AF - 40712, . . �. :r=—
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Number Fixtures �� x $2.00 a�
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
Water Heater-99,000 BTU x$3.00 � p
Ground Run Old Bldg. x$3.25
E1ec. Water Heater x $2.00
Gas Fitting Fees:
lst 3 Fixtures x $2.00 ,�
Additional Fixtures x $ .75
Gas Range-199,000 BT[T x $5.00
Repairs � Alterationa
See
Deacription: Code
State Surcharge .50
TOTAL FEE $ � � �
'he undereigned hereby makea application for a permit
`or the work herein apecified� agreeing to do all work
.m strict acco�dance w ith the City Ordinances and rulin
rf the Department of Buildinge, and hereby declare that
�h� �acta and representatione etated in thie
tppl �tio� are ti'ue aAd _corxecat,. � _
G-/2-��� �
��
6ERALD T. �'AYNE
300 BRUNSWICK AVE S.
GOLDEN YALIEY, MINN.
MINN. REG. NO. 4741
INDUSiRIAI — JUDiCUL
COMMERCl/1L — TOPOGR1IPHICAL
cirr LOTS — PI.^TTIPIG
LOT SURVEYS COMPANY
LAND SURYEYORS
R6tiIST6RED UNDER LAWS OF STATE OR dIINN�SOTA
LICENSBD BY OBDINANCE QF CITY OF MINNEAPALIB
5747 W. Broadway 533-942Y
Minneapolis, Minnesota 55428
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A917 tDf�HO AVE. N.
BROOKLYN PARK, MI�IN.
MINN: REG. NO. 6743
INVOICE NO. `� °=° � i �
F. B. NO. 1� °28
SCA�E �^ c �'� �
Q — DENOTES IRON
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Ata�nded to show foundation �ecember 17, 1973
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Ws hareby c�rtify thal thiti ia a trus and correcf representattan
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o� a�uroey of tl+e bounderie� oF the above described land end � p ' �x
the loa�tion, of all 6uildings end dvleibt� enc►oechmente, ii eny, g � �r �� J. �•
fram'o► on teld land. 5�0� / °}}✓�-riy.a��',� � I� �,.�.�-�
Suroeysd by us fhiaG ?�•�ay of �Gr'��-���' Ip- �� �li� ���:�an9 �i���� .
.
City of Fridley
_. r 4T T11R TQP OI Ti1E Trr►Ni
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r�-------� COMMVNITY GEV[I.O�MENT Q1V,
� � MOTECTIK Nt�CTIpq Of►T,
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Comp etion Date
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PLUMBIiVf, PERf�IT APPLICATIt�id
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A ress
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-1 -- _-- --. . -- -
Plumbin Fixture Rates: N0. RATE TOTAL
Number Fixtures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Basin x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg. x$3.25
Elec. Water Heater x $2.00
Gas Fitting Fees:
1st 3 Fixtures x $2.00
Additional Fi.xturea —+'
x $ ,75
Gas Range-199,000 BTU x $5.00
� Re eirs � Alterations
� �y� See �
DesL�`ript,i�on� s a i I "�Iy `0� Code �~� I
u
State Surcharge .50
I TOTAL FEE ,S S � �e
I
!The undereigned hareby makes application for a permit
for �he work herein apecified� agreeing to do all work
in atrict accordance w ith the City Ordiaances and rulin
of the Department of Buildinga, and hereby declare that
a11�th� Facte and repre8entationa atated in this
application are true aad correct.
� �
� �- � �'� y - iy
'Signature Date ;
.
t
�
City of Fridley
AT THE TOP OF THE TWINS
i �
� �
� • COMMUNITY DEVELOPMENT DIV.
� Vy �������
r � � PROTECTIVE INSPECTION SEC.
1 � �
� �"'1 � CITY HALL FRIDLEY 55432
�___.Jl-' �•� s�z-ssa3aso
SUBJECT
BU ILDING PERMIT
NUMBER ' REV. DATE PAGE OF
910-F15 11/2/73 � �
T �12380
R EIPT NO.
� ��
APPROVED BY
JOB ADDRESS 5554 East Da.nube Road N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 3 2 �nnsbruck North Znd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Robert Laugen Homes, Inc. 6866 East Fish Lake Road, Maple Grove, Minn. 55369
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER
USE OF
MAIL ADDRESS
1������� Residential
ZIP PHONE LICENSE NO.
7 CLASS OF WORK
¢� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE 0 REMOVE
8 DESCRIBEWORK Constru.ct a 42 x 24 3 Dwelling and a 22 x 24 Garage
9 CHANGEOFUSEFROM
TO
STIPULATIONS provide a hard surface driveway. Provide a verifying survey before
capping. Provide Z x 6 plumbing wall and extend firewall thru soffits.
WATER LOCATION: 5' South of Sewer
SEWER L�ATION: Wye 154' South of Manhole
Wye Elev: 948.80
Top of Footing: 951.80 Minimum
Inv. of Ma.nhole Elev: 946.74
SEPERA�E QER�
1TS REQ�IR.E� FOR iNtR1NC �
. M�AT1
NG, pLUMBII�G AND St�NS.
TYPE OF CONST.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOd Fl"2]
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-�.
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI'
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $37 OOO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIO S OF ANY OTHER STATE OR LOCAL LAW REGULATING con,- $63.00
STRUCTI OR T��PERFORMANC OF CONSTRUCTION.
PLAN CHECK FE'
� �� ��— � �
S GNATURE OF CONTRACTOR OR AUTH�QRIZED AGENT � IDATEI EN I
.__ . _ �
IDATEI I LDG I
DCCUPANCY GROUP OCCUPANCYLOAD
Sa. FT. CU. FT.
1020 28 560
OFFSTREET PARKING
STALLS GARAGES
SURTAX
�.7.�%
SAC CHARGE
275.00
TOTALFEE
$355.17
:R VAL ATED THIS IS YOUR PERMIT
��_ � ��� :9
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER � S NAME : BUILDER : o- OOl��ff �iUC.
�
�wnxESS: annxESS: l��66 �. �s� � t ,�.
' . � Rpf-C �a' �a �+� � /�(i,✓.Y , �.�'' � !o�
NO:.� 5 5 � STREET:
Lo�r: 3 Br.ocx:_
�,4. s
� ADDITION : �iV.S�,��s'.L't/ c,t /VD/t7,�/ � '=P �I�O/�/.
���
CORNEA LO�: INSIDE LOT: � SET&1CK: SIDEYARD:
Appliaaa� aCtach to thia form �o Certificates of Survey of Lot and proposed
building location drawa on these Certificates.
HESCRIPTION OF BUILDING
To Be Used Ass
� �N£�L�nrl� Front: �Z Depth: � � � Height: ��
Square Feet :/� 2� Cub ic Feet :��`� .5 6 p
,
R!Z�-t� Front : �'Z Depth : Z�i Height : f0
Square Feet; S a. � Cubic Feet: S�. ��
1�►pe of Conetruction: �/`'��.D �1�/�M-E Eetimated Coat: $� Z, 0�
To Be Completed: �' 3 m' ?�
The �ndereigaed hereby makes applicativn for a permit for the work herein
apecified, agreeing to do all work in sttict accordance with the City of
Fridley Ordiaances aad suli�gs of the Department of Buildinga, and hereby
decla�es that all the facts and repreaentations stated in this application
are tuue aud corxect.
IaATE II ! d" o: G�?-3 $IGNA • G
(See Reve7rse side �'ox Additioaal Iaformation. ) �-- � �''� �' � "� -� �� �
� � ' �, ,�r � - .�
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. � , � � a � !� = � �� � - <
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�BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Iaspector of Buildings ahall, before iasuing peitnits for the
erection of aay building or stzvcture, or for any addition to any existing
building or structure, or for any alteration or repairs to aay existiag
buildi�g o]r stxucture, upon application therefore, require the payment by the
applicant �or such permit of fees to the amouat herein below set forth and in
the manaer herein provided to-wit:
UNIFORM BUILDING COAE: Type 1, 2� 4-$2.15 for each one thousand cubic
feet, ox fraction thereof, in auch cubical contents. Type 3� 5-$1.85 For
each oae thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of camputing fees for building permits, the cubical contente
of aay building or addition, is determined by �ltiplying the ground area
covered from a point aix (6) inches below the floor line of the base�ent
or the cellar to the average heights of the upper surface or to the average�•
height of the roof eurface of the wain gable of a pitched roof.
Fox repaira or altesationa to an exiating atructure, the £ee stiall be at the
zate of $3.00 per each five hundred dollars ($500.00) oa fraction thereof in
�he cost of all proposed work.
Ia ao caee shall the fee charged for a.ny per.mit as set forth in Section 2 be
leae than $5.00. • �
VBRIFICATION OF FOUNDATION
NOTE: Permits for eoaetructioa will be isaued a miaimum of 24 hours fram the
ti�e of applicatioa, to allow for proper review of the proposed structure and
of the constsuct�on aite.
A Cex'tified Survey o£ the lot, ahawing the location of the foundation, once i.t
ha� beea conatnicted, wi�l be required before proceedinr� with the framing.
CERTIFICATE OF OCCUPANGY
Application for a Certificate of Occupancy ahall be made ten (10) days pxioz
to the u�e or qccupancy of �y atructure for whi�h a building pe�nnit has beea
iseued; and said atructure shall aot be used or occup�.ed until a Certificate
of OccupBt►cy has beea isaued.
e
GERALD T. COYNE
3D0 BRUNSWICK I1VE S.
GOI.DEN VAILEY, MINN.
MINN. REG. NO. #741
INOUSTRIAL — JUDICIAL
COMMERCIAL — TOPOGRAPH�CAL
CIIY LOTS — PLd�TTING
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LOT SURVEYS COAIIP�INY
. LAND SUItVEYORS
B��fTaBED UNDEA 4AWS OF STAT6 OF ffiNNESdTA
LICENBED BY 08DINANGE OF C1TY OF MINNEdPOLIB
5747 W. Brondwoy 533-4922
Mi�neapr►lis, Minnaisota 55428
�ttrap�or� �prtifu��r
G�E'.`�ir ,. �;L�: �r�`'.,'.iii; i_>J.,�' ,�; .
RAYMOND A PRASCH
69�7 IDAHO AVE. N.
BROOKLYN PARK, MINN.
MINN. REG. NO: 6743
INVOtCE NO. t�' � � �
F B. NO. !�°�0
�Q.
SCl1LE 1" �
Q — . DENOTES IRON
r v��L��T �.�, �.T � �rJ ���rf �.:� �re� .
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We hereby cerFify thet thie ia o irue and correct represenfation .--' y -
of e wrvey of fhe baunderiea of the a6ove dascribed lend and ,f � �
#he (oc�tion of sll buildinge end vloible encroachmenta, if enq. � ,'� _•
fro� c* e�+ fold lend. ►� Cd � -.'�- ;:.�• � �'�' � �-�...F � �` -` i',�,�.:' �= i
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HOUSE HEATING TEST RECORD
ADDRESS �'� APT. FLOOR == CITY SUBURQ
OCCUPANT OWNER %�' �
HEAT LOSS �,:_DATE HTG INST.
GAS C0. METER BADGE #
SOLD BY " '� '"r� INSTALLED BY �'�' - °
Elechical Work By ' Gas Line By ��' �`
TYPE OF HEAT GA FA ��� HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE - MAKE OF BURNER
Model ' �� -
Model
Serial Max. BTU Rating
: t+, ;
INPUT x°' �° _;� MAKE OF FURNACE ��
Model
CONTROLS -
THERAAOSTAT ;�'����'= �"_' Heat Plug Vent Size `r� �
Yalve J tl KIND OF LINER `` ��`�%' SIZE NONE
Limit '' '� � Drah Hood Regularor te �
Limit Setting Filters Size Number
Fan Setting ' Chimney Location Inside. `r�� Outside
Pilot Typa Chimney Construction -`i"-
Pilot Make ,
Pilot Model Smoke Bomb Wiring
Pilot Tlming f�' � ' Draft '"o, Test Tag
L.W. Cut Off Door Pressure Lighting Inst.
r
Prossure � y'� Pereent CO2 �-`�� Date Tested ��� '�"
Input CFH Pereent 02 '� '` Company Testing�,f'°T '�
Stack Tamp. Pereent CO ' '�� Name of Tester
Form 235
SuBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� �
COMMUNITY DEVELOPMENT OIV.
r � v � PROTECTIVE INSPECTION SEC.
� '� �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE
�""� � �'� 612-571-3450 9t0-F15 12/6/85
JOB ADDRESS 5554 EastDanube R08C� N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
oescR. 3 2 Innsbruck North 2nd Addition
2 PROPERTYOWNER MAILADDRESS Z�P
Dave Schutte 5554 Ea.st Danube Road N.E.
3 CONTRACTOR MAIL ADDRESS Z�P
Patio Village 3918 West 49� Street, Mpls., NIl�i
4 ARCHITECT OR DESIGNER MAIL AODRESS Z�P
5 ENGINEER MAILADDHESS Z�P
PAGE OF
� �
PER .
I°_ 18307
RECEIPT N .
� �
APPR ED BV
SEE ATTACHED
SHEET
PHONE
574-1873
PHONE LICENSE NO.
93 8- 79 89
PHONE LICENSE NO.
PHONE UCENSE NO.
8 USE OF BUILDING
RE S 1.CZP.ri't].d �.
7 CLASS OF WORK
❑ NEW ClX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 15' x 16� Three Season �oxch.Additioz�
9 CHANOE OF USE FROM
STIPULATIONS
TO
s�P��a-r� ����ir� ��c������� �o�
�+JE�IIV�, 9���T1��9G, ��t1�flC i�lG AR9� SIGN;�.
8°�
,
J
��'' �z,
. :;i, ,� , E�: � i ,
��� C�t�'I-�;,�o�aL � E���� � �� e�,� � y_�,;' .
��ii'^� ���?r :° 6' �5 y p
7 �, r
_ ...Ft Q t, � � '�!� � P. , �. y�p,
TYPE OF CONS7.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. � NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATIOId 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4, 500
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW GULATING CON- yS`SO. SO
TRU TION OR THE PERFORMAN� CONSTRUCTI .
`Ii���� � PIAN CHECK FEE
l z �p �� $12. 63
SIGNATURE OF CON i RACTOR OR AUTHORI2ED AG T IDATEI WHEN PRi
�DATEi e
OCCUPANCY GROUP OCCUPANCY LOAD
SO. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$ 2.25
SACCHARGE
TOTALFEE
�C�t$t $ 65 . 3 8
Y VALIDATED THIS IS VOUR PERMIT
p� r
A T�
p� [] City of Fridley Effective 4/1/84
ADDN. [ ] �R-1 AND R-2 �
pLTER. [ ] Building Permit Application
Construction Address: �-S.S � � �Q/%da'�-
Legal Description• � � � A "` `�� l`� �S� � ���� ��'� `� �
. �n,io_ ..��u �2, �_�y � .�i�dr� �'��e�Y . � � `7�'/6�'73
Owner Name 6 Address:
Contractor:�yT�o i✓J/%aq�- Tel. 1� ��'- ��
Address: �i�� � �9 `2 -� ���'�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROYEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER : '�ii�9p SP�:t e�-•... 1gad�- /S'.1'/� � 2� C� �
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
9�jy) �
Type of Construction: aX'� F�� _ Estimated Cost: $�,�a���-��
Approx. Completion Date: JQ�! /S� �98�0 ��
I���J r a�(�� ��•�� ���Ip, �� Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE:I��-�S� APPLICANT: �.��� Tel. � 9.�"%%��
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
�OTN.
STIPULATIONS: � �,
CITY IISE ONLY
� ��
g 1 .C��
$ �,��
$
$ "�
� �'
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC U nit
Fee Determined by Engineerin�
$
�3o Agreement Necessary L 7 Not Necessary []
/' /% •
_ / ��-'�'
4
��'��' /:',/ ��
BIIII,DING PERMIT FEE SCHEDIILE
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 Valuation
�1.00 to $500.00
�501.00 to $2,000.00
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for eaeh
additional $100 or fraction thereof, to and ineluding
$2,000.
$2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraetion thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $1�.50 for each
additional $1,000 or fraction thereof, to and
ineluding $50,000.
$50,001.00�to $100,000.00
$1Q0,001.00 and up
$283.00 for the first $50,000 plus $3.00 for each
additional $1,000"or°� fraetion thereof, to and
ineluding $100�000.
$�33.00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraction thereof.
DRIYEWAY DEPRESSION ESCROW
(Concrete Curb 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
approaeh With 6 ineh depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOONDATION
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 onee it
has been constructed will be required before proceeding with the framing.
_
����
� c� G� �1,�
3�0 � �
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GERALD T. COYNE
700 BRUNSWICK AVE S.
60LDEN VALLEY. Ir11NN.
MtNN. RE6. NO. �741
INDUSTRIAL — JUDICIAL
COMAAERCIAL — TOPOGR/1PHICAL
CITIf lOTS — VLATTIN6
�
(I�
LOT SURVEYS COMPANY
LAND SURVEYORS �
�T6QED UNDSQ LA�B OP STAT6 OF llINN164pTA
11CBN86D BY OgDINAAtC6 Of CRY Ol► E[INiNEAPOlJB
5747 W. 8roed.sy 533-9922
Minneepdis, Minnesote 554?8
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RAYMOND A. ►RASCH
6917 IDAHO AVE. N.
BROOKL1fN PARK, MINN,
� IdINN. REG. NO. 6��3
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SuBJECT
c�ty of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
i �` ���� COMMUNITY DEVELOPMENT DIV.
r ��' i PROTECTIVE INSPECTION SEC.
� ,= i�"1 � CITY HALL FRIDLEv 55432 NUMBER
�"'"'�'� �'� 612-571-3450 910-F15
JOB ADDRESS 5554 East Danube Road NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
oesca. 3 2 Innsbruck No
2 PROPERTYOWNER MAILADDRESS
Dave Schultz 5554 East Danube R
3 CONTRACTOR MAILADDRESS
Bob & Sons Roofing 4553 Xerxes Ave S, Mn
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
REV.� OATE PAGE Of
7/19/94 � �
�22729
RECEIPT NO.
� ! �
APPROVED BV
SEE ATTACHED
SHEET
ZIP PHONE
ZIP PHONE UCENSE NO.
920-1251 Pendi.
Z�p PHONE LICENSE NO.
21P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK � NEW O ADDITION O ALTERATION ❑X REPAIR ❑ MOVE O REMOVE
+
8 DESCRIBE WORK
Reroof House & Garage (32 Squares) Tear-off
9 CHAN(iE QF USE FROM
TO
STI PU LATIONS
Underlayment must comply with the State Buiding Code.
TYPE OF CONS7. oGGUr'n
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONING SQ. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OFi IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS
I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2 /{OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGULATING coN- $54.00
T UCT N OR E PERF MANCE OF CONS UCTION.
v pLAN CHECK FEE
� License SC $5.00
SIGNATURE OF C � RACTOA OR AUTHORI2ED AGENT IDATEI WHEI� RL
1/
GROUP OCCUPANCYLOAD
CU. FT.
OFFSTREET PARKING
$1.20
SAC CHARGE
Fire SC $2.40 .
TOTALFEE
$62.60
'� THIS IS YOUR PERMIT
na
�
NEW
ADDI�i
ALTER
[S
�t,
I1
� • CITY OF FRiDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Apptication
Effec.tive 1 / i /94
�a�s�
�onstruction Address: ,'r� �`� � /J��i�s�� � _
Legal DeLCriptian:
Owner Name & Ac
�ontractor: �
�Address:�_:�5'�.�
. ., � . .
0
,.'.:��,�%as ..
Tel. #
MN I;ICEI�SE'# � � � �it16J �l�C�
. Tel, # : �oZ� -'7 �- � � �
Attach to this application, a Certificate of Swvey of the
lot, with the proposed conshvction drawn on it to scale.
� D�SCRIPTIOI�1 QF �I11�PROVEMENT � � �
LIYING AREA: Length Width Height Sq. Ff.
GARAGE AREA: Length Width Height 'Sq. Ft. �
DECK AREA: Length Width HgtlGround Sq. Ft.
OTHER: �� �r,� �- ��� �,��-o �- ���-�.� c, 3 2�
Corner Lot [] Tnside I.ot (] Ft. Yd Setback Side Yard Setbacks
Type of Construcdon: ��-=-c �-- ��t� ��= $ �-�� � ��
Approx. Completion Date: / �/�
(Cost on Back)
Driveway Curb Cut Width Nceded: F. 6 Ft x$ -$ •�o ,� � s%
DATE: � l � APPLICANT: �� � Tel. # �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� ��'� ��
$ � � `r L7
� /, � c�
$
$ �CUI>
$
$
$
$
� � ���
� Y !i � �
Fe� Scheduie on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,(m0 Valuation
$8W per SAC Unit
$S .00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary j] Not Necessary []
. '_
.
BU[LUING PCRMI"f FEE SCHEDUGE
"l�tic C;iiiei i3uildiri�; Ufticial stiall, i�efore issuing permits for the erection of any (wilding or stnicture,
c>r ti�r any ad<lition tc� <iny cxisting buildin�; or s[ructure, or for any altcraiion or rcpair to arty cxisiin�;
(>uildin�; c>r struciurc, u�a aPp�icdtion thcrc%rc, rcquirc thc paymcnt by thc applicant for sucti �ermit
c�f� icc:s tc� thc: a�►iount t�crcin tx;l<nv sct !<�rtl� and i❑ tt�c tuanaen c�rcin �rc►vidui to-wil:
"1'O"i'A L V il Lt) t?
� 1 to $500.
$SO1 to $Z,OOp �
$Z,001 to $25,0(?0
�25;001 to $50,000 -
I�i;i;.S
$IS (Minin�um Fcc is $15 plus surcharge)
$15 for fust $SQQ plus $2 for each additioaal $100 or
fraction thereof, to and including $2,ppp -
$45 foc � firsf $2,ppp pius �q for each additionai $1;000
°r fradion thereof, to and including $25,ppp �
$252 for first $ZS,ppp pl� �_50 for each additional $1;OOQ
or fradion thereof, to. and including $50,000 --
$50,0(}1 � to $100,000 . � � � $414_SO for first $SO,OOU plus $4.50 for e�ach additional . . .
.$1,000 or fraction th�eof, to and including $100,000
�100,001 to $500,000
$500,001 ta $l,0pp,ppp�
$i,000,001 and up
$63950 for fa� �$100,0()0 plvs- $3_SO for each additioaal
$1,000 or fraction thereof, to and including -$Spp,pQp
$2039_SO for the first $Spp,ppp Plas $3 for each additi[on.ai
$1,�0 or fractiou ti�ereof, to and including $1,ppp,UQp
$3539_50 for t�te fust $1,pOp,ppp P1us $2 for each addifioual
$1,0U0 or fraction t�ereof -
DRIVEWAY DEPRESSION ESCROW
(Concrete Ctui� Streets On1y)
A[ternate "A": Removal and replacemeni of curb aud gut�er on(y - Driveway width plus 6 feet times
$13_50_
Alternate "I3": Removal and rep(acement oE curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plas G feet times $15_75.
VGRIF[CAT[ON Or rOUNDAT[OIY
PerrniLs for cor�suuciion wiil be issued a mutimum of 24 hours from the time of application to allow
for �roper rcvicw of tiic proposui stiucturc and of thc coastruction sitc_
A Certificate oC Survc-y of d�e lot, stiowing the location of the fc�unciation once it has it t�as hcen
conzt�-uc:lul �viil t�c rc:yuirc:cl bctorc j�rc�ccetlin�; with tl�c framinF;_
�
��.
ADDRESS
PIN
LEGAL DESC
PERNIIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 iJNIVERSITY AVENITE NE
FRIDLEY, MN 55432
572-36U4 l+'AX:
� ! �lJ: _ :_� �l
: 243024420078
: INNSBRUCK NORTH 2ND ADD
: LOT 3 BLOCK 2
: BUILDING
: RESIDENTIAL
: ROOFING
571-12i37
� �
PERMIT O.: 2004-00910
DATE ISSUED: 06/15/2004
VALUATION : $ 853.00
NOTE: REROOF SMALL BACK PORCH. ROOFING SHALL BE IN ACCORDANCE WITH IRC 905.2.7.1 AND
UNDERLAYMENT AS PER IRC 905.2.7.
STATE LICENSED CONTRACTOR 1
APPLICANT
KAUFMAN SHEET METAL ROOFING (9324)
2521 24 AVE S
MINNEAPOLIS, MN 55406-
OWNER
SCHULTE DAVID E& KATHRYN C
5554 E DANUBE RD NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This pernut becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and lrnow the same to be true and correct. All
provisions of laws and ordinances goveming this type of wor�
will be complied with whether specified herein or not. The
granting of a pernut does not presume to give authority to
violate or cancel the provisions any other state or local law
regulating construction or the p ormance of construction.
Applicant Date
Bldg Insp
BUII..DING PERMIT FEE
FIRE SURCHARGE
STATESURCHARGE,VALUE
LICEN5E SURCHARGE
TOTAL
,
35.70
0.85
0.50
5.00
42.05
Permi� �r��p�ction �ar
Wii► �e ds
To Ma�led
�omeo�ner To Post
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
JUN.14. 2004 4� 50PM KAUFMAN ROOFING ~ �' � — N0. 096— —�P.1i2— •—=---�
N�vv � a °� . � � � � 8�
ADDN ��� C� OF FRIOLEY � E�fective 1/1P2002
ALTER �� 6431 University Ave NE, Fridleyt MN 55432 {763) 572�604 61dg Insp
I� SINGLE FAMILYAND DUPLEXES R-1 AND R 2 �
�
BUILpiNG PERMlTAPPLICAT►ON
s ����� � ��� �
Canstruction Address: � 5 � ��'[ YI(1�. �- � � � � � � �
Legal Description: ,_�
Owner Name � qddress:
Con�tractor. %��i�,�,l �
I.MNG AREA:
GARAG� ARF�;
�'na t l
G�
T�i.
���
MN LICENSE #
�� Tel, # �O%' 7o�a U �o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scaie.
DESCRIPTIOId OF IMPFtOyEM�NT
Len9th " Width i,i, Height , ��Sq. Ft ' �
Length Width ____� Heig�it Sq. Ft
DECK AREA: Length
OTHER:
Sq. Ft
� 3 w
Construction Type: Estirnated Cosk $
Driveway Curb Cut Wdth Neede�: F� + 6 Ft = Ft x$ =$
,
DATE: �-) ' I�"- t APPLiCANT V Tel. #�0 ��- �aa � a�s
��-�-�_ `._.. .
Call (763) 572�6Q4 for Permi� Fees if mailing in applicaticn or F to 763�71-12$��f usin credit card an we will
call you for ca�d number. --�---
CITY USE ONLY - � n��� C��
t�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
D�veway �scrow
�rosion Control
Park Fee
Sewer Main Charge
TOTAL
� ��� e�
$ ' �-
$ � ��
�
�_ .� o c�t
$
$
$
�
� �a• °s
Fee 5chedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50!$1,000 Valuation
�1200 per SAC Unifi
$5,00 (Sta#e Licensed Residenfiai Contractors)
Alt. "A'' a� Alt: "B" Above
$450.0� Conservation Plan Review
Fee Determined by Engineering •
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
^ '��11�1q �14�I ��
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SEP-21—�ea5 11�41 S�HERER BROS LUMBER 7634333341 P.02i02
SEP—�1-2005 11�05 CITY �F FR]DLEY r.ea�a�
BU1�.C�1Sl�g
Inspections
763-572-3604
t�t�
PR�PERTY pWNERI
TE1Ve+�NT
CONTitACTOR
SUBN,IT A COPY OF ,
Y"Gi�R STATt LICEI�SE �
W17H ��FpLICATION
1'!{UP.�.tZL'Y �'�1'�,
��RI'�,iT TY��
TYPE OF WORK:
DESCRiB� WORK BEiNG
SIZ� OF IMPROVEMENT
BUILDZI�TG
�ST��NT]:t�� .A,�PY.ICA��'XON
��'�'X (.�F F�I�T���'
L�
Permit
Racaiv�d $S+:
I�ate R,�e'd:---
�
NaNtE��.1�-2 "t�� l..LtWt �6L. 'TRACM �'�:---,
STAit LICENSfi � a� sxn oArE 3� 3�• a6
.�vD�ss:�l#t� ��t�N �y N 4 ci � STAT� ZIP S'�S ��
r;�u�aE ���� et��• `iti� Fax 7G3-a3g •i°l�l
D 9A3EMFNY E7N1SH O ROOF
❑ DEt:K O SID1Nd
NUh�E7t OF SQu�S
GAR-�G£�5
PROPGSF..D S12E.
PROF'JSEil HEIGHT: _��
S[D1�
G � �ny�
� Nnn►4a+�n
O O+ha
O HQUSE & QARnGB
O ATTACHED GARAGE
O DETAGHED GARAGE
[]SofSc
0 Trlm
❑ Fateia
O DRAIN TJLE
D Ol`H�2
G11 fJ aOw R��+.iT
W1rtDAWS
i?� EXISTRJG OPENlNGS OYca DNa iACATIGN OF WRJDOWS
Uk FflR 27�W OFbTnNCiS-DESCRIEE SJZE OF •
OPA3llJG CH/LNQES &
T1�PF O€ WIi�DGw TOBE NSTqi.��D MTMBER OF �fDOWS
t�,.,. �.��� ��x� s,��:u �►x vtu.v�+,�rYOr�, rrve�,va�az�vc Tz� cosT oF
(U��NG �'k�E 1�97 U.B.0 ��� SC�i�DULE)
� OTr�L JC.1; Vt�.LUA1 ii'►N 5i ���� UCGU�ANC'
Pcrrnit Yee
�{d.rl IV:.VJE �'
$ui'C��E
Fir�t Surehargc
License S�uuurchas�,e
r
SP.0 Charge
L�fb Cut Escrow
�.iGstOil CoAt'i 01
Park Fee
Sewer Main Charge
x'otai Due
I hereby apply for a
r,onformqr�.ce with che
permat but only aA ap
pian in the case of al
SlGMA7URE OF APPLl�
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$AS�T.4%NT REMlOR�i.tNO 9U��i ,
1. ExistinE Flour Plan
1. Proposed flonr plm
3. I.ist of s4vc4+r31 man0crs 6o be nscd
FOR NEtiY CONSTRUG'I'ION tNGLUDP.VG DECKS,
�DD1x� S_A! FOR!'.�s�R c� rsMiT':
1. Sioo Pla�lSmvey sA�Rna d+e ae�sting sas�ure�
9t1A prGyAiod yrajus
2. Two sets of conswution plans
3. Enc,rgyCalculsrionc
AND N�A7'ERIALS:
Se€� Back Page far �ee Schedul�
65% of Build.ing Pcsmic l��e
(.ci005 j cfines che coial job valuauon — Minimum �.50
.001 x Portnit Valua�ian (D/143�b)
SS.00 (S� Licensed Residential Con[s�ccors)
� 1450 pe�x SAC Uait (�I�s co MwCC for determination)
g+6#i= ftx$20-5
�450 Conscrvation Plan Review
t�ee Deteza�,itaed by Engineering
Ag�reem,ent necessary ( ) Non Necessary ( )
MaM: ch�cY:4 Peyable to: Citv oi Fri�lev Ateac
?HIS IS }W APPL1GnT�ON FOR F. PFRM�T-t�}OT VpJ,�D LR�I71L PROCESSED
�rmit and I�cknowledoe [hat rhe iufornlauon above is cotyplete and accurate; that the w�rk wz�l be in
and codes of the Citry of Fridley an� with the Minnesots Contan�uion Codes; cY,at I und�rstand Nis is noc a
� a ermit and work is aoc eo start withouc ,� permit; that che waric will be in securdanee wi�h the approved
Qises revjew andappro�sl afplans.
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Building
[nspectioris
763-572=3604
�A'fE
3ITE ADDRESS .7
tHIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMTf A COPY OF
YOUR STATE LICENSE
BJITH APPLICATION
` PROPERTY TYPE
PERNIIT TYPE
BUILDING
RESIDENTIAL APPLICATIOl�T
CITY OF FRIDLEY
E-MAIL ADDR�SS � V�.J f.� �
O OWNER �'AMRACTOR
PHOAIE: ���" S`i�� ��
STATE LICENS ��.+
ADDRESS: �J .
PHONE �P 5 %" b � /
SINGLE FAMII.Y/NEW CONSTRUCTIi
� O FAIVlII,Y/NEW CONSTRUCTION
❑ BASEMENT FW1SH ❑ ROOF
❑ DECK ❑ SID1NG
TYPE OF WORK: I ❑
—�
DESCRIBE VVORK BEING
SIZE OF IlVIPROVEMENT,
NUIJBER OF SQUARES _
GAItAGES
PROPOS£D SIZE:
PRO�SED HEIGHT:
Permit No.: �j �Lv
Received By:
��F�P 14 07
r� � a.� o�.a� ► v�
. crrsr,� .
F,�x G 5'r— � 310 - Y</oS
SIZE
STORIES
�st�v o wn�mows
�7TLE
T[�R
JG POOL
N
[,II�TG
�.�'C"w� V� a�� M�i6y�
WIDTH � HE�GHT
❑ HOUSE & GARAGE
❑ ATTACi�D GARAGE
O DEfACHED GAR.AGE
G�a �
A�rn SS'�3�
�� z� S�II S�.
Ft.
BASEMENT REMODELWG SUBMIT:
1. Existmg Floor Plan
2. Proposed goor plan
3. List of struchnal members to be used
SIDING . FOR NEW CONSTRUCT[ON INCLUDING DECKS,
❑ Vinyl �Soffit � ADDTfIONS. 8c FORCHES SUBI�IIT:
❑,v��� ' ❑ Trim 1. Site Pian/Survey showing the existing snvctiues
❑ Other . • 0 Fascia and pmpo�d projeck
2. Two sets of consavction plans
W�VDOR'S 3. Energy Calculations
IN EXISTING OPEI�IWGS OYes �No I.�ATION OF WWIIOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WIIQDOW TO BE INSTALLED NUMBER OF�VJWDOWS
ALL FEE BASED QN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
� -. ��.�� �1J �S G E 1 .B.0 FEE SCHEDULE) f� ' . /
TO OB VALUATION $ 09 OCCUPANCY TYPE �1CSl�iw,��,G �
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$ ,5�
� • �0
$ r7 , UZ'
$
$
$
$
CC $
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)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: ity of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building pemut and I acla�owledge 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
pemut 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 1'ch requ' s rev'ew and approval of plans.
SIGNATURE OF APPLICANT � PRINT NAME J e�1n � Wi �it1[� DATE ` I�I p�
Page 2- Buildi.ng Residential Applicataon
_z
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permifs for the erection of any building or
structtzre; or for any a.ddition to any existing building or structure, or for a.ny alteration or repair
to any existing buildang or siruc�ure, upon appl�catiori tfierefore, require the payment by the
applicant for such .permit of fees to th.e amount herein below set forth and i.n the manner herein
provided to-wit: . : . � .
VERIFICATION OF FOUNDATION
Peimits for conslruction will be issued a m.inimum of 24 hours from the time of applicaiion to
allow for proper review of proposed structure a.nd of the construction site.
A Certificaxe of Survey of t�e lot, showing the location of the existin.g foundation will be
required before proceed.ing with the fram.ing, New Houses Onlv
City of Fridley .
Building Inspections Deparhment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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Building PLUMBING Permit No.• 6
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY �'�e�
DATE �� � � V YOUR E-MAIL ADDRESS
STl'E ADDRESS
THIS APPLICANf IS: � OWNER ONTRACTOR
PROPERTY N�: p VI� I�Ir
OWNERI pDDRESS: A I�/w7 STAT��a;
TENANT
PHONE:
CONTRACTOR N,�vtE: � � �
SUBMTf A COPY OF STATE LICENSE # nj puunloi�ng aNd �eati�ng 9-Ne.
YOUR STATE ADDRESS: g174 Isanti St. NE • Blaine, MN 55449
LICENSE WITH pgp� Office: (612) 784-4792 • Fau: (612) 784-9136
APPLICATION
PERMIT TYPE �GLE FAMILY ❑ TWO FAMII.Y ❑ TOWNHOUSE
TYPE OF WORK: � �W �YLACEMENT
DETAILED DESCRIPTION OF WORK � � �� T�Q��S
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
�$TMBER OF EACH BELOVI�
�� BATH SINK/LAV FLOOR DRAINS 1, SHOWER WATER PIPING
= gpTHTUB _ GAS PIPING (N�n crn'LICe�vse) SWIMMING POOL _ WATER SOFTNER ($35�
CLOTHES WASHER KITCHEN SINK �WATER CLOSET BACKFLOW PREV. ($15)
DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IIZRIGATION
— WATER METER OTHER
PERMIT FEE PRUJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OYER $500
Permit Fee $ . Number of fixtures @ $10.00 � x $10.00 = $ (�O —
Surchar e .50 Number of fixtures @$15.00 x$15.00 =$
TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$
State Surcharge = $ .50
Tota1= $ D, Z�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge 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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of lans.
SIGNATURE OF APPLICANT� �� PRIlNT NAME� ���` DATE �Y! ��� ���
PLEASE NO�: SEPARATE PERMI'TS A�tE RE CJ1R�D FOR BUII.DING ELECFRICAL AND MECHANICAL WURK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
3uildin.�g
[nspections
763-°572-3604
763-5�2-4977 F�
�ATE�
iITE ADDRESS _
1'HIS APPLICANT IS:
BUILDING
RESIDENTIA,L APPLICATION
CITY OF FRIDLEY
EFFECTIVE I-1-0S
YOUR E-MAIL ADDRESS
��� 2�
❑ OWNER �CONTRACTOR
PROPERTY OWNER/ NAME: �'� ��+� k � �
TENANT pDDRESS: � L�� � 4^`` ��cSj CITY
pr�nuF� 7�3- S?`{- 1 �73 --
Permit No.
Received By;�
D�����
ATE`"�'1 Z1P S�� «
CONTRACTOR fwDRESS: ���� ''��`�"Q ��y'�'� �� �� ��b�`1�'�'' STATLi"1`1ZIP S�7i�
SUBMIT A COPY OF PHONE �J��'— �3� �� FAX (o�! — 3� �— l S f
YOUR STATE LICENSE STATE LICENSE # a��'� 3�S`'� EXP DATE 3 c�
PROPERTY TYPE �SINGLE FAMILY/NEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
PERMIT TypE ❑ ADDI7'ION u u�+v
❑ BASEMENT FINISH ❑ ROOF
��g ❑ SIDING
❑ SWIMIvI
TYPE OF WORK: I 0 NEW HOME CONSTRUCTION
❑ Mp1NTENANCE/REPAIR
DESCRIBE WORK BEING
OF
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HETGHT:
SIDING
❑ Viny1
O Aluminum
❑ Other
WINDOWS
IN EXISTING OPEMNGS ❑Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPEATING CHANGES &
E OF WINDOW TO BE INSTALLED
GTH
SIZE
STORIES
JSHED ❑ WMDOWS
❑ DRAM TILE
' ❑ OTHER
NG POOL .
O ADDTTION
O REMODELING
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GAR.AGE
❑ DETACHED GARAGE
� � SO Ff
BASEMENT REMODELMG SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be usad.
FOR NEW CONSTRUCTION iNCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT�
❑Soffit 1. $ite Plan/Survey showing the existing structures
❑ Trim and proposed project
❑ Fascia 2. Two sets of consUvction plans
3. Energy Calculations
LOCATION OF WINDOWS
OF
TYP
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHE OCCUPANCY TYPE
COTAL JOB VALUATION $ �� �� �`�
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)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( ) '
Make checks payable to: City of Fridley Attach
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Tn4.�1 ilna
$ � ��.�-
S ( J �� �
$
$
$
$
$
THIS IS AN PLICATION FOR A PERMiT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I ackno ge that e informa ' e is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minneso onshvction ; that I u tand this is not a permit but only an apptication for a permit and work is not to start without a
permit on site; that the work will be in accor ance with th r m the e of all work which requires ' nd a roval ef plans. ,/
SIGNATURE O PLI ANT PRINT NAME .._I ���i � DATE � ��l �
� DATE �ti���
APPROVED BY _
Page 2- Build.ing Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erectian of any building or
structure, or for any addition to any existing building or structure, or for any altera.tion or repair
to any existing building or structure, upon applica.tion 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 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
Faz: 763-502-4977
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�oo �u�swr�:rc av�. s.
60LDfJd V111.LEY. MIiVN.
" MINN1. REfi. NO. 4741
iPiDUSTRIAL — JUDICIAI
COMMERC1/\L — TOPOGit�4PHICEtI
GTY LOTS — PLATTINC�
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We hareby cdvl�fy #tret thie is e true and correct rspresentetion
of a aurvqy oi 4he boutada►ies of. fhs above deecribed land and
+he loxat{on of eN buildinge snd viaP6le encroechments, if eny. (r
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310 Wexford Heights Dr.
New Brighton, MN 55112
Li�ense #20003805 �
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• Structure will l�e 2 x 10 GT
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• Step rise will be 8" max.
�—Fi�i�s�ae�'aic. no��l�n� • Posts will be 6 x 6
• Step run will be 9" min. . �'e�yM Z�
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