO. 9LOCK TRACT OR ADDITION SEE ATTACMED
DESCR. jO 2 Harris Zake Estates SHEET
2 PROPERTY OWNER MAIL ADORES$ 21P PMONE
Marion Born 1560 Dana Court NE 763-571-5068
3 CONTRACTOR MAIL ADORESS ZIP PNONE UCENSE NO
Rlein Home Improvement Inc 2488 Arlin ton Ave E, Maplewood MN 55119 20161594
d AfiCHITECT OR DESIGNER MAIL AODRESS ZIP PNONE LICENSE NO.
612-790-0302
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTEFiATION O REPAIR O MOVE : O REMOVE
8 OESCRIBE WORK
Construct a 16' x 10' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS �
See notations on plan.
����'��
�efore di89ing call for
�II uti�ny lacations
REQ!lIRE 002
D BY L��
" TYPEOFCO 3T. OCCUPANCY(3ROUP OCCUPANCYLOAD
SEPARATE PEFMITS ARE FEOUIRED FOii EIECTiiICAL, PLUMBING, MEATIN(3,
VENTIIATING OR AIR CONOITIONING
THIS PEfiM1T BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTIOM 20NING SO. FT CU FT.
AUTHORI2ED IS NOT COMMENCED V�IITHIN 80 DAYS. OF IF CONS7RUCTION
OR WORK IS SUSPENDED OR ABANQONED FOR A PER100 OF 140 DAY$ AT �
ANV TIME AFTER WORK IS COMMENCED. ° NO DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIfV THAT I MAYE READ ANO EXAMIN�D THIS APPLICAdION 1 STA�LS GARAGES
AND KNOW TNE SAME TO BE TAUE AND CORRECT. ALL PROVISIONS OF LAW$ yq�UATION SURTAX
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMP�IED
WITH WHE7HER SPECIFIED MEREIN Ofl NOT. THE GRANTING OF A PERMIT � 1 s%6O �.$8
DOES NOT PRESU E TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEqMIT fEE SAC CMARGE
PAOVISIONS OF NY 07HER STATE OR LOCAL LAW REGULA NG CO -
STRUCTION TME PERfO M E OF CONSTFUCTION �63.1.5 Fire .S�', �1.%6
P�AN GMECK FE T07 FEE
� � cen S $5.00 $ .79
�GN4TUAEO ON•17AC10AOpAUTHOA�2EDeGENT �O�iE� HEN ROP � ALIO TE TMIS IS YOU PERM17
S�GNnTURE O� OWNEp��� OWNEp BWLDER� iOATE� � ' BLO �NS� ' � � �� E �
NEW
ADDN
��
Legal Description:
LMNG AREA:
GARAGE AREA:
DECK AREA:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATION I
Effective 1/1/2002
(763) 572�6D4 Bidg Insp
� ������
V�, b
� 1 �'� /i � l� �
Tel. # ��� �7 7� -�3��
���aa�; ��� S-s-1/�
Attach to th�piication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length wdth Height _�_ Sq. Ft
Length ._/ �P Width 1� Hgt/Ground �_ Sq. Ft
OTHER: �
Construction Type:__ ��� �� c� �� l�ac �d � Estimated Cost: $ ��'�(� � � / �¢ �
Driveway Curb Cut Width Needed: FL + 6 Ft = Ft x$ _$
DATE: APPLICANT: � ��G� Tel. # � �� d.��1
l.Ji� �
Call (763) 572-36Q4 for Permit Fees if maili�g in application or Fax to 763-571-1287 if using credit card and we will
call you to� card �umber.
PeRnit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 3. ��
$ �
$ . .�
o—
$
$ _ � OO
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
TOTAL $ �D � ( STIPULATIONS:
BUII..DING 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 e�sting 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,�0
$2,001 to $25,0�
$25,001 to $50,000
$50,001 to $10U,000
$100,001 to $5�,000
$5�,001 to $1,000,000
FEES
$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 $14.00 for each additional $1,�0
or fraction thereof, to and including $25,(�0
$391.25 for first $25,000 plus $10.10 for each additional $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 $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,0(�,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCItOW
(Concrete Curb Streets Only) '
Removal and replacement of curb and gutter only - Driveway width plus 6 feet��imes $17.(�.
VERI�iCATION OF FOUNDATION
Permits for consttvction 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
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