AF - 40710SUBJECT ��P
c�ty of Fridley 1427
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T '
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EIPT NO.
� 1 �______ COMMUNITY DEVELOPMENT DIV. •
r � PROTECTIVE INSPECTION SEC. �% � �
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�' /���1 � CITY H ALL FRIDLEV 5$432 NUMBER REV. DATE PAGE OG APPROVED BY
""� � •�� 612-580-3450
910-F15 ��5��� � �
JOB ADDRESS 5547 East Danube Road N. E.
1 LEGAL LOT NO. BLOCK TRACT OFi ADDITION SEE ATTACHED
DESCR. Lj 1 Innsbruck North 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
DaVerne Corporation 1393 - 16th Avenue N.W. New Brighton 631-1213
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
$a3R@
4 ARCHITECT OR DESIONER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO.
6 USE OF BUILDING
Resi.dential
7 CLASS OF WORK
l� NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Construct a 6Q' x 44' Dwelli� and a 24' x 24' Garage
' RE U�ED'� FQR., WiRti�C,
9 CHANGE qF USE FRO
t�flTSt�� P�.U1M�Ii�G AND SI�`�iS. .
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. All peat and unsound
material must be removed and site inspection called for. Compaction tests on
any sub-footing fi11 will be required every 2 feet. Provide copy of truss
design. Provide 12" bn center spacing for floor joists under livi� room or
double every 3rd floor joist.
SEWER IACATION: (Approx. 11.5' Deep In Street) 164' N.E. of Manhole (Inv. 951.91)
WYE ELEV: 949.72 TOP OF FOOTING: 953.22 Mi.ni.mum
WATER LOCATION: 3' S.W. of Sewer Service ������
DRSVEWAY DEPRESSION COST: N/A ''
TMe canr o� t�o�r ooes Not c�tr,vt�ec r�E g��fe ���a �,t� toce4 ut+tities
A�CUru�tr oP utWnr totr►nONS ,�v� �r��nOr,s. �;LEPHON� - ELECTRiC - GAS Etc.
tMli OATA IS fOR 1NfOWAAT1pN PU�PG5lS ONLY ANp
�ar�s us�w0 rc r�ovw v�u�r r�E nvFO�,a�►noN I R�C D�Y LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, NPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIOIdING. WOOC� FZ'aIIiC
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. 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 R—�. �.9OZ i- S%F) 43, 800 Tota.l
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTRE,ET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRFCT. 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 � S5S�SOS yS`2%.9O
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-
STRUCTION OR THE PERFbRMANCE OF CONSTRUCTION. � S�.%S.ZO $375.00
��1� PLAN CHECKFEE TOTA�FEE
C�] �!llhsn� � 7'" � � � $ 43 .80 $621. 90
SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT ATEI WHEN PROP RLY VALIDATED THIS IS YOUR PERMIT
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SIGNATUREOFOWNEIi11FOWNERBUILDERI IDATEI 6 BLDG �NSP � qATE
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THIS DA7A IS F�R INFORM�+TI�N PUF.POSES ONLY AND
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THIS DATA IS F�R INFORMATI�N PUf:POSES ONLY AND
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APPLIC/1TIOid FOR RESIllrNTIAL LUILDICJG PEF�I�ITS
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Address : Address : %� g'� - /� � �@ n _ (�0 •
T�z. r�o. �� 1- ia� 3
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No. : ��'y �1 Street: ���oC j ��I.LJX��►4��, �� �
LOT: BLOCY.: � 11DDITIOPI: .�oJ��f'jE,���� �'� �A��.
CORIQER LOT: IPdSIDE LOT: S;_,TBACK: SIVEYIIRDS:
Applicant attach to this forn► Tao Certii'icates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRI PTIOfd OF BUI LDI NG '
To Be Used As: �
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c.�ttS Front: �! Dep�h: 7�� Height: �O`
Square Feet: J d=— Cubic Feet: v�BJ d�o
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� Front: � Depth: �� Height:� /�'
�r�lC.�� Square Feet: Cubic Feet:
Type of Construction: �Qp � ���� ]�� Estimated Cost: $ �G,�i.�� �
To Be Completed: ��_ % . � �
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired _� $ $
(S�E REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
sFecified, agreeing to do all �vork in strict accordance with the City'of
�F idley Ordinances and rulings of the Department oi Buildings, and hereby
eclares that all the facts and representations stat�d in this application
are true and correct. See reverse side for additional information.
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DATE : �� 7 7 S I GNATURE :��,,Q�_ f'�(,�(:�YCJ
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1925 Oakcrest Avenue
220 - 20th Avenue North
PROJECT:
���� ���`���� - .� ���� ���: �F ��►�'���
Roseville, Minnesota 55113 (672) 636-7744
St. Cloud, Minnesota 56301 (612) 253-3451
REPORT OF DENSITY TESTS
BLOCK l, LOTS 3, 4, AND 8
EAST DANUBE ROAD
INNSBRUCK NORTH, SECOND ADDITION
FRIDLEY, MINNESOTA
REPOR`.PED TO:
DaVERNE CORPORATION
1393 16TH AVENUE NW
NEW BRIGH3'ON, MINNESOTA 55112
CC: CITY OF FRIDLEY
BUILDING INSPECTION DEPARTME
ATTN: MR. RON HOLDEN
GEC JOB NO: 1419 - DATE: AUGUST 22, 1977
Eight field density tests were conducted at the referenced
site on July 29 and August 2, 5, and 12, 1977. The tests
were done using the Density of Soil in Place by the Sand
Cane Method procedure (ASTM D 1556�.
One Standard Proctor Density T�st (Moisture-Density Relation of
Soils using a 5.5 ].b Rammer and 12 inch Drop, ASTM D 698-70), ��
previously reported in GEC Job No. 2379 and identified as
Proctor No. 1, was used.
Three Modified Proctor Density Tests, numbered 2, 3, and 4
(Moisture-Density Relation of�Soils using a 10 lb Rammer and
18 inch Drop ASTM D 1557-70), were also conducted.
Relative density was then computed by dividing the t'ield density
by the Proctor density, expressed as a percentage.
The results of the field density tests are as follows:
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HYDFi.OLOGY • SOIL AND FOUNDATION ENGINEERING •'FEST BORtIVGS
MaTERIALS TESTING. PERCOLATION TESTING. ENGINEERIIVG GEOLOGY • CONSTRUCTION INSPECTION
!
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GEC #1419 - Page 2
FIELD MOISTURE � RELATIVE
TEST TEST DENSITY CONTENT PROCTOR DENSITY
ATO_ DATE LOCATTON DEPTH cf ) % NUNIDER /
1 7/29 Block�l, Lot 4. 1/3' below grade 107.7 20.8 4 90
Rear Frost Footirrg �
2 7/29 Block l, Lot 4 1/3' below grade 104.3 18.8 4 g�z
Rear Frost Footing
North Side.
3 8/2 Block 1S_L.at_.� �' below grade 120.6 4.9 1 �, 104
Rear Frost_ Footing �,,�
4 8/2 Block 1,'Lot 1/3' below grade 134.8 6.6 2 lOBi
House Cen �.
5�8/5 Block 1, Lot 8 1/3' below grade 122.6 10.5 � 2 9g �
South end • • . �
6 8/5 Block 1, Lot 8 1' below grade 125.8 8.9 �2 101i
North end
7 8/12 Block 1, Lot 8 1/3' below grade 122:7 8.5 4 L�103
Frost Footing-SE
8 8/12 Block 1, Lot 8 1/3' �low grade 121.1 3.8 3 104
Frost Footing-NE
1
2
3
4
�.'he results of the Proctor tests are as follows:
OPTIMUM MOI3TURE MF1?CIMUM DRY '
SOIL�DESCRIPTION C_ONTENT %) DENSITY, (pcf)i
SAND, medium grained, brown (SP) 12.5 116.0 -
SILTY AND SANDY CLAY, brown (CL) 12.8 124_1
SAND, fine grained, brown (SP)
SAND, fine grained, brown,(plastic=SM)
12.2
13.4
Based on the results of the field density tests, it.is our
116.2
119 . 3•�
conclusion the soil was compacted in a suitable manner and will
provide adequate structural support for single family dwellings. ,
Report Prepared By:
�.�� �.
��
Charles W. Bisek
� Under the_Supervision Of:
��'�
l
R bert E. Pen ergas , P.E.
Minn. Reg. No. 8450
al Engineering Corporation
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MfAT LO�S CALCULATIONS DEPARTMENT O� BUILDIMQ�� VILLAGE OF CHAVIAPLIN
WeatAentri� Guide Coo�truc¢ion I�o. Imulation
Window� I Doon Refereaee Out. Wap lat. WaU Ceiliaa Roof Floor Kind How Appliec�
Yet— o Y�o 19
Fl. Raom l.eo�th � Width Hei�t r 3 jf-i �'r a Room Len�th � Width — �iei�ht J�
Windows and Doors—Cr+�ckage and Ana �/indcws and Domrs—�rackaae and Ares
WldtA H�I�At No. of Lle�al t, Ana qllAth HN�06 No. ot Llnwl tL Aru
N. ot p�ne of p�ne Il�hl• o� erack ep. tt, Na mt D�n• el pane II�At� o( cnut p. tl.
5� s � �✓ � ��'t JL I 5
° �° � 'ti� iF �-- � �� 1 �
Z �
�Z � _� Q Coef. Beu % 7:;t � c�
In6lcntion %Q ' t'+ 1a61traRioo
a)
Glau � ci L�' f� �
Etp. wall
Net e�p. wall
1n� wall
c��i��Q Q�- — �
Floor
Total Btu. . � d'
Required eq. h. ED.R or �q. in�. WA. Leader ana
Fl.i �m ��r, w�a�h Hei�ht
�s
Windo� and Doo�s--Cr�eksge and Area
WlA h Hsl�et No. o! Linqt tt. Arq
Na ot paw et p�a� Il�sb ot eraalt p. [L
� � �
/ 3 L s�� / ��v ��u
tn6len�on
'o
Glw
E:p. waU
Nd ap. wap
In� vvaD
Cei)ing
Floor
Total 8cu.
Required eq. k. ED.R. or sq. ini. WA l.eader arca
Fl. Rooen � Length Q/idth
Windowe and Doon--Craekage aad Area
W/dth Hel�ot No. ot Ltnul tt. Ara�
Na ef psn� o! paa� Il�bb of cnet p. tt.
o " �a 5 ��
/ ' � � �' P� ` >
i v ! � c�
c
InfJtralison _ � ?� e
n
Gl�a
q
�• p� '�
Net e�. wall
In� wall
Ceiling
Mloor
TetalBtu.
h. E.D.R. or p. ios. �Q/A Lwder ues
ae�
, �, CJ
ii� c-'
�I
e�
3 vZ �
> G 4✓
Glau
��
Nec e�. «rell
I �� �
c�a�
Floor
� Total @ta
���
_���
_��
���
h. E.D.R. or aq. iai. W.A. L�eader area
Fl.I R�oom ( I..en�th Widt6
Windows and Qoon--�raekage and Ae�ea
WIdIA Il�l�ht Na o! Wnnl lt. Aroa
No. ot pan� e[ oan� Il�st� o[ cr�cl� p. [t.
�
9�_
✓% �b2D
i� S�
In6ltration
Glsu
F�p. wall �
Net ezp. wall
Iat. wall
Ceileng
Floor
Total Btu.
Required sq. ft. ED.R. or sq. ins. Q/.A. Leader area
Fl.� Room I Length Width Height
9Vindovv� and Doors—.Craelca�e, and Area
WI4tA R�1�6t Na ot Llnul tL Aru
No. et pan� ot p�e� IISAt� o! encY �a. !t.
Coef Btu
lnfiltration
Gla��
�p. WaII
Net esp. wa11
In� wall
Ceiling
Floor
Total Bta
Requered �q. h. E.D.R er ,q. ie�. �IA. Lea&r area
lROOKL�N ►RINTING � ADV. CO.
��`��.n ,�
1 � ff':' . .. . . r`,
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#: �� � �
- �-
. r..
ril 27,. 1978
���� �� �������
8431 UNIVERSITY AVENUE N.E., FRIDLEY. MINNESOTA b6432
. David Ficek
Ve�rne CArporation
93 - 16th Avenue N.W.
New Hrighton, MN 55112
7ELEPHONE ( 812)571-3450
Re: Final Inspection at 5547 East Danube Road NE
Dear Mr. Ficek:
A final inspec�ion was made on April 26, 1978 of the above address and the
following it�s were noted which must be completed before the structvre
can be finaled out;
1. Provide frost footi.ngs for deck by May 6, 1978. �
2. Provide l�,ouse numbers on structure by May 6, 1978. �
3. Provide door closer between house and garage by May 6, 1978.
4. Provide sod in the front arid side yards by October 16, 1978.
We will �pect the above items to be completed by the scheduled dates when
reins.peations will be made to determine compiiance. If you hav e any
questions on these items, please feel free to contact me at 571-3450.
Sincerely,
RON HOLDEN �
Building Inspector
RH/mh
�� _ �
:.� �
`!�._ .,.._,--- �
, �
�= A' i-=
��.«�X
��� �� `�'
� �`�, ` r' �
r �E -
�. June 29, 1978
;�
m
f _,.� ,� .. .� �, .. ,.,,� � � � ,, ;
�. 7. � v 3 w� `�" � � ' � "" .. X� 14.� �.,,
8431 UNIdERSITY AVENUE PI.E., FRIDLEY, MIPINESOTA Sb432
' TELEPHONE ( 612j571-3450
Mr. Lyle Trease
5547 East Danube Road N.E.
Fridley, NIl�T 55432
Re: Final Inspection at 5547 East Danube Road N.E.
Dear Mr. Trease:
A final inspection was made on June 28, 1978 of the above address and
the only item left to be completed before the structure can be finaled
out is to provide house numbers on the structura. We will expect this
to be done on or before July 21, 1.978.
If you have any questions on this requir�ent, please conta.ct me at
571-3450.
Sincerely,
RON HOLD�1
Building Inspect�or
Rx/mh
SUBJECT P
City of Fridley � � �� � 3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT NO.
� i y_____ COMMUNITY DEVELOPMENT DIV. ���
r � � PROTECTIVE INSPECTION SEC
' ' /'�'\ � CITY HALL FRIDLE� SS432 NUMBER REV DATE VAGE OF APPROVED BV
�""'"� � ��J 612-571-3450 910-F15 7/28/95
� �
JOB ADDRESS 5547 East Danube Road NE
1 LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACHED
DESCR. �{ 1 Innsbruck North 2nd Addition SHEET
2 PiiOPERTY OWNER MAIL ADDRESS ZIP PHONE
Jerome R. Jungquist 5547 East Danube Road NE 574-1099
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Sam.e
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION CJ ALTERATION .❑ REPAIR ❑ MOVE ❑ REMOVE
X
B DESCRIBE WORK
Reroof House & Garage (38 Sq) Tear-off
9 CHANGE OF USE FiiOM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS AFiE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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 CEHTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT 2$SO 1.43
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTFUCTION. S4. OO Fire SC . HS
PLAN CNECKFEE TOTAIFEE
5' NAT RE OF CON'RA H R AUT OAl2ED AGENT IDATEI WHEN PNOPER VALIDATED THIS IS VOUR PERMIT
�' ,L► . ° � �9- f'S- �"LGL�t e �`G�
5� URE OF OWN R�iF OWNE UILD IDATE� B G�NSP ptJ E
NCW 11
ADDN � � CtTY OF FRIQLEY
ALTER j � SINGLE rAM[LY AND DUPLEXES R-1 AND R-2
Buiiding Permit Application
Coastruction Address:
Legal Description:
Owner Name & Address:
Contractor
Address:
LIVING AREA=
GARAGE AREA:
DECK AREA:
OTHER:
SSy 7 � � .�f}Nu,�� �
0
Gff'ective 8/ 1 /95
- ' ��
� �- y
�✓�'G� t�1s � Tel. # �..�%�' ���
MN LICENSE #
Tel. #
Attach to this application, 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 Width Height Sq. Ft.
�gth V�/idth Hgt/Ground Sq. Ft.
�-�� � � �-� �,� � / ��2 0 � 3� �� .
�
Corner Lot j] Inside Lot (] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estima.ted Cost: $ ° avSZ
Approx. Completion Date: � -3� iJ�
. (Cost on Back,�
Driveway Curb Cut Width Needed: . 6 Ft = x$ _$
DATE: �'�� "�� APPLICANT: � Tel. # - a ��
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� ��,��
� � ��
$ /. �.�
$
$
$
$
$
$ _
v �,
$ c1���'
Fee Schedule on Reverse Side
.001 of Permit Valua.tion (1/lOth%)
$.50/$1,000 valuation
$850 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" vr Alt. "B" Above
$450.00 Conservation Plaa Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�
sue��tf R NO.
City of Fridley 3 06 5 6
AT TME TOP Of TME TWINS � � I L D 1 N G P E R M I T
r
; � RECEIPT NO.
� ; � __��_ COMMUNITY DEVELOPMENT D1V.
r � � PROTECTIVE INSPECTION SEC. � '
� . , b
� _ �"'1 � CITY MALL FRIDLEV '}5132 NUMQEN REV O�TE P�GE OF APVnOVED B�
�"""'� � �'' 612-57�-3a50 e�aF�S 2/10/00 � �
�oe A oaess 5547 East Danube� Road NE
� LEGAL �OT NO. BLOCK TFACT OR AODITION SEE ATTACNED
oescR. 4 1 Innsbruck North 2nd Addition SNEET
2 PROPERTY OWNEA MAtL AOORFS$ 21P PMONE
Jerome Jungquist 5547 East Danube Road NE 574-1099
3 CONTqACTOF MAIL ADDRESS 21P PNONE LICENSE NO
Wellington Window & Door Co 3938 Meadowbrook Rd, St Louis Park MN 55426
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PMONE �ICENSE NO.
933-6300 City
5 ENGINEER MAIL AODRE3S 21P PNONE IICENSE NO
B USE OF BUILDING
Residential
7 CLASS Of WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Re lace windows
8 CHANGE OF USE fROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
�:ALL ��� �rN�q�, rNS��crroa
I�II�THIN 10 QAY"� Ot� WO�tK
COMPLETI01� Pern�lt Insp�ction Car�s
COPY T� H�i�EO���E� � 1�lill �e Malle�
To Hor��owner % Posi
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED POR ELECTFICAL, PLUM8ING, MEATING,
VENTILATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NUIL ANO VOID IF WORK Oii CONSTRUCTION ZpNING SG. FT CLL FT.
AUTHORI2ED IS NOT COMMENCED V�IITMIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERI00 OP 120 DAYS AT
ANV TIME AF7ER WOfiK IS COMMENCED. NO DWLG. UNITS OfFSTpEET PARKING
I HEREBY CERTIFV TMAT I HAVE iiEAO AND �XAMINEO THIS APPLICATION 1 STAL�S GAiiAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUR7AX
AND ORDINANCES GOVERNING THIS TVPE OF WpRK WILI �E COMP�IED �
WITM WHETMER SPECIFIEO HEREIN OR NOT. TME GRANTING OF A PERMIT � lO � OOO �S . OO
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEI THE pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• @181.25 Fire SC �LO.00
STqUCTION OR 7NE PERFORMANCE Of CONSTRUCTION •P
PLAN CMECK f TOT L FEE
Cit c se 196.25
S�GNGTUpEOFCON7FACTOpOpOUTNOp4EDAGENT �D�Tp� MEN R VALI TMIS�OUR PERMIT
� � i
S�GNnTUAEO�OWHEaii�OWNEpBU4DEp� �DAtEi Bl0 �NSp � OitE
�
/
�[ J
ADDN
ALTER
Effective S/10/99
� � CITY OF FRIDLEY
[] SI�i TGLE FAi1�.Y A1�TD DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
� Construction Address: � � 7
Legal Description:
1'%�
Owner Name & Address: � 'S� — Tel. �°C,� � Q! 9�
Contractor: P 1 � MN LICENSE #
Address: f o0 � � rJ�J Tel. #���' °%,3 �j-��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawa on it to scale.
DES�RdF'I'Ia►1�14F Il�LR.��1�1�'I.'
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTI�R: „ �
Construction Type: �/��
Driveway C�rb C�t Width Needed:
DATE:� – ��' APPLICAI�IT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
Ft. + 6 Ft =
Cost: $_ ,(�, �� 6�
_$
$ /�/. �s
$ /p.00
$ S �o
$
$ citv
$
$
$
$
$ � a�
Tel. # �
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 [ ]
STIP TIONS:1���//J�' � d�ct� �'T�� �'``� /�`�L �"Ei���/�y
�-�,�� � .��G .1��/�G� dr-- Ti'�/� �u�'� /�T�.
��. �1�, �.- �- � 19�7 �, �, �.� -- � _
� SuB�E�T . �
City of Fridley 30893
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� � RECEIPT NO.
� `v __��� COMMUNITY DEVEIOPMENT DIV. ��
r � � PAOTEC7IVE INSPECTIQN SEC.
i . .
� _ �"'1 � CITY MALL fRIOLE� SS�32 NU49EP 11EV DnTE VAGE Os Avnt�pVEO 8�
�.__.J`.' '•� 612-571-3450 910-F15 5/Z/�� / /
108 ADpRESS 5547 East Danube Road NE
1 LEGAI �OT NO. BLOCK TqACT Oii ADDITION SEE ATTACHED
oesca. 4 1 Innsbruck North 2nd Addition SHEET
2 PROPERTY OWNER MAIL AODRE$$ ZIP PMONE
Jerry Jungquist 5547 East Danube Rd NE 574-1099
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO
Norling Exteriors Inc 341 79 Way NE9 Fridley, MN 55432 784-8936 20098700
a ARCNITECT OR DESIGNER MAtL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAII ADORESS 2�P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside 13ouse & Garage; Soffit/Fascia
9 CHANf3E OF USE fROM T�
STIPULATIONS
Per Section i402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering. Install soffit ventilation to meet the State Building Code.
TvPE OfCONST. OCCUPANCY GROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIfiEO FOR EIECTRICAL, PLUMBING. MEATING,
VENTILATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL ANO VOIO IF WOiiK OR CONSTRUCTION 20NING SC. FT CU FT.
AUTHOR12ED IS NOT COMMENCED V�IITMIN 80 OAYS, OF IF CONSTRUCTION
Oft WORK IS SUSPENDED OR ABANOONED FOp A PERI00 OF 120 DAYS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNI7S OFFSTREE7 PARKING
I HEpEBY CEqTIfV THAT I MAVE READ AND �XAMINED THIS APPLICATION 1 STA�LS GARAGES
AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of �AWS VALUA110N SURTAX
ANO ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMP�IED @
WITM WHE7MER SPECIFIED MEREIN OF NOT. TME GRANTING Of A PERMIT W 11 s OOO �S . SO
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CMARGE
PROVISIONS OF ANY OTNER STATE OR LOCAI LAW REGULA7ING CON• � 193� . 2S Fire SC � Z L. OO
STRUCTION OF TME PERFORMANCE OF ONSTRUCTION
� PLAN CMIECK fEE T AL FEE
e
� �' �' O� Lice e SC $5. $216.75
S�GNATUAEOFCON'AACTOAOpAUTMOA�2E' OGENT IOATE� Wj{ N PR E VALI A ED TMIS I�R PEpN�IT
I �i i�y
3 �,�,
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Effective 1/1/2000
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
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Construction Address: ,; � �/ � � �� ��s f 3
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Legal Description:
Owner Name & Address:
Contractor:
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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�_ Tel. # c.5r � / ° ! � '��
_ MN LICENSE # .2 z���
'�-- Tel. # �� � � � �,�
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Attach to this application, a Cert�cate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
r oPOe is, c,
Construction Type: �e�id � ��{�--� � ��c�� ��ov�r Estimated Cost: $ lr,. �� � I 1
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � �'�� APPLICANT: � v � � � � � �� � Tel. # � � � - ���,,a'�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ l�15, .� �J Fee Schedule on Reverse Side
Fire Surcharge $ 1 I� D� .001 of Permit Valuation (1/10th%)
State Surcharge $ � E � $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ �'"j a c� C� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee
Sewer Main Charge
1����1
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
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Building BUILDING Permit rTo.::�� �� �'r4 �
Inspections RESIDENTIAL APPLICATION Received By: "�' '�
763-572-3604 CITY OF FRIDLEY vat��e�d:�c� �� 2�1
763-502-4977 FAX EFFECTIVE 1-1-2010
DATE�('a - � � � �� YOUR E-MAIL ADDRESS
SITE ADDRESS 3' ��% _ � L l� e�c h r,� b� f� �.
THIS APPLICANT LS: J$ OWNER OCONTRACTOR
PROPERTY OWNER/ NAME: �L� i�E��T (i( h G- �!� �� 5 7'-
TENANT p�D�ss: � N G= li o. H r� G� Y Pt�r[1' �y'i� d��- C� STATE
,�� � �h ZIP,fS��Z
PHONE: % G `3 " '
CONTRACTOR NAME: C T � p I-�
SUBMIT A COPY OF STATE LICENSE # ? �, EXP DATE 3' 3/'��2
YOUR STATE LICENSE -�--F-
AND CERTIFICATE OF ADDRESS:�B �� /�/ L G� W CITY ��oU e v STATE �i�iZIP S B
WSURANCE pHONE FAX
PROPERTY TYPE (�SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE 0�DITION ' ❑ GARAGE/SHED ❑ WINDOWS
❑ BASENIENT FriVISH �ROOF ❑ DRAIN TILE
O DECK O SIDING � OTHER
O SWINIMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDI7'ION
❑ MAINTENANCF./REPAIR ❑ REMODELING
DESCRIBE WORK BIING DONE: T G�L N o�C -12 e �o o�!-f o �c, S� � G-� ya �i �
SIZE OF IMPROVEA�NT LENGTH WIDTH HEIGHT S FT
ROOFING ❑�-IOUSE ONLY gpSEMENT REMODELING SUBMIT:
NUMBER OF SQUARES .,�� �KHOUSE & GARAGE I, F�cisting Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DE1'ACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCfION INCLUDING DECKS,
0 Vinyl OSoffit ADDI1'IONS. & PORCHES SUBMIT:
O Aluminum � Trim 1• Site Plan/Stuvey showing the existing structures
and proposed projeck
� Other � F��a 2. Two sets of construction plans
R'IN1)U�'VS 3. Energy Calculations
IN EXISTING OPININGS �Yes ONo LOCA110N OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
a1.1. r��;�� axr; IsA��;u ulv VALUA"1'1V1v,1NCLUlllNG TIiE C05T OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Swcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
ANCY
$ � 9/.� � See Back Page for Fee Schedule
$ °� 65% of Building Permit Fee
$ ,� .001 times the total job valuation
$ ,� A� .0005 x Permit Valuation Minimum $.50
$ ° _r- $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= 8x$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ � a, �� Make checks pavable to: Citv of Fridlev 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 work which requires review and approval of plans.
SIGNATURE OF APPLICA� �PRINTNAME_ 11�cC P�P ti,P l.(�C�'%i'�i�DATE�o �%� �jJ