AF - 42047n
�
� -°'�' Village of Fridley, Minn.
. BUILDING PE1�.MIT �°• 17 9 8
Date: . . ./.� .(.7�.�!......
OwnerQ...�.... .� .��%9�:t.Q,,�. Buiider ..............................................
Address ....�.r�... _ . . . Address .............................................
- - . �s � � t
LOCATION OF BUILD[NG
No. . . !. �G •�. . Street . .�.a�°.��� .. . .. . . . . . . .. .. . Part of Lot . . . .. . . . . . . . . . . . . . . . . . . . .. p. .
Lot �. T.�. I . . . Blocic . . . . . . . . . . . . . . . . . . Addition or Sub-Division �l:"''�.•�. `:� . . .�.�. . . . . . . . . . . . . . . . .
Corner Lot . . . . . . . . . . . Inside Lot . . .!A`. . . . . . Setbacl. �.� . . . . . . Sideyard . . . r � . . . � : �J . . . . . . . . . . . . .
To be lised as:
� . . ^ .......
.....................
Type of Construction
DESCRIPTION OF BUILDING
Front . � � . Depth . . � � Height . � . `?. Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . .
Front ... .. .. . Depth ........ Height ........ 5q. F't. ........ Cu. Ft. .. .....
��: � . . . . . Est. Cost . ./. � . ��:': . . . . To be Completed�� • • • • •�i�
In consideration of the issuance to me of a permit to constxuct the building described above, I agree to do
the proposed work in accordance with the description above s t rth and in compliance with all provisions of
ordinances of the village of Fridley.
�� ���
In consideration of the payment of a fee of $. ��.�., permit is hereby granted to .: f. .....`. . .
. . . . . . . . . . . . . . . . . . . . . . . . . to construct the builcling 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 worlunen, in all work
done in, around and upon said building, ox, any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding locatian,� construction, alteration, maintenance, repair and moving of buildings with-
in the village� its and this _ 't may be revoked at any time upon violation of any of the provisions of said
ordinances.
� ...� ...............
..t. . Builaing Inspector
NOTICE:
This permit d'oes not cover the construction, lnstailation or alteration fo� wlring, plumbing, gas heating,
sewer or water. Be sure to see the Buiiding Inspector for separate Aermits for thase items.
H
B
e
L'
ru�uw: vnunnwoaa o-oaa�
OF PitOPER'
described as
�RLEIGH C. SMITH
Registered Professfonal Engineer aad Land Survegor
lszls way�ia soulevara wapzala, Mfnaeso2a
PLAT QF SZJRVEY
f�-id c�irra r3 ..S �a .bal It� 15j� �% ��
��%m%t��������a•.� � �o
Scale: 1 iArh ."„��eet
�
I
t
5
4
{!
P
ti
� #
w�^ �
AV
�
✓�
� '
+ - ` ;
O
_,l�,r,����� 4�. .� � ' f„
,.._„ _..�..,�.,.��„ .
CERTIFICATE OF LOCATION OF BIIILDING
1 hereby certify that on , 19_
I made a survey of the proposed location of the building
on the above described property and that the location of
said building is correctly shown on the above plat.
CERTIFICATE OF SUAVEY
I hereby certify that o*+ ��'".,f�f ,�.�, 19.,�
I surveyed the property descnb d above and that the above
plat is a correct representation of said survey.
� J.�
1� �� d� � f � ..r .�f �� � _ - �
�
, �
; �
x
�
� >. .�.
l
v
Fp�'�4� � - ve. . . �
;
;,
Date:
Owner
Addres
F
Village of Fric�l.ey, Min.n.
BUILDING PERMIT
,��,.���.��"`�.'`P:..��. ��.........
�. �� � d ��
4 �.f..�'i�.��. i ��.�.:�:7.�•�",��
�} ..�`��6-' '
S . �`�F.'�r�.,�. . . . : w ��R ����'� °6 d'�i���
�r
�o
;-
4.
1 �9 2 5 � - �,� ��� ��
_ � � ���Y
Builder . .... ,. .. . ....
Address . �.1� a!;�.� a, ,�, ; �� r�t� ��'. .,; -, ,�`,�,f, , , , !�.� . �
� �� � � c�� CAT[,ON OF BU,�LDING
N�wyk:�a�'�.... Street .�.��o..:���.i�'::�:..��::....�.A`.�Partof Lot ..... .....................
, � �t,�'/; . { . . . . . . . . . Block . .� . . . . . . . . . . . . . . Addition or Sub-Division�`:�:�.�.�� ��:�i�: .. : .��4�.. .,;�.��. . . . . . . .
Corner Lot ........... Inside Lot ........... Setback ....:...... Sideyard .............................
DESCRIPTION OF �UILD(NG
To be Used�,
. . `,� � . :* �. . 'R`=:` .�: . . . Front ,' : ��3.`�: . . Depth � k''�.� . . . Height /..� L' ���/ Sq. Ft.,,,�`C�: . . . Cu. F� . . . . . . . .
f
.... ..... .......... Front ........ Depth ........ Height ..... . Sq. F� . . Cu. F`t. .....
.. � �� �
Type of Construction p �:'�=t°>�pi? . . . . . . . Est. Cost . . . . .j.��.w� .��'. :':""' . . To be Completed �..�l�."'��.�:�!"� :�.+.
.t"E-`�,c��'�1 .�'� ,�' �Ge� .� ��?"°'�"� �'F��r,� �°;��+ .,�1�� �.�i � ��« . �. �'�,�r..�"�°e�f�rl �¢-�Ciy
�
1� �,Xt�a—' /'�''>,�._����+ �+�:��� i .,d��- �*�; � �•rs:� .,��'��,M°/�tu� ��.�'�,,��,„� �i� �' �, �..
� , �i�4 .��! � a
,.<�'�`!�•�'°'�ll�,�+�-� t3�e.• �r,� `�i' ��+'�:=,az.,�n-�:�,��� F ��;iG► �9��''�t�,'�,"� , C�'.�'�-` s��� � �,f�{='"�``c�
..7 ,r� ,��t-�fl, "'�J„v�t�� /°i��-�� �st ��� ��r
f � ,�If� ,�+'•,'t.t..pt.�ii��Y.'�' '.�`�.d'wt�� --���� ��,�'-^-3+'�'�,671i.'`v d"�j ""'u!�'��'��` ���'J�'.;G'�,�, Aa.`� .°':i�'`�"l��'j t�l-
.°e�,� f .r^"�+s= �°j� e�d �-�� ,� z�`GC--iG+� ��' � /�"��"�P -:-�-�'i+{�� ..a^�'�°".
,� �'' � -�,+� � �� �'.�-,��! 1��'
���'�f7� + a��,��', � �� �k��a� • ,�r=r�
e� � G-�1°� �. �,�, �.;� .�.-� � d �
"!'�F,�°�,�jt� d� �^Tai+{''� 1 !,�i`��f"� `� /,� �..,,°-y�*�` �'p+'.'y��`��,�' �OKv" i.+r.e'"�r�° �' f �
1.:�'� �iC� 0't��1 v�i� ��.. `�'� �"�13� ,
In consider�,tion of the issusnce to me of a permit to construct the building described above, I agree to do
the proposefl work in accordance with the description above set fQrth and in �ompliance with all �rnvisions of
ordinances of the village of Fridley. �A � z''� � � � � ��', �.- �
, �� s
' �' � � �-,� N�, ��. S - �m�}�.,
• ��:':�:k�3^ ..4... p ..�. � .... . .
:
— -- �.
Tn consideraiaon of the payment of a fee of $.,r+�r�.:.:°°. ., permit is hereby granted to .��..? i.`s��`Z�' ��::....
�
`.'er;
�`��,,�»
e� ����. ... .. ... to construct the build'u►g or addition as described above. This permit is granted upon
the express condition that the person to whom it fs granted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall con�orm in all respects to the ordinances of
Fridley, Minnesota. regarding location, construction, alteration, maixrteaance, repair aad moving of buildings with-
in the villa.ge limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinancea
.n
P
*�►
F�.
_ . •� ��� � �,�a� � � s��� �-='suila�ng Inspector
NOTIGE:
This permit does not eover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. �e sure to see t�Buildtng Inspector for separate permits for,�se items.
�
TO
. � � � . , ,� ._.. .,� � i �r �' �' � �' i
r� �
�� :, d � '�'d �' � .� r� � � � .� �
��_,- p��ecs�s;.°.�± �r ^,:; n.
.;.� i 4.t'eH,: a,�<�•. ,Lt t=:`: .n, u:.,.�..
e'n-�.��•a�°�6�, E�'�`6 °a; _..;: �&'e �'3 �: � '� ���
C":;".�..'�v�: ��" . �.. `���
SUBJECT: ��gar�tt�t.].cLir�Permit �1I.,AD� DATE: �uae 14, 1�71
FOID —
' 1 !
s�Q��II�'R�Ti��GS�'ri�T'�[iii�'iF�� £���*nIIr►�n �G�t@���➢iF�����i� �1��s
i�� - - .� at ' � 1 �i.a . � • 1 • t � t i� 4 �' !v l f .�
G.
PLEAS� REPLY TO -� SIGNED
DATE SIGNED
SEND WHITE AND PINK COPIES WITH CARBON INTACT PINK COPY IS RETURNED WITH REPLY.
DETACH THIS COPY — RETAIN FOR ANSWER
Caty of Fridlep, IV.Eiun..
6431 University Ave. 1�. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: - Mav 6,. 1971
Owaer: -Af.red B �ph� ��nn Builder
Address � 5�� Fexn�.A� p�►vp 1�1.1P _N.E Addre3s
No. _�1521_V street
Lat Ei 1, � Block
Corner Lot ..._._._....__.._._ Inside Lot X
Sewer Elevatfon
To be Used as:
rara„g� �
Type of
Maintaia 18"
In consideration of
'�e Proposed work in a
OP�DBIIt�B Og 1.� C1Ly �
Fr�nt _2� �epth I �
Front .._ epth
;oncr te&B1oc �
�e cente i e of str�,e
BUILDIN
art
or Su10 •an At
k �... �
dati II atio
/OF BU ING
�" Height � n �
_ \Heipht
$1. 000;
of Lot
SQ. Ft. --6�.9-..b. Ca. Ft. --�R.6...
Sq. F't. Cu. Fi.
To be Completed August 71
hard surface drive.
o� permit to cons ct the building descrlbed above I agree to do
the escription above se fo and in ompli th a�l prov3sions oE
� s !
0 a
In conside 'on oP the payment o'i a fee of $ 13. 00 ���ti � hereby granted to Alfred Philiuson
to construct the building or addition as described above. This permit is granted upon
the express ondition that the person to whom it is granted and his agents, employees and worlunen, 9n all WOrk
done in, ar d and upon said building, or any part thereof, shall conform ia all res�cis •to the ort�3n$nC� of
Fridley, esota. regarding location, construction, alteration, maintenance, repa3r and mov3ng of bwile�iII�
�� � city ]imits and this permit may be revoked at any time upon violation of any oE the provi�ions of 8aid
r
CE BELISLE
NOTICE:
This permit does not eover the eoeatrvetion, installation for wtring, plumbing, 8as healing, aswer o� weter. Be sure to �
t6e Building Inspeetor ¢o� aeparate permifs fo� fheae ifema.
=f ' _ , r
0
n
APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: L"7'L�%��� � � ��.,�L�O�so�BUILDIIt:
AnD1tE�aS :_ ISZ 1 F��� �r�. AnDxESS :
NO • . 0� 'I S TREET :
LOT :�� d-dT G�/ °d 9,� , d
���: ADDITION • �'���,� C� �,
CORNER LOT: INSIDE LOT:� SETBACK: SIDEYARD:
Applicant attach to this form Ztao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As: �
� l�2 �A� -Q._ Front : 02 ei � Depth : oL � ' •, Height • �� �
Square Feet: (��� �•�H Cubic Feet: � � %�
Front: Depth: Height:
Square Feet; Cubic Feet:
, Type of Construction; �o,vcf2� � 13Loc/< Estimated Cost: $ �, °° °
To Be Completed : � wi �' '1 1 �
The undersigned hereby makes applicativn for a permit for the work herein -
specified, agreeing to do all work ia stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildiags, and hereby
declares that all the facts and representations stated ia thia application
are true $nd correct.
n�,� : �( — 3 ca -� 7 / szGru�� : �j . �
,.
(See Reverse Side For Additional Information.) ,�,�
� � � ►, y �
I� � u _ ,�. ;_� :`i 9 , � � , �, ,:., ;" � , ,,i F� � � �, ,� ,7- ,?" �, F� � �p" �_: �-r
3�.�'"'� � � ,}..- �., - q°-.- � ,r •
� � '� 1 " � �` � � � �- '� , , • �-` � � (:-`<_ r� F � �
.. � p`=„ � �, � � . • �
/ ` -
�� � ,i. �< � a` � ,#' . t ri Y� r'� r� A- � �' a�' _ 4� , ,r' °'� . ��
� D � .� f
w
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing peamits for the
erection of any building or structure, ox for any addition to any existing
building or structure, or for any alteration or repair� to any existing
building or structure, upon application therefose, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in
the ma.nner herein provided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Z`ype 3& 5-$1.85 for �� �
each one tkiousand cubic feet.
�
�_ .., _- - - --
ADDITIONAL INFORMATION
For the purpose of computing fees for building perniits, the cubical conterits
of any building or addition, is determin�d by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average.�
height of the roof surface of the ma.in gable of a pitched roof.
For repair� or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any pextnit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedint� with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificat�e of Occupancy shall be made ten (10) days prior
to the uae or occupancy qf any structure for which a building pennit has been
issued; and said structure shall not be used or occup�ed until a Certificate
of Oacupancy has been issued. -
� c
�
_.1 ---
�
..v,_ 22 - - --- -
�-- � � n c'�— �� tJt� � �Z �� �k �'• � i
r �� Z ��
� `°""` - --- ��;
i���;�n/ %N %-Ro� I
2 y x � Qs.
4
i-
t ±+t P � I .. _ . t n- Lrt y � 3r . • _'f .n�r .b ��` ,.
$� �" �����. � f.a r � �j�y � ��` " �'Sz.�.'���k, p''��?: d�.. �1. a�� �, y�" �., ,� �"N . .�� � y� .-,. ., s � � ���4b � i.. ,��- � . .. �� ,x �k: �i`y'��'�' �, �g
� >.' i v � ' a� � ,rf' _ '"1^t .� t � y `�y � �'i' _ _i4 '�'�� . _ �� : �. �'x o a S a„ g '�-r�.�n � �** t� � i� `� � s,. . ,. � .
S i �t p� e3� �-, o� 7 �.dr >��: `^ : .h� s �" � �r':
a+ k�, C L ql�,� �,A il�l ryu�� ,� 4, ��r...T ►4P • r;�, � r :�' ; .., .` , �.,,' x r e�a.� bq �1�d��
1 i .g �� �w9,,�e ' 1 � �„ i � . 4 , J`rif'��h !R a "� k: +��C ������T'
J n.+ i �0�7�` :r !' �'T��a.r� �.'��' ,.4 � 'f!s'4` A4�� �x ..1 �y,nC`�
� � f:a �'I Q �� p y� �: ./,��� .' .�� t4 � �.� �.i.:. t 1 :�,
i� + - �y'�n .,r �p�. '�� � d��� . ` ���.'��4 j!�i� ��`�►i� it�74 �v.� ' l�r 'rY c .: .��T.:
�.CAL1Ct� t �E�.T , � .10�1ib:iE#.�KVi�66r9'i's�A'lki.�10�� !��'tiPSNb"t N
} ; �'� f�� +� , �� . . ' ��� � � � � rt
. .. . `. ;. ..t�., a,.. � �� , ���,. . ��. � ��� _ ... .
1C�'p?` i��OPLRTY OF ., . . _ ; � �,,. f t ,r
� . - - � . . . . . � , � . . ' . .',r� .
�,e�►�sioi� 1521 Fes'nds�e Arre. �. E�,� F�;l�. �,���a_ , �;� `
a�ae�a w� Fr�u. That o the st e� '"
�a. 4
"�i�t � '
t, .�
.a:a �
',f
I
1
.�
r f
• , ,, , . . � . , • . , , ;.
F ^g� 'r: ,: , '' , ,�
., ,
_ , . . ..
_ , ,, r , :: , � ; - , r : • � ;,•
tt � � .. , . , ...� �',�.. .. � � �,p, � � _ ���� ���, '` �4 { � .. -
. �4.�'� �
.�
�!
�
, ��
�
�.,�
1
,.
�
;'�
_ �_
�
' ! ' ��
,
f � �
; �
' � �
I : ` r � r
� � r ,
i E % � � (�%� � �' r �,. ' ' '
� ` ' ' �
I
; n
�
� , � 1 .f '
i ,.
i�
p "
, � , .
� �;
�� • -
,� .
i � �� �
� � M,� , . , ,
� �
; ,,
� ` ,
� I
� � , .
� �: � �r � � .. �'� i"�I
e !.
} .
� _ �M1 ' �_ � � r `:
' y4 iA
1 � p ^� �,
�� ��S•7 � p'1 � i�
S re p� �
� � MGNsatl �}m� � �o� �gi� � v A ^ .l �/ �" ,.�� •�� � ��°t � ,�� '� � �y° r
� � w hRt Pro�lase� � p y- p �• f `
� 46.3 Caa w..y� �� r �.�
� ' �` a y � � , � � &� � � p � , � ��d �
°. � � rd�-� °�' „`'s 4 ¢� �`�/ � �' �.s'.1.� t��:
,;
f„ , ; � . r•
� _ �g,�j ; : � � '] �. o �� - t��/� .� �, `� � ,�` � �
Q.Z -
� * ,, ':
F���°�D�I.E �YE• f�.�. ,';
CERTIFICATE OF LOCATt�N OF BUILDING CERTIFIC�i�E OF SII�Y�Y �
I heteby eertify t6et ot�. I�Ob. 16 ls f?�„ I he� aertify that o� �.______�._�8 , .` 5�
1�Brla � eur�v�+ of tihe io�ats��r� �f kh� �iplidlapC ��) Aq tbo ' 1 u�ra gt� the �e� p e r c 8 dte�criDad �iac��ra���i th�C th�► A'b�i�e' . �° r;
o b ove desc r t F j e d prope r t y e n d t h e t t he loca t i4n a� � a� 1 i €
I. bnild4�g{$) i� correctl� e own on above pfs� � pbt ie s e�troet reproeent�sLion ¢t ea4� eprtey�.
� , � :.. �'
°*tf n4,
+r ^ . �/ � . . �.-^--.-m_--,«..,..�;F—^,.. . ..-,...�,. . �..-.—�...,...- ... ...� ...e.. -. '�a.
' f
�P Jt��IV J. RYAN. REGiSTE.R�D SURVEYOR. Np. ab4�ts Pi t' '+�
.�C r�iT 8� -�Rhlt. QOa,,` - - ' :. . ",; � ' ry�"t ', � � �;I
�,jr � 1 . ,' s' ' c� � R i S ��; � � � +' . y �sC.i'��"��A���r �t�,�,_t,� �:.
i �. � p�� �_ v ^ v- r . + t7 w�. � rr� �� _ i n� � � i - � r �
'k^ r `c = r:- � �� � i r A .e.. y L � � )�; ^'i � 1'+4.^a �y1�� R c� R'� �.- y J r> �� � ���� k �o- ,a � � ._,.
�;,i i . ',., �' _;.d�,r_ _ �.V; �t .. ,-�ia � a-r r � a r--S w�, �'; � a p Y4r �'-�' 7� G F�
�x�iYi�L. . � . �Y� ., s . � � i'��; r� , �.
sue�ecT PERMIT NO.
c�ty of Fr�aley , i49 �
AT THE TOP OF THE TWINS g U I L D I N G P E R
r
� � RECEIPT NO.
� `y _ COMMUNITY DEVELOPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC.
1 ` ,
(` �'��1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
L""'�'� ,'� 612-560-3450
910-F15 10/17/78 � �
JOB ADORESS 1521 Fernda.le Ayenue N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. E�"e �. A11C1. S11b. #92 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Roger Arel 1521 Ferndale Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
S ame
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Res identi.al
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE � REMOVE
S DESCRIBE WORK
Construct a 26' x 27' Masonry Garage
9 CHANGE QF USE FROM TO •
STIPULATIONS provide hard surface driveway. Provide pitch and gravel 5 ply built up
roof.
` �w:
:_ -,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. N,IBSOILL^�7
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT %�.O 5600
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 PROVISIONS 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 $6, 737 �`3.3%
DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OP CONSTRUCTION. � �S`22, %2
PLAN CHECK FEE TOTAL FEE
68 31.77
SiGN UREOFC ORORAUTtiORi AGE IDA7E1 y\I EN PROPE LY I AT D IS IS YOUR PERMIT
�
�= � -��- 7 - IO-�I�- ?�(
IGNATURE � OWNER UF OWNER BUIL RI IDATEI n. DG. INSP DATE
.
CITY Of f1tIULCY .
• , a ..��
APPLI C�TI OP� FOft iZGS 1ll[:NT IAL BU I LD 1 I`1G PEI3f�lI TS . �� _
' (�1�LW, �LTL"-R�T10(�dS, �L�llITIO(J�, OR REPAI(ZS) ��'O '
,��` � . . -�
"� . . . .
r^ • . .
F� • � •
� ow���r�: !`� r.UILll�R: `�.���� �� - ' .
Aaaz�ss : �.5�"�/.�-��� N��� Address : �
. • Tel. No.:
No. ���2/ Street: �,�,�✓��I%��� • ..
r,pT; l3IACY.: ADDITION :
CORN�R L�JT: II�SID� UJT: S3T}3ACY.: SID�Y11RD5:
ApplS.ca'r.t attach �to L-his fozm ��o Certiiicates of Survey of Lot and proposed
buildinq locatian drawn on these Certificates. •
DESCRI PTIOPJ OF BUI LDI I�G
� To Be Used 1�s:
0
. ,.
fiv" rr � y i� .
o . oZ � Depth : 2. • Height : �'
Square Feet: 7�� Cubic Feet: • J�� � a
�1'ront: � Depth: � Height:
' 5quare I'eet: . Cubic Feet: '
7.jrpe of Construction: �,����°��-- ' Estimated Cost: $�p %,�,?, '��
xb Be Coinpleted: Alt. A Alt. B
Proposed Drive��ay �9idth If Isew Opening Ts Desired � $ S
(SEi: R�VERSE SIDE OF SHEET)
The undersigned hereb5� makes application for a permit for the work lierein
specified, agreeing to do all ��=ork in strict accardance �,rith tl�e City of
Fxidle�� Ordinances and rulings of the Deoartment oi Buildings, and hereby
declares Lhat all the facts and representations stated in this application
are L-rue and correct. See xevcrse side f�r aclditional in - rmation.
��; , r J � SIGNa1TUP.F:
Sti�ulations: �
(� O•�'' .�`
. .
• �2 I���w�.�%t ��'c.�. �'c�t�C.
Q
,�i.L. $�,�.Lr ��to� .
r0 D
Q � � `
�
,� � 2. 7 Z
�,�.. � ,s. 68
��� @ . 9y�X�; ���� 3. � i
� ,
. . 3�� ry�
BUILAIf�G PERf�IIT FEt� SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs to any er,isting building or structure, upon appJ.ication
therefore, require the payment by the�applicant for such permit of fees to the amount
h�rein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) '
Alternate A: Removal and replacement of concrete curb and
gutter on1y; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17.20
� 1 1 � : \ � ' : � l
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 below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 ,�ier each five hundred 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 %rth in Section 2 be less
than $7.50 plus $.50 state surcharge. '
_ ; _ � � � � � i � � �
NOTE: Permits for construction will be issued a mini.miun 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 Suxvey of the lot, showing the location of the founda.tion once it
has been constructed will be required before proceeding with the framing.
� � • � '��
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
sa.id structure shall not be used or occupied until a Certificate of Occupancy has
been issued. �
�
a
SUBJECT
City of Fridley °- 17 2 3 3�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
i �
� � .
� `v ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. /�1 � 7 y
�
i1 i �
-_--� ����,,, CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
i 612-571-3450 910-F15 g�'7�83 / /
JOB ADDRESS 1521 Ferndale Avenue N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. P't. ,I. A11C1. Stlb. �92 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Roger Areil 1521 Ferndale Avenue N.E. 571-0978
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Pilgrim Resnodeling 10091 Pil ria� Wa 42 -
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILUING
RESIC�C.'II't].31.
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install alumi:num trim
9 CHANGE OF USE FROM TO
STI PU LATIONS
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 SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO 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 PROVISIONS OF LAWS VALUATION SURTqX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1�200 �`.rOO
DOES NOT P SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISION F ANY STA OR L CAL LAW REGULATING CON- 2Q..5O
S RUCTIO O HE E M NCE OF CO STRUCTION. $
� �PLAN CHECK FEE TOTAL FEE
'= $21.�.0
nrU OF ONiR TORORAUTHOFI2EDAGENT � E� WHEN PROPERI.Y V IDATED THIS IS YOUR PERMIT
SIGNATUREOFOWNERiIFOWNER6UILDERI IOATEI BLDG INSP � TE
�
CITY Of FItIOLCY
. Effective Auq. 1, 1981
tiPPLICATIO'1 fOft RCSIOL'i�JTl/l� [3U1LD1i;G P�fL'lITS
(t�c►�, A1ter.�tions, Additions, or Rcpairs)
BN+NER: a 2 � r
AD�RESS: _ ! ;�%�/U�,� .�
TEL n0: S�/— � 97�'?
.
QUILDER: 7 //?�� �/%fo �Gc�
�./
non��ss: �O ' l
TEL 1�0: - ��S �o �o�?,,,3
Construction Location
STTtIZsT NO: %s�� STItEF.T: %���1.0
L07': - `� - �i HLOC9C: ADAITION: �s'�.4�6 a C� � � �� ��
Corner Lot: Inside Lot: _ Setback: Sideyards:
Ap�licant attach to tl�is fozm two Certificates of S�rvey of lot and
propo�ed building location dr�wn on certificates to scale.
DESCRIPTIO�� OF COi�;STF:�JCTION
_ Front: Depth: Height:
Squanc Feet: Qibic Feet:
l�'ront : Depth : H eigl�t:
Square Feet: C1�bic Teet:
iype of Constructien: �/()m �//� Esiimated Cost: $/p`�(,� "
Zb Be Or�r.�pleted: 0�0 8�_
Alt. A Alt. 8
Proposed Driveway S�idth If New Opening Is Desised: $ $
. . S�E PEVF;R;j' SIDL OF StIEET
ZSie undersianed hereby m11;�� applic�tticn for a pericit fcr the �:vrk herein specified,
agzeein� to c'+� .all work ii� strict accordance ��ith the Ci�y of 1'ridle}• Otdinances a�id
rulin�� of tl�e Dep��rtme��t of IIui�c3ings, and hereby declares t 11 tl�e facts and
represes� titions stated �n this applic.:tion e tr correct.
D.�TE: � SIGNAZUI.�.:
Stii,ula tions :
�� S�
���
�
� ' s '
�
-
4� c. �
e
f �IT�i� -z��3� - - -
The Chief Buildiag Official ahall, Defore iasuing permits for the ereetion
of any building or atructure� or Por any addition to any existing building
or structure or for any alLeration or repairs to aay existiag building or
structure� upon appl�ieation therefore, require the payment by the,
applicant for such permit of fees to the amount herein belox set forth and
in tbe manner herein provided to-xit: .
Sotal Valuatioa
=1.00 to �500.00
=501 to �2,000.00
a2,00, to �25,000
a25,00, to a5o,000
Fees
=10.00 �Minimum �15.00)
=10.00 for the Pirst a500 plus �1.50
for each additional �100 or fraction
thereaf�-to and including �2,000 � �
�32•50 8'or the first �2�000 plus a6.00
for each additioaal a1,000 or fraction
thereof� to and iacludiag �25�000
�170.50 Por the firat �25, 000 plus
��•50 Por each additional �1,000 or
fraction thereof, to and including
a5o,000
�50,001 to a100,000 �283.00 for the first �50, 000 plus
�3.00 for each additional a1,000 or
fraction thereof, to and including
�100,000
�100,001 and up a433.00 for the first �100,000 pl us
a2.50 tor each additional �1�000 or
� fractioat thereof
Plan Check: 25 percent of buildiag permit fee.` �
Drivevay Depression Escrov: Concrete curb streets onlq.
Alternate "A": Removal and replacement of curb and gutter only -
DriveWay tridth plus 6 Peet times �13•50
Alternate "B": Removal and replacement of curb and gutter and
iastall a 3 foot vide approach With 6 inch depth - DriveWay Width
plus 6 feet times �15.75
._ . � � �.-
Permits for construction will be issued a minimum of 24 hours Prom the
time of application to allox Por proper-,revieW of the proposed atructure
aad of the construction site. -
A Certificate of Survey oP the lot, ahoWing the location of the fouadation
once it has been constructed Will be requfred before �roeeedina witb the
Pramiag.
sue�ecr P
c�ty of Fridley T��- � _
ATTHETOPOFTHETWINS gUILDING PERMIT 22411
r
RECEIPT NO.
� �
� • COMMUNITY DEVELOPMENT DIV.
� ; 4 ����� ,
r � � PROTECTIVE INSPECTION SEC. � � �
1 i �
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE OF APPROVED BY
�•"'� � �'' 612-571-3450 910-Fi 5 4/ 11 /94 / /
JOB ADDRESS 1521 Ferndale Avenue NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED
DESCR. Pt 1 Auditor's Sllb. ��92 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Roger Arel 1521 Ferndale Avenue NE 571-0978
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDHESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING ,
Residential
7 CLASS OF WORK
O NEW � ADDITION O ALTERATtON O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House -
9 CHANGE OF USE FROM T�
STI PU LATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEAT�NCi,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTFUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 6D DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO 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 ]. STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GHANTING OF A PERMIT � I. � SOO . �S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 3S . OO Fire SC L. SO
PLAN CHECKFEE TOTALFEE
SIG IRE OF CON'RACTOR OR AUTMO � ED AGENT IDATEI yy EN PRO VALIDATED IS YOUR PERMIT
� /� � . , I�
SiGNATU OF OWNERUi OWNER�BUILDER� IDATE� "° �!\ - BLDG �NSP "'-''�����
NEW
ADDN
ALTER
[l
[l
[l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 1 / 1 /94
ConstructionAddress: ,`�„� / y� �-� � � ��• --- —
Lega1 Description:
Owner Name & Address:
Contractor:
Address:
LIVING ARfiA:
GARAGE AREA:
DECK AREA:
OTHER:
��
u
Tel. #,S�/ -� � ��
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction dra.wn on it to scale.
Length
Length
I.ength
DESCRIPTION OF IMPROVEMENT
Corner Lot [] Inside Lot [] Ft. Yd Setback
Type of Consiruction:
Approx. Completion Date:
Width
Width
Width
�� — �2 �
Height
Height
HgtlGround
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Side Yard Seffiacks
Estimated Cost: $ /� � � �,
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �/ G APPLICANT: �`' Te1. #,� �/- Lg� 7�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Patk Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ���" C�
$ �- ��'
� e ���
$
$
$
$
$
$
$ � ���`
CITY USE ONLY
Fee Sch�ule on Reverse Side
.001 of Permit Valuation (1 J lUth %)
$.50��1,� �%�U211'lOII
$8� per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservadon Plan Review
Fee I?etermined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
.�;
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any bui(ding 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 se� forth and in ffie mann�r herein provided to-wit:
TOTAL VALUE
$1 � � to $S00
$SOl to $2,000
$2,001 to $25,0�
$25;001 to $50,000 - .
$50,001 to $100,000
�
$100,001 to $500,000
$500,001 to $1,000,000 .
$1,(30U,001 and up
FEES
$15 (Muumum Fee is $15 plus surcharge)
$15 for first $�0 pins $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for fust $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,QQ0
$252 for first $25,000 ples $6.50 far each additional $1;000
or fraction thereof, to. and including $50,000
$414.50 for first $SO,OOQ plus $4.50 for each additional
$1,000 or frad�ion thereof, to and including $100,000
$539.50 for fust �$i00,OQ0 plus $3.50 for each additional �
$1,�0 or fractio� th�eof, to and including �$500,000
$2039.50 for the 5rst $500,000 plas $3 for each additional
$1,000 or fractio� thereof, to and including $1,000,000
$3539.50 for ifie fust $1,000,0(}0 plus $2 for each additional
$1,000 or fraction thereof �
DRIVE�VAY DEPRESSION ESCROW
(Concrete Ctirb Sbreets Only)
Alternaf.e "A" : Removal aad repla.cement of curb and gutter only - Driveway width plus 6 feet times
$13.50. �
Alternate "B": Removal and replacement of curb and gut#er aad install a 3 foot wide.
approach with 6 inch depdi - Driveway width plus 6 feet times $15.75 _
VERIFICATION O� FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of tlne construction site_
A Certificate of Survey of die lot, showing the l�on of the foundation once it has it has been
constructed will be required before proceeding witfi the framing.
' sue�etT PE
City of Fridley 3133
AT TNE TOP OF THE TWINS � � I L D I N G P E R M I T
r
; � RECEIPT NO.
�_����_ COMMUNITY DEVELOPMENT DIV.
r � V � PROTECTIVE INSPECTION SEC. ����
i . ,
`--_.� �"��'� CITY MALL FRIDLE� SS132 NUMBER pEV O�TE P�GE OF �OPROVEO Br
L 612-571-3450 91Q-F15. 8/22/00 / /
JOB ADDRESS 1521 Ferndale Ave NE
1 LEGAL ��7 N0. BCOCK TRACT OR ADDITION SEE ATTACMED
oesca. part of 1 Auditor's Sub. #g2 SMEET
2 PqOPERTY OWNER ��,1� MAtL ADDRES$ ZIP PHONE
Stephanie Bee� 1521 Ferndale Ave NE 763 502-0470
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
�irtz Construction 16138 Goodview Cr Lakeville MN 55044 952 891-4208 20216415
a ARCNITECT OR OESIGNER MAIL ADDRESS ZIP PMONE �ICENSE NO.
5 ENGINEER MAIL ADDIiESS 21P pNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION �J REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House and Gara e 21 s Tear Off
9 CHANQE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO FOFi EIECTAICAL, PIUMBING, HEATING, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTII.ATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL AND VOIO IF WORK OF CONSTRUCTION ZONING S�. FT CU fT
AUTHOR12E0 IS NOT COMMENCEO WITNIN 80 DAYS. OF IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED fOp A PERIOD Of 1Tp DAYS AT
ANY TIME AF7ER WORK IS COMMENCEO. NO DWLG. UNITS OFFSTFEET PARKING
I HEREBY CEFTIfV THAT I MAVE READ AND EXAMINEO TMIS APPIICATION ,' STA�LS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. A�L PROVISIONS OF LAWS VAI,UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED �1 SJ�S.00 ,�.92
WITM WHE7HER SPECIFIED HEREIN Ofl NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TMEi pEqMl7 FEE SAC CHARGE
PROVISION OF ANV 07HER STATE OR LOCAL lAW REGULATING coN- �66•ZO Fire SC .��.•S4
TR CTIO OR TME PERFOFMANCE OF ONSTRUCTION
PLAN CNECK FEE TOTAL E
�% � ��-� License $5. 0 3.96
S�GNATUAE OF CON'AACTOp 0�7 AUTMOA�2 GENT IOATE� EN FOP �LIDAT O IS IS R P�EJA'M
rV
S�GNATUAE O� OWNEAi�f OWNEpBU�IOEp� iO�TEi e� �h50 r��rE
N � � � Effeativve 1 /1 /2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bidg Insp
ALTER [] SINGLE FAMILY AND DU�LEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 3iL,'�-
� 'J
Construction Address:_�J`fG�� �,.P�'����/,p ��—��j��,�� �
Legal Description:
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. # ��-����
�
MN LICENSE # , � /� , /�
Tei. # ,�5.� �-�'9/-��G�-/
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. F�
Length Width Height Sq. Ft
Hgt/Ground Sq. Ft.
O ���
Construction Type ����� %�� � Estimated Cost: $ , /('�
,
Driveway Curb Cut Width Needed: Ft. + 6 t= Ft x$ _$
/.
DATE• APPLICANT: ` Te�, a
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ ��. �O Fee Schedule on Reverse Side
Fire Surcharge $ � c� `� .001 of Permit Valuation (1/10th%)
State Surcharge $ � $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$ � $1100 per SAC Unit
$ . Od $5.00 (State Licensed Residential Contractors)
$.
Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
$ ,�
BUII�DING PERMIT FEE SCHEDULE
The Cluef 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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $5�,000
$500,001 to $1,000,000
$1,000,001 and up
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 $2,000 plus $14.00 for each additional $1,0�
or fraction thereof, to and including $25,000
$391.25 for firsi $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,� plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 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
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ciirb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "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 $23.25.
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 l�ation of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
*
-. D
.�r -t
� O
� �
m �:
� �
� O
y' �
N �
O y
� n
-,, n>
� �
0
� �
0
� '�
��
0
�• �
�• �
oa �
CD
.a a
o �
� �
� y
� a
O �
� �
-�
� a
. �
�
S
0
c
.+
�
m
z
�
-o
m
-�i
�
Z
'n
m
m
�
�
V
O
0
�
_
�
� � IZ
d �
� `� �
� � �
� �
�
"�O X �
�
� � �
c � Q" Z
� 1 �� o
�
0
�
OG
�
7
�
�
m
�
m
r
�
�
� �
� �
1
�
�
m ^
� �
� c
�A� �
�, �W
�•�'*�..�
���,.. �..,_
v
�
m
R1
i-�
T
�
�
�
�
�
D
�
m
Q
�
C�
CNn �
� eo
�
o �,
fll \
tD p.
C
O �
D _
a �
n�'
�
�
c�
0
�
0
�
o �
�
D m
r �
m �
m �
II1
00
m
� �
�.
� o
� � y �
a � � �
� � � �
m � o �
a
� � 01 y
� � � �.
y W �, CD
y _. � a
.�. oa
�
�=o`-°-
a� a �
� ° ° `<
r►< °_' 3
� N �
d. �• � y
� � � �
�'aNa
� � � �.
� � �, =�
� � A �
m a � -�
� � ° o
c � � �
m �
� � v
� N � �
Q '� �
f7 p�j �. rr
O rt S -�.
� �, � o
� — � ,,.
,.��Sm �
m n CD
��o
N O �
� � N
Q N N
� 3.
�
r D
� Q
°. �
< fD
� N
\
N (�p
O �
D�
a �'
a�' D
� �
m�
o °�
� o
�
O N
� r
�
�
�
Z
W
D
c�
v
D
n
0
�
fl.
O
�
�
OG
D
�
N
c�
y
G�
�
N
�
m
�
G� L� D � �
N N y � fA
� � � '� n �
� �. � CD � �
c�p p�q N o� C� �
3
� z � � fD
"� � ,��+ � N
7 a . � �
o � T .� a
� Q--T 0
— �
.° f �� �
� � � � G
� � W � o
� � � �
� -" �
v � W
� �
a� �
m �
%9 {�A {79 iy9 �!9
N � r�+ ►-� (,�
cJt O O O O
°o °o °o °o o° °�'
m
fA 69 4f! � b9 {f1
0
�
W W
C '`
�
m
�
N
Q
m
Z
n�
m
2
'D
N
N
m
Z
0
m'
�
.Zl
'n W --I Z
�-��,o
— C � o
�� m
� �
C �D �
OC
c
�
� y
�-
_
� �
o _, C?
� Q A
n �
O p
� �
� �
m
� ^
lD �
� N�
r rv �
Qr,i z `�
0
� o =
O
G
�
m
�
�
�
v
m
�
-�
D
�
m
�
n
O
�
-�
�
�
�
�
m
�
�
-�
z
�
/'� ���
l,�r 9
�
�
�
m
N
C�
_
m
v
c
r
m
"h v � d� (7
� W � W �
F-+
rnv���
`'' Giv,,z`m �
v
� � � y �
o ,+ r
� �P � �G I�l
� W � �
N N m Z
00 z �
� m �°
m
C7
-�
O
z
�
C
�
a �
� z
'�
r
��
� O
�ii Z
m .,�
a�
-�1 �
O �`
Z�-
Z�
v�
a�
�Z
OH
vz
�v
o=
Z
Z -�
'� Z
�n
m�
3r0
�' Z
a�
v<
v "'
Z
��
n �
N O
Z
�
C � W
° � v
z o
� �
c rn
rn � �
�
� n�
� �1 w�
O L�
� �
h �
�U �
� 1 �
,
r-,
rr.
rr,
�
�
rt
w
<
�
L
�
'�
G
w
n
�
ti
O
O
W
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIANCES OR THE
APPLICATION WILL BE RETURNED
r�R��en�� �� ��r �/GI�T Cnl`I�!E('TOR AI�D CnMBI ISTInN Q IR VERIFICAT10111
��� �nl�cin+ an=p �ran --, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes ( 1 No ()
The venting system is plastiGPVC and meets all current codes and manufacturer
speaflcations including s'izing� length, number of elbows and termination. Yes (► No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specificatio�s. This does
indude AGA-GAMA Category I Central Fumace Ventin� Tables for fan
assisted and natural draft appliances.
The eY ��emb ��on a�r is sized and installed to meet t0ie current codes
and manufacturers specifications.
When I�equired to i��� " n_w cemh��etien airi it Wjll b@ SI'Led alld 'Itlstalled
to m�t the current codes and manufacturers specfications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
�n jp�p� neN v_►�piystem, the undersigned h�reby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does indude AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installedl correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
•.. .. - .- .�. �- .����.� -� ... -� .��-«. � .���.�.�
AppGance #1 Type BTU Input e Fan Assisted or Nat _
AppGance #2 Type BTU Input � Fan Assisted or Nat _
App�i�� �3 Ty�e gTU �nput ________ Fan Assisted or Nat _
Total Appliances _ Total Btu Input
Cflmmon Vent Type Vent Height _ Diameter inches
AppGance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type �
o� ��zonc�NS (�es�� �� s �� f ( G � s �. �%�,e e v� � G � � /i',. �
HEATING CO: /' � r-°5� c��° 1-1 �Gi� ¢ I. -c- %-� e+r--- 9e
Signed By. ��� �—�> Date : / o+? ?�a -�