AF - 41830n
Date:
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City of Fridley, Minn.
BUILDING PERMIT
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N� 6536
„� LlJCATIO O UILDING
No. yar ,L./ � Street ,..�" 1��G�������� Part Lot�
Lot ' "' Bl�k Addition or Sub-Divisian
Corner Lot — 7naide Lot " � Setback � � � Sideyard � � �
Sewer IIevation
Foundation IIevatfon
DESCRIPTIOW OF BUILDING
P
To Used
Front =.�_ Depth ..� �O Height �� Sq. Ft °�� G1. F't
t Depth fTeight � Sq. F't. Cu. F't
7.j►pe of Construction Fast. �� �� �� To be Completed
In consideratton of the issuance to me of a permft to conatruct the building described above, to do
the proposed work in accmrdance with the d�scrlption above aet forth and in ce all ons of
orrlinances oP the dty oP Frldley.
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In camslderatiton of the payment of a fee of $��._, , permit is here graated to
to conatruct the buflding or addition as descrYbed above. This �ermit ia gra.nted upon
the expresa crondition that the peraon to whom it is granted and hia agents, employees and worl�ien, fn all work
done fn, around and u�n said building, or anypa� thereof, ahall conform in all reapects to the ordinances of
FridleY� Minnesota reg la:ation, conatruct�on, alteration, maintenance, repair and moving of bufldings
ordinance�e. d� limits and� permit may be revoked at ar�Y� u// �iol�o�g say of the P�visions of eaid
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BU�1�Ilg I�B�CtOP
� NOTICEs
'llds permh deas erof eorar t6s eo�ruell�, tmtalla�tse br �rldee, plum6teg, ea 6�adog, saru or wafer. 8� soro to sN
1M &tildie8 les�ader ior ppanlr p�rmlls tor f6a� (t�ms.
APPLICATION FOR BUILDING PERMIT
CI�f OF FRiDLEii, 1�1�1ES4TA
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LOCATION OF B?►�DING
No. �� ���� Street; ���tst�� Part of Lot
Lc�� ^ �$'- �% � . .
Block AddiCion or Subd3vision �
C��caer Lot Inside Lot_ Setback ''a S� Side Yard ] �,
SEWER ELEVATION FOUNDATION ELEPATION
Appl9.cant attach to �his�form Two Certificatea of Survey of �ot and propa�ed build-
ing locaCion dra�na an these Certificates. '
1�o be used as :
DESQtIPTION OF $UILDING
� Depth �. � Height
...�..
sq. Ft.� .l �,�-. d c�. �t.
Front Depth Height,
Sq. Ft. Cu. Fe.
Type of Construction ,�� EetimaCed CoeNl ��•���
To be Completed --
The undersigned hereby �akes application for a permit for the work herein specified,
agree;ng to do all work in strict accordaace 6aith the City of Fridleq Ordinances snd
�?lings of the �epa.rtm?nt of P�uildiags, and hereby dec7ares that all the f�cte. and
representations st�ted in this application are erue an� correct.
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DATE � � SIGNATURE � . •
(Sclaedule of Fes Costs caa be found on the Severae Side).
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BUILDZNG PEIiIti'QT FEE SCAEDULE
Section 2o The Inspector of Buildia�a shall, befose iasuing any permit f�sr
ehe erecCion of a.ny bt�ilding or structure, or for any addition to �nq exist-
ing building or atructure, or for any alterations or repairs to any exi�t3ng
build3ng or stcructure, upom application therefor, require the paymen� by the
applicant for such permit of feea tt� the amount herein below set forth end
in the manner herein provided to-�aiE;
2.1. �'or any auch permit for Che e�ectioa o.� enq f�re-prbof building, oCher
thaa a garage�, warehouse, factory or grain elevator, tir ior the erection of
aay fire-proof addition. for sim�.lar accupancy, to any existing building
shall be at t�e raee of $i.40 for eacYr one thousand cubic feet, or fraction
thereof, in such cubical contenta.
2.2. For any such permit for Che erection of any fire-proof g�rage, warehouse,
factory or grain elevator, or for the erectioa of aay fire-proaf edditiQn,
�or aimil�ar occupaacy, to any existiag building ehall be at the rate of $1.25
for each one tl�ousand cubic feet, clasaified as °1fireproof" bq Section 502 of
the Minneapolis Building Code..
sovs�s
2.3. For any such permiC for the erection of aay noa-firepsoof buildiag other
than a garage, warehouae, factory or grain elevator, or anq non-fireproof
addition, for s3milar occupancy, to any exieting building - permit $1.00 for
each one thous�.nd cubic feet.
GARAGES
2.�.. For any such permit for the erection of any aon-£irepro�f garage,
war�houae, factorq or grain elevator, or for the erection of any nou-fireg�ooi'
addit�on, £or similar accupancy, to any existing building or for �ach such
��tlding or addition - niaety cents ($0.90) for each one thousaad cubic feet
or fracCion thereof, in the cubical coatents thereof with a minimum of $4.Q�0.-
For the purpose of camput3ag fees for building perm3te, the cubical coateats
of any buildiag og addit3on to a uniform height throughaut by �Ltiplying the
grouad area covered from a point six (6) inches below the floor line of the
basement or cellar to the average heigh� of the upper aurface or to the
aver�ge height gf the roof aurface of the main gable of a pitched roof.
2.5. For repaira or alterations to an exiating structure, the fee aiiall be
at the rate of $3.00 per each Fin� flundred Dollara ($500.00) or fractfon
thereof ia the coaC of all progosed work.
2.6. In no case shall the fpp.,chargad for any p�r�it �s set forth in
Sectian 2 be leas than $�i_00.
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. 1AND: SURYE1fORS ' � � ;
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CERTIFiCATE tiF SURVEY: , . _ �
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i t�s�r c�r n�►t �os �s � taue a�ic to�r ��sm�rnnor� a+ a suav�r oR n� �otnm,�s op n� asove
p�BED LNND. AND TN@ lOCAT10N OP ALL BUADMGS. TNEREON, AND ALL V�BLE BYCROACHMENTS. IP ANY.' FROM OR ON SAID
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AS StlRVEYED BY FA8 TFOS, , � �T H , 6AY OP .. „ .»il�AY ........ ...�. .... /l.D. i 9.. � �.
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Caty of Fridley, Minn-
BUILDING � PERMIT
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, LOCATION OF BU IN
No.6�_ Str�et of Lot
Lot Block Addition or S b- aai .—_..—
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Corner Lot _ Inside Lot �� ��back �Sideyard ..��
Sewer IIevation �— � Foimdation IIevation
DESCRIPTION OP BUILDING
To J /� ��°
Front � Depth �,�� Height � (� 34• Ft � (�. F't ��-�—�` �
Fro � Depth ��Teight � Scl. Ft Cu. Irt.
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Ty�e of ConaLructlon F�t. ��-- To be Completed
In cansideration of the isauance to me of a permit to construct the building
th� proposed work in accordance with the d+escription above set and
orrlinances oP the dty of Frldley. _ � i��� �
to do
�ns of
��i �
In cons4deratton of the payment of a fee of $�� , permit fa hereby granted to
to canstruct the buflding or addition as descrYbed abave. This permit ia granted nPon
the express condition that the peison to whom ft is granted aad his agettts, employees and worlrnnen, in all work
done in, around and upon safd buflding, or anypart thereof, shall conform fn all respects to the ordir►ancea of
FricIIey� Minnesota g lxatfon, construct�i�on, elteration, maintenance, r+epair and moving of buildings
witbin the dty ]imits��thia permit may be revoked at any time upon viola� an,y of the provfaions of said
ordivanc�s. �a _ `� � 1
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�'� NOTIC�
'11� psemt! deu aot eorar �hs eeestrncHee, lestalldiee hr �rirleg, plumbiee, ea 6�tine, aw�r er �rasr. B� wes to ae�
fln Bufldie8 In�etee fer ap�ral� p�rmiis for thas Ihna.
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�s � util�. aat�,� � 8� �[m �� � +�c �`r�e �� �� -
� �t�r� �'�`� � �c�tt �Ci�r -� �t � ��d 1-�1�_°'�ti � �=, - . .
C� �� �1iB � �� �� �t�#�'tg �a� t!� `:�� ��[ ��
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9�i� �hex� b+� �► �ba� qs���.� � �d� t� �G���
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55� F�i�ont st. N. E.
Minuespo]is 32 s �n.
Maxch 2, 1964
Building Inspector
Cit� Hall
Fridle�� Minnesota
Dear Sir:
@uite some time ago my husbat�l calle d you and had you come
over atid. inspect our house which l�r. Ralph Lund huilte 'i'�ie doors
do not fit prop�rl�, in fact there isabout one-hali inch all
around th� outside doors, which lets in a lot of cold. All the
fl,�ora have cracks in them that are at least one-fourth inch wide
where the flooring has shruak. The ba$ement floor is all cracki.gg
up also.
As �et r�a ha�e had nothing done about it and I would like to
know if ar�hing is go3ag to Toe done, and if so, w}aa}t and when?
I ahould think when a person bu�rs a new house it should be in
good condition and ee�rything would b� in �riect shape. If a
person didn+t care what it �moked l�tke he �rould buy r�n older hoaae«
I�Ir. Lund evi.dently used all green lumber in that house, which I
should think wou7� be. agains� �.11 building rules and P��a�'ilOOSa
In response to your letter to him the onlg suggeation he•has
made is to put tile in �he basemgnt and �e should pay for it �nd
lay it. T told him that 3.f he wanted to pa� for it he could go
ahead but that �e wouldn't. Isn't thera some wa�r that he could
patch those craclts up with cem�nt so the�r would be a7.lright or
could lay aaother la�er of cemen� over the entire floor2 T�Te do
�t n�cessarily want �ile although we wouldn�t object if he �rants
to put in and pay for it. I told him all we raanted �ras the cracks
repaired. Since then we hae� heard nothiug and he h�s made no
effort at all to do ar� repair work of any ldnd since you �mote him.
� would lika to l�ow if tP�ere is so�thiag that c�n be done a�d
�rhat i� would be. I would appreciate hearing from you as soon as
pussible. I would also appreciate i� if you would induce Mr. Lucgi
to do someth3ng about it. If somatha�ng isn'� done in the near
.fliture I shall be forcod t,o resort to mora drastic u�ethods.,
Sincerely�
�Z . G�`���.� -� ,
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819 - 89th Avanue Al. W�
Miuneaptslis 3�, �lianes��� : .
lte; 5�� F�i�nt�nt Si,': N. E. � _
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On Januar� �, 19f�r, I:m�de a€ine�, ins���i.� di tt�i-s
bnildin� at t1a�t re�ques� uf the �i�neo�r►er. I%und , eh�t, ba��c�-
a11,9, YQ� hav� � verq g�cut buil�i�i�g,, b�� �he �asem�nt flocEr- 3s ° �
c�gcking fn many, p��ce� a��. a��s Ch� ecatire f��arr, Tki�s, c�f
cau�se, s'hould �a� hagpen. I ca� �caene �n+� e� �z+tt� era�lcs in V
aay £iaor, bu-� xzv�hin.g �tke thia. I s�tg;e�t thst y�u ���ves th+a
f%cior until ii�iaq nY J�an� �d at �'t�C �i�e, hav� y��►r Ai�son�y Can•
tra,�tor go �� a� �clean tbeee cra�ct�� af �r3* �acts� r„�en� -�nc� �r�r� .
h�ve you, anc`t regair tt,� ��eh a fi,r�e m�.�rtu�r+� nf c�nien�, .�an� and
wa�er. � am �f tb� o��ni�t th�t ��3s f�c�r caill �t�y £�ecsm �hg� .�
tin�e on i� $��9.�1,9 good canditi;on.
The� h�neo�e�t hai�l qutt� �£ec�' �+th$r +�a��$ints i� �eg�rde -
to �hrialc�ge af yon�r oak flao�ciri�a c�s�ks ;i� variousr p��e�s b���e�. -
the base aad 3��r finishes� ,fioor, pnor fi�= o� s���e i�� t�e; �tao�s, �nd
a.�rack in e�i� sheet �rock, in aae �o�a�r. �ese, af _ cvu�ese, do �ot
look g�l c� a new build?tag �nd u���ker do �hey te�d �o ��px�ve
yaur re�ur.��ion �� a bui'�de�r, bue tb�sa thing� go beyo�d �c�ia3
sade requ�rem�►ts �a � ce�a do r►oCh�.ng $bout �Y� but hri�,g threm _
to Y!ov� acteation. The bas�ne �l.r�or muse be- ce�d far ia the
Sp�ring : ` .
AGJ;cks
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Caty of Fridley, Minn.
BUILDING PERMIT
Date: Mav 19 , 1970
p�; 1`Pril A_ Prokon g�� Same
Address �52—�a�.rmAxa.t Str.eet AddTesB �amP
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N° 1065
LOCATION OF BUILDING
No. .—.552� Street _.. F�'r'r"on r t_____ Part of Lot
Lot 3Z,.3.873.9__ Block T Addition or Sub-Division Riverview Heights
Corner Lot — Inaide Lot Setback __._ Sideyard
Sewer IIeval3on — Fo�mdation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Storage Shed �t 14' Depth 22 � Height 10' �. � 264' �� 2640'
F'ront Depth _ I�eight Sq. Ft Gw. Ft
Type of Construction Frame ��, �,�700. 00 To be Completed 2 Months
In con�lderal3on of the fssuance to me of a permit to construct the bwtlding described above I agree ta do
the propcsed work in accaraance with the descrlption above set forth and in compliance with a�l provisions of
orrltnances oP the dty of F'rYdley.
In con�fderation of the payment oP a fee of $ 5. 00 , p�t � hereby granted to Cecil Prokop
to construct the building or addit3on as d�cribed above. Thia permii ia granted upon
the eupress condition that the person to whom ft is granted and hia agents, employees and worl�en, 9n all work.
done fq around and u�n safd building, or anypar� thereof, sl�all conform 3n all respecta to the ordinance� of
FrlcIIey� Minnesota regarding local3on, conatruct�on, alteration, maintenance, repe3r and moving of bufldinga
within the dty limita and this permit may be revoked at aqy time upon violatfon of aay of the provisions of seid
ordinanc�.
�S �
LAR�NCE BELISLE
NOTICE:
'Itds perml� d�s ee1 eovsr ths coe�teueHee, InslaQgfoe for �rh�ng, plum6tee, gu huHne, sswsr or walsr. B� mn to ns
the Butldin8 lespeetor tor �sparaia parm8s fo� thsss Iteeu.
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APLICATION FOR RESIDENTIAL, ALTERA,TION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S . NAME : ��Q (�_� � ,�._ p�,�?e O lr�� UILDER :_ � e � e � � o ��. � !<�„a,,,
ADDRESS : �� � � rl��. � e�' A�t u �,� � -S r ADDRESS : �a' �' ,� � � ,=� ,� `� �%%,
NO :.��� �- S TREET : �/� 1 I� /'�I L� Qv d ,�%-<
LOT; � � BLOCK: r"� ADDITION: �� v � � (s l -C c,.� �l �S
CORNER LOT: INSIDE LOT: SETBACR: SIDEYARD: "
Applicant attach to this form �tao Certificate� of Surveq of Lot and propoaed
building �ocation d�awn on these Certificatea.
HESCRIPTION OF BUILDING
To Be Used As:
S r o � r� 9 .� Front : � `� �� Depth : ,� � � 1. Height : y���' � �
' S uare Feet : �_ ;� -� �` `� � °��-�
q Cubic Feet° �=
Fraat: Depth: Height:
, Square Feet; Cubic Feet:
. ��� �
�rpe of Construction: �-�-�-��� Eetimated Coet: $ °� � �'. �' �
To Be Completed: .�, �1 U w��l s
„ The undersigaed hereby n�alcea applicativa for a permit for the work }aerei.n
speci�ied, agreeing'to do all work in attict accordauce �tith thn Citq of
Fridley Ordinances and rulirsgs of the Depart�nt of Buildinga, and 1�eseby
declares that all the facte aad representatione etated in thie applicatioa
are true ead correct.
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DiATE : `� / % .� � � S �GNAT[JRE • � ';- �e
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(See Aeveree Side For Additional Information.)
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. T'he Inspector of Building� shall, before �.ssui.ng pesmit� fox the
erection of any buiYding o�c etructure, or for any additian to aay existi�g
buildiag or atructure, or for any altera�ion or repairs to axty existing
building or stiructure, upon application thexefore, require the payment'by the
applicant for such permit of fees to the amoun� herein below set forth and ia
the manner herein pravided to-wit:
UNIFORM BUILDING CODE: 1�pe 1, 2� 4-$2.15 for each oae thousand cubic
feet, or fraction thereof, in such cubical coatenta. Type 3� 5-$1.$5 for
each oae thousaad cubic feet.
ADDITIONAL INFORMATION
Far the purpose af computing feee for buildin� peamitge tbe cubical contente
of any building or additioa, i� determined by multiplyiag the grouad arme,
covered fram a point �ix (6) inchee below tlxe floor line of the baBes�sat
at the cellar to th� average heights �f the upper aua�fas� or to th���erage.�
•height of the roof eurface of the m�in g�bl� of a pitehed xoof.
For repairs or alterationa to an existing struc�ar�,�the f�e s�all be at �he
rate of $3.00 per each f�.ve hundsed doll�a� ($500.00) or £raction thes�of in
the coet of all propo�ed work.
7s� no case ehall the fee charged for any pez�it se aet forth in Sec�ion 2 be
1
ess=�iat�y $�.00
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VARIFIC�IT�ON OF FOUND�►TION
NOTE: ,Pmtmita for e�anstruction will be isaued a m�i�:m of 24 boure fsom tbe
t3�e of �pplication, to allow for proper review of the proposed atsucture aad
of the canetsuction aite.
A Certifi4d Survey of the lot, ehawing the locat�,on of the foundatiaa, once i�
iw-�been constructed, will be required befots t�o�eedia� �ith the fzaming.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupaacy 9ha11 b� made ten (10) daqe prior
to tiae uae or occupaa�y of as� etructure fos which a buildi�g permit heu beeu
., �.seued; aad said atructure el�all aot be used or occupl�ed until a Cartificate
of bccup�aacy has beea ieeued.
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��o�. ����i.�.��'� �9�`�� �S�o�i,������ �'U�L�. i'elephone �21-6340
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SUBJECT �„[�� Q,
City of Fridley � 15 6 7 9�T
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
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COMMUNITY DEVELOPMENT DIV.
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L1 = �
_-_-� ��'���,,� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
i 612-571-3450 910-F15 4/28/80 � �
JOB ADDRESS 552 Fai�ont Street N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL 37�39 J Riverview �l �1'tS SEEATTACHED
DESCR. g SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Cecil Prokop 552 Fairmont Street N.E. 786-2604
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and ara e and alter ara e r�f
9 CHANGE OF USE FROM TO
STIP�ULATIONS
Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys.
SEPERATE PERMiTS REt�UiRED FpR V�tif���t�,
�i�AT1iVG, PL,UM�IN� ANb S1G�S.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED 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 OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PFiOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT yfi]. QQQ . SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
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SIGNATUREOFCONTRACTORORAUT ORIZEDAGENT �DATEi .�"�� HEN PROPERLY - LIDATED THIS IS YOUR PERMIT
C' ° � .�� 4c -��= �'� � �� �Q ,Q��� � _�
SIGNATURE OF OWNER�IF OWNER B DERi IOATEI BLOG iNSP �ATE
CITY 0� FRIULEY -
Af'-f'L�C(1'i'IOl� FOft RESIDCNTI/ll_ �UILI)IP1G PERf�1TTS
((dew, Alterations, Adclii:ions, or Repairs)
� ObltdER: :�� � �
ADDRCSS : �`� ,� ���,�' ,�/ � � �'
L �
TE�. no: �� � � a � o �`
�UI LDER : . ����v�.�i,
ADORESS: •
TEL fd0: '
Construction Location
- STR�ET NO : � STl.2LIsT: ��. ,
LOT: �} % �� - � j BLOQ::
Corner Lot: Inside Lot:
ADDIT'LON : ����?� ��` �l�CZ � ��'�O
Setback: Sideyards:
Applicant attach to this foxm two Certiiicates of Suxvey of lot and
proposc:d building location drati•rn on certificates to scale.
DESCRIPTIO(d OF CONSTRUC7ION
6
, T �� rront: � Depth: Height:
� � f�� ���, Squa�e Feet s C:ubic I'eet:
Front :
Square• i'eetz
Type ot Coizstruction:
Zb Be Oompleted;
Depth : Height:
Cubic Fe�t:
. . ��a• OG
Estimated Cost: $
, _ � Alt. A Alt. B
Proposed Driveway Wi.dth If New Opening Is Desired: $' $
, , SEE REZTERSE SIDE OF SHF�T .
The undersigned hereUy makes application �or a pexmi�t for the h�ark hei:ei.n sPecified,
agreeing to do all work in strict accordance with the City of ]?ridley Ordinances and
rulings a.f the Deparin�ent oi' Buildings, and hereby declares i:hat all the tacts and
representations stated 3n thiu applica�ion aze true and correct.
DATE : � �- � �'
S�ipulations:
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l��r�--c_�
v���.
• L'U]Ll)11VG i'L-li('ll I I t.L- t;Ciil.l.)ULI. .
CJ..Cx701d 2. 7.'}te Tn:.:pector. oL• Ilui.].Qi.��y ;:;h,i7.]., l�cl.'o�:c �. ;:�ui>>g L�enniL•:; f.'ol i:he ez'�:cL•i.on
�f any )�uS.J.cl:i.ncJ o�: :�t:iuet:tir.•e� or. f:ar. atzy �tC7C�].l:loIi La �i�,y e>:S.:,ti�u� uttilcli.nc� �x �LxucLu�e,
. or. t��y- ��ny �il.tcr�ii.iou oz• r.c����i.r. ; Lo •��ny cx.i.�,t.ii�c� ),u;.7.c].i.>>�,� or >Lr.uctiurr., ui�on app].icatio►1
'i:1►�:r.cfor.c, r.ec�uir.e Ui� �,��iymcr�L• by thc aT,Z�].i_r:�-��it: for. �,��ch ��crmS.L- of fees ta tl�c amounL-
hezcin l�cl.oti•� scL- for.th �i»cl i�i i:lic manncr lic�r.ca.n pLOVa.dccl L-a-wi.L•: • �
1�1.4? COI�.�`I'P.UC'�.'IOI]: :;ir�gle l.'��mi].y Ilomes and Car.acJc�: $�.00/�.,000 cubi.c teet.
PJ��1� C1i1:CY: 25 k�crcent of bui.ldir,�7 a��ermi.t i:ee. .
ll12IVEY111X llL•'I'RL•'5�70I�: (Concrc:L-c, Cur_h :;L�:ceL�s Orily) �
• nl.tcr»�ii.e A: I:c�noval ai�d �:cpl.accmenL of concrete curb and
c�tit,tcr. o��ly; Drivea�ay widi�li ��lus 6 feeL- x Y15m75
hlter.nat:e. i3: �:emoval. and r.epJ.ac:emenL- o� concreL-e cuxb and -
. ' • gut�i:er arid i�is�a).J. a 3 iooL- �•�ide approacli �oiU� ''
' . G S.nch de�th; Dri.vec•ray widL-h plus G i'eeL- x$17.85 �
. [jJZITIQ�.�I_ INf=0R��1i� IO
�'or the pur�ose of- compuLi_ng fees for_ buiJ.d9.ng permi.t�, L-lie cuUica7. con�ents of any
builda.nc3 or. addiL-i.on, is c1cL-ennined by rnu1L-i.pJ_yiny L-he gr.ound area covered from a
, p�i.nt si}: (6) inches beloca. i-Yie floor line of i:he basemeni: or th� ce.11ar L-o the
avexage }ieights af L-he upper surface or L-o the average he�.cPub of the roof surface
of the mai�i gab].e of a pitched roof e �
I'or_ rep�zrs or ali:erations to an existang structure, the �ee shall. be a� the rate
o� $3.00 per eacii five hundred dollars -($500.G�) or fz:action ihereof in the cost
o� all proposed work. . .
I�z •no case sha�.]. 4he �ee charqed ior any permi� as . set forth in Sectian 2 be less
Ll�an $7.50 plus $.50 state surcharge. '
VERTFICATIO�! OF F�Ut�ID/1�"IOfJ
NOT�: Permits ��r construci.ion will be issued a minimum of 24 hours from the �a.me
o� a�pZica�ion to allow for proper review of L-lie pxoFosed st*:uctw:e and of the .
cozastruction s9.teo
11 Certificate oi' Surve�� oi the lot, sl7oc,�ing the location of- the foundation once i�
lias been cons�ruci�ed will be required be£ore pr.ocecditie� �vifil� the �a:aminq.
�E,�T I F T C�T E 01= � C��L[' /� �d CY
�1pp�.icatian for a Certifica�.e oi Occupancy shall be made ten (10) da��s prior� to the
usc or occ:upancy ot any si:i-�icture for wli�.ch �i builci�.iig i)Ci7lllt �1c1S been a.ssued; aiid
s�zic� siructure sliall xioi: ba used or OCCUj,�1CC�i uritil a Ccri�ificafi.e oi' Occu�,�ancy has
Ueen issued.
0
rR� .O.
. '
N� �] City of Fridley Effective 4/1/8G
ADDN. I � �R-1 AlTD A-2 �,� �� �J �I
pLTER. [ 7 Building Permit Applieation ``�
Construction Address : � -`� � l�"� � � �-�� f'� �-' � � ' 7c' <�� c`� /
Legal Description: .
Owner Name & Address : � �� C', � �'"�r w ��C' _� � _� �L � a ) � r� �J1.C,•'�- i Tel . # ���� � � � � �� ���
Contractor: Tel. �
Address•
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction dra�an on it to scale.
Length
DESCRIPTIOA OF IMPROYENIENT
Width Height Sq. Ft.
Length Kidth __ Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $
Approx. Completion Date:
�
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: �E� $ >���°-� $
See Back Page for Explanation
) ,
DATE: � �� � � ,�:� �. APPLICANT: :7�`a , '���/i- r ( . Tel . � °fr;�;, -�'�,--C ',�A
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
TOTAL
STIPULATIONS:
�
�
$
$
$
�
S
CITY DSE ONLY
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1�000 Valuation
��►�� �er SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Neeessary [ ]
BIIII.DIKG PERMIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure, or for any addition to any existing building or structure, or
for any alteration or repair to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein beloW set forth and in the manner herein provided to-Wit: '
Total Valuation
�1.00 to �500.00
�501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,001.00 to $50,000.00
�50,001.00 to $100,000.00
3100,001.00 and up
Fees
$10.00 (Minimum Fee is �15.00)
$10.00 for the first �500 plus $1.50 for each
additional �100 or fraction thereof, to and including
�2,000.
$32•50 for the first $2,000 plus $fi.00 for each
additional $1,000 or fraction thereof, to and
including $25,000.
$170.50 for the first $25,000 plus $�.50 for each
additional $1�000 or fraction thereof, to and
including �50,000.
$283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including �100,000.
Su33.00 for the first �100,000 plus
additional $1,000 or fraction thereof.
DRIVEiiAY DEPRESSION ESCRO�I
(Concrete Curb Streets Only)
$2.50 for eaeh
Alternate "A": Removal and replacement of curb and gutter only - Driveway Width plus
6 feet times $13.50
Alternate "B": Removal and replacement of clxrb and gutter and install a 3 foot wide
approach With 6 ineh depth - DriveWay width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Permits for construction �ill be issued a minimum of 24 hours from the time of
application to allow for proper revieK of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation onee it
has been constructed xill be required irefore proceeding With the framing.
sue�ecT PER
c�ty of Fr�aley 2 2 3 0�_
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T ---
�
� ` RECEIPT NO.
� `L � ._ COMMUNITY DEVELOPMENT DIV. �� �
r � � PROTECTIVE INSPECTION SEC.
i = i
� /"'1 � CITY HALI FHIDLEY 58432 NUMBER REV. DATE PAGE OF APPROVED BY
�.---� � •�� 612-571-3450 910-F15 2/28/94 � �
JOB ADDRESS 552 �aixx�llqnt Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
oescR. 37 r 3$, 39 J Ri.verview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Cecil Prokup 552 Faa,rmont Street NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO.
Ostendor� Contract�,ng 26619 Feltan Ave ami.n MN 462-3655 3577
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WOFiK
❑ NEW ❑ ADDITION �O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Constxuct a 25' x 36�� Handica ram to dwellin
9 CHAN(iE QF USE FROM TO
STIPULATIONS
See notations on plan,
TYPE OF CONST. OCCUPANCY CaROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEAT�NG,
VENTILATING OR AIH CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEO 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. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8OQ y�, SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THH pEqM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S27-eQO Fire SC $. SO
PLAN CHECK FEE TOTAL FEE
License �r. y�JaOV. $2(�3V
SIGNATUREOFCONTRAGTORORAUTMORIZEDAGENT IDATEI WHEN PROPERLY ALIDATED TNIS IS YOUR PERMIT
`- - �� � ,2��,8-��
SiGNATUREOFOWNERiIFOWNERBUILDERI IDATEI B OG �N P naTE
NEW
ADDN
. ALTER
[l.
Il
[l
' CITY OF FRIDLEY .
SINGLE FAM�.Y.AND DUPLBXES R-1 AND R-2 �
, .. �uilding. Permit Appiication . .
ConstructionAddress: .� z5� ��,'/s �Yd�� G��
Legal Descripdoa
Owner Name & Address: �'�� l� Y'% ��,p Tel. #
�,, � „ ._, , .
MN LICENSE #r� #�-�� �7
Te�. � .� ifldz .3�SS
Contractor:
Address:
Eff�tive 1/1/94
Aitach. to this ap�lication,� a Cer`�ficate of Survey of �the .
lot, _ w��th .tfie•proposexl cons.truction dra�vn on it to scale. �
� DESCRIPTION OF IIVII'ROVEMENT
m
-�_
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length �Vidth Height Sq. Ft.
D�CK AREA: Length ��Vidth �� Hgt/Ground Sq. Ft.
OTHER: ��� S—�/� �'a� � l� �2.�r � �!- ���� ?,.—��
Corner Lot [] Inside Lot [ j Ft. Yd Setback Side Yard Setbac�s
Type of Construction: Estimat� Cost: $'� �''� �,
Approx. Completion Date: _
(cost on Backj
Driveway Curb Cut Width Needed: Ft. + Ft = t x$ _$
DATE: G' APPLICANT: Tel. # �6Z ���5
, �...�
� CITY USE ONL
Permit F�
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
i
0
$_� �.
� ���
$
$-
��_
$
$
$
$
`�v
i
�
.
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOt6%)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Liceased Residential Conhactors)
Alt. "A" or Alt. "B" Above
$450.W Conservation Plan Review
Fee Determined by Engineering
Agreeme� Necessary [ ] Not Ne�essary [ ]
BUII.DING PERMPf FF� SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any build;ng� or structure;
or for an}r add.ition to any existing building or strucdire, or for auy alteration or repair to any� existing
building or stcucture, upon application therefore, require the pay;nent by the applicant for such permit
of fe�s to the amount herein below set forth and 'an die maaner herein provided to-wit:
TOTAI.. VALUE
$1 � �� � to $500
$501 to �$Z,IX}0
$2,(l01 to $?.5,000
$25;001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,0OO,OQO
$1,WU,OU1 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
� fraction thereof, �to and including $2,000 - � � .
$45 for fiist $2,000 pins $9 for �each additional �$1;000 �
or fraction thereof, to and including $25,000 . .
$252 for fYrst $25,OQ0 ples $6.50 fvr each additional $1;000
or fraction thereo�, ta. and including $50,000
$414.50 for first $50,0(I(1 plus $4.50 for �ch additional
$1,000 or fractiom theaeof, to aad including $100,000
$639.50 for f�rst �$100,0� plus $3.50 for each addidonal-
$1,000 or fradion thaeof, to and including -$500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,Q00 or fraction thereof, to aad includ.ing $1,000,000
$3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof -
DRIVEWAY DEPR�SSION ESCROW
(Concrete C�rb Streets On1Y)
Altemate "A" : Removal an.d. ,r�pla.cemem of curb and gut.�ea� only - Driveway width plus 6 feet tim�
$13.50.
Alternate "B" : Removal and replacement of curb and gubter and install a 3 foot wide .
approach with 6 inch depth - Driveway widtL plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for coastcuction will be issued a minimum of 24 hours from the time of applica6on to allow
for proper review of the progosed structure and of the coast�uction site.
A Certificate of Survey of �e lot, showiag the l�on of the foundation once it has it has been.
coastructed will be required before proceeding with the framing_
,
C�.�� � ��� ���%.
�
�
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,; �, �
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����'� �I� -
� �--- - -- - - -t - -�-- - -
ti I
sue��cr -
City of Fridley
AT TME TOP OF TME TW�NS g � I L D i N� P E R M I T
;,
,�
� ; y _._�� COMMUNITY DEVELOPM�NT OIV.
d � � PROTECTIVE INSPECTION SEC.
� _ �"'1 � CITY MALL FRIOLE� 53132 NUMBEN
�"'"�" �'� � 612-571-3450 s�aF�S
JOB ADDRESS
552 Fairmont Street NE
t IEGAL �07 NO. BLOCK TRACT OR AODITION
oesca. 37 , 38, 39 J Riverview
2 PiiOPERTY OWNER MAIL AOpR�S$
3 CONTRACTOR
Mark Osborne Con
4 ARCHITECT OR OESIGNER
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
8 DESCRIBE WORK
Reroof House (15
9 CHANGE OF USE FROM
MAIL ADOfiE$S
tS
4/1/99
ZIP
O ADDITION O ALTERATIpN p REPAIR
X
PAGE OF
/ /
MIT�
9125
�� (C!�
�ED Bv
SEE ATTACHED
SNEET
PNONE LICENSE NO
411 522-3858
PHONE LICENSE NO.
20143166
PNONE IICENSE NO
O MOVE O REMOVE
Reroof Gara�e (8 Sq) 2nd Laver
TO
STIPUlAT10NS �
Underlayment must comply with the State Building Code. Roofing can be
the 2nd layer but not the 3rd.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
TYPE OF CON:
SEPARATE PERMITS AqE REOUIpED FOR ELECTRICAL, PLUMBING, MEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFMIT BECOMES NULL ANO VOID IF WORK OR CpNSTfiUCTION ZONING
AUTHORIIED IS NOT COMMENCED Vj!ITHIN 80 DAYS. OR IF CONSTAUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS A7
ANY TIME AFTEii WORK IS COMMENCED. NO OWLG. l
I NEREBY CERTIFV TNAT I HAVE REAO AND EXAMIN�D THIS APPLICA710N 1
AND KNOW TNE SAME TO BE TAUE AND CORRECT. ALl PROVISIONS OF �AW$ VALUATION
AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL QE COMP�IED
WITH WME7HER SPECIFIEO MEREIN Oii NOT. TME GRANTING OF A PERMIT � 1� 8OO
DOES NOT PRESUME TO GIVE AU7MORITY TO VIOLATE OF CANCEL THE pEWMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN• �56.75
STqUCT10N OR 7ME PERFOpMANCE OF CONSTRUCTION
� P1.AN CMECK I
��� Lic
S�GN4TU�7E OF �pN7RACTOp ON AUTNOA�ZED OGENt 1 ATE� Er
S�GanivaE O� OwNEA�ic OWNEp Bu4DEA� iOATE� BLO
SQ.
STALLS
C �5_.
GROUP �OCCUPANCrLOAD
CU FT.
OFFSTREET PARKIN(
IGARAGES
$.90
SAC CMAR
Fire $1.80
TpTA EE�
4.45
iS iS r aE
,
� ,,,
patE
� � � Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 /
BUILDING PERMIT APPLICATION � I � � �,,,
t � ���
conscrucdon�►adress:� �°2 -�'rs� ,w�h. ���/�'
Legal Description:
Owner Name & Address: Tel. #
Contractor: � � � � � � � �Vl � �' � �� J�% S,� MN LICENSE �t � p / � % � L
Address: ��' � � ��—� I � � C) [� �.��.� � .'�h}0%� Tel. # �2 2 °' 3 g s�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length � Width Hgt/Ground Sq. Ft.
OTHER:
r9 �
--�— —U �
�s /�:��
Construcdon Type: Estimated Cost: $ �`� l��
(Fee Schedule on Back) ,� %���
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
. �
DATE: APPLICANT: � � cy��,.�.-t _ Tel. �� D Z�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
S1'IPULATIONS:
� � � ��
$ �e � G�
$ ��
$
$ .:� C:���
$
$
$
$
$ �
�S
CITY USE ONLY
Fee Schedule on Reverse Side
.(?Ol of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors) � .
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
,
I
c�ty of Fridley
AT TFIE TOP OF TNE TWINS
;,
.�
; �v _ COMMUNITY OEVELOPMENT DIV.
r � •• � PpOTECTIVE INSPECTION SEC.
� j .
l--_•�� �"' �•� CITY HALI FiiIOLE� 55132
L 763-571-3450
SuB�ECT
BU ILDING PERMIT
NUMBEF REV OATE PAGE OF
910-F15 12/27/02 / /
JOB ADDRESS 552 Fairmont Street NE
1 LEGAL �OT NO. BLOCK TRACT Oii AODITION
oesca. 37,38,39 J Riverview Heights
Leona Prokop 552 Fairmont Street NE
3 CONTRACTOR MAIL ADCRESS
All Season Exteriors 10035 Jay Street NW, Coon
� ARC111TECT OR OESIGNER MAIL ADDRESS
S ENGINEER
8 USE OF BUILDING
Residential
� CLASS OF WORK
B DESCFIBE WORK
Reside House
9 CHANGE Of USE fROM
MAIL ADORESS
O NEW ❑ ADDITION O AITERATION
TO
�....,. ..v. �
33305
�
����
APpqOVEO BY
SEE ATTACHED
SMEET
763-786-2604
Z�P PIiONE LICENSE NO
55433 763-421-1422
ZIP PHONE IICENSE N0.
20093546
Z1P PMONE IICENSE NO
� REPAIR ❑ MOVE ❑ REMOVE
STIPULATIONS
Per Section 1402, 1997 Uniform Buildin� Code, requires that a weather res�stive
barrier be placed over exterior sheathing to protect the interior wall coverir.g.
Exceptions for this provision would be if sheathing is an approved weatherproof
panel or wher. the siding is an approved.weather barrier. Viny� siding is not
a weatherproo� covering unless the manu�ac�urer states this in their �.pp1ication
guide�ittes. Cai�. for inspection of wrap before covering. CauZk and �lash all
exterior openings.
SEPARATE PERMITS ARE REOUIqED FOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST. OCCUP
VENTI�A7ING OR AIR CONDITIONING.
TNIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHOR12ED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION SO. FT
�R �NORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY 71ME AF7ER WORK IS COMMENCED.
NO DWLG. UN17S
I HEREBY CERTIFY TNAT I MAVE READ AND EXAMINEO TMIS APPLICA710N 1
AND KNOW TME SAME 70 BE TRUE AND CORRECT. A�L PROVtS10NS Of LAW$ STA��$
ANO ORDINANCES GOVERNING 7HIS TYPE OF WOiiK WILL BE COMPLIEO �ALUATION
WITM WMETHER SPECIFIED HEREIN Op NOT. TNE GRANTING Of A PERMIT �J�465
OOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOIATE OR CANCEL 7NE pERMl7 FEE
PpOVIS10NS OF qNY OTMER STATE OR LOCAL LAW REGULATING CON-
SiRUCTION OF TME PERFOR ANCE Of CONSTRUCTION $153.ZS
n
PLAN CHECK FEE
� SIGN4TUpEO�CON'A4 T q q• T�1 q1 License .$,5�
C O O u ZE04GEN� iDAfE�
4 �
'^��� ��cuPnNCYLOAD
CU FT
OFFSTfiEE7 PAqKING
IGAqAGES
SURTAx
$3.73
0
re SC $7.46
kl FEE
169.44
�IS IS VOUR � RMIT
NEW [ j CITY OF FRIDLEY Effective 1!1/2002
ADON ( j 6431 Universily Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Cohstruction Address: .��:%'� �c�cU rno�7� /V- �
Legal Description:
Owner Name 8 Address: �ed�lc� �CD P Tel. #�1[��—'?�!� �2�� �'
Contractor. � �' ^ �c��v� i�e�,�t.0 MN LICENSE # b � -��q���
a
Address:_ _ I f�7`�5 � �k�, �4e�' ti-(.v' [4'�vv+ �cA�n ��s Tel. # ��� ° �2 t _ �c! z2..
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this appiication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
Construction Type: v�2 �� c�c Estimated Cost: $�i, �)Cv5 ��
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DAT.E: � Z—��R �O �. APPLICANT: �- Tel. #?��' �f Z I� 1�[ 22.
Call (763) 572�604 for Pertnit Fees if mailing in application or Fax to 763-571-1Z87 if using credit card and we will
call you for card �umber.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Drnreway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ � �"3. �s
$
$
$
$ � � C��
$
$
$-
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conserva6on Plan Review
Fee Determined by�Engineering
Agreement Necessary [ J Not Necessary []
$ I (O • '� '� STIPULATIONS:
�
BiJILDING PERNIIT FEE SCHEDULE
The Chief Building OfFicial sha(1, 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 applicaxion therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provicied to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,OOQ
$2,001 to $25,000
$25,(�1 to $50,000
$50,(301 to $100,000
$1 Q0, 001 to $500,000
$500,001 to $1,000,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,�0 plus $14.00 for each additional $1,000
or fraction thereof, to aad including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0�
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $1(�,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,Q(� or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000, 000
$1,000,(�1 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
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 construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be
required before proceeding with the framing. New Houses Onlv
�
Building
Inspections
763-572-3�
DATE r �
SITE ADDRESS �
'I'HIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
MECHANICAL
RESIDENTIAL APPLICATION
� CIT�' (�F FRIDL�EY
❑ OWNER
NAME:
ADDRESS'
PHONE:��
CoMPANY NAME;_
CONTACT PERSC .
STATE LICENSE �1_
ADDRESS:
PHONE
'�'SINGLE FAMII.Y
• YOUR
�� . r
:��=
.
❑ TWO FAMILY
TYPE OF R'ORK: I � ��''' ����
DETAILED DESCRIPTION OF WORiC '��
C�
9
Pernut
Received By:
MN 55408
STATE ZIP
FAX-- � —
❑�
❑ TOWNHOUSE
/ C�t fn� C.Q/ �
PER MS 16B.665 the permit fee is a mii►imnm of $15.00 or 5% of ihe total cost up to $500.00, whichever is greater, foX the
improvement, installation or replacement af a residential fixtuie, excluding the fixt�res. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Lalior cost between $300 to $300 = cost of labor � x.OS -� ' �
FOR PROJECfS WIiERE Id�BOR EXCEEDS $500, �yEES ARE $ASED N$10.00 PER FDZTTJRE, EXCEP'I' WHERE NATED. F�Iq7RES: (AIDICATE TOTAL
NUIv1BER OF EACH BELOWj � ��� '
Ec1WPmentInsta[led . MFG: �"'Yl/ MODEL: ��� SIZF/BTU_���
�;; MODEL: SIZ�TU
x MFG: MODII.: SI'LFIBTU � �
� �A/C $Z5.00 CE (GA�S) �15.� GAS RANGFJOVEN $10.00
AIR TO AIIt EXCHANGEER $15 CE (WOOD) $35.00 NEW GAS QRII.L S10.00
BOILER $35.40 �FIJRNACE $35.00 _GAS UIdfT HTR �10.00
CHINWEY LINER $10.� AS DRYER 510.00 PO(7L HEATER $35.00
DUCT WORK $10.00 GAS PIPINa $10.00 VENTII.ATOR $15.00
Sorcharge
TOTAL DUE
. .�,_ ... .. _ �
g Number of fixtures @$10.00 x 10.00 =
$ .50 Number of fixh�res a� �15.00 x$15.00 =$
$ Number of incd�res @ $25.00 ,� x $25.00 = $�
Number of fixtures @ $35.00 � x $35.00 = $�
State Surcharge = $ 50
Total = $ ,��
THIS IS Ald APPLICATION FOR A PERNIIT NOT VALID UNTIL PROCESSID
I hereby apply for a building per�nit and I aclmowledge that the infomaation above is complete and accurate; that the work will be in I
conformance with the ordinances and codes of of Fridley and with �e Nlinnesota �Const�uction Codes; that i understand this is
not a permit but only pli ' r a ork is not to start without a permit; that the work w�l be in accor ce ' the
approved plan na the of rk hic equir�s view and approval of
SIQNATURE OF APPL �/Yl ATE ��
City of Fridle�
Building Inspections Department
5431 iJniversity Avenue NE, Fridley, MN 55432
. 763-572 3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS EXISTlI�G HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTIN:� k#a6rf�:S .:�>:,: .. . � : .
�- _� �'.�.;,t;
�,�� _ .;;` -
1. Combustion Air (See note belo`w�)� ^ ``��, ; � � ''', � '�'':.
- � `�
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Na�.iaral Gas or Propane/IFGC Chapter 3�vith It�II�T Amendments
2. Make-up Air (See note below)
a. IlvIC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel oth.er tban gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss &�ooling load. per room
a. Required on new constru.ction IMC 1346.0312
5. Ventilation .
-- a. Per 1VlN En� _Cod.e 7670 or 7672 - _— _
6. Duct Design Per IlVIC 1346.0603:2 . .:� _..
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations