AF - 41667/
� City of �ridley, Miinn.
� BUII.DING PERIVIIT
Date: . . . . .�:'�;'. . �. �:-: . . . y,�:--. �,�, . .
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A/�/��p� �� • Builder -�-'�''�
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• •������i������������• �LL�a.qO •���i������•
L�AT�OIV OF BUILDING
. .,�� f .•�
No. . . . .� . street . . .�',''����/ � ,���%
'^'"''�'�' ' • , ,�,./�,,� �
LOt . HIOCI{ �..�`e `r;. .'�/,�,�{; , P81'� OP I.O�
..�/.�.:... ..:.......... Add�on or \
C�rner Lot . . .�,1F. . . . . . . L�side Lot . . . . . . Sub-Dfvision . . ,�
. ...... . Setback . �,;�: :.?i.� Sidey
�ESCRIPTION OF BUILDING
TobeU �:
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- -�' .. ... �a
FTOIIt � r � �.,,,� �� s 1I
�° J
� 3960
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•�������������.������•
�'''��'s�r.r�'• - • Y •� •.�. . . . . . . .
'd ...����.-p ..:...........
. .. .. .. .. .. .... .. .. . ��nt . . �,� � � . ......� IIeight �� �,� Sq, Ft. .a�. �.� Cu. F't, ,�/�f�
�'Pe of HeYght '�
ConstruC13or1 ... .... ... . .. .. . ... A9t. CoBt�,: j�;��;'� •�'.�°'_•'•' To be Cern„�e+e,a• . G�' Fk ... .. ...
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il
Itt conaideration of Yhe issuana tfl � of a per�t � construct the buildin
� Propased work in accordanc� �� �e • g de�ribed above, I
ordinanc� of the dty oP Frldley. d�P�ion above aet forth and in compllance wi �e� �O do
th all provisions of
.e� .................. .............................
•. In consideration of the payment of a fee �,—•.••..
� a• .�• .� ., P�mit ia hereby 8ranted
.. ° .................. td� construct the buildin8 tion as d ........
� :..........
the express condition that t�e or addi escribed above. This Pe�n�it is �n
done in, .around and ui�on :said � n�o whom .�t L grante�l and bia a8eirts, em lo �ted
Fridley, Minnesota re �, or�au3►.Pa�t the�eof, shall conf p Yees aad woi�p�, �� work
in the �'�1S ioeation, . construrtta�� alteration, �� °� in all respects to the ordi�ces oi
ordfnances. �� and this. Permit may be .revo]ced at anY time u�olation of any of th� �f �
�
�rovisio��o �
NOTICE: � , � "�_ `
This permit do� not oove� ihe oonstruoUon t
�ewe� o� wate�, t���atton o� alteratton ior wiMnp� plumbiep� a� b��n�,
Be su�e to eee the Buitdln� lnspeotor for ae
parate pee�nits to� these ttems •
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APPLICAT�ON FOR BI�ILDIlUG PERMIT
CITY OF FRIbLEY, MINNESOT�
Owners Name � � Builder
Addreas ���•�����,-. � . �ddress _.
" � �LOCATION OF BIIILDING � ' • " . � �.
No. Street � '���P��^�-�.P�t af Lot ..._._. � � . .
Lot,��'B3ock . �iddition or Sub. Di.v. ���• 1�
, L t : . � side Lo� Set �,ck � .��"'�°
C�rn�r •
Applicant atta,ch to thi� form Cer.ti�icate of Stsirvey.of Let and proposed .;.
building location. - - . � �..
. � �• I�ESCRIPTION OF BIIILDING � . . . • . � . . -
. , .�.� • , . .
To be ' ussd as �: ., ' . . � : �, •
� ' Front �' � .-- Depth��eight � . .
� � �_� Cu. Ft. - .
; . . - . -Front Depth � N-�ight
_ .. , .
�� Cu. E't. � � � ' .
Sq. Ft. � :..
'Type of Construction ,��ot�r � Est3.�ted Cost ° � � o ..� .
To be comple�ed . � ��"� . .
The undersigned hereb� makes application for a permit for the�work '
herein specified' agreeing to do�all work in strict accordance with the
City Ordinances a.nd ruling of the.Departr.�ent of Buildings� and hereby •
declaxes tha�E a11 the ft�cts and representa.tions stated in this applicat,ion
are true and correct. • , .
�O — ����1 � .tD�' � .
I�.te. � � � `3 � Signature
(1 Sch�edule of Fee Costs can be found on the Reverse Side).
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" B�i3LbING PERMIT FEE SCHEAD�LE "
Section 2. The Inspector of Buildings shall, before issui-ng any permit
for the erection of any building or structvre, or for any addition to
ar� existi�g building or�_structure', or for any alterations or z�epairs to
an� existing building or structure� upon application therefor���require
the pa�ent b� the applic�iist for such permit of fees , to the amo�t
herein below aet forth and in the manner herein provided to-wits
2.1 For any such perrait for the erection of any fireproof building,
other �than a garage,� wareYiouae, factory or grain elevator, or for the ,
erection of any fireproof addition, for aimilax occupancy, to any
e�cistz.ng building sha.Il be at the rate of.-°��,40 for each one thousand
cubic feet, or fra ction thereof, in such cubical contents.
�..2.2_ For any such permit for the erection of any fireproof garage, waxe-
house,� factory 'o'r grg'in' elevator; or � far- the erection of any. £ireproo,f
addition, for similar occupancy, to any existing building.�s��, b�,at the
rate of �1.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneg.polis Building Code."
HOUSES �
2.3 For ariy.such per�it.ior the erection of ang non-fireproof building
other��'than -�. ga.�age, iaarehouse, £aetory or.Y:grain elevator, or any_
non-fireproof addition, for aimilar occupancy, to any existing�building.
Permit �1.00 for each one thousand �ubi�-feetR :� ,,�
�----- - . . , -
�ARAGES . . - . ., _ . . . .. - ., . ; ,
2.4 For any such permit ior the erection of any non-fireproof garage�
wasehouse, factory or grain �levator,- ar.�ox� thE erection.of_any non- .,
fireproof additiqn,,.for,aimilax occupancy, to any existing�building or
._ . �..
.
for eacli°'S�ich `�built�irig'-or additio�: -Ninety-Cents, for each �ne.:,
thousand cubic feet or fraction thereoi� in the cubical contents thereof
with a minimun o f �4.00 e _ : .._ _ _ : � . , � ,:
For the purpose of computing feesofo� building �erm3ts�the �uhic,a7.,,
. co�tents of any building or addition to a uniform height throughout by
multiplying the ground ar�a. covered fro� a point six (6): iri�hes�below
. the.flPOr line of the,basenent or cella.r to the average height of the
_, , _
upper sizrface or� t'o the av2rage height of'. t�se r_oof surface o� the ma�_
., ,.gable of a pitched roofe �
2.5 For repairs or alterations to an existing structure, the fee shall
be �.t the rate of �3 000 for each Five Hundred Dollar's� (�5�•04), , or� :
__. fraction thereof in the cost of �.11 proposec�- work,
_. ._ ... _ ..
2.6� In no..case aha�l the fee ch€jrgec�`�dr-a:riy=�r�� as �set for.�h in
Section 2� be less tliair �I�.OQ; � - .
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[�EAT LOSS y, CULATIONS ���� 9 DEPARTMENT OF BUILDINGS NIINNEAPOLIS. MINN. ;
Weatherstrips A.S.H.V.E. Construction No. Insulation !
Guide
Win ws Do rs Reference Out. Wall Int. Wall Ceiling Roof Floor Kiad How Applied
Y —No I No 19—
Fl.� Room � Length /Width � Height Fl.) Room Length Width ' Height �
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �'
�Vldth Helght No. o[ Lineal f. A[ea Wldth Height No. oY Lineal ft. Aiea
No. of pane of pane lighte o[ crack eq. ft. No. o[ pane o[ pane llghta � ot crack eq. ft. �
� � �. � 2�' 8..� � � � .� � / �'Y. ��, �
Inhltration '� � ; � '
Glass � , �
Exp. wall � �4 ,.�
Net exp. wall � � �
Int. wall
Ceiling %� ?'i
Floor / �' �� �
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl,� � Room � Length ,� Width��
Windows and Doors—Crackage and Area
Wldth Hetght No. ot Llneal ft. Area
No. ot pane ot pane Ilghte ot crack eq. tt.
2- � � 3 � �
In6ltration 3 '�
Glass
Exp. wall / '�. �� � �'° / 6 �
Net eap. wall
Int. wall
Ceiling ^� �
Floor � �s �j/ °�j
Total Btu.
:Zequired sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. „r�,,. Room � Length � Width
Windows and Doors—Crackage and Area
Width Height No. ot Llneal ft. Area
No of pane oY pane Ilghta o[ crack sq. It.
�Q �� � �- • � �%7. �
Infiltration � �� ',��'�'
Glass �i�
Exp. wall � d ^ �' ,Q
Net exp. wall �
Int. wall �
Ceiling ' � � Z ,'�
i�loor � ^ �'�� �
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. ader area
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Infiltration $ �'
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Net esp. wall 'y' �
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Ceiling f��P,� ' � �'
Floor B./ �
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.� � o Room � Length `� � Width
Windows and Doars—Crackage and Area
Wldth Hefght No. ot Lineal tt. Area
ot pane of pane 1lghta ot crack eq. ft.
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Infiltration
Cslass -
Eap. wall � Z
Net exp. wall
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�ef. Btu
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Fioor '��'&�' �' �''' ��' '�3 `� !
Total Btu. � � `� ��
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
� FI.� Room I Length ,�6��dth /J '���,Height �%
Windows and Doors—Crackage and Area
Wldth Height No. of Ltneal [t. Area
No. of pane ot pane ►lghts of crack aQ. tt.
0 ��' �� � �' ��„��
Btu
` �` � Infiltration
� Glass
Eap. wall '�
��'Q Net eap. wall
Int. wall
;b � � Ceiling
'� Floor ,�
� �" � TQtal Btu.
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IRequired sq. k. E.D.R. or sq. ins. W.A. l.eader area J
�=�� ,�oR dea�t,� ����
. D•rb� �79 i
HFAT LOS�CA�.CULATIONS ��% 9�� DEPARTMENT OF BUILDINGS MINNEAPOLIS. M1NN. I
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows ( Dooys Reference Out. Wall Int. Wall C,eiling Roof F7oor Kind How Applied
1` o Y�e�No 19—
'j�.� Room � Length � Width Height Fl.� Room Length Width Height ,
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area '
�Yidth Height No. o[ Llneal ft. Area Wldth Het66t No. o[ Lineat tt. Ares
No. of pane of pane Ilghte o( crack aq. ft. No. of pane oY pane llghte of crack eq. tt.
Z� � � �� �
Infiltration
Glass
Exp. wall � Q � i
Net eap. wall _
Int. wall
Ceiling � 1 9�
� Floor
Total Btu.
�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
^�FI.� Room ( Length � Width
Windows and Doors—Crackage and Area
Wldth Helght No. oL Lfneal tt. Aree
No. o[ pane ot pane Ifghte ot crack eq. ft.
�L ?i `,� 1 2� 3 � � �
In6ltration
Glass
Exp. wall '%.0 9• �
Net esp. wall
Int. wall
Ceiling � a. � %1
Floor
Total Btu.
Btu
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4� Windows and Doors--Crackage and Area
Wldth Helght No. ot Llneal [t. Area
No. ot pane of pane Ilghte ot crack eq. ft.
e�i �L� � �'� ?.�'
Coef. Btu
lnfiltration "� �P
Glass �� 0 e��
Exp. wall ' ',� �. ,� . �
Net exp. wall "Z.. j � �-� 7 b
Int. wall
Ceiling
Floor
Total Btu
2 � ��� / � , �
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sq. ft. E.D.R. or sq. ins. W.A. Leader area
Btu ,
Infiltration
Glass
E.Sp. wall
Net esp. waU
Int. wall
Ceiling
Floor
Total Btu.
Required sq. k. E.D.R. or sq. ins. W.A. Leader area
FI.I Room � Length Width
Windows and Doors—Crackage and Area
�Width Helght No. o! Llneal tt. Area
No. ot vane af pane Ilghte ot crsck a9. tt.
In6ltration �
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Glass
Eap, wall
Net eap. wall
Int. wall
Ceiling
Floor
Total Btu. '
Required sq. k. E.D.R. or sq. ins. W.A. Leader area ��
F7.� Room I Length Width Height
Windows and Doors—Crackage and Area
W1dth Helght No. of Llneal It. Aree
No. of pane of�Aane lighte ot crack ea• tt
Coef. Btu ,
Infiltration
Glass
Eap. wall
Net ezp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. k. E.D.R. or sq. ins. WA. L.eader area
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560-345U
�6,�C'� O .��'{-��e
� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE April 25, 1975 FRiDLEY, MINNf50TA 55421
H. L. Bordeaux
8115 East Ri.ver Road N.E.
Fridley, Minnesota 55432
Re: Change of House Numbers
Dear
It has been necessary for this office to change the address
af your house
FR029 8115 East River Road TO 8106 Fairmont Circ].e N_E__
LEGAL DESCRIPTION Lot 4, Block l, Bourdeaux's SprinQ�Brook Addn.
We have notified the Post �ffice Depaztment, Minneapolis Gas
Company, Northern States Power Cor.►pany, Northwestern Bell Telephone
Company and various departments in City hall. of this change.
DGC/mh
Sincerely,
DARREL G. CLARK '
Co:amunity Development Adm.
f
560-3d30
�� � �����
� �
ANOKA COUNTY
6431 UNIVERSI7Y AVENUE NE ANril 25, 1975 FRIDLEY, MINNESOT.� :i543�
Minneapolis Post Office Department
Superintendent of Delivery
1st & M�rquette Avenue
Minneapolis, Minnesota 55402
Re: Change of �iddxess
City of Fridley
Gentlemen:
We are listing the following change of address in the City of Fridley;
NAME: Mr. H. L. Bordeaux
FROM: 8115 East River Road N.E., Fridley� Mn. 55432
T0: 8106 Fairmont Circle N.E., Frid�.ey, Mn. 55432
LEGAi, DESCRIPTION: Lot 4� Block l, Bourdeaux's Spring Broak
We have notified the occupant of this change and we would appreciate
it very much i� you would change your xecoxds accordingly.
S 9.ncerely,
DARREL G. CLARK
Community Development Adm.
DGC/mh
CC: City Water Billing Dept.
Ci.ty Assessing Depaxtment
Minneapolxs Gas Company -�rooltlyn Puxk Offi.ce
Northcrn States Potaer Company
Noxt}iwestern Bell Telephone
City V�ters RegistraCion
Homeowner
CITY OF FRIDLEY
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 5543Z
TELEPHONE ( 8i2)571-3450
April 11� 1983
Ms. Judy Zirngible
638 Van Buren Street
Anoka� I�A1 553�3
Residential Rental Property Located at 8106 Fairmont Circle N.E.,
Fridley � NII�1 z z�
Dear Ms. Zirngible:
Enclosed you �ill find the City's application form for a license to
operate residential rental property for the time period from
September 1, 1982 to August 31, 1983•
Section 220.11, of the Fridley Housing Maintenance Code, states that,
"To allo� for a systematic enforcement of this ordinance upon rental
dWellings� no person on or following the sixtieth day after the
enactmen� of this ordinance shall operate a rental dWelling Without
first having obtained a license to do so from the Cfty of Fridley...
No operating license shall be issued or renewed unless the rental
dr+elling and its premises conform to the ordinanees of Fridley and
the la�rs of the State of Minnesota."
Therefore, you are required to complete the enclosed application,
sign it and return it r�ith the appropriate fee to the City offices no
later than A�� '--�°,—; 983 .
G�r.'G�v�e •�"� ��
If there are any questions or problems, ple ase feel free to call on
me at 571-3450.
Sincerely,
% '
a�
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
ENC: 1
0
�� ��„
., x,
:�a
t.;��.
CITY OF FRIDLEY
6�31 UNIVERSITY AVENUE N.E., FRIDLEY. MINNESOTA 55C32
TELEPMONE ( 812)571-3450
A ril 26, 1983
Hs. Judy Ziragible
636 Yan Buren Street
Anoka, !g1 55303 '
Re: Residential Rental Property Located at 8106 Fairmont Street N.E.,
Fridley� !�1 55u32 (SECOND NOTICE)
Dear Ms. Zirngible:
Enclosed please find this department's letter dated April 11, 1983 xhich
brought to your attention the need to apply for and receive a license to
operate residential rental property at the above listed address.
As of this date, no application has been received. Therefore, the City
must again require that you complete the enclosed license application
form� sign it and return it with the appropriate fee ard late fee� no
later than �".ay 9, 1983• If there are any questions or problems, please
feel free to call on me at 571-3�50.
Failure to correct this violation may result in this matter being turned
over to the City Prosecutor for his legal consideration.
Sincerely,
L
ST EN J. OLSON� R.S.
Environmental Officer
SJO/mh
ENC: 2
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the exis ting chimney or s tack;
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_ all_ current_Code requirements for SizP anc+
totel BTU connected
6. Has To ta 1 hea ti ng BTU' s of �p oo a
J
All other BTU's
TOTAL
�a� a o Q
/ � �l P!/ G/
/G �C
Rema rk s � � ��,v������ ��� � � ,, �
No ( )
No ( )
No ( )
No ( )
Yes ( ) No ( ) — - -
. HNe��, lRerWee
f>7� �"......,.,. ,lT,.�...-
C om pa ny P��' ���'
5 i g ned By �o.�s.�f��.���.�����_�
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MOUSE NEATfN6 TEST RECORD
���C Hi 7 '� /E G /�-
`ADDRESS �I db F��+^�1��� G/,_'__�►T. FLOOR CITY S{idURdJ���G��
pCCUPANT �/� ������8�� QMNER
M�AT L�S m 4C DATE MT INST. �� '� v;90
SOl D bY �� ��' � tl�TAL�f 0 dY
Et.�.� �..k s�, c.. �tA. s�, �
TY►E tlf MEAT Gn fA �_Mt sTlAY S�AC� MTR. lliilT MTR. OT14ER
CAS OE G►+ COMVERSI�
YAKE W1KE Of bURNER
1bi�i a 1ri1
Swi� l /Q 4D .Z. S'6 D/e � li�s �TU R�t� w�
II+PUT �� IMK� Of FURw►CE
IYiI
TMERMOSTA
V�In �.
t�� _�
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�u� LMi� �
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P�i.� �r.r. _
CQNTROLS
M�et Pln�
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//
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c�D Of L�wER SI2 MONE
Owb M..� R.ry�.w. �
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Spillaqe eh
l..1� Mf! •ri.y
'ItN Ti�:n� Q� < - Twt TM
L.M. Ga 01f � ON hasa�n q= Li�+Nw� lesf.
.....M. '�. S r«�aw�. co � a. T...a � - - 9
h�M CEN �o � I.rs.w� 0� �� G�w* T�stt� as�1 = q•P io
Ssei TM�. S�bs 5 � h�rM CO � M�r d T��Nr
Certiffea�� o! Co��pant�ncy_ 11
�° I �(� ��� �o�o�� �✓z-e-�� il �� �6
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�G� �������� � r �
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.
� LV �������
r � � PqOTECTIVE INSPECTION SEC.
1 �
� i /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF
�"'"� � �'� 612-571-34b0 910-Ft 5 11/13/92 / /
JOB ADDRESS g106 Faa.rmont Circle
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 12 Audi.tor Subdivision 103
2 PROPERTY OWNER MAIL ADDRESS ZIP PHOI
� Ji.m ZirniYale
3 CONTRACTOR
Same
4 AF;CHITECT OR DESIGNER
5 ENGINEER
8106 Fairmont Circle
MAIL ADORESS
MAIL ADDRESS
MAII ADDRESS
P�RMIT NO.
� 21649
RECEIPT NO.
�a �l
APPROVED BV
SEE ATTACHED
SHEET
55432 785-1012
ZIP PHONE LICENSE NO.
ZIp PHONE LICENSE NO.
21P PHONE LICENSE NO.
8 USE OF BUILDING
Dwe l ling
7 CLASS OF WOHK ��EW p ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Build new garage
9 CHANGEOFUSEFROM
STI PU LATION S
TO
TYPE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONI
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OF IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp��
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pER�
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION.
TURE
OCCU
SO.F
)WLG. UNITS
STALLS
\TION
$9,Q66.24
IT FEE
$117.Q0
OCCUPANCYLOAD
CU. FT.
OFFSTREET PARKING
IGARAGES
SURTAX
$4. 53
SAC CHARGE
Fire SC -$9.07
TOTALFEE
$130. 60
�HIS IS YOUfi PERMIT
/r-/'� -� �
� ni7E
NEW [ j
ADDN [ ]
�.�R [ l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-Z
Build.ing Permit Application
Construction Addre.ss: � � (� � �cs-; ,r,r-� a � t �i s c 1 �
Effective 3/ 1192
Legal Description:
Owner Name & Addre�,s: k l L��r7 � i� r11�� �'� �'G i'�141 �5 � r� ��Tel. # 7�'�°� '/,(� �
COI1tCdCtOr. � ,f� l� �.f MN I.IC�$E #
Address: � A N� �� Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed consbruction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
I.ength Width Height
�ng� Wl�h Height
I.eng�th Width HgtJGround
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ J Inside Lot {) Ft. Yd Setback Side Yard Setbacks
Ty� of Construction: Estimated Cost: $%T 0/ 6.�Y
�FOR. COI�ICtIOd IidLe:
Driveway Curb Cut Width Nceded:
� /
1
' ��� TeI. # � `� ��
APPLICANT: �
(Cost on BackJ
Ft. + b Ft = Ft x$ _$
DATE: / U ��"
�TY USE ONLY
Permit Fee $ // 7� Fee Schedule on Reverse Side
Fire Surcharge $ `� �� .001 of Permit Vaivation (1 / l Oth %)
State Surcbarge $ �/. s3 $.50/$1,000 Valuation
SAC Charge $ $700 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contra.ctors)
Driveway Escrow $ Alt_ "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engine�ring
Sewer Main Charge $ Agreement Necessary t] Not Necessary (]
TOTAL
STIPULATIONS:
$ / 3p 6�
�
0
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing per�its for the erection of any building or structure,
or for any addition to any existing building or struct�re, or for any alteration or repair to any existing
building or strueture, u�n application therefore, reqinire the payment by the applicant for such permit
of f�s to the amount herein below set forth and in the manner herein provid� to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,400
$2,001 to $25,�
$25,�1 to $50,000
$SO,OQ1 to $100,0�
$100,W1 to $5�,000
$5�,001 to $1,�0,�0
$1,�,(�1 and up
FEES
$15 (Minimum Fee is � 15 plus surcharge)
$15 for first $500 pius $2 for each additional $100 or
fraction ther�f, to and including $2,000
$45 for first $2,� plus $9 for e�ach additionat $1,�0
or fraction thereof, to and including $25,�
$252 for �first $25,� plus $b.50 for each additional $1,�
or fra.ction thereof, to and including $50,�
$414.50 for first �50,0� plus $4.50 for each additional
$1,(?00 or fraction thereof, to and including $1�,000
$639.50 for first $1(�,(�l0 plus $3.50 for p.ch additional
$1,�0 or fraction ther�f, to and including $S(�,000
$2039.50 for the �irst $500,� plus $3 for each add.itional
$1,�0 or fraction thereof, to and including $1,(�10,000
$3539.SU for the �irst $1,(300,� plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCRO�ff
(Concrete Curb Strests Only)
Alternaxe "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
approach with 6 inch depth - Driv�way width plus 6 feet times $15.75.
VERIFICATION O1F 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 structure and of the conslruction site.
A Certificate of Survey of the lot, showing the location of the founda.tion once it has it has been
constructed will be required before pr�eeding with the framing.
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sua�ecT PERMIT .
City of Fridley
ATTHETOPOFTHETWINS gUILDING PERMIT 2�458
r
� ` ECEIPT NO.
COMMUNITY OEVELOPMENT DIV. � ��
� PROTECTIVE INSPECTION SEC.
i t �.��
r ; �;
� � ,
� �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�"""'� � �'� 612-571-3450 910-F15 4/27/94 � �
JOB ADDRESS g106 Fairmont Circle NE
t LEGAL �OT NO. BLOCK TRACT Oi; ADDITION SEE ATTACHED
DESCR. 12 Auditor's Sub. �{'103 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Zirngible 8106 Fairmont Circle NE -
3 CONTqACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
$,$IIl2
d ARCHITECT OR DESIGNER MAIL ADOF;ESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 17' x 28' Addition (2nd level)
9 CHANOEOFUSEFROM TO
STI PULATIONS
See notations on plan.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIHED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. 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 PHOVISIONS OF LAWS yALUATION SURTAX
AND OFDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED 11,095 �S.SS
WITH WHETHER SPECIFIED HEREIN Oii NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FiEGULATING coN- 135 . OO Fire SC � L L. O9
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �
PLAN CHECK FEE TOTAL FEE
$151.64
� 51 NAT RE OF CON i RACT R 0 AUTNORIZ A NT IDATEi w N P LY LIDATED THIS �S YOUR PER� _
�� �-Z7-`� � G���� � �i�� �
SiG TURE OF OW ER iiF 0 ER B D R� �OATE� BLDG iNSP �p7E
NEW
ADDN
ALTER
[1
�
[1
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective ll 1 /94
�Is4g
ConstructionAdciress: � `% � ��IP���T �d � � - --
Lega1 Description: L a�� L2. � ll'' �i i�� i��
Owner Name & Address: ����� �� �l�+�f���L �' Tel. # '7��� I�Z
�
Contractor:
Address:
MN LICENSE #
Attach to this application, a Certificate of Sutvey of the
lot, with the propos� construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
� � � �7 �fl
LIVING AREA: Length I� Width �.� Height �� Sq. Ft.
GARAGE AREA: Leagth Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot }�J Inside Lot [) Ft. Yd Se�ack Side Yard Setbacks
Type of Consiruction: �,UO�`� �'�1 C Estimated Cost: $
Approx. Completion Date: � q, _ i i�'�, �. ��
(Cost on Back)
Dri�eway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � f � �; APPLICANT: �� Gi.�c� Z ld^ �� � � � Tel. # �� � "I C� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ I �� . D�
$ U.��'`
$ � � �.��
$
$
$
$
$
$
$ .�
. � � -.
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engin�ring
Agreeme� Necessary [ ] Not Necessaiy ( ]
STIPULATIONS: .. �-
BUILDING PE1tMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure,
or for any add.ition 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
$1 ' � to $S00
$501 to �$2,000
$2,001 to $25,000
$25;001 to $50,000 - -
$50,001 to $100,000
$100,001 to $SOO,U00
$500,001 to $1,000,000 .
$1,(�0,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for fiist $�0 pius $2 for each additionai $100 or
fraction thereof, to and including $2,000
$45 for first $2,OOp pius $g for each additional $1;000
or fraction thereof, to and including $25,Q00
$252 for fiist� $2S,Opp pl�s $(.SO for each additional $1;OOp
or fraction thereof, to. and including $50,000
$414.50 for first $50,ppp plvs $4,Sp for �ch additianal
.$1,000 or frac:bio� thereof, to aad 'mcluding $100,000
$639.50 for first $100,0� plus $3.50 for each additionai.
$1,000 or fractiom d�eof, to and including -$500,000
$2039.50 for the first $SOO,ppp pins $3 for each additional
$1,000 or fiac;tion thereof, to aad iacluding $1,000,000
$3539.50 for the first $1,000,000 pius $2 for each additional
$1,000 or fraction �thereof •
DRIVEWAY DEPRESSION ESCROW
(Concrete C�urtr Sireets Only)
Alt�rnate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13_S0.
Altemate "B": Removal and replacement of curb and gutter 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 structure and of the co�ostn�ction site.
A Certificate of Survey of the lot, showiag the iocation of the foundation once it has it has been
coastructed will be required befoee proceeding with the fram�g.
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