AF - 40606�
n
City of Fridley, Minn.
BUILDING PERMIT
_st _28, 1959
Date : ............�---...._.. ---- -• --........._---•--••-•----.......-••-•-----�--�--•�---�--.._...._..
Owner: .... �.��.._�,��e.._....__....---•---......--- .................... Builder ................_SB�e
Address ..._7235 __�R8$ . $�.99T_..R08t�.__......_. ---• ----.- Address
. ......---� ..............�------�-� -
N° 41'74
LOCATION OF BUILDING
rro. ......?23�� ............... Street .--EelB�---R3V@T... R09�.................--�--......................_................ Part of Lot .............................-•-�----............._...............
....................
Lot ..._......_..... ---......... . Block ......................................._............ Addition or Sub-Division .._...�•.:_�...�...bt....�V�.._�............_.._............._.
Corner Lot
Sewer Elevation
Inside Lot . ......_�..... � ......... Setback ........... ....._....................... Si�eyard
..........................�---............ ........-----...... -� .......... Foundation Elevation ........---�--....
DESCRIPTION OF BUILDING
To be Used as:
Detsched
..�� ...... ...........:.......... Front - � -....�.5 t... Depth . .2�.=.._.. Height . 1Q.�...... Sq. �t. .__.3.3...O..:t_..
........ ..................... ........... ......... Front .:..::.................. Depth ..._................... Height ............:. ....... Sq. Ft. ........... .......
;, �nnn
Type of Construction ...........�&� ............................ Est. Cost......x�T±.•00........................ To be Completed
cn. Fc. 3.�00 �-
Cu.FL ........................
In considera.tion of the issuanoe to me of a permit to construct the building described above, I agree to do
the proposed wo�k in accordance with the description above t forth and in pliance with< al1 provIsians of
ordinances of the city of Fridley.
.
' • -- �- ---- ------.. .. .. __�•• •-._.. . .... . ..._ ............._..............
In consideration of the payment of a fee of $.......�F!� permit is hereb
.............., Y 8z'anted to....--------.......... --....... �------.._..._..
....._-----�----....-•-�-�---------��--�•-•-.---��---�.---� ............. to construct the building or addition as described above. This permit is granted Upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all reapects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and maving of buildings
within the city limits and this permit may be revoked at a�y time upon violation of any of the provisions of said
ordinances. _
Building Inspector
NOTICE:
This p�rmit do�s dot cow� fh� eonskuNioe, imfallation for wiring, plum6i�, q�s hNfhp, awK w waler. � wn M a�
fh� BuiWing InspeeMr for s�paraN p�emits for fh�se iNms.
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APPLICATION FOR BUILDING PERMIT
CITY OF �IDLEY, MINNESOTA
Ownera Name �G 7-e ✓ - NS/�� Builder_ J Ah/ �P
, _. �_. .
��'ess � ; �02- �'7 G ,� ' , %f�i Addr'es8 . S/�/i� LF
.l,�--� --T
�-T"... ... . .
. .. ,'.i.�...... - � � . . � - � . �
"= �� : � `: . LOCA�ION OF BUILDING � : .
No. %� ��S Street �, ��1��_p,� ,�,� Part of Lat .,�Q' �/�
Lot.�- `-'-:° � Block . Addition or S�b:Div. (�
Corner I�ot Inside Lot�Set ,Ba.ck Side-i�ard .
SEWER ELEVAT�ON FOUNDATION ELEVATION
�P�-iiaa�i�: attach
lo��ctri`,`
:i.:. . . -.
ta t�is forYn Certifica.te of Survey of Lot and propo�ed building
DESCRIPTION OF BUII�DING
To be used as: �G�G�'� .
�
_ F`ront �,5 Depth_��,..�-_,Height : / c�
sq ;�t: . �3 a cu. Ft. , -�+3 � p . ._
s-..
Front Depth Iieight
Sq. Ft. Gu. 1�. ,
:i.:i�. =i:;..... _ . � � �' �
T�►pe o�'- Construeti�n�_fj ,;�� �--Q Estimated Cost �
To be,� completed_ �r'�' ., ,/'/� -�i� ,� y/r - . `� : � ,
The undersigned hereby makes application for a permit for the �ork here�.n specified,
agreeing t�o do alI work in strict accordance with the City .O�di�ances and ruliz� of
ihe j?apa�tm�nt af Bu3:ldingsy: 'and hereby 'declares that. all� the facts and represdnta-
tions�,,sta� .;� `thi� applica�ion a�re true and correct. � •"
.��.� � /q
DATE . `'� �' � " � / SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
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BUILDING PERMIT F'E�E SCHEDULE
Section 2. The Inspector Qf Buildings shall, before issuing any permit
for the erection of any building or structure, or for any addition to
any existing building or struciure; c�r for any alterations or repaire to
any existing building or structuref upon application therefor, require
the pa.yment by tY�e-�applic�nt for; �t�c�: permit_,o� fee9 to the amount
herein below set �tif���; �� in 't�� �ner �'t���e��i provided to-wit:
2.1 For ar�y such perrnit for the ereCtion of any f3.Y`eproof building,
--° -- ��- �- �-e���er-..�ban_..a.,_g�age�warehat�s�,,. factory or grai�n elevator, or for the
� ..
erection of any fireproo��addition;���for���3.�:�:a�'--occn�cy.,_, to any ;._;; -
�:�:��.�
°~~�� --••-----���i.�g__bui�,�;�.r'ig, sh�ll .be� at�, _the rate of $1.40 for each one thousand
� � i� thereof,.i.n such et�bical .contents.. ---.___._..._._.. {`-;,1
cubic feet or fra cti.o
2.2 For any such permit fitir -t�e ere�tio�?`.':o,:f any fireproof garage, ware-
house, factory or grain elevator, or for the erection of any fireproof
.._.....__. .__.. ..__ _....
ad�i�iori; ""for siinilar occupa.nc�,. .to,. any existing building ,sh�.11 be at t e
rate of �1.25 for each one thousand cubic feet", c��:ssi�ied�--a-s� "��'�e�Z'-Qa�n ;`
..__._.___.. ...._ _.__- --
by �ec�ton 502 of th��Minneapolis Building ode. ., ;,
._...._._<--- ;-�.;.._:I�ITSES` : ,.: ,•.: , _ , �
. .�.a ...
_. _.._....__...._ .............
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2.3 For any su.ch. }�extait for the erection o�`��ariy "�on-fireproof buildi�g �� �3
.._.._.. _ _.... ..._...._ _.. _____. . ,.
other �Yian ��--garage; ware�ouse; factory or grain eleva. or, o�_ any
_ • -- - -�.
;_,:.:
.; 3�o�n��irepr�o� addition, for similar occupancy, 'to° any" ex�sting tiu3�ding-.;�`��=
Permit �1.00 for each orie tY�ousand'cubic fee.t. , .. ,
. . . ��,::.,.._ :.;
. � •4 � � � � � � . � , - . . . _ . � . . ".') a.
GARAGES ; _ ; . ,, , . . � �
2.4 For any such permit for the execti0n •f any non-fireproof garage�
warehouse, factory or grain elevator, or for the erection of any nori-
fireproof addition, for aimilar occupa.ncy, to any,:existing b�i�:ding..:ox; ,-
��-�--° -- --• --€c�-�a�Ii '��h.. building o�c ,addition. Ninety Cents for each one
. ..
thousand cubic feet 'or fract3on �thereof, in tl�e ��ubical .contents thereo
__._.__._.. .___._.. _. ...--
with a minimu� of $4.00.
.. . _. .
_ .. ._......
, �
____.... _ .... _�__.. . ;
-�- ---- --�---� -�-For- the p�'pose of computi.�g fees for building perm3ts the cu'�icai�� ��
..
contenta of any building or addition to--�� unifor�,..�eight throughout y
multip•lying the ground area covered fro� a point six (6) in�'hes b�elo�t""" `� ��"
the fl�or line of the base�e-n�t- or � cellar •�o the • av�ra�e height of the
.. ,
���° -- - -� - - -.. ...wgger._sux'faee<��o�;;.�:to -the. average height of the roof surface of ��ie main � �
gable of a pitched roof. � ' � ' � � � " ` ' '
_ ____ __ .... .... .__.._..._...
- �---- - -.. .
. .. .... .... ... . .
2.5 For repairs or a1�eTa�ions to- an exis-ting .structure, tki�, fee ..�h�., „
�' `� b���t�t'�e rate of.�3,00 for,each Five Hundred Dollars (�500.00), or
- ' `� f`rac�'ion;_th�reof :�n �he cost of all propos:efl work. � . .. . ,:: �.:,,.
_. . . .. _ . .,_� . ..� .- . ,'. ,
2.6 In no ease sha11, the _fee charg�d `for �any�'�er-�t.,as �set -�s�x'th i�n
Section 2 be less than �1r.00. " ' � � '� . _
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SUBJECT � 129�1
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � CEIPT
� �
COMMUNITY DEVELOPMENT DIV.
f � L � PROTECTIVE INSPECTION SEC. 7��C'J��
� �
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1
i-_•• � /'�'1'� CITY HALI FFiIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV
L � � � , 612-560-3450
910-F15 4 24 75 � �
JOB ADDRESS 7235 East River Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 5, 6 1 Hillcrest Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZiP PHONE
Donald L. Lennox 7201 East River R�ad N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE IICENSENO.
$ ENGINEER MAIL ADOHESS ZIP PHONE LICENSE NO.
8 USE OF BU�LDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDlTION IX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK addlllg.
Fini.sh ara e b sidin and overhead door
9 CHAN(iE OF USE FROM TO
STIPULATIONS
� SEPERATE PERMITS REQ�UIREi� FO#� VNIRiNG,
HEATING, PLUMBING ANO S���fS.
SEPARATE PEHMITS ARE REQUIRED FOR ELECTFiICAL, PLUMBING, HEATING, TYPE OF CONST: OCCUPANCY GROUP OCCUPANCY �OAD
VENTILATING OR AIR CONDITIONING. WOOCI �aIIIC
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 SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT R I.
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT,,, yS`300.00 .SO
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 THE PERFORMANCE OF CONSTRUCTION. „ S.00
"' PLAN CHECK FEE TOTAL FEE
$5.50
i tArUREO:CON7HACTOROR THORI2EDAGENT �DnTEI WHEN PROPERLY VALIDATED THIS �S YOUR PERMIT
2�f - S �A� I Q (.�pt�,,iZ "
SIG � UREOFOWNERIIPOWNEHBUILDERI IDATEI BIOG. WSP DATE
a�
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
GITY OF FRIDLEY, MINNESOTA
' LD • �
�WNER S NAME: ��rt �� c�{ • /BUI IIt. G�.,C _ , ,
a�nnxESS :1�� � � �c� �• ADDRESS :
NO :.�. 3 S^ S TREET • b�� 1..�Z-LV�i� (/ 1 b�
��
LOT : � �' � BLOCK : � ADDITION : �/��iLe�-�� F�y � r
� � �n-t,
CORNER LOT: INSIDE LOT: SETBACK: SIpBYARD:
Apglicant aCtach to this form Ztao Certificates of Survev of Lat aad proposed
building 2ocation drawn on these Cert.ificates.
� HESCRIPTION OF BUILDING
To Be Used As:
Z Froat: Depth: Height:
Square Feets Cubic Feet:
Frant: Depths Height:
Square Feet; Cubic Feet:
Tgpe of Conatruction: �,(� o-�-cQ � Estimated Costt $ 3 6 d •
To Be Completed: _�
�_
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, aad hereby
d�eclares that all the �acts and regresentativns stated in this a�plicatioa
are true and correct. �
�ATE : `` - 5'• SIGNATURE : '
�(See Reverse Side For Additional Information.)
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erecCion of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs 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 hexein provided to-wit:
tJNIFORM BUILDING CODE: Z�pe 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contenCs. Type 3& 5-$1.85 for
each one thousand cubic feet. �
ADDITIONAL INFORMATION
For the purpose of camputing fees for building permits, the cubicai: contents
of any building or addition, is determined by multiplying the ground area
covexed from a point six (6) inches below the floor line of the basemenC i
ox the cellar to the average heights of the upper surface or ta the average �
height of the roof surface of the main gable of a pitched roof.
�or repairs or alterations to an ea�isting structure, the fee shall be at the -_
rate of $3.00 per each five hundred dollars ($500.00) or fractioa thereof in '�
the cost of a11 proposed work.
In no case shall the fee charged for.any pexmit as set forth in Section 2 be
' less than $5.00.
VERIFICATION OF FOUNDATION
NOTEt Permits for construction will be issued a minimum of 24 hours frain the
ti.� of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the founda.tion, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used. or occupied until a Certificate
of Occupancy has been issued.
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FIRE QEPARTMENT MEMO
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T0. BUILDING INSPECTION
ASSESSING
SUBJECT: FIRE DAMAGED S7RUCTURE DATE: 7/18/90
FiRE HAS OCCURRED AT
7235 E. River Rd.
DD E
7/18/90
DATE OF F E
FD-7
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ADURESS
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N° �,:�u550
����� `. � . �.
�S �r_, ��.f�2 .
OWNER " �O �
BUILDEf; �
OATE �-��/�� PERMIT NO.
DESCRIPTION
_ �'� �1 �'i � �
INSPECTION RECORD
DATE REPORT
�-� t. � fi �,.1 ri rJ f�.. ('� fa+'�,
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OWNER �Ep �yhQ Q�,�,LS ' ' ECTOR
�..
� M � UiRI'r�
%
J
, i
sue�ecr PER .
City of Fridley w���NG 2 6 9
' , AT THE TOP OF THE TWINS ����;� p E R M I T RECEIPT N.
r
� �
� ; y __�___ COMMUNITV OEVELOPMENT DIV. �J
r � � PROTECTIVE INSPECTION SEC. 3 /�'3 %
`---- � �����;•� CITV HALL FRIDLE� SS4$2 NUMBER REV. OATE PAGE OF APPIi0YE0 BY
i �� 612-571-3450 910-Ft5 3/13/90 / /
JOB ADDRESS '7235 East River Road N.E.
t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACMEO
DESCR. Pt. 5, 6 1 Hillcrest SHEET
2 PROPERTY OWNEFi MAIL ADDRESS 21P PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Herbst & Sons 2299 County Road H, Mounds View, MN 55112 784-8510
4 ARCHITECT OR DESIGNER MAIL AD�RESS Z�P PHONE LICENSE NO.
5 ENGINEER MAtL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res iden tial
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Wxeck 560 sf Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Remove �oundation � Site to lae leveled unless nernt hczuse to be
constxucted within ane yeax ^ then basement excavat�.on can be
gxaded w.ith 2:1 slo�e.
SAC ch�rge to be credited when new house is construc�ed.
TYPE OF CONST. OCCUPANCY CaROUP OCCUPANCY �OAD
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBINCa, HEATING.
VENTILATING OF AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS OF IAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING Of A PERMIT
DOES NOT P SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PROVISION F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $1S. QO
STRUCTIO R THE PERFO CE OF CONSTRUCTION.
�( �" e� PLAN CFIECK FEE TOTAL FEE
,/� � / � �� $15. Q.Q
SIGNATUHE OF CONTRACTOR OR AUTNORI2ED AGENT IOATE� yy N PROPERIY ALIDATED TNIS IS VOUR PERMIT
� SiGNATURE OF OWNER iiF OWNER BUIIDER� IOATE� • BLDG �NSP r1 TE �
[ ] M��
X) wreckir�g
•,• ��,� i=--
N - .-,. � .���
• � / •;• ` Y:r�l'�� Y• •�
I�dl D2SG7'1pt101']: �i �
04�►17eY' & AC�1�2SS : �'1 � #
contractor:_- � 2�5�% �` � a.�S �e1. # rl��-/-�10
A�dress • o� � � i)l�State Lacer�se #
�U �
HUII�II� y��"''�
L1.VIIKJ Ared: I£Il�l _� � W1CIt1'1 � HelC�}'lt SC;. F't.
Garage Area: I,�ngttz �j Width � Height Sq. Ft.
Other: Iex�gttz width Heic�t Sq. Ft.
d
� � � ���
♦
r ity �•. •'� � :� � �.��
CU. Ft.
Estimated Cost of Wrecking/Mavir�q Approx. Oa��letion Date
1 �:r_ �� :i- , �/1��:���l,
City Water/Sewer Mpls. Gas Co�aany Northern States Pdwer Northwoestern Bell Z�el Cb.
571-3450 fiCi 372-4720 [) 566-9120 [] 293-0665/293-1319 []
�
Water Bill Paid: Yes [� Amount Zb Be Cbllect:ed [$ '- D� ) Initials �L '� ._
V
Mwirig Route:
FEES
Mavirig: Principle Building into Fridley .
Aooessory Building into Fridley .
'Ih�x�h, within or out of City .
. . .
$ 80.00
$ 20.00 lr+'L*+��++�*� Fee: $15.00
$ 15.00
Wrecking: For each 1,000 c�bic feet or fraction .$ 1.25
For structure.s which wduld be impractical to cube, the fee shall be based on the
total cost of wrecking at the rate of $6.00 for each $500.00 or fraction.
The undersigned hereby makes ap�lication for a peYm.it to wreak,/move the building descri.bed
ai�we, agreeing to do all werk in strict aocordance with the City Ordirianoe,s and rulings of
the Building Departme,nt, arid the State Oode which requires water well on the P�Y
to be sealed by a State licerLSecl watex well driller, ar�d declares t all facts and
representations stated in this ap�lication are true ar�d oo .
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CSI��IIJSY AND 8'1'AC1C VBRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes �) No ( j.
2. Is free from rust or �deterioration � Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
.m .
4. Is securely supported � Yes (�j No O
5. Meets all current Code requirements for
size and total BTU's connected Yes ( j No ( j
-- S. Has total heating BTU�s of '
. �A11 other BTU�s � � . �
TO'i'�1L B'I�'s .. .
Remarks
Lisf Alterations Beinct Done•
HEATING COMPANY ,
Signed By
Date
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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 DIV.
r � v �� PROTECTIVE INSPECTION SEC.
� �
� � �"'1 � CITY HALL FRIDLE� 55432 NUMBER pEv
�"'""� � ,�� 612-571-3450 910-F15
JOB AODRESS '7235 East River Road
t IEGAL �OT NO. BLOCK TRACT Oq ADDITION
DESCR. S� S, All 1 Hillcrest
2 PROPERTY OWNER MAII A�ORESS
5teve Roggenbuck
3 CONTRACTOR MAILADORESS
Roggenbuck Custom Built Homes 514 78 Ave NE, �
d ARCHITECT OR DESIGNER MAfL ADDRESS
DATE I VAGE OF
11/22/93 / /
22244
RE EIPT NO.
�(3�
APPROVED 8Y
SEE ATTACHED
SFIEET
PHONE LICENSE NO.
Park 55432 786-7875 6E
ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res i den tial
7 CLASSOFWORK n NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
`1S
8 DESCRIBE WORK
Construct a 38� x 24� D�,s-elling and a 20.� x 22�
9 CHANGE OF USE FROM TO
STIPULATIONS �rov%de Cit� wi:th.verifying survey before capping� Provide sod in the
�ront and side �ards� k'rovide a li.ard surface driveway. Existing detached garage
must be removed �x�n site or a Specia� Use Permit approved for a second accessoYy
building be�ore germit can be finaled. See notations on plan.
WATER & SEWER IACATT�TS: See City Enginecring Department
w�R����
Before digging ca1! for
all utility iocations
454-0002
REQUIRED BY LAW
TYPEOFCONST. OCCUPANCY GROUP ' OCCUPANCY�OAD
SEPARATE PERMITS ARE REOUIREO FOR EIECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OFi ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STA�LS
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPUEO yS`�4FQQ(a
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMiT FEE
PROV�SIONS ANY OTHER STATE OR IOCAL LAW REGULATING CON- $612. SQ
�TF,tUCTION ' THE P RFORM��O�CsONSTRUC� License SC $S.00
X
S�GNATUAE OF
D AGENT
IDATE�
FT.
OFFSTREET PARKING
IGARAGES
SURTAX
$47.00
SAC CHARGE CREDIT
Fire SC $94.00
TOTAIFEE
$758.50
:D TNIS IS YOUR PERMIT
rTEW
ADDN
AI,TER
[l
[l
IJ
Coa�truction Address:
Legal Description_
Oarner Name
� �,�i�r• �t �
Address: ��5�
�Bu<<.
2
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Buiiding Pe,rmit Application
�c�
,�i4S7� /v� .� �.� - - - -
��r�
ess: �7
-'' C�CI `
�?l?�` /�v
a ���
�� � 19��
\�
�
Effective 5126/93
� 4c�
- - --
y�G at ��r 5��I/.�. o f 1� i� �1,� /�/itc.���-sT �J�ti��� C'�
� Tel. # ��� "%�i�
�' o� E'.v �c.c,�
' ixu �7Ti� `���GT �•�n E� MN LICENSE ��
�iL S�,�io� `�,C�F ��;�� Tel. �` v�'Sy.3 Z
� ��� ���s--
ach to this applicati�, a C'�ficat,e of S�rvey of thern�N . 912 x(s4,31�2.45)
with the proposed oon�ruc�iton drawn oR it to scale.
'SPUT % �112 x i32,Eb t2�45)
DESCRIPTION OF �OVEMENT t�w� : �r'� K�f�' )
�/�� (�G�1�GCc�`'iu CsA(� s '�4 xC1lo )
LIVINt'�r AREA: Length Width Heig�t Sq. F� �'l � U �
GARAGE AREA: L.ength Wi�h I�eight S9- Ft. �i � /
AREA: /� Width H Grouad Sq. Ft. �� �
DECK Length �l/ 8d
OTHER:
Corner Lot [ j Inside Lot [ j Ft. Yd Semack Side Yatd Setbacics.
Type of Construction: Es�mated Cast: � �-�"r�` `�'¢ C� �
A�rox. Completion Date:
(Cost on Back)
Driveway Ctirb Ct�t Width Needed: Ft. + 6 Ft = Ft x S =�
DATE: �DU�� APPLICANT: S��E'` ��� E'`,��� Tel. #"�DG-��%s—
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Snrcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TUTAL
�
S.
$.
�,
$
S
$
S,
S
lZ,�c�
, DD
� -QO
�
�Oa
._..,
. ��
�1�� �/�o ���1%1� /
� �o ��9 g �3-��
Fee Schedule on Reveise Side .
.001 of Permit Valuatioa (1/lOth9�� -
$.50/$1,000 valuation
$750'per SAC Unit
$5.00 (State Liceased Residetrti2�1 Contractois)
Alt. "A" or Alt. "B" Above
Conservatian Plau Review S4S0.00
--- Fee Determined by EnginoerinS
— Agreemeat Necessary [ ] Not Necessary [ ]
S,��g;=�- STIPULATIONS:
�
�
.
,�3dtd�
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall; before issuing permits for die erection of any building or structure,
or for any addition to any ezisting building or strucdire, or for any alteration or rep�air to any eaisting
building or stivcture, upon application therefore, require the payinent by the applicant for such permit
of fees to the amount herein below se� fozth and in die manner herein provided to-wit:
TOTAL VALUE
$1 to $S00
�501 to $2,000
y"1,001 to 525,000
$25;001 to $50,000 - .
�50,001 to $100,000
�
$100,001 to $500,000
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first �500 plus S2 for each additional $100 or
fraction thc�eof, to and including $2,000
$45 for 5rst �2,000 plus $9 for each additional $1,000
or frdction thereof, to and including $25,000
$252 for first� �25,00p pl�s $(.50 for each additional $1,000
or fr�chon thereof, to. and including $50,000
$414.50 for first �50,OOU plus $4.50 for each additional
$1,000 or fraction th�eof, to and including $100,000
$639.50 for fnst 5100,000 plus $3.50 for each additional
$1,000 or fiac�ion thereof, to and 'wcluding $500,000
$500,001 to �1,000,000 � $2039.50 for the first $500,000 plus $3 for each addition.al
,$1,000 or fra.dion thereof, to and including $1,000,000
$1,000,0p1 and up $3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof -
DRIVEWAY DEPRESSION ESCROW
(co� c� sa� 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 gut�ter and install a 3 foot wide .
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued� a minimum of 24 hours from the time of application to allow
for proper review of the proposed stiucture and of the construction site.
�.� ,
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
construct.ed will be required before proceeding widi the framing.
.
.,
Energy Code Average U Calculation �a�us�
for Residentia! Buildings 3 Stories or Less
Site Address � 2�� �, l�(,�1[-(L 1f�-17 - �
Ovmer � � - Date — °t 3
Contractor or Designer �(L o� C� E N B u ��- 1�.1 STO r-1 �-o Nt E S
Address Phone
, ...,:.. .
Tius worlcsheet is for use with the 1989 edition of the Model Energy Code with Mimesota amendments adopted May 6,
1991. It is intended to determine compliance with Chapter 5 of the Model Energy Code� Component Perjormance Merhod.
Step 1 Determine U-Values of Building Assemblies:
Above Grade WAII Sectioa
R Vulue Framing
Extsnor Air Film 0.17
. (o I
- 2, t�co
In � / (�i�
�iL` i�i�
.'1�
Inte�ior Air Film 0.88 -
•� R�„ - i o.�4
U� i l/R�,�. _ �
Band Joist w►d Bs9emeat WaU Section
R-Value lnsulation
. Exterior Air Film 0.17
�
VIN�P� ,�I
3 UI l.T�-t tL 2. D(�
�1 . �. Vl
'12" s R , �+S
r t— Intenor Air Fiim 0.68
I�..,.,,,.' ZZ.qI
, 0 Z U;,�,.;,,, = 1/1�..,,e,� _. 0¢3
; �
:__._............_.__._., �
❑ 16" O.C. Fr�uning: (Q..iS)x , o �3 + (0.85)x ,�
OF
❑ 24". O.C. Framing: (0.10)x � + (0.90)x "�
'[1.,�' .oSo� -� Line 1
, P�.vr..l.
!` „` ��, �
. , .s.� '�
A�4' 4� •'.
o� 4 � Q �'-4,��
.�d- -
.�, wp,
.�
Rre.r.ao...r '
2 r� �
� -I l
�t¢�
R Value
Extsrior Air Fiim 0.17
V1►iv � _ (� I
Zxlo
1�
�
2.�
,S9
19
Interior Air Flm 0.68
"r— I�,,.,;a,. = 2�, �-1(
U��q� i 1• �i�Y)pi 3 0 �
♦
. _.
Line 3
�R��a�
� � G�SS p� G�wr,�
Pv��l
,. �
n
0
` Energy Code Average U Calculation cM�e�po��s�
for Residential8uildings 3 Stories or Less
J
Site Address
Ovmer � �,— . Date a 3
Contractor or Designer RO G G E1� $ t,e U� G� 5 Tv r� �+ o i..1 �S
Address Phone
RooUCeiling Section
R Value Framing
Ext�rior Air Film 0.81
2 � �f F�.n,��a '�, 35
+ Inouladon o� top �Z
. S6
Interior Air Film 0.81
tt6i�„�3 3 8 �!3
:-
•�Y
�
R-Value Insulation
Extarior Ai► Fdm 0.81
���.�o� q-4
S/� 5 � . S'�
Intarior Ai� Film 0.61
�_ �S,?�
/�� _ .
[J6.�,� ° 1"'��t �2(0?' ;._...._._............_...._._ ..............._._._._..........,- U�..r..o. ° l�..r.�. .OZ.I
a �6M o.C. Framing: �o. �s�x � +co.as�X [� .._......._._.......__ ................ .. .............. ............ _ _. . ...
or �
❑ 24" O.C. Framing: (0.10)x .pp� +(0.90)x , 0196 :U,o,�,�.,�„' ,D2L2 --- Line 4
CathedrAt Ceiling Section
R Value Framing
ominp —.
Intefior Air Film 0.61 -
� �
,1�
r
Uc�.m.s s � • '�/ �
❑ 16" O.C. Framiag:
or
❑ 24" O.C. Frapring:
. 5)x � +(0.85)x U
(0.10)x r�� +(0.90)x ��
� U�, _ - -._......
�..
" R Value Insulation
— Ext�rior Ai� F'ilm 0.81
I rwulation
Intsrior Air Film 0.61
jt, _ . s
'Lwlwa� �
U;,.r.e.. = 1/I�...,�„� _
J
Energy Code Average U Calculation �ea�us�
for Residential Buildings 3 Stories or Less
Site Address
Ovmer Date
Contractor or Desiener G C� �N i3 uG� .
Address Phone
Step 2 Determine Allowable UA Values:
Allowable UA�� ��, Calculation
Totsl A� p„ (gross waU area except basement walls havin 50% or more of
their area below grade) � � �' x<- ... .. ...... .. . Line 6
Allow�ble U�,,, value for Minneapolis.......... o.i i <..... ... ... . Line 7
A��U (mulhply Line 6 by Line 'n I 9`�' � a I E- _._ .................._._............. Line g
14ti„u ........ '
Allowable UA��� CA1Ctl171i�OD
TotalA�,� ...................................................
Allowsble U� value for Mimsapolis...
3. Allowable UA,�a,,,� (mWtiply Line 9 by Line 10) .....
2 �' x <- ........................_....__.... Line 9
o.o2s <-._._..._ ........................... Line 10
Z , S�� <-._._............_._._.......... Line 11
Step 3 Determine U Values a,nd Areas of Windows and Doors
List window
Unit Quantity
�
2
3
4
5
6
to be installed: — 5��
W indow Type .
List door t es to be installed:
Unit Type Quantity
I I 2� S
2 1 30
Door Type
T�;"�'L P ►�-0
„ .,
A�a u�t�D
Location Area Total Area U-Value UA Value
(p. n.�ch �mit) (.0 oow) (1'aal An. a u-vap�s)
Y
�
�
+
+
+
+
+
Total ------ - -
Total Wiadow Area ZI 3�9 � Window UA ( 02 . Z ;
_.__ ............._._._._... ......._._...........�... Line 13
Area Total Area
cw. a..ce uo�> c.0 uoaq
I � �,3�
U-Value
,D"�(
UA Value
(r�,u� �r«,� u•v.a.�
I, 3��
21, ' + 21.� 0 l + l. S3�O �
Total _ _ L•�ne 14
Total Door Area Q-( R= Door UA 2� � �
-�-�-.........._._...._._..........._...._._..........� Line 15
Page 3 �
w
- r
Energy Code Average U Calculation ��e�,�us�
for Residential Buildings 3 Stories or Less
Site Address
Owner Date
Contractor or Designer CL v l,� la�"�LJ � �,c.c.�c-
I Address Phone
List sk li ts to be u
�
Unit Type Quautity
1
Z
Skylight Type
����
__-_
-�-_-
Total Skylight Area
Total
Gnht UA
U Value %�'
fraalArw u.vap,e> .
+
Step 4 Determine Actual UA Values:
Actual UA� Calculation
Entcr U�,,,, from L jpg j on page 1 of this workshset ................................................. , ps0 S
;
Enter A� M„ fran j,jpg� on page 3 .......................................... l? � 1� �
Subt�ract total wiadow area (Gom jrjpg,� from A�� .... . 213,
Subtract total door area (from Ljp�� from A -�� �
.o...0 ........
= A,,,,,,, = I 51�. X. oso
J
, . �L�ne 16
:_._....... �i�
J
- vA,„,,,,, - 17, oZ
Enter U from ' on e 1 ofthis wor�sheet �� `- Line 1g
• ►..;.� I.ute.� paB ........................................... p
�
F.uter perimeter of band joist ia feet ............................................ �]
,
Muldply by height (R.) of band joist .................................... x �
��
• ' "lW�,,;. � 8r 7 X /, %%p
Actusl UA�„�..�, � Ut�;,,,M + UA.�,�, + Up�,,,,�„ + Uq,,,���
D2.2 +�(�+L..Lr•���+��coi =
jr1�C..�.� j.11l�.� Jrl�$ jrll��
P�� a' ,
' U�°►a..�,,,�' !.9 %�
;_. L��
�8 i��
� L�ne 20
:...._._............_._ .................._...._ .. . �
.J
�
Energy Code Average U Calculation �e��u,�
for Residential Buildings 3 Stories or Less
Site Address
Owner Date ` °I3
Contractor or Designer Ro C, ��N gu��
Address Phone
Actual U�� Calculation
Enter U„„uWN.. �� L1�4 on page 2 ........................................................................
Enter A���.�;.. &om Liug.4 on page 3 ...........................
................. 9. Z
Subvact cotal skylight aroa (from Line 1� from A��,��,;� �_�
Actud UA��,�,� = Up,�,�� + Up�� s
2�. Z + C—�� �
Liue.21 Li�1Z
s` 1w iooGewliy ' J6 3� 2 X
,eZZ
Z�.82
' L1A,.�� = ZI ,8 Z. .__._.._. Line 21
2l, SZ ._._._............_._...._ ..............._._._. . ..._._._._._. L��
� Step 5 Compare UA Values and Determine Compliance
Allowable UA�, value fran j,jpC.,$ Iq�f, SI ._._._............_._._._ ................._._................._._...._...........
..._...._.....__ ..............._.
Actual UA value firom yjpg,jQ I�N, �� _._._.........._......_...�.�_ .............._...._._.
.................. .. ..._..........
�.. ............
�
L�ne 23
.L�ne 24
If ].jpg,�4 is less d�aa or equal W L10e,�, the above grade wall systems are in compliance. See note below.
AllowableUA value from �----.__......._._._._ ..............._._._._............_......._._.........._._. Line 25
.n....�«w.� Liogll •• ZH, S1g ...... ..........
Actuxl UA value from ( 8 Z ._._._ ................-�-�-.k". ��ne 26
Lin�?1
2 .__...._ ................................_...._ _..._.
... ..
n.. .«r.� ....... �
If j,jp�„�¢ i� less than or equal to j,jpg,�� the roof/ceiling systems are in compliance. See note below.
NOT�►: Compliaace u dw acbeived if 1ha wm of L�i.2��d 1�1�6.2i ir ka t6as or eqwl w t6e wm of y�,js aad j,�j�.
Ra..+.u....r � j+l0�� .................................... �Q ,
For foundation walls insulated fuU 1�bt, this valiu must be S or more.
For foundation waU insulated only to t6e froat line, tlus value must be 10 or more.
Slab on Grade R Valuea
Heated alAb (heat ducts or pipes imbedded in stab) value from ener�y code table .....
Un6eated slab value from eoer�y code table ..............................................................
Installed R value must equal or exceed value entered.
Page 5
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C[IYOF
FRtDLEY
FRIDLEY MUMCIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
May 6, 2002
Maxweil Luebeck & D Wolfe
7235 East River Rd. NE
Fridley MN 55432
Re: Paved Driveways
Dear Property Owners:
In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance.
They were declared a public nuisance for a numbe� of reasons, such as: they can cause
erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the
City's storm sewers and detention ponds. When g�avel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadline is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002.
If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at
the Anoka County Courthouse. A misdemeanor citation is a criminat offense and is punishable
by up to 90 days in jail and/or a$700 fine.
If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so 1 can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, if you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any other questions, please feel free to call me at the above number.
Sincerely,
Stacy St mberg
Planner
C-02-53
_
_
C[TYOF
FR[DLEY
FRIDLEY NtUNICIPAL CENTER • 6431 UNIVERSITY AVE.1�1.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-128�
July 2, 2002
Maxwell Luebeck & D Wolfe
7235 East River Rd. NE
Fridley MN 55432
Subject: Paved Driveway Reminder
Dear Property Owners:
This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by
December 31, 2002'.
As you are aware, the City Council adopted an ordinance declaring gravel driveways a public
nuisance. They were declared a public nuisance for a number of reasons, such as: they can
cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in
the City's storm sewers and detention ponds. When gravel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadline is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*.
If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, if you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any othe� questions, please feel free to call me at the above number.
Sincerely,
Stacy S omberg
Planner
'If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Moka County Courthouse. A
misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine.
C-02-83
Building
Inspections
763-572-3604
DATE (O'' I '��i /U
srrE AnDxESS rl 2
THIS APPLICANT IS:
PROPERTY
Q ♦� �N
TENANT
CONTK�►CT�R
SUBMIT A COPY OF
ypUR STATE
LICENSE W�
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDI�EY
YOtJR E-MAI
E�.s�t-_ � i �re�
� OWI�JER `�pNTRACTOR
. . � �.
LVHIVIL. � C�
ADDRESS: 2-- $ C7 �o
�r 2 �
PHONE:
Permit No.
• - - - . : .,!.�
. ,'� . 1 , ` : 1 I
A'
NAME: (.,117���'1E3C� DATE � �-- - l �':7
STATE 1-ICENSE # Chamnion C� STATE Z�
�D�S. 651-365-1340
o d Rd. #100 F,�
PHONE -----
ii1'YL1l.N 11vt.
�SINGLE FAMILY
❑ TWO FAMII-�' ❑ TOWNHOUSE
PERNIIT T�E
❑ �W C�4tEPLACEMENT
TYPE O�' WO�:
DETAILED DESCRIPTION OF WORK
's a minimum of $15.00 or 5% of the total cost up So $5� h�a reflect onl�y the cost of labor )
PER MS 16B.665 the permit fee i excluding the fixtu�'e (
improvement, installation or replacement of a residential fixtiu'e, X.OS =_,__
Labor cost under $300 =$15.00. Labor cost between $300 to $500 � P� ofF 1��' �C �� NOTED
FOR PROJECTS W�� �OR EXCEEDS 5 5 0 0, F E E S A R E B�� O N $
NCTIv�ER OF EACH BELOVI� — SH��NG pppL
FI,OOR DRAIIJS
BATH SINK�1-AV GAS PIPING fNF.En cm"��� — WA�g �,OSET
BATHTUB WASHER KITCHEN SINK "�WATER HEA'PER �$35)
CLOTHES "— �UNDRY TRAY W p� METER
DISHWASHER — —
permit Fee
TOTAL DUE
�g�s: (�NDICp,TE TOTAL
WATER PIPING
WATER SOF'I'NER ($35)
BACKFLOW PREV. (S15)
FOR IRRIGATION
_ OTi�R
Number of fixtures @ $10.00 x $10.00 = $____---
$�._•� riumber of fixtures G� $35A0 X$15.00 =$�.—
Number of fixtures @ x$3 5.00 =$_._
$ � � State Surcharge = $�?�
Total = $ —
THIS IS AN APPLIC?`T10N FOR A PERMIT NOT VALID UNru- PR 10�E�S�E�D accurate> tliat the work will be in
ermit and I ackno�'ledge that the information abov�ts cnmp �� I�derstand this is
I hereby apply for a building p of Fridley and with the Minnesota Cons�uction Codes;
for a ermit and work is not to start without a permit; that the work will be in accordance with the
conformance w�th the ordinances and codes of the City lans.
not a permit but only an application P roval of p ��p
approved plan in the case of all work which requues review•and app ` j,,,,,�„ S%,� _�il� jQl� DATE — 3'V
�'"1 li?'�� .. I� PRiNT NAME .�" r uci ls�
�
SIGNATURE �F AI'PLICANT a 1
City of Fridley
Building Inspections Depart� 55432
6431 University Avenue NE, Fridley,
763-572-3604
F�,X: 763-502-4977
-� 2�.1� `�
�
Building
Inspections
763-572-3604
763-502-4977 FAX
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-09
DATE � 1 a'� 1 V-1 YOUR E-MAIL ADDRESS
SITE ADDRESS �a3 5 � � (% �. �
THIS APPLICANT IS: ❑ OWNER OCONTi2ACTOR
PROPERTY OWNER/ I NAME: �� � V
TENANT ADDRESS: n
CONTRACTOR
SLJBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
Permit No.:
Received By�/ V�
Date �: ,-� pl N
� r Q i� CITY �r� ��/ STATE l�(/ ZIP 5 S�/,
G �o
NAME:_ �G �,.1 Gt @.r �L' � (!� �j�it, . I GtC' f _i
STATE LICENSE # �^� EXP DATE
ADDRESS: � I�i � Y l kft SOv� � Ud CITY�fin 24�0 � C(S STATE �)�IP SS �/3
PHOD� 7� 3-�/S� - a73 o Fax �3 yS �-G� 3�
H SINGLE FAMILYMEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
PERMIT TYPE ❑ ADDIT[ON
❑ BASEMENT FINISH
❑ DECK
TYPE OF WORK: ❑ NEW HOME CONSTRUCTTON
❑ MAINTENANCE/REPAIR
DESCRIBE WORK BEING DONE: �CG, / o' �G
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yes �No
OR FOR NEW OPENINGS-DESCWBE S[ZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INST;4LLED
❑ GARAGE/SHED
❑ RQDF
6'SIDING
� SWIMMING POI
S1ZE
STORIES
O WiNDOWS
❑ DRAIN TILE
❑ OTHER
❑ ADDITION
� REMODELING
!� c u !� f SiGiQ
❑ HOUSE ONLY
❑ HOUSE & GARACE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
u � � �.�.� � O�'L ��
HEIGHT SO FT
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
OSof�it ADDITIONS_ & PORCHES SUBMIT:
0 Trim L Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of wnstruction plans
3. Energy Calculations
LOCATION OF WINDOWS
NUMBER OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
fOTAL JOB VALUATION S �� C � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ 5v
$
$
$
$
$ �� !o TI
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$21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks pa_yable to: City of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and [ 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 rmit and w�erk°'is no start without a permit on site; that the work will be in accordance with the
approved plan in the case of alr ork uires review d approval of plans.
SIGNATURE OF APPLICA�i'� ,.-� y PRINT NAME C� G,. r� nQ�^-c—( (.0 �DATE '�C.�, n a g^ a/
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 15` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2 000
$2,001 to $25,000 $69.25 for 15` $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 15t $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 15` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $ ] 00,000
$100,001 to $500,000 $993.75 for 15` $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 151$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 for the 151$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: 763-502-4977