AF - 41123n
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Ci.ty of Fridley, Minn.
BUILDING PERMIT
! �
N° 6698
d�;:
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DatB: % �
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Owner:
Addresa Address
,�.�.�, �
TIO � ��JI�.�DING
No. 6�.�i�- str+eet l�-, _ % „��,,:; r/ j� � Part o� t�,
Lo�t _ Block � Addition or Sub-Divisfon , �
��
Coraer Lot _�� Inside Lot — Setback .,�� Sideyard ��<�-��� —
Sewer Elevatian
Foundation IIevation
DESCRIPTION OF BUILDING
� � U � � � Front �,,i�. Depth ;,;� Hei�ht �� Sq• �''�. � � � F�+���
�- t Depth FTeight S9• F't. Cu. F't.
Type of Constructfon � F�t.-C�.,���� -.� To be Completed
Cy���
In consideration oY the issuance to me of a germft to construct the building descrlbed above, I agree to do
the P='oP�d work in accordance with tt►e d�scrlption above aet forth and in compliance with Provisions of
or�iinancea oP the dty oP Fiidley. �B s
G�/
In cons4deratton of the payment of a fee of ��`�, Permit 9s hereby graated to
to construct the building or addition as desccibed above. This permit is granted nPo�►
fihe express c�ndition that the person to whom ft is gi�anted aad his agents, emPloyees and workmen, fn s11 work
dane in, around end upon said builciing, or anypart thereof, shall cwnPorm fn all reapecte to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maiatenaace, repair and moving' of bufldings
wlthin the dty l3mits and tt�ia pernzit may be revoked at any time u �o Qn of aay of the provfsions oE said
ordlnaac�s. �1. n p/ /
Buflding Inspector
,^� NOTIC�
'llds permh doss nof ea�sr t6s eoeslrueNon, 6utatla�toe ier rrietag, plum6te9. 6as 6saNng, sav�r or wdsr. B� �ora fe as
Nn Bulldie� Insp�e�ar fer apuab �rmtfs fe� �h�a hu�a.
, �, ..
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
s� �
OWPdER ° S A]AtKE $UILDER
ADDRESS ,ADDRESS
LOCATIOPi OF BUILDING
.
No. ,� � � � Street
Lot���Block Addition or Subdiviai
Corner Lot Inside Lot Setback S
SEWLR �LEVATION FOUNDATION II.E�ATION
t of Lot
F]
Applicant attach to this form.l'wo.Cert,ificates of Survey of Lot and proposed build-
in� location.drawn on theae Certificates.
DESCRIPTION OF BUII,DING
To b, u ed 8s; � '
Froat � Depth Height ,
Sq. Ft..--,���Cu . Ft . �� f�.��
Type of ConsCruction
To be Completed
Front Depth Aeight
Sq. Ft. Cu. Ft.
Eatimated Cost
The undersigned hereby makes application for a permit for the work herein specified,
a�reeing to do all work in"strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facte a�d
representations atated in this application are true and correct.
�
i
n�� sic��� � -�`���� ��
(schedule of Fee Costs can be found on the Reverse Side).
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BUII,D?NQ PEItMIT FEE SCHEDULE
Seation 2. �he In'spector of Bu3.ldings shall, before isst�ing any permit for
�he erection of any building or structure, or for any addi�ion_to anjr ex�s�-
in� bui.lding or strucCure, or for any alterations or repaigs to any'e�is�ing
bu3lding or srcrv.cture, upon application therefor, require the payment by �he
applicant for such permit of feea ta the amount herein below set forth and
in the manner herein provided to-wit;
2.1. For any such permit for the erection o.f any fire-proof buildit�g, othe�
than a garagei_warehouse, factory or grain elevator, or for the erect�Con of
any fire-proof additioa, for simi.lar occupancy, to any exiating buildin�g'
3ha11 be at the rate of $1.40 for each one thousand cubic feet, or frac�3on
s:hereof, in such cubical contenCa.
2.2. For any such perm3t for the erection of any fire-proof g�rage, warehause,
factory or grain elevator, or for the erectioa of any fire-proof a�.ditioa,
for similar occupancy, to any existing building shall be at the r�te of $1.25
for each one Chousand cubic feet, classified as 01fireproof" by Section 502 of
t�ie P%�tnneapolis �Building Code.
I-SOUSES -
2.3; For any sucta permit for the erectioa of any non-£ireproof buildiag other
than a gara�e, warehouae, factory or grain elevator, or any non-fireproof
addition, for similar occupaacy, to any existia� building - permit $1.40 far
each one thousand cubic feet.
GAItAGES
2.�s. For any such permit for the erection of any non-fireproof �arage,
warehouse, factory or grain elevator, or for the erection of any non-f��egroo�
addit�to,n, €or similar occupancy, to any existing buildiag or for each such �
bu�.iding or �ddiCioa - niae�y cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thexeof with a minfmum of $4.00,
For the purpose of compu�ing fees for building permits, the cub3cal coatents
of any building or �ddition to a uniform height throughout by multiplying t�,.e
g�ound area covered from a poimt six (f.) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the
average height of the roof sur£ace of the main gable of a pitched roof.
2.5. For repairs or alterations to an exis�ing structure, the fee shall be
at the rate of $3.00 per each Five I3undred Dollars ($500.00) or frsction
thereof in the cost of al.l propased work.
2.6. In no case shgll the fee.chargad f.or any permit as set forth in
Sectian 2 be leas than $4.00.
---- -----+ - - n - . n
�-��-,-- �. - � - = - -� ---- - -�- -�_:�-_ __- _ �.-,o
HARVEY A. CARTWRIGHT
ANOKA GOUNTY BURVt1/B
M[NN�PIN COUNTY SURVEYS
MINNEAPOLIi su�vEr�
eOtO PALM BTREET N. W.
suMee, 4•�ess
owwcw
INDUiTIt1AL — JUOIGIAL
BU8INESS — TOPOGRAPMICAL
CIT• LOTS — ILATTINa
CARTWRIGHT & OLSON
LA.ND SUR i'EYORS
RlOIlTtR[D NND[11 LAWf Oi •TATt OR MINN[60TA
LICiNilO •Y ORDINANC[ pi CITY OF MINN�APOLIf
326 PLYMOUTH BUILDING FEo�tA� 8-6721
HENN6PIN AT SIXTM • MINNEAPOLIS 3. MINNESOTA
�arbtpor'�c QcrtitKatt
COMBINING TMt R[CORDS 0/
J. E. NILL, Cwi� ENOINE6R
csrwousNeo �ps--
C. F. SANDHOFF
CIVIL ENGINElR
69TABL18N6D IYO�
JAMES NELSON
__ - Suevsrow
csT�ausNio �ou
METROPOLITAN LAND
SURvE1rOR8, csTwo�isNeo ��e+
� ! 13 L ' ; �; - ���' ,� `��' �: .
I hereby ceriify that this is a true and correct rapresentat3on of a aurvey
o �': �
Lot 12 and 2�, Block 9, Spring Broo3�: Pas�:
?s surveyecl by me this 12th d�� o`' Lu�ust, 1953.
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SUBJEC7
City of Fridley
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
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f ; y___.__; COMMUNITY DEVELOPMENT DIV.
� � PROTECTIVE INSPECTION SEC.
1 = i
� �"'t � CITY HALL FRIDLEY 55432 NUMBER
�._--� � �'� si2-5so-3a5o 910-F15
JOB ADDRESS
1 LEGAL ��T NO. BLOCK TRACT OR ADDITION
DESCR.
2 PROPERTY OWNER MAIL ADDRESS
4 ARCHITECT OR DESIGNER MAIL ADDRESS
SAI� -
5 ENGINEER MAILADDRESS
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION
8 DESCRIBE WOF;K
garage ro�f repai`r
9 CHANGE OF USE FROM
STIPULATIONS
REV. DATE PAGE OF
10/5/t6 � �
Brook Park
ZIP PHONE
ZIP PHONE
I
Z�p PHONE
ZIP PHONE
�
PE T NO.
r. i3807
REC T NO.
�'�s �
APPROVED BV
SEE ATTACHED
SHEET
IICENSE NO.
LICENSE NO.
LICENSE NO.
❑ ALTERATION l� REPAIR ❑ MOVE � REMOVE
TO
� u4��� ��� VV1��1�'" �
,=`�A.��- �°=��;vi1TS ���
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TYPE OF CON57.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �� OOO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 7� CJO
STRUCTION O HE PERFORMANCE OF CONSTRUCTION.
� —� PLAN CHECK FEE
,- . �� � �'� °� 7
SIGNATURE OF CONTRACTOR OR AUTHORI2ED AGENT IDATE) WHE PR�
e _
OCCUPANCY GROUP OCCUPANCY LOAD
S�. FT. CU. FT.
OFFSTREET PARKING
STAL�S GARAGES
SURTAX
.50
TOTALFEE
8. 00 ="
T S IS YOUR PERMIT �
a �,,
�ATE �
.-fr�
CITY UF FRIDLEY
APPLICATION FOR RESI DENTI�iL BU ILDING PERMITS
�NEI�J, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER' S NAME : � � BU II,DER : �, �i r �G -,�/�a�l���,-�:�..�
ADDP.ESS : "' � ADDR�SS :�z ���� �'iy� /1I4�
NO : . �l%4 � STIt�ET
LOT : � � .S� BLOCK : _ 1j ADDITION : �J / NC�= lS'�OU � ���c
CORI�I�TER LOT: � INSIDE LOT: S�TBACK: SIDEYARD:
Applicant attach to this form Tsao Cextificates of Survey of Lot and proposed
building location dratan on these Certificates.
IiESCRIPTION OF BUILDING
To Be Used �s ;
�(� {'��,g° ¢� Fxont : a T Depth : � L' Height • % �
ROUP' �+�Q��' ' Squaxe Feet; �g Cubic Feet:
Front: Depth: Height:
Squaxe Feet; Cubic Feet:
Type of Construction: � 121�`v1E� I� Estimated Cost: $�[O�O. 0�
�To Be Completed: {'/ l.�' % � � �
The undexsigned hexeby ma.kes applicativn for a pexsnit for the work herein
specified, agreeing to do all woxlc in strict accordance �aith the City oi
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
axe true and corxect.
! �
DATE : l" COI �� • S IGNATUI'.E • CO/ r
(See Reverse Side For Additional Information.)
��riLr'►n e�' �%, a��
R � �iD �.00
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}3UILDING P�I2MIT PE� SC1iEllULE
SECTION 2. The Inspector of Buildings shall, before issuing pennits for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
bu3.lding or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount hexein below set forth and in
the manner herein provided to-wit: .
1�iEW CONSTRUC'�zON: Si.ng],e Family Homes and Garages: $A�.00/1000 cubic feet
PLAN CHECK: 25 percent of building permit fee.
ADDITIONAL INFOR1��iATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches Uelow the floor line of the basement
ox the cellar to the average heights of the upper surface or to the averages
�height of the roof surface of the main gable of a pitched roof.
r
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five fiundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $7.50.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
time of application, to allow for propex review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the foundation, 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 �ccupancy of any structure for �ahich a building permit has been
issued; and said structure shall not be used ox occupied until a Certificate
of Occupancy has been issued.
�
,.
3uilding
`nspections
763-572-3604
�ATE___'i�
;ITE ADD
i HIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLE�
YOUR E-MAIL ADDRESS
�OWNER OCONTRACTOR
Permit N
Received By:
Date Rec'd:
PROPERTY OWNER/ Np�: e j��q n �'�l� �
TENANT ADDRESS: �iC9C�e� � �i'vrsr� l�Us•Il� C1TY_ �T�S47L1�.�_STATFJMi�IP��
PHONE• L�i�`��-_ � �l�(—`7 ��
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATTON
STATE
EXP DATE
ADDRESS: CITY STATE ZIP
PROPERTY TYPE ��GLE FAMILY/M
0 T6V0 FAMIL.YMEW
PERNIIT TYPE 0 �DITION
0 BASEIvIENT FD�iISH
O DECK
�rYrE oF woRx: o �
DESCRIBE VdORK BEING DONE:
SIZE OF IMPROVEMENT
O ROOF O DRAM TILE
O SIDII�IG ❑ OTI�R
❑ SWU�IlvID�G POOL
WIDTH HEIGHT
F�
xcwr-uvc; U tiVUJb VNLY
NUMBER OF SQUARES �� �OUSE & GARAGE �ASEMENT REMODELING SUBMIT:
GARAGFS O ATTACI-IED GARAGE 1. Existing Flaor Plan
PROPOSm S1ZE: 0 DETACf�D GARAGE 2' Pr°posed fl°°r Pla"
PROPOSED HEIGHT: 3. List of strucdual members to be used
SIDING FOR NEW CONSTRUCTION INCLUDIIJG DECKS,
0 Vinyl OSoffrt ADDITIONS. & PORCHES SLBMTf:
❑ Alwninum ❑ Trim 1. Site PlanlSurvey showing the existin� strucwres
❑ Other � Fascia end P�P�d P�l��
WIIVDOWS 2. Two sets of com�ction plans
II�l EXISTII�iG OPENWGS �Yes ONo LOCATION OF WINDOWS 3. En�gy Calculations
OR FOR NEW OPENII�IGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WII4DOW TO BE IIVSTALLID NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING TI� COST OF LABOR AND MATERIALS:
TOTAL JOB VALUATI N���� a�� B•C �E OCC[JPD ANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Co�ltrol
Park Fee
Sewer Main Charge
Total Due
$
$
$
$
$
$
$
$
$
$
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)
$1550 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
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PRQCESSED
I hereby apply for a building germit and I aclmowledge that the information above is complete and accwate; 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
percnit but only an application for a erm� and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of al! work wha v' �a proval of plans.
SIGNATURE OF APPWCADI7�� � ��� � - PR1NT NAME Cyf�f� i� �°j M� N DA'fE 7����J (�
f` �-' o'
Page 2- Building Residential Application
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any a.ddition 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 farth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Permits for constzuction will be issued a minimum of 24 hours from the ti.me 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
$uilding Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977