AF - 40319�ai�
sue�ecT M
City of Fridley 17 8 8 7
ATTHETOPOFTHETWINS gUILD.ING PERMIT
f ��
' ' RE
� � •
� `y _ COMMUNITY DEVELOPMENT DIV. � / ��
r � � PROTECTIVE INSPECTION SEC.
l1 i �
--_.� �r���,', CITY HALL FRIDLEV 55432 NUMBER REV. OATE PAGE OF APPROVED BV
L 612-571-3450 910-F15 4/2/85 � �
JOB ADDRESS 7065 East River Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt�-.2 R@V. Aud. S11b. �77 SHEET
2 PROPERTYOWNER MAILADORESS ZIP PHONE
Harold Paul 7065 East River Road N.E. 571-1487
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
George, R. Johnson 541Q Girard Avenue North, � Brooklyn Center 55420
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
566-23 51
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
RL'S].CIPI1.'tl.dl
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroo� D�aelling
9 CHANQEOFUSEFFOM TO
STIPULATIONS
Roof can be the second layer but not the third. Insta.11 ridged
galvanized valleys.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(;, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. �SPha�-t
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZON�NG SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IP CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �- STAL�S GAFiAGES
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 $],�ZOO $.GO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- y�`2O. SO
S U TION OR THE PERFORMANCE OF CONSTRUCTION.
� P N CHECK FEE TOTAL FEE
I ��11��16 $2�..�.�
S�GNATURE OF CONTRA OR AUTHORIZED AGENT IDATEI HEN PROPERLY LI TED THI IS YOUR P R IT
YP` � �
SIGNATUREOF OWNERiIF OWNER BUILDERI IDATE� BLDG INSP AT
NEI�I [ ]
ADDN. [ ]
�,T�t. I ]
Construetion Address:
Legal Desaription:_
Owner Name & Address:
Contractor:�
Address:�
LI9IAG AAEA:
(iARAGE AREA:
DECB IIREA :
oTx��:
City of Fridley
R-1 AHD R-2
Building Permit Application
Effective �/1/84
# °-2 �
Attach to this application� a Certificate of Survey of the
lot, With the proposed construction draWn on it to scale.
DESCRIPTIOP OF II+lPSOYEi�NT
Length Yidth Height Sq. Ft.
Length Yidth Height Sq. Ft.
Length liidth Hgt/Ground Sq. Ft.
�r�. �%`'�`' d 1-�t r��'' �i �1�'� ��� 11 i�� s� s�r t�r/�
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
Type of Construetion: �'��d� °�r�G � � � �� Estimated Cost: � /� o`�
Approx. Completion Date: - I °�'���
Alt. A Alt B
�
Proposed Drivevay Width If NeW Openiag Is Desired: � a
See Back Page for Explanation
�ATE
; f Q�- D 1 APPLICANT: Tel . � / `� � �� ° �
Permit Fee
Plan Check
State Surcharge
3AC Charge
Park Fee
Sever Nain Charge
?OTAL
STIPULATIONS:
CITY QSE OALY
� �0. S� Fee Schedule on Reverse Side
� 25� of Building Permit Fee
a � O �.50/�1,000 Valuation
� �425 per SAC Onit
a Fee Determined by Engineering
�
a f ( Q Agreement Necessary [] Not Necessary []
�
�'a `
t
BIIII.DING PERl�lIT FEE SCHBDIILE
The Chief Building Official shall� before issuing permits for the erection of any
building or structure, or for any addition to any euisting 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 belrna set forth and in the manner herein provided to-xit:
Total Yaluatioa
=1.00 to =500.00
�50,.0o to a2,000.00
�2�001.00 to �25�000.00
�25�001.00 to �50,000.00
Fees
�10.00 (l4inimum Fee is �15.00)
�10.00 for the first a500 plus �1.50 for each
additional �10d or fraction thereof� to and including
�2,000.
�32•50 for tbe first �2�000 plus �6.00 for each
additional �1,000 or fraction thereof, to and
including a25�000.
�170.50 for the first �25,000 plus �4.50 for each
additional �1,000 or fraction thereof, to and
iacluding �50,000.
�50,001.00 to �100,000.00 a283•00 for the first �50,000 plus �3.00 for each
additional �1�000 or fraction thereof, to and
including �100,000.
�100,001.00 and up
��33.00 for the first a100,000 plus �2.50 for each
additional �1�000 or fraction thereof.
DRIYEIiAY DEPRBSSIOA ESCRO�i
(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 replaeement of curb and gutter and install a 3 foot Wide
approach with 6 ineh depth - DriveWay width plus 6 feet times �15.75
9ERIFICATIOA OF FOUNDATION
Permits for construction Will be issued a minimum of 24 hours from the time of
application to al1oW for proper reviev of the proposed structure and of the
construction site.
1 CertiPicate of Survey of tbe lot, shoWing the location of the foundation once it
has been aonstructed will be required before proceeding With the framing.
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CHIMtJEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (,)
,
Z. Is free from rust or deterioration Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported Yes ()
5. Meets all current Code requirements for size and
tctal BTJ c�:���eeted
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Com pa ny
Signed By
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CHIMr�EY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney o r stack;
1. Has been carefully examined Yes (,)
,
2. Is free from rust or deterioration Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported Yes ()
5. Meets a11 current Code requirements for size and
total BTU connected
6. Has Total hea ti ng BTU' s of
All other BTU's
TOTAL
Rema rk s
No ( )
No ( )
No ( )
No ( )
Yes ( ) No ( )
Com pa ny
Signed By
Da te