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y y SUBJECT � Mi429�
� Cit of Fridle
' ` AT THE TOP OF THE TWINS B U I L D I N G P E R M I T • CEIPT NO.
r
� `L ___��_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
i� � �
_-_.� �r"',•� CITY HALL FRIDLE� 55432 NUMBER HEV. DATE PAGE OF APPFOVED BY
� 612-580-3450 910-F15 8/18/77 � �
JOB ADDRESS 1591 Dana Court N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. $ 2 Hr1ZT1S Lake Estates SEEATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Brickner Builders, Inc. 6245 Ben More Drive, Fridley 574-9871
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDIN(3
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 52' x 2' 1' a ' '
9 CHANGE OF USE FROM�EATiNG� PLUM$1lVG AND StGNS. ,
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side
ya�ds. Provide a verifying survey before capping. Provide truss design before
capping. Remove all peat if encountered.
SEWER SERVICE: 5erved from manhole, Expose sewer service to determine minimum
top of footing elevation.
�TER 5ER�7ICE: 10' South of Sewer Service, 50' East of Manhole, 28' N.N.E. of
stop box serving the lot south of Lot 8.
DRIVEWAY DEPRESSION COST: Alt. A. 18` + 6'- x$11.75 =$282.00
�e cmr oF: r�c�r� oo�s �T GvAa,� rHe WARNlHG �
ACCURACY OF UTtUTY LOCATI�NS APtD ELEdA710NS.
1`IS DAYA IS fU�2 INFO�MAT101+1 PU�POSES OPClY b.NJ Befare digging call local utilities
PERSONS 1151NG IT SH4111D VEEifFY THE IOVFc;Ui�Mtiif00� TELEPHONE - ELECTRIG - GAS �tc.
dN TH� SITE
REQUIRc[� �� �-�W
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI Fi�O
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SO. 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 R-�- �.352 �- SZS 29,728 Total
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 HEREIN OR NOT. THE GRANTING OF A PERMIT $53.540 yS`2Ej.%%
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCT THE PERFORM OF CONSTRUCTION. , ' 5�-18.9�- $375.00
PLAN CHECKFEE TOTALFEE
9 � � ` $ 29.73 $550.41
IGNATUREOFCONTHAC RAUTHORIZEDAGENT IDATEI W1iEN PR PE�LY VA� THIS IS YOUR PERMIT
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SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG I SP �p7E
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ANOKA COUNTY
560-3450
FRIDLEY, MINNESOTA 55432
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Civil E,ngineering � �� � Telephpne 784-600a
iMu�icipat Er�ginaerie►g Engitieers & SLtT��'yCfT5 o►en 5ode 61�
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Certificate of Survey por i J���_�-�r�"�'�_____ _���� 0•
� C1TY OF FRiDLEI( ���NS AND El� E� � TME
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CCU�►GY Gf �� j1ON PUP�OSfcs O�LY hr�..
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Before �igging casl local utiiit9ss
TELEPHONE � E�ECTRBC - GAS Et,�
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dtscribed lo»d, ond of fhe loca►io� of all building�a the.eqn, ond alt visible encrvacbmenis, i1 a�ny, trom Or on
said iond. As su�veyed bX me this dar of ;,�„ A.D i4 F.
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o QENOTE� ►RON MONUMENT
�=�= DENOT�g RI�AAlNAGE �. UTIWTY E�gEMENT
SUdVRB11M ENGIPiE�RtNG, �NC.
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Address:
CITY OF FRIDLEY .
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
�NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
No. l� 1�
, . LOT : ���
CORNER LOT:
Str eet :
BLOCK:
IN5IDE LOT:
�UILDER: Lc�d�^�.v-- �����'� ��'" `� -
Address : � °� �J �� �,�/ �- ��-.
Tel. No. �`�� � d���/
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�_ ADIIITION: °'� ,,2��� � �✓? °��'� ��� .
�� S: TBACK: �J SIDEYARDS: �U
Applicant attach to this form Ztvo Certificates of Survey of Lot and proposed
building location drawn on these Certificates. �
DESCRTPTION OF BUILDING � . �,
To Be Used As : ��, ,�?� � �,.� ,
`� " •
Front: �� Depth: _� Height: � � , '
Square Feet: � � �� Cubic Feet: .'� '�� �� �
Front: 2 Depth: �� Height: / o
� Square Feet: Cubic Feet: ,�� ���
-�� sy �
Type o€ Construction: ��% � � Estimated Cost: $�� s�� ��
Zb Be Completed: �� ' Alt A Alt. B
/
Proposed Driveway Width If New Opening Is Desired � $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby mal�es application for a permit for the work herein
specified, agreeing to do all work in strict accardance with the City of
`�Fridley Ordinances and rulings of the Department of Buildings, and hereby
: aeclares that all the facts and re�resentations stated in this application
are true and correct. See reverse side fo itional in�ermation.
_ � ;,. �"� �
DATE: � �� �°� SIGNATURE: s'`� - �/'l'/'�i�� � ����--:
.
Stipulations : /�,��% � � � �. ��
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BU1LDIt�G PER��IIT FEt SCH�DULE
SECTION 2. The Inspector of IIuilditigs shall, before issuing �ermits for the erection
of any building ar structurc, or for any additio� to any existir�g building or structure,
�or for any alteration or repairs to any existing building or structure, upan application
therefore, require the payment by the applicant for such permit of fees to the amourit
herein below set forth and in the manner herein provided to-wit:
NEW C�235TRUCTION: Single I'amily iiomes and Garages: $4.00/1,000 cubic feet..
PLAN CHECY.: 25 percent of buildinq permit fee.
DRIVE47AY DEPRESSIGtJ: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 fee� x$11.75
' Alternate B: R,emoval and replacement of concrete curb and
gutter and install a 3 foot wide approach with
• � 6 Snch depth; Driveway width plus 6 feet x$15.40
�pDI T IONAL I(JFOR�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 th� cellar to the
average heights of the upger surface or to the av�rage height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 �er each five hundred dollars ($500..00) or fraction thereof in the cost
of a�l proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
i-han $7.50 plus $.50 state surcharge. �
VER�FICATIaN QF FOUNDATION
Ne�TE: Permits for construction will be issued a minimiun af 24 iiours from the time
of application to allow for proper review of the proposed structure and of ti:e
construci:ion site. •
A CertificatP of Survey of the lot, showing the location of the foundation once it
has been constructed will be requiied before proceeding with the framing.
CtRTIFICATE OF �CCUPANCY
Application far a Certificate of Occupancy shall be made ten (1G) days prior to the
use or occupancy of any structure for �ahich a building permit has been issued; and
said structure shall not be used vr occupied until a Certificate. of Occupancy has
been issued.
r
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Yage 1 ot 4
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION +
OWNER: DATE �� �� � 7 �
-�
_SITE ADDRESS : � 9�'' ��✓t�°� �� PHONE : '�7� � / � 7 /
CONTRACTOR: , � �� .
Deterntine working square footage of each
l. Total exposed wall area...... ����%� sq. ft. x .17 = /�� v
2. Toal roof/ceiling axea ...... � �� sq. ft. x .OS = f°�'�
• Total exposed wall area above floor = ,�` �i.�
a. Total wall window area ................................. /� s• ��i
b. Total door area ....................................... �?. ��f
c. Total sliding glass door area ......................... 3�,?e
d. Total fireplace wall area ............................. Q
e. Total� wall framing area (average 10�) .................. 7,o .
f. Total riva.joist area .................................. a.
g. wall area above floor .......................... �
h. wall area above floor ..........................
i. wall area above floor ..........................
j. wall area above floor ..........................
Total exposed foundation area = G� `�• S�
k. Total foundation window area.� .......................... ��'�
l. Total n't foundation area above grade ................. �.,t'
fa Determine "U" value of each wall segment
.` � �� (e.g. window, door, each separate wall section)
�� .,,,� ��. �- / . � / /'
� � a... � �. �o 00 X ��U�� � _ � b • �50
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d. � � X ��U�� . `L � _
i1
e. � 7�. d X��U�� s�� _ �. 6:/
f. �f� g njJn e�� = S�' �
g. �,�� �. y X „U„ . �A, = a • l�
h. X "U" _
i. g ujJo a
�, X uUa =
k. X "U" _
1. � . .� g �,U�� . � = 7� 'L . `�
3 . ............................. Total = �• 7Y
If item #3 is the same as,
or less than item #1, you
have met the intent of
SBC 6006 (c) 2.
�
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0
• Exterior Envelope Average "U" Computation
Total exposed roof/ceiling area = _���
m. Total skylight area ............................
n. Total roof/ceiling framing area (average 10�)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
m. X "U" _
Page 2 of 4
A. X "II^ _
` g 7/
o. � g„U.� a D � S
4 ........................... Total = S � •�'�/
If total of #4 is the same as, or less than #2, you have met the i.ntent of
SBC 6006 {c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
l. + 2. _
3. + 4. _
�
�
' WALL SECTIONS
NOTE: Use 10� of opaque wall area for
� fxame construction
FRAP2E Z9AT•T•
�
s�_ .
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-- '- ... . .
•` �� \ 61
6 ��F�'� , � �.
ESG. #3
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Page 3 of 4
Construction R-Value
1. Interio air fi]m 0.68
2 . _ ' L r' ;, _ � � �%�
3 . � '`;� `i �� � � a � ,�
4 . � �' v /.
L � �.
5 . � � �. �
6. Exteri�r air film 0.17
TOtal ^, �/� s ��
/ / '
1. Interior air film 0.68
' s �
2 . �... ' ,�` �i�: �,���. � • '��9
�,� ,
e �� �
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3 . 'f�.� .--� � �=.���•.� B
" �_
4 . �j� `' �,,��'.t�-�,_'�-�� � A _ �+ • � �
--� �
5. �,�,� ��, � q,,� _*,`"� �` �'�
�
6. Exterior air film 0.17
��� ���'G� o ° �7
l, Interior air film 0.68
2' � `��- �� ' ��'�� ��
3 . � 2. �! � �' �'�
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� �
4. �� °� �;���'�'"�� /, f ��
� k'� J
/ q ��
5. ���e� �i�, �;��. � �. ��
6. Exterior air f ilm 0.17
Total �
/s•s'�r '�
1. Interior air film 0.68
2.
.
s. � � �� ��'
4.
5.
6. Exterior air film 0.17 ��
Total � . ,� 3 �
, �• � a . • : .
. � ` G
���-��-T � • � . • � • � � „ � �
��� r��
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((1 .• '` . . • - • . ...' / 1 �
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FI6. #4 ' • - �
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'• o —
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.�
. � � . !t� /l ( � 1 r r _. ( � -- r�r
�t �
NOT�: Indicate tyoe, "R"'value, depth and
place�ent of insulation.
s
� RQOF/CEILING
rr � j:
• vE2�T �l til�t I f L' �
..�, � • .
, / 1 � .
/
��ented Heat flow .
. . up . - � .
FIG. �5 � ' � �
o ��•!��!H� ��'lc1_'!1�:i:^ `�i�•C+e�r.�3'iC.R^.l,G4T,ie1 ..
- - -�-r
. ��l_% `�� `� � L� � .
Heat flo�� up � . .•vented
. .. � - �.. •, : �' ..
- .FIG. #6 .. ... . .
- . � � • � . � if
' « 1�u�-�Vf�1,'1�D � . . " .
, , �. • . . :
.., � . �Heat � �' �
. : . . ' £low up - .. • ' � . ;
. ,� . . , . .
F�r. A� • � . . . � .
rage 4 of 4
Construction R-Value
1. Interior air film 0.61
2 . r �. � � �" r;,4^l�� , a �,
3 e
• � � --�'"� �
4. Exterior air film (still) 0.61
Total �� �cj' - ��
N
l. Interior air film 0.61
2•
3.
4. Exterior air film (still) 0.61
Total
l. Inside air film 0.61
Z.
3.
4.
5. Outside air film 0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
�
. _ _ . _�"�'�
�
��.� � �'� � �
�,. � �lBYRBAN �
;. � NQINEERINO � 1
--ING -- —__ — - —
a� , -- - . _ -- — ------ _ _
��y� a
� � Ciuil, Municipal & Enaironmer�tal Engineering
Land Surueying • La.nd Planning • Soil Testing
�
Mr. Dave Harris
6279 University Avenue NE
Fridley, Minnesota 55432
Re: Lot 8 Block 2 �
Harris Lake Estates
Dear Dave:
�s�'
I'� Main Office 571-6066
� j 6875 Highway No. 65 N. E.
�' Minneapolis, Minnesota 55432
� � South Office 890-6510
I 1101 Cliff Road
, Burnsville, Minnesota 55337
September 20, 1977
� ��
� J
��}�,
At the request of Tom Brickner on 26 August 1977, we examined the
foundation soils on the above captioned lot and found peat soil overlain
by sandy fill to approximately 3 feet. Tom was told to remove the peat.
at which time we would inspect the excavation.
We examined the excavation on 31 August 1977, and found it to be
clean of peat materials. Contractor was told to widen excavation
slightly. Contractor then began hauling in sand fill.
On 1 September 1971, we took two density tests at the level of
2 feet of fill and on 9 September 1977 we took two additional density
tests on the completed fill of approximately 4 feet. The density tests
passed with all being above the 90� minimum required.
Based on the above, it is our opinion the foundation fill is
satisfactory to support a single family frart�d dwelling with two
#4 reinforcement bars in the footings.
If you have any questions, please call.
PJM/J P
cc: City of Fridley
Tom Brickner
Jerry Belair
Robert Mfrader, Reg. Eng, E. A. Rath6urt, Reg. Suru.
Wm. E. Jenaen, Reg. Eng. Wm. K, Meyer, Reg. Eng.
�
Sincerely,
SUBURBAN ENGINEERING, INC.
eil�i� .
� .
Peter J. Mol�naro, P.E.
Wm. E. Price, Reg. Eng. Cary R. Narris, Reg. Suru.
H. Willtam Rogera, Reg. Suru. Bruce A. Pa�ereon, Reg. Eng.
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1977
aer
Briclrn�r Builders
6245 Ben lyiore Drive N.E.
Fridley, 1�ln. 55432
� .� . 1 �.� . � � d' e ��� ,. 7.
8431 UNIVER5ITY AVENUE N.E, FRIDIEY, MINNESQTA 55432
TELEPHONE ( 812)571-345�
Re: Final Inspection at 1591 Dana Court N.E.
Dear Mre Brickner: �
A fi�l inspection was made on Dec�er 19, 1977 of the above address and
the following it�s were noted which must be completed before the structure
can be f inaled out;
l. Provide ash clean out to basement wa11 inside by January 10, 1978.
2. Increase hearth width to 20 inches to compensate for shailow (I.S inches)
firebox depth by January 10, 1978.
We will expect the above items to be completed by the scheduled date when
a reinspection wi11 be conducted to detenaine compliance.
If you have any questions on the above items, please contact me at 571-3450_
Sincerely,
RON HOLDEN
Buildi.ng Inspector
RH/mh
��
,� ,,
;.��--
-�:
...'J ��r� ���L�..'.
� - ��
'�
_;a ,;
February 2],, 1978
CI�"Y OF FRIDLEI�
8431 UNIVERSITY AVENUE N.E., FRIOLEY� MINNESOTA 66432
TELEPNONE ( 812)571-3480
Mr. T�n Briclazer
Brickner Builders
6245 Ben More Drive N.E.
Fridley, Mn. 55432
Re: Final Inspection at 1591 Dana Court N.E. (Second Notice)
Dear Mr. Bricicner:
A final reinspection was made on Februaxy 16, 1978 of the above address to
determine compliance with our letter of Decenber 19, I977 in which we
info�med you of the followi.ng items which had to be completed;
l. Proaide ash clean out to basement wall inside.
2. Increase hearth width to 20 inches to caanpensate for shallow (18 inches)
firebox depth. '
Would you please contact me to let me know when the abave work will be
completed and a reinspecti.on caii be made.
Sincerely,
RtJN HOLDEN
Building Inspection
Rii/mh
�
sue�ecr PERMIT NO.
City of Fridley � � .� � 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � RECE
� ' COMMUNITY DEVELOPMENT DIV �� �
' ��: --�-'-
r � � PqOTECTIVE INSPECTION SEC.
i . �
' � �'��1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED BV
�'""'� � �'' 612-571-3450 910-F15 7/23/96 / /
JOB ADDRESS 1591 Dana Court NE
� LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 8 2 Harris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Sonny Fite 1591 Dana Court NE 572-0309
3 CONTRACTOR MAI� ADDFESS Z�P PHONE LICENSE NO
Mohs Contractin 5530 135 St W,Sava e MN 55378 447-4065 20064597
A ARCHITECT OR DESIGNER MAIL ADDRESS ZtP PHONE LICENSE NO
5 ENGINEER MAILADDHESS ZIP PHONE LICENSENO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
�❑ NEW ❑ ADDITION O ALTERATION O REPAIR O MOVE O fiEMOVE
%
8 DESCRIBE WORK
Reroof House & Gara e(28 S) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comly with the State Building Code.
a
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOH ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CON ITIONING
THIS PERMIT BECOMES �IULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COM}rMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEd OH ABANDONED FOR A PERIOD OF tpp OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2�310 �1. iC)
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAT�NG CON-
TRUCTION OR T E PERfO MAN OF CONSTRUCTION �7�F. %5 Fire .SC. �2.31
� PLAN CHECKFEE 70TALFEE
'C �� License SC $5.00 $83.22
GNATUAEO CON'RACTOAOAAUTHORIZEDAGENT �DATEi WNEN PqOPERLY V LIDA7ED THIS IS YOUfi PERMIT
- �����-.,��- - � �--
S�GNATURE OF OWNEA��F OWNER BUiLDEAi iDATE� BLOG NSP r�qTE
NEw
ADDN
AI..TER
�]
[l
[�
ConstructionAddress
Legal Description:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R 1 AND R-2
Building Permit Applicarion
/��l ,D�,� �
Effective 3I1/96
/
�3��j�
Owner Name & Address: _ �d,=,�,v� %.° Tel. # �� -(,� Q �
Contractor: �/p�s �� ' ,���„� MN LICENSE # b�c� ���_
�
Address: - �.�� �-, �O� � Tel. �# y%- �p ��
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTHER:
Attach to this application, a Certifica.te of Survey of the
lot, with the proposed construcrion drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
Wic�th Hgt/Ground
�� o � �i, f / �'f�
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construction: 7''P�-��=/ r� Fr/a Estimated Cost: $ �� /� �
Approx. Completion Date: '�-� � �
(Cost on Back) �
Driveway Curb Cut BVidth Needed: Ft. + 6 Ft = Ft x$ -$
DATE: r�- APPLICANT: _� �- ���4,/�'y Tel. #`yC/7- Y��S
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Conixol
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ % . s'
� �.�/
$ �� � o
$
$ �• �
$
$
$
$
$ �'�-o�o�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Va.luation
$900 per SAC Unit
$5.00 (Sta.te Licsnsed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BIJILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
sttucture, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25, 001 to $50, 000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for ea.ch additional $1,000
or fraction thereof, to and including $25,�0
$349.75 for first $25,0� plus $9.00 for each additional $1, 000
or fraction thereof, to and including $50,000
$574.75 for first $50,0� plus $6.25 for each additional
$1,0� or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.� for each additional
$1,1100 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for e�ch additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ci�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certifica.te of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
__
Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE � ' / � - (J �° YOUR E-MAIL ADDRESS
SITE ADDRESS / �� � � �' � C �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
❑ OWNER �ONTR.ACTOR
NAME: .J � n ^ � �
aDDxESS: j S� / ./)� � �
punl.rF• % �o� - �i � -O� `�
CONTRACTOR I NahrrF� �7� �� ��./ �r.� t f�' � e f; ��
Permit No.:
Received By:
Date Rec'd:
CITY �`'��l�j/ STATE�'�� � S�!�
SUBNIIT A COPY OF STATE LICENSE # ��Y �� 7��'/ EXP DATE ✓°� 7
YOUR STATE LICENSE ADDRESS: ��iS P"�' � P�Uy/ .Sf �� CITY "F'h'h fi' � f STATE� f S� ��
WITH APPLICATION PHONE � ' � �/ ° � �✓ � FAX lvi - 7 � I - ��2 �
PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORiFC
PERMIT TYPE ��DTfION O GARAGE/SHED O WINDOWS
❑ BASEMENT FINISH ,B�I�OOF ❑ DRAIN TILE
0 DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
�rE oF woxx: � ❑ r�w
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
ROOFING
NuMBEx oF sQu.SxES 3 �
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS OYes ONo
OR FOR NEW OPENINGS-DESCRIBE SiZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
�
u
❑ HOUSE ONLY
r$�iiOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
NUMBER OF
�� ��
WIDTH HEIGHT
BASEMENT REMODELING SiJBNIIT:
1. Existmg Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMTf:
1. Site Plan/Survey showing the e�tisting strvctures
and proposed project
2. Two sets of conshvctiion plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING� 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �'"1 ?� °" OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surchasge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �[� ,a.s See Back Page for Fee Schedule
$ � 65% of Building Permit Fee
$ 3_q 3 .001 times the total job valuation
$ �,� tp .0005 x Permit Valuation Minimum $.50
$ � ,C`!� $5.00 (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for detennination)
$ ft+6ft= ftx$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ O`R _ I l J Make checks uayable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the inforrnation above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work wlri equires ew and approval of plans.
SIGNATURE OF APPLICANT ���1�'` / cc.�:i� PRINT NAME � /�/� h � , S �� � DATE � _ � � _ ��
Page 2- Building Resideatial Application
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 applieation 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:
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed shucture and of the consizu.ction site.
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
City of Fridley
Building Inspections Deparinient
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
Building MECHANICAL Permit No.:'
Inspections RESIDENTIAL APPLICATION Received By: - O 9
763-572-3604 CITY OF FRIDLEY Dat��1:AUG
763-502-49%% 'r'� EFFECTIVE2-19-09
DATE b O S YOUR E-MAIL ADDRESS
SITE ADDRESS � � f 4Ja n �. �+.
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY Np�: �'� `( �"; .�. c
o�� AnnxESS: � S�./ 0�...�. c�, crrY F�rr � I�� STA'fI��► ZIPsr��
TENANT PHONE: ^% (o �- S 7 7- D, O� ,,�
CONTRACTOR Co�aivx Nan�: '`� a� T� �
SUBMIT A COPY OF CONTACT PERSON: d� ���s
YOUR STATE STATE LICENSE # 2700 N. F011Ybw AW EXP DATE
LICENSE WITH ,c�DRESS: 8g��3.�1 CITY STATE ZIP
APPLICATION pHONE FAX �
PERMIT TYPE f�S1NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: ��W � �P�CEMENT ❑ ALTERATION/REMODEL
DETAILEDDESCRIPTIONOFWORK f ns�� (�9aS �: ree I�c� f nsc/'� ��s /%-•t
' FEES ARE BASED ON $10.00 PER FIX1'URE, EXCEPT WHERE NOTED. FIXTURES: (INDICA�'E TdTAL NIUMBER OF E�KCH BEtAW� :�' :: �
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. .
Eqaipmentl�istalled IvffG:. Y��Ga�n i�(a MODEL: H L G S('T SIZEJBTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
A/C $25.(TO FIREPLACE (GAS) $15.00 _GAS RAATGF/OVEN $10.00
AIIt TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GR]LL $10.00
_BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
CI-IIMNEY LINER $10.00 GAS DRYER $10.00 P�L HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
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9, t �. ��'3 ° . � . '�s'�.� "�O�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNfIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in
conforniance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME /� L�✓ ���� S�� G DATE a�� s'�0 ci
APPROVAL IIVSPECTORS SIGNATURE DATE
x,�..: \ g, ;�. "q r ;� - r.�
��;. {4, r � �' f a~'�A ��i...
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
� .����.�� ��� � ��
e:+�M � e���M r��?e�ti9 s�ib
�8�i��d @Gf8�:c1�
REQUIRED FOR NEW/EXISTING HOMES '��r��j� gg�� ��
►����s ���
l. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Cha.pter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Cha.pter 5 with MN Amendments MN Rule 1346 Sec. 501
_ _ ._ 3. Venting_ - - _ . . _
_ _ , __ a, . _Gas .a�pliances .IFGC Cha�ter S wi� MN Am��i�ents : � . P _
b" Euel ot}�er than gas IMC Cha.pter 8 with MN Amendments _ . �.
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. N 1 t 04.4.13
5. Ventilation
a. Per MN Rule Cha.pter 1322. Sec. 1104 _
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.