AF - 39502sue�ECr PERMI
City of Fridley � 6 8 8 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� � R IPT NO
� �v ______ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. Q��
�
� j � s3
l---. A �r���,•� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
i �� 612-571-3450
910-F15 12/22/82 � �
JOB ADDRESS 5449 East Brenner Pass N.E:
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 6 Innsbruck North Townhouse Plat 6 sHEer
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development Corp. 46Q0 Lake Road, Robbinsdale 55422 536-9936
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct an 18' x 28' Townhouse 't "D"
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. TATOOCl FYd1IIQ
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING 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 EXAMINEO 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 HEREIN OR NOT. THE GRANTING OF A PERMIT $37,650 y�`].$.83
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-
STRUCTION OR T E F ERFOFMANCE OF CONSTRUCTION. yS229. OO $425. OO
`� PLAN CHECK FEE TOTAL FEE
d �� . �✓ %�iZ.d -�,� e $ 72.83
SIGNATURE CONiRACTORORAUTHORIZEDAGENT IDATEI WHE PROPERLY T S IS YOUR PERMIT
�v�ZP °�-
SIGNATUREOFOWNERIIFOWNERBUILDEHi IDATEI -x DG INSP qATE
CITY OF �KIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PER��ITS
(NEw, ALTERATIONS, ADDITIONS, OR REPAIRS).
OWt7ER: DARREL A. FARR DEVELOPMENT CORP . BUILDER:� S�
Address: 4600 LAKE ROAD" Address: �
R B ,
� Tel. No.: 536-9936
No.: 5449 Street: East Brenner Pass
L�: 2 B7ACK: 6 ADDITION: 6th
CORNER LOT: INSIDE IAT: X S;TBAQC: SIDEYARDSs
Applicant attach to this foxm Zt,ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As: "D"
HOUSF Front: 18 Depth: 28 Aeight: 28
� �.
' Square Feet: 1440 Cubic Feets -
Front: Depth: Height:
Square Feet: CZibic Feet:
��►pe of Construction: WOOD FRE�ME Estimated Cost: $ 32, 250 ��(�-� -
, .
-Tb Be Completed: __ �� lgg3 `
� Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $ -
iSEE REVERSE SIDE OF SHEET) .
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in 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. See reverse side for addi ional information.
DATE: /z �. SIGNATUR�: � .
Stipulations: . �
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sue�ecT PER
City of Fridley � 17 3 fi 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.
� �,: ------, l ! �1d'✓�'
r j � PROTECTIVE INSPECTION SEC.
�
� _ �
l-__- A �����,'� CITY HALL FRIDLEV SS4$2 NUMBER REV. DATE PAGE OF APPROVED BV
i� �� 612-571-3450 910-F15 1/17/84 / /
JOB ADDRESS 5449 East Breriner Pass N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. �. 7 Innsbruck North Townhouse Plat 6 SEEATTACHED
SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Darrel A. Farr Development Corp. 4600 Iake Rd. Mpls. , N.¢�T 55422 536-9936
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential Townhouse Gara.ge
7 CLASS OF WORK
� NEW O ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 1Q' x 22' Ga.rage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI FY,'�R2
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 ZZO ZZZO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAqKING
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 $2�349.60 y�i�..I.%
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERMIT FEE SAC CHARGE
PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING CON- 38.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $
� PLAN CHECK FEE TOTAL FEE
i-�9- �y $39.6�
SiGNnru Eo CON7RACTORORAUTHORIZEDAGENT IDATEI WHEN PROPERLY V IDATED TFiIS IS VOUR PERMIT
°' _ - �
SIGNATURE OF OWNER IIF OWNEP BU�LDERI IOATEI ,y BLDG iNSP f1ATE
E�fective ��g, l, 1961
CITY �� C {t 1 DLCif '
�i�f'LICATI�'� FOft RCSlDLi171%i a��lLD1�,G P�r���TS ,
Ql�c�►•�. fllteratir�ns, �dditions, or �c�airs)
0��►�ER: Darrel A. Farr Development Corp. •QUILD�R: SAME
AD�RESS: 4600 Lake Rd. Mpls., MN 55422 �D�'2C5S:
7EL �50: 536-9936 �EL N0:
P
ConstPUCtion Location
ST1tI�T i�0: 5449 ����: Eas� enn� P..�A�
���: 1 �I,o�c; 7 �na�ao:�: 6th
Corncr Lot: Insii3e �t: i �c4b�ck: Sideyards:
Ap,�licant att�ch to tl�is form 4s.�o Certificates of Slirvcy of Iot �r►d
p_opo�ed buileling l�eati� elra�+n on eertifieates �o scale.
DESCR1PT10�� OF CO;�S7FUCTIOt�
Garage F'z�oni: 10 �spth: 22 Height: ��
SqUarc t'eer: �bic Fcet:
Front: D�pth: Neight:
Square F'c�t: t�labic I"eet:
:��pe of Co :�tructfon: Wood Frame Estimated Cost: _S 1.8Q0
Zb Be Cbr.:pleted: June 1983
�,lt. A �lt. B
Propos�d Driwc���ay 6:idth If Alew Opening Zs Desired: $ S '
, , S�� PiVF.R�L' SIAi OF S}IF..LT .
95�� undeYSioned hereb:� :n�1;c� �Pplic�ticn foz a perr.it fcz the �ozk he-ein sp�cified,
t�greein3 to cb ,all aork it� strict accoz3snce d�ith the Ci��� of I'ridle�• Ordinances enci
rulin�� of the De1�.ii�tJnent of d3ui2clin�s, and hexeby dec]azcs �hat all the �act� and
rcpresc�t.igicns sra�sd .an tr,is a,7Plic�tion aze tzue and co_rcct.
���: I— 13—Sy sac�anzvrv: �i'�_�-___���'�'`"'
�tii�ulataons :
0
�F �-�f
sue�ecT PERMIT NO.
City of Fridley o 17 4 0 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � REC .
� ; V �������
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. /�y�
� i , "/
� /""1 � CITY HALL FRIDLE� 55432 NUMBER HEV. DATE PAGE OF APPROVED BY
�'"'"� � ,�� 612-571-3450 910-F15 1/17/84 / /
JOB ADDRESS 5449 East Brenner Pass N.E. (.Association �arage)
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 7 Innsbruck North Townhouse Plat 6 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development Corp. 4600 Lake Rd. Mpls., NIlJ 55422 536-9936
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
S�I3@
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
7.bwnhouse Ass.ociation Ga�age
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10� x 22' Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI FY'3It1@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD OF 120 DAYS AT ZZO
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 VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2 �343. GO yS`�.. �.%
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $38. SO
PLAN CHECK FEE TOTAL FEE
/1�� . � _/-/ 7-�i $39. 67
SiGtvArU OFCONTRACTORORAUTHORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP �A E
�
�iTY �1F FitIGLLY
�af't'�I(.l1iJ�X1 FOft �:C52DL��T1P.� �UlLD1f:G P�R;�ITS
�idLrti� d1i tl r � t e Gi�S ��►dd i t yi���5 ��i' �:C�a i �-S �
�ffective ?1ug. 1, 1981
OF� IlE R: Darrel A. Farr Develonment Corv . •�UI L4��R : Game � '
�IDJf:ESS: 4600 Lake Rd. Mpls., MN 55422 61DI��CSS:
�E� �Q; 536-9936 �EL 1d0:
Co�Strvction Location
STJtL�T t1� :
BA7': 3 —
��•R�; East Brenner Pass
�a.��c: � a�ni�°io:�: 6th
Corncr Lot: Insii3e Lots � �etb�ck: 5ideyards:
�p, licnnt �tt�ch to t)iis form ta.�o Ceztfgicates of S1�rvcy of lot r�nd
p-opo�cd builc]ing locatian e�ra•an on cc�rtificates to scale.
DESCRIPTIO�� OF CO;tST�+JC710U
Garage Faont: 10 �epth: 2� _ Height: 20
Squarc �'eet: �l�ic gcet:
l�ront: D�pth: iieight:
;quare g'en_t; Ctibic Y'eet:
7�pe of Co.,stzuction: Wood frame Estimated Cost: _S���._
�b �e Odr.:plcted: June 1984
1�►lt. A �lt. S
�ro�s�d Dzivc��ray �:i'ath af xc� Opening Is �s3s��: S� s —
S�L piVF.iLL' �IDE OF S1lE�T _
'I�e undersioned hereb�� :n�1:c:� ��p1Sc�ticn �oz � perr.it fcz the �ozk he-ein spc�cified,
egreein� to cb .all �ork it� strict �ccozd.ince ��ith ihe Ci�y of iridle�• Ozdi��ances e�ici
�ulin�s of tl�e Deia�rlmel�: of Dui:c7inrs, and hereby dec]�zes th�t all tlic fact� and
re�rec�,t.iicicns s2�t�d :.�, 't�is applfe�ti�n a.-` true and co�rect.
�: �z:
I-I�-Sy saei�►�rv�: � .
�tai�ulaticns :
,
,. ,-
`�i�-
�
sue�ctt P �
C�ty of Fr;a��y 310 8 7
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� `L ����� � COMMUNITV OEVELOPMENT DIV. _ �
% � � PROTECTIVE INSPECTION SEC. �
�
ir = �
-.-- ` ��'��;•, CITY MALI ffIIDLEr SS�Ji NUMBER NEV DATE VAGE OF APVROVBD BY -
ti �� 612-571-3450 9�aF�s 6/27/00 / /
J08 ADORESS 5443, 45 , 47, 49, S 1, 53 East Brenner Pass
t LEGAL �OT NO. BLOCK TRACT 06i ADDITION SEE ATTACHEO
DESCR. 1-(� 6 Innsbruck North Townhouse Plat G SNEET
2 PROPERTY OWNER MAIL ADORES$ ZIP PNONE
Innsbruck Townhome Association 651-224-5482
J CONTpACTOR MAIL ADDRESS ZIP PHONE lICENSE NO
Garlock-French Roofing Co ., 2301 E. 25th St., ls., MN 55406 612-722-7129 000014
1 ARCNITECT OR OESI(iNER MAIL AOORESS ZIP PMONE IICENSE NO.
S ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO
B USE OF BUILDING
Residential
7 CIASS Of WORK
❑ NEW O ADDITION O ALTERATION L� REP,AIR O MOVE O 6iEMOVE
8 OESCRIBE WONK ;
Reroof Townhouse Building (Tear Off)
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
it lnspection Cards �
�Nill �e Mailed
T� �fomeorunor To Pos�
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. FIEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONING S0. FT CU fT.
AUTMORIZEO IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO DyYIG. UNITS OFFSTREET PARKING
d
1 NEREBY CERTIFV TMAT I MAVE READ ANO EXAMINEO TMIS APPLICA710N STA�LS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF �AWS yqLUATION SURTAX
ANp ORDINANCES GOVEqNING TMIS TYPE OF WOqK WILI BE COMPLIE� ,�21,631.00 .��.O.HO '
WITFI WMETMER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AU7MORITY TO VIOLATE OR CANCEL TME pEpM17 FEE SAC CMARGE
PROVISIONS OF ANY OTNEti S7ATE OR IOCAL LAW REGULA7ING coN• �349. ZrJ Fire .SC .�2�..63
STqUCT10N OR 7NE PERFORMANCE Of CONSTRUC710N
PLAN CMECK FEE TOTAL E
$ .68
S�GN�iUpEO�CON:AACTOAOpAUTN0�112ED�GENT iO�iE� EN iiOP l ALIOATED IS YOUR PEpMIT
r /
�� �
S�GN�tUpE O� OWNEp��� OWNEA BU40EA� � iOAiE� e �NSp � � f�p�( "
sue�ecr P
Clty Of F1'lfi�e3' 3 3 0 0��
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T�
�
� ` EIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ���5
� j V ��'��
r � � PROTECTIVE INSPECTION SEC.
' i '
( /'��1 � CITY FIALL FRIDLEY jS�J$ NUMBEF REV OATE VAGE O� APPROVED B�
�----�: �.' 763-571-3450 910-F15 8/22/02 / /
JOB ADDRESS 5449 East Brenner Pass NE
1 LEGAL �OT NO. BLOCK TRACT OFi AOOITION SEE ATTACNEO
oescR. 2 6 Innsbruck North Townhouse Plat 6 SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
Rathleen Mickelson 5449 East Brenner Pass NE 586-9789
3 CONTRACTOp MAIL ADDRESS 21P PMONE IICENSE NO
Hendel Construction 4997 Page Ave NE, Rogers MN 55374 428-7992 20192808
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADDflESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOI;K
❑ NEW � ADDITION ❑ ALTERATION O REPAIR p MOVE O REMOVE
8 DESCRIBE WOfiK
Construct a 14' x 10' Deck
9 CHANGEOfUSEFROM TO
STIPULATIONS
See notations on plan.
1IVAR��
Before digging call for
�II utility location�
4540002
REQUIRED �Y LAVV
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIfiEO FOR ELECTRICAL, PIUMBING, IiEATING.
VENTILATING Ofi AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION 20NING S�. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIfY TMAT 1 MAVE READ AND EXAMINED TNIS APPLICATION 1 STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yALUATION , SURTAX
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WMETMER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A PERMIT �1,540 �.77
DOES NOT PRESUME TO GIVE AUTMOqITV TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGULATING CON• @57.�5 Fire .Sii �1.5�F
STRUCTION OF THE PERfORMANCE OF CONSTNUCTION p� N CHECK FEE TOTA� FEE
/��� �IZZ � Z Licens $5.0 4.36
S�GNATUAE OF CON�AACTOA Op 4UTMOA�ZEO AGENT IDATEi NE PRO VALIOAT THIS IS�U���
�r
S�GN4TU�7EO�OWNEp����O�NNEpBU�LDEp� �OATEi OG �NS ���TF
3
s�EVY C j
�ON t 1
�� fl
CiTY OF �RIOLEY
6431 Un'rversity Ave NE, Fridley. MN 55432
5lNGLE FAMILY AND DUPLEXES R 1 AAiO i� �
BUILOING PERMRAPPLiCA'ilON
Construction Address: � ` ` �
���
E4Tectiv� 119/Z002
(78:3j 573�604 Btdg Insp
�
�� ����
�egal Descriptior�: — � vl ��
Owner Name 8� Address: � . ����- , �: . ieL # �'� �� - i7.�'�_
��
` MN LICENSE # � 1 �'�� �,�
Contraci�r. .��,�-� f�z `�
Addres�: �,��'� e` e�� �- �r� ' ��3 �y T��. # ��_„�l_�-
� � =�-�� s
Aitacl� t� this application, a Certifica#e of Survey of tl�e
lat, with the propased constnlction drawn on it to scate.
DESCRlPTtON 0� IMPROVEi49ENT
LIVDNG A�; Le�g� _,�,., Wtdtl� - Ffeight _�_ Sq. Ft
�3I►RA►l3E AR�At Length ____,__� Width Height � Sq. Ft
DECK AREl1: Lengih � Width �a � HgUGrcund �% ° Sq. Ft �� r
�THER:
Construcfian Type: � Estimated Cost: S��'Y�l '�-s?"�
Drivev�eay Curb Cut WicJth Needed: ft * 6 Ft = Ft x$ = S
DA'i'E: �� d � � � APPLlCANT: ������ Tel. # , �7 -- '��G- °-%��3L
Cafl {763) 572-3604 far Pe�ndt Fees if mai�ing in application or Fax to 763-571-126? if using credit card and we wilt
call you i�r cacd number.
CtTY USE ONLY -
Permit Fee
Ftre Surcharge
Sta#e Surci�arge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Cantrol
Park Fee
Sewer Main Charge
TOTAL
� .OS'
$ �
$
$ /
$ � DO _
$
$
$�
$
$ � 30
��e Schedule on Reve�se Side
.00'! o# Permit Vaivation (1f10th°/a}
$.501$'1 �0001falua#ion
$120� per SAC Unrt
$5.00 (State Licensed Residential Contractors)
Ait "A" or Att. "B" Above
$450.00 Conservation Pian Review
Fee Determined by�Enginee�ng
Agreernent Necessary ( ] {Vot Necessary [ �
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�EAM -�----�
� � and
Fo�tlnq TabJe
1voiS:
. � bear�n mcfsr b�e
ovara suppor�
dA� be�m� oY� ar mare
�tembers sltalf be
• t�alled toge�aer wrih
2 rows ot 16ri Nait,
at 16"O.C.
POS7 --
3Vi" Minimum
Pin or other
apprtaved
rasiener —
C+C�NCRETE
PI�R
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CecQ o
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e�aDee
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BALUSTER
� � .�
°': � '
MANUFACTURED
eEaM suPPORr
A�TERNATE ..�
BEAM �aErr�Af '
P OST ---+
5'h" Minimum
(4X6 or 6XS}
ALT�RNATE
6EA}� �GOOO�
p�sr =--=-
3►!a" Mirtimum
I 42•
MiniRSUm
� __._r .�.�.
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See Tab1e
Por FooPing Size
J�iST, ,
see �o�sr
Span rePsre
;..�. 7wa
1%2u �PCj3Lj8
Solts with
Washetrs
� � ■'
�asr► a�y�s �
.� s # ���+
�E�KING
16� or less Span:1' and �/i•
C7v� 16' Span: 2"
C� �' �ne �1:" Carriagc
�Bott with Ws�sher
it 2"X6" or
� targer beam.
Two �/s" Bolt�
with Washers
through Manulactured
8eam Support.
-Qv —r
� e0 :
8" �pc$�
� Q �,
.----....�--►
See Tabtz
tor Foot;ng S;: e
1.EOGER
Same s�ze �s jo�sts.
s
install l.ag �ews
ihat penetrate
11Iz" min9mum inio
rim joist or wa11
studs. (Mi�i�rrtum
two,/e" Lag Screvrs
every 16"l
rvor�•
Jaist hangers must
be correct siae !or
joist size used
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3Hl �O S3�M11lddd JNINZIf18 '13(1� JNI��fld3?J N3HM NI a31'll� 391Sf1W MO"138 3Hl
Building BUILDING Permit r�o.: � a
. . �t, �` ``, Z �l� �
Inspections RESIDENTIAL APPLICATION Received By'.°��1G'
763-572-3604 CITY OF FRIDLEY vate �: D���`� �00
763-502-4977 FAX EFFECTIVE 8-19-09
DATE �a/� /0 9 YOUR E-MAIL ADDRESS
SI7'E ADDRESS .J `f � � 'E i5��n �) ff�L �A-�i5
THIS APPLICANT IS: ❑ OWNER �NTRACTOR
PROPERTY OWNER/ NAME: n% �� y � II �2 i! C rr, f�
TENANT ADDRESS: _ J'r�`� % E B�Q�'1 �! fti'L ��+5.5 CITY_ !�' IO��+�y _ STATE /2M�ZIP .,��`-t�
rxorrE: 1�! a 730 —�cn g� °
CONTRACTOR NAME: R 11" �K�I�S �
SUBMIT A COPY OF STATE LICENSE # ac� � 353 a�F EXP DATE
YOUR STATE LICENSE
AND CERTIFICATE OF ADDRESS: r,?4r Oq f�,��i� /� � CITY_ C'y/!S/`Fy p STATE �IVLIP�
INSURANCE pHONE S 3 � �/`� FAX
PROPERTY 1'YPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/I�TEW CONSTRUC170N STORIES
PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED �.WINDOWS
❑ BASEMENT FINISH 0 ROOF ❑ DRAIN TILE
❑ DECK O SIDING ❑ OTHER
� SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDI1'ION
❑ MAINTENANCFJREPAIR �REMODELING
DESCRIBE WORK BEING DONE:_ /�B`yj0� ye- aQeP� p L% wl.� d0-y f- %/T) !t
SIZE OF IMPROVEMINT LENGTH WIDTH HEIGHT S Ff
OOFING � HOUSE ONLY BASEMENT REMODELING SUBMIT•
NUMBER OF SQUARES ❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
IDING FOR NEW CONSTRUCTlON INCLUDTNG DECKS,
O Viny} ❑Soffit ADDITIONS & PORCI-LS SUBMIT•
� A�uminum ❑ Trim 1• Site Plan/Survey showing the existing structures
��� ❑ Fascia and proposed project.
2. Two sets of constructiort plens
WINDOWS 3. Energy Calculations
IN EXISTlNG OPENINGS i8`Yes ONo LOCA7'ION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPEIVINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $�;�� 1� C G� nr,riTpsrrr�v T�,n�
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surchazge
SAC Chazge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
_$ N d•�'d �' See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ � .001 times the total job valuation
$ � .0005 x Permit Valuation Minimum $.50
$ �(� $5.00 (State Licensed Residential Contractors)
$ $2000 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$22=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
_$ '�- _:�i Make checks pa�able 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 information 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 on site; that the work will be in accordance with the
approved plan in the case of all e•k �vhich r quires review and approval of plans.
SIGNATURE OF APPLICANT � _/�,/\ pRINT NAME C e . �(�% DATE l Z"— 7— o�
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $] 00 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to
and includin �$500,000
$500,001 to $I,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,000
$1,000,001 and up $5,608.75 forthe 1� $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 structure and of the construction 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 Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: ?63-502-4977