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City of Fridley, Mirm..
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No,�� Stceet �,�� Part o Lot
Lot �.._.___ Bloek �._ Addition or 5ub-Division
<
Coraer Lot � de I.ot � Setback .�� �— Sideyard ��-9��
Sewer IIevation ���� — Foundation IIevation � ��� G�
DESCRIPTION OF BUILDING
To V . � �
Front � Depth �� Height °.��..� S�l• b''� �`� ���?`,�'
Front Depth �Te�,ig�t � �. Ft _°��;�Cu. Ft�_��..��
F� �����e� � L��'�o be Completed
�ie Construct4on t �-.�.---
Ia consideration oP the issuaace to me of a permit to construct the build9ug descri�d above I agree to do
the praposed work 9n accordance with the d+escrlption above set forth and in compliance wi afl Prov3sions of
oidinanc�s of the dty of Fridley.
In consideration oP the gayment of a fee of $��permit ia hereby graated to
to construct the building or addition as descrYbed above. Thispe rmit is granted upon
the express c�ndition that the peraon to whom ft is granted aad hfs agents, employees and workmen, in all work
done fn, around and upoa safd building, or anypa� thereof, ahall conform in all respecta to the ordinances of
Fridley, Minnesota reg �g lacation, conatruction, alteratlon, mafntenance, repair and moviag of buildinga
within the dty limfts and th�s permit may be revoked at any time upon vi� of aay of the P�visions of eaid
or3inaac�. /`�, �, .�
Buildiag Inspector
NOTIC�
'llds � d� eof eever ths �mirudion, t�taDtlion fee rrirta9. P��+m9� 6a 6�Ins, sswar e� walsr. B� sma to �
t6o Bulldie� l�te� fe� apardr � fer �6ae hsms.
560-3450
C�f o r�dle
� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55421
TO WHOM IT MAY CON'CERft:
September 3, 1965
1540 Fern.dale Avenue N. E.
Fridley, Minnesota 55421
The red tag may be removed with the stipulation that prior to occupancy
of this building, a11 requests stated on the Cond�mn.ation Card and made
by the Health Officer be complied with.
Sincerely,
�' . .:Y�
,{ ��� . � ��.;� :��� �
� �
ALLEN G. JE SEN
Building Inspect
City of Fridley
AGJ:cks
ATTENTION
�
�
ro �� J�s �• H�gley, Health Inspector
City of Fridley
.�� _., •� '•=, - . �
Edina, Minnesota 55424
L-- -. _ _ - --- _..
SUBJECT Possible Health Hazard
City M�uager
City of Fridley
6431 University �,venue N.E.
Fridley, Minnesota 55421
DATE �ugust 5, 1965
Jims I understarid that tha vacas�t house at about 1556 ��r�a? @. ( it is lst
...
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fl.•c '_ = -� • • 14_! • �. •' y • _�,t.•._ • ec •��-,{�Y�cy • •o • U• �
._ :._ _. .. = ' = •
I believe Nationai Funds q�� it.
SIGNATURE ���(� ��r �l�:���`"�___� Earl P. Wagner, City Manac�
REPLY: , � � �
--. -- --- - --
that a complaint was - Mr. Gayle Gille�pie, 154i Ferndale. The
house is rg�:±�r e�d f�em �n
evidence that the dwelling �aas struct�ue�Lly unsoc�d. From a public health
stand�oint _the rear �aoaden sten� shQitld b� �_i
and a haadrail provided. A handrail should also be provided for the froat
ste}�s gnd a coc�nle ef breken w3 ndr�d,� �.��r7 tn t,.�, rensf 9 r�7 �e_ �0.. � e
_ �-.. -.— �-.. �o---e.- _ _ ____
out of_horizontal plane_due to sagging, however, this coadition could
- ..--
s e e strc�cttctre. Foundation walls �eeffied to be aound and the lower
half ef th� l�eug_�_�{ t,� f,ava ,1„
it could be �ade f it�f o httmaa habita��t i n� �er� I� d never --i�� .
, , pap R1�,�00 for it.
CC� ����_�8.�� _.___.-_._�_� DATE- $��� SIGNATURE
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City of Fridley, Mirm..
BUILDING PERMIT
Date: _ March 18, 1966
,��-�l� �
N'° 8719
�: I,oren Box�nn g�� �f�� giu,ldprs
�� 151�0 F�rndale Ave, N.E. Ad�e Bloomington, NU.nnesota
LOCATION OF BUILDING
No. 1 0;�'_ g�t Ferndale A4e. N. E. Part oE Lot
Lot 2 __ Hlock 1 Addition or 8ub-Divfsion �'.Y � s, lst
Coraer Lot _ Inside Lot
Sewer IIevatfon
To be Used as:
RII�IODEL Front
Front
Type oP Construct[on
SEtback � Sideyard
r. Foundation IIevation
DESCRIPTION OF BUILDING
Depth Height Sq. F't. Cu. FL
Depth �Tefght Sq. Ft Cu. FL
.� F�t. Cost —�a�fl�__ To be Completed �1,�66
In conaideralion of the �lssuance to me oP a. perm4t to construct the bufldiug described a e I agree to do
th� ProPosed work in acc�rdance with the d�salption abo}��t Porth and in coinp�anc���afl ���q�i�Ons of
�dinances oP the dty oP FridleY• I n �1J . ����� if� /
Ia conafderatton of the Pa3'a►eat of a fee of $--�rQ�, Permit fa hereby granted to � f�—.
$ui,l,t�ers to construct the bufldfng or addition aa described above. This �ermit is granted upon
the express conditlon that thepe�on to whom 4t fs granted aad his agent�, employees and workmen, fn all work.
done 9n, around and upon eaid huild�ng, or any thereoP, shall conPorm 9n all respecta to the orainaac� oE
Fridley� a�innesota re3gar8ia� ��,� �� t�ea�y� �� l�a�tio�n o�f e� the provisfo s�oP ea�a
wi�� dLy limits and tls�s
A � .f��... '�., C� i .:1•:'.H.�JY
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NOflC6e
Thb p�rmb doa aot ao�nr tla aom�►uaHoe. �natalbNee h� �1�leo, pMrmbtnq, oa huHn�, aw�r or rraM�. M ain to �
fln dnpdirt� lequo�ae tar apanf� pemtb /e� 16a� H�m�.
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APPLICATION FOR BV1LDIftG PERA'aT
CITY OF FRIDLLY,.MINNESOTA
OWNER' S NAME �!� � BITII�DER �_ � r��".�'
ADDRESS „�, ������� a� ADDRESS o `��� �"��
.
LOCATZON OF BUZLDI G .
N0. %� � O STREET °� o PART pF LOT
�
LOT '� BLOCK .!`' ADDITTON OR SUBDIVISTON � , , � ; �
CORNER LOT INSIDE' LOT � SET]�ACR SIDE Y
SEWER ELEVATION FODNDATION ELEVATIQN " '
Applicant ateach to this form Two Certificatea of Survey of Lot aad proposed
building location drawa on these Certificatea.
To be used as';
DESCRIPTIOIQ OF BIIILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Degth Height
Sq. Ft. Cu. Ft.
-5=���'.� Estimated Cos ����� ° �
Type of Construction � �,� , , � -
To be coinpleted
The undersigned hereby makee app7.ication 'for a permiC for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordiaances and ruliags of the DeQartment of Buildinga, and hereby
declare� that al]l the facts and representat3ona stated in this application
are true and correct.
DATE�� � a�-y�''t' �' � l"��
(Schedule of Fee Coets can be found on the Reverse Side)�
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BIIILDING PEI�T FEE SG%EDIILS
SECTION 2. The Inspector of Buildings sha]L1, before iseuing any permit�for
the erection of any building or structure, or for any addition to anq esiating
building or structure, or:�os any alterationa or repaira to aay exiating
buildfng or atructure, upon application therefore, require the payment by the
applicant for auch pesmit of fees to the amount hereia below set forth a�c� in
the manner herein provicled to�wit;
2.1: For auy auch permit for the erection of any fire-proof building,
other tha a garage, warehouse, factory or grain eleva�or, or for the erectfon
of any.fire-proof addition, for similar occ�apaacy, to any esiating building,
sha11 be at the rate of $1.4D-for each�one�thousand cuhic feet, or fraction '
thereof, in such cubical contenta. ��
2.2 For any such permit for the erection of any fi,re-proof garage,
warehouse, faetory or �raia elevator, or for the erection of anq fire»proof
addition, for similar occupancy,.to $ny eui�ting building shall be at the
rate of $1:25 far each one thousand cubic feet, claseified as "fireproof"
by Section 502 of the Minneapolis Buildia���ode.
flOIISES
2.3. For any such permit fqr the erect�on of aay aoa-fireproof
building,.other than a garage, warehouse, factory or �rain elevator, or
any non-fireproof addition, for aimilar occupancy, to any exieting building �
permit $1.00 for each one thousand cubic feet.
GARAGES . _. .
-
2.4: For any such�permit #o� tihQ�erection of any non-fireproof garage,
warehouse, factory or gra�ta elevator, or for the e�rection of any.non-fire•proof
addition, for aimilar�occupancy, to anq esi�ting bu31d3ag o� for"each such ��
building or addition - ninety cents ($0.90) far ea.ch one thous.and.cub3c feet
or fraction thereof, in the cubical �ontents thereof with the miaimum o£ $4.Q0.
For the purpose of computing fees for building pt�rmi�ts, ehe`cubical conteuta
of any building or additi_on �o�a uai�orm height through'out by multipLyin,g the.
ground�area-aovered from a po�nt s3x (6j inches below the floor line of.the
basement Qr cellar to the average hr��ght of the upper surface or to the average
height of the roof surface of �the main gable of a p3tthed roof.,
2_ For repairs or alterationa to an exiating structure, the fee s,hall
be at the rate of $3.00 per each Five Hundred Dallars ($500.00) or fracti�n
thereof in the cost of all propoaed woik. �
2.6. Ia no case shall the fee charged for any permit as set forth in
Sectioa 2 be lesa than $4.00.
STORM REPAIR DAMAGE FEES:
Resfdential; Eatimated Cost of work u� t�s S5r�.0� �- $5.^..a
Estimated Cost of ��c��`�: c°,�� Y:���::.�1�1 - Y:�.,'�0
i-'o -a. _o.ti.
Commercial; Estimate�'�oct o� �an�is u� r�.� =':��:�'"oi�'� -$1'�0
��_Es��mate�,..;ost of �u�lc ovr�r $ �L'�.UO - $2t, la
« _
,
ATTENTION OF: F=OlYt2
�----- . . - -------------- -----_ - - - _-_'1
-__. ----
All�n Jenson�` Build _ City Manager
ro __�__ • 3ng' inspector __ Cit�,�.�.� .
� of Fsidley .
L— __ - - � _.
SUBJECT Vacant home at 1556 Ferndale DATE August 5, 1965
: e �i }... � � .L _}. � J t t = - - s • • G . . �. !. ' _. ..
_._._... .._ .. _.. - = . , 0..:' • • � • � _ _
• • O. ' .. � � • O • J. . ; � �. . . � .� � i � � - .:- � - �, G
satiafaction, or should it be condeau�ed2
SIGNATURE
REPLY: _�.
0
C
E
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� � '�' �__ __�.__c. `� � � ,�� t �' [.� 5 �
�----
DATE , � � � �^ SIGNATURE
REPLIER'S COPY-RETAIN FOR YOUR FILES
sue�ecr PER .
City of Fridley 2�. 6 81
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � R NO.
� �,y _ COMMUNITY DEVELOPMENT DIV. � ���
r � � PROTECTIVE INSPECTION SEC.
i i �
� r'��l � CITY HALL FRIDLE� 85432 NUMBER REV DATE PAGE OF APPROVED BY
�'"'"� � ,'� 612-571-3450 9t0-F15 12/1/92 / /
JOB ADDRESS 1540 Ferndale Avenue NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 �. L3Y'Y'Y�S First Addition SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Bab/Mary Nehring 1540� Ferndale Avenue NE 571-5321
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Allstar Construction 3315 N Hwy 100, Mpls., MN 55422 593-5325 3
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUtLDING
R2 S l C�@il t].11.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [� REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOHK
Reroo� House (� 5qua.xes 1 Tear�o��'
9 CHAN(3E OF USE FROM TO
STIPULATIONS
_ Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE HE�UIRED FOR ELECTRICAL, PLUMBING, HEATIN(3,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1. STALIS 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 $477 $�5O
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $�-5.00 Fire SC $.4S
PLAN CHECK FEE TOTAL FEE
��' � � %��j� License SC $5.00 $20.98
SIGNATUREOFCONTRACTOf:ORAUTMORIZEDAGENT IDATE� 1�HEN PR�PER ALIOATED THIS IS YOUR PERMiT
a � l ,�J i2- I— 9'L
SiGNATUAE OF OWNEA ��F OWNER BUILDEAi �DATE� BL �NS �iATE
��v '[ l
ADDN [ ]
ALTER [ j
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: / S�O F'�tI f%ql.E ,,¢ (/•
,
Lega1 Description:
Effective 3/ 1192
4wner Name & Address: o� d'/1/�„�Q i/✓ ��/� � N(�- Tel. # 5-? %-,f',3� !
Contractor: f�L�ST'fJIQ �D^%$ �U G7-Zo N MN LICENSE # 30� `J�'?
A�esS:33�S N• NwY. t Q0. .�/I�GS•,�tt�r/� s S"y�z- Te�. � 5'9'3-,�'��S"
Attach to tltis application, a Certificate of Survey of the
lot, with the proposed consbruction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Le�tgth Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width HgtlGround Sq. Ft.
OTHER= �JSQ. TGR�oe�t�. �6�a�. S�/NG-L.�
Corner Lot [ J Inside Lot [ J Ft. Yd Setback _
Type of Consbruction: E v o
Approx. Completion Date: o? � a
Driveway Curb Cut Width Ne�ed: Ft. + b Ft =
Side Yard Setbacks
Estimated Cost: --, . '— °`�� %
(Cost on Back)
Ft x $ _ $
DATE: o? APPLICANT: G�' � SS' � Tel. # J��� �3�
/�p C?•t�c4��
CTTY USE ONLY
Petmit Fe.� $ / a . �' �"
Fire Surcharge $ - �/�S
State Surcharge $ , � �'
SAC Charge $
License Surcharge $ � �'�
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ � f� ' 9�
STIPULATIONS:
F� Sch�ule on Reverse Side
.�1 of Permit Vatuation (1/lOth%)
$.50/$1,�0 Valuation
$7i10 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Ne�essary [ ] Not Necessary ( )
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erectioa of any building or structure,
or for any addition to any existing building or struct�ue, or for atry 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,�1 to $25,�
$25,001 to $50,�0
$50,(ml to $100,�
$100,W1 to $S�,OQO
$S(�,�1 to $1,000,�
$1,00t?,001 and up
FEES
$15 (Minimum F� is $15 plus surcharge)
$15 for first $500 plus $2 for each additi.oaal $100 or
fraction ther�f, to and including $2,000
$45 for first $2,0�0 plus $9 for each additionat $1,000
or fra.ction ther�f, #o and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction ther�f, to and including $50,000
$414.50 for first $50,� plus $4.50 for each additional
$1,000 or fraction thereof, to and including $1�,000
$639.50 for first $100,000 plus $3.50 for e,ach additional
$1,000 or fraction thereof, to and including $500,000
$2039.50 for the �irst $500,000 plus $3 for each additional
$1,OW or fraction thereof, to and including $1,000,000
$3539.5� for the �rst $1,�,000 plus $2 for each additional
$1,000 or fraction �thereof
DRIVER/AY DEPRESSION ESCROW
(Concrete Curb Strcets Only)
Altemaxe "A" : Removal and replacement of curb and gutter only - Drivewa.y 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 - Driveway width plus 6 feet times $15.75 .
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum �f 24 hours from the time of applica.tion to allow
for proper review of the prapos� structure and of the construction site. �
A Certificate vf Survey of the lot, showing the l�ation of the foundation once it has it has been
constructed will t� required before proceeding with the framing.
SUBJECT ,
City of Fridley 25 49 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M t T
i �
� �
� ' COMMUNITY DEVELOPMENT DIV. � �
i � V �
r � � PROTECTIVE INSPECTION SEC. �
1 ` �
� /"'1 � CITY HALL FRIDLEV 85432 NUMBEH NEV OATE VAGE OF APPROVEO BY
�----� • •�� 612-571-34b0 910-P15 9/11/97 � �
JOB ADDRESS 1540 Ferndale Avenue NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. L 1 Larry's First Addition SHEET
2 PROPERTY OWNER MAIL ADDRES$ IIP PHONE
Stanislav Petrashov 1540 Ferndale Avenue NE 502-0053
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
S8.IR2
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASSOFWOFiK � NEW ��DDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Construct a 9' x 12' Entry Addition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan.
���.��
8��0� d�gg1R ��
a11 ati�ity �$ �af � fbr
�Sq.�Z t'°°�
�EQ����D
�EP1�R/�i"E PERMITS RE �Y ��I/
WIRIMG, HEATIiyG, A!U gu� q FOR ^.
ND ;;l���S.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SC. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTHEET PARKING
I HEREBY CERTIFV 7HAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GAFiAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS yqLUATION SUFTAX
AND ORDINANCES GOVERNING THIS TVPE Of WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �l s lOO $3. L7
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT fEE SAC CHAHGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �P12�F. %5 Fire a)C, �6..rJ�F
PLAN CFIECK FEE , TOTAL FEE
$134.56
S�GNATUREOFCONTRACTORORAUTNORIZEDAGENT �DATE� WHEN PROPERLY V ATED TNIS IS YOUR PERMIT
���n��s� � ��"�G� �� �� - , � q—° — �
SiGNATUREOFOWNEAiifOWNEFlBUILDERI I TEi C� ���'�' BLDG NSp qpTE
NEW [ )
ADDN [l�]� CITY OF FIdIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: /`3 L/'(� jC�� � ���r ¢fG�O /vL� /�%r,�,�.
Effective 1 / 1 /97
�����
���7��
Legal Description: �
Owner 1Vame & Address: �y��yj�� � � � � �� ��� �. Tel. # ���` � Q��,� .
n a-,
Contractor:
Address
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE #
� Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length � Width � � Height /Q � Sq. Ft. � � � �, ��
Length Width Height Sq. Ft. ��� 3�
�n� �id� Hgt/Ground Sq. Ft.
Consttuction Type: RStimatQrl Cost: $ �� �` p�
(Eee Schedule ori Back)
Driveway C�rb Cut Width Needed: Ft. +� 6 Ft = Ft �x $ —$
DA1'E: ��' • /L/ ' `J APPLICANT: �,���d��Q�
� �� ��sTi� (.�Ji� � � Tel. # ��� c� � � ,
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULAT(OI�1S:
$ �1���
$ �
��
$ ,
$
$
$
$
$
$
$ /� J (o
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Peimit Valuation (1/lOth%)
$.SOJ$1,OQ0 Valuation
$950 per SAC Unit
$5.� (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
P.
r �`
[3U[LDING PERM[T FEE SCE[EDUI,i;
"1'he Chief Building OfCcia( shall, before issuing permits for the ereation of any building or structure, or f�r
any addition to any existing building or structure, or for any alteration or repair to anq existing buildinv or
stiucture, upon aRplication ttierefore, 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
$5�1 t0 $Z,Q�
$2,001 to $25,000
�V25,001 t0 �5�,0�0
$50,001 to $100,0(}0
$100,001 to $500,000
$500,001 �o $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
C
$21 for first $500 pius $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2, 000 plus $12.50 for each additional $1, 0�
or fraction thereof, to and including $25,000
$349.75 for first $25,OU0 plus $9.00 for each additional $1,000
or fiaction thereof, to and including $50,�
$574.75 for fust $30,000 plus $6 25 for each additionai
$1,000 or fra.ction thereaf, to and including $1Q0,0�
� . ..
$887.25 for first $100,OQ0 plus $5.00 for each additiomal
$l,��or fraction thereo�.to and including $5�,�
$2887.25 for the first $500,�0 plus $4.25 for each additional
$1,(�0 or frdction thereof; to and including $1,(M?0;000
$5012.25 for the fu°st $1,0�,(?DO plus $2.75 for. each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ciirb Streets Only)
d.r.• _
�t
�„-
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.�0.
Aiternate "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
I'ccmits for construction will be issued a minimum of 24 hours from the time of application to allow for pro��r
r�view of the proposed structure and of the construction site.
�� Cei�.iticate oti Survey of el�e lot, showing the location of the foundation c�nce it has it has heen c�nstruc°_��:
��'i;1 l,� reyuirecl hefcire 1)I'�ILL��jIIl� ��rith thc framin�.
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NEVV [ ]
ADON ( J
ALTER �
CITY OF FRIDLEY
6431 Universiiy Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/2002
(763) 572�604 Bldg Insp
��� ����
� Construction Address: 1 Sy d �e � +^� c�a�� � a �' �- '� ' �
Legal Description: L��� wes°s' ��.�,�t�-�� s;ae �F p�.�e w��.-� �e..�! b�- o.,cl�i't`L � k�
� Owner Name 8 Address:C�r-, *►��t�� ►Sy� �ecnc�.4 a•+t /?.� r�.� � �y Tel. # �
Contractor. C i a-, o'F �� �d�� MN UCENSE #
Address: Tel. # _
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Ce�tiflcate 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
nC�
ce 1 �
63-57�'l8�-'�- (�racFio•�1�3�
Construction Type: Estimated Cost: $
xDriveway Curb Cut Width i�eeded: .� Ft +�Ft = Ft x$ /�1 `�� _� % S 3 v�
xnA�: �- S-a a- APPUCANT: �-�ar-� v"`c C� e Tei. #(o i a•�i`� a� �i ��5�
Call (763) 572-3604 for Pertnit Fees if mailing in app8cation or Fax to 763-571-1287 if using credit card and we will
call you tor card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
S
$
$
$
$
$
$
$
$
$
TOTAL $
/�.�- Uv
CITY USE ONLY -
Fee Sche�Jule 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 Conservation Plan Review
Fee Determined by�Engineering
Agreement Necessary [] Not Necessary [ j
STIPULATIONS:
,
BUILDING P�RMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,�1 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,0OO,OQO
FEES
$23.50
$23.50 for iust $500 plus $3.05 for ea.ch additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional$1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,�0
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,0(� or fraction thereof, to and including $100,000
$993.75 for first $1Q0,000 plus $5.60 for each additional
$1,t)00 or fraction thereof, to and including $5(�,0�
$3,233.75 for the first $500,000 plus $4.75 for each additiona►
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRE5SION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
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 sflte.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
10/04/2005 11:36 9529265960 NORTH�dEST EkTERIORS �����3 � PAGE 01
APR-14�2�Q 15:0a FROM CITY OF FRZAL�Y Tp ��9529�6`i��6� P.02i02
C1TY taF' FR1D1'EY ��BC�lvte �111�04
N�+Y i) ��1 ���rstty Av� NE, F'ttdllap� MN 8�132 17��1 A9� �dg �P
�N {�1 �lN�I�� F/sN11L.Y ANI� BllP6�..?(f� R-1 /�N� R-� (?63)'.37°M9�7 Faac
�'�T� �.r�° ��f��srJ� ���M1T A���ICATION
f'
�ctw��s�'w�tl�i11 il�ldr�: � �
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'[ zuTE1 w ��t :..r�.... " a "�'!
l�tf�€�ffit�' ... . ,.. . ��{. ��d
: b..,.
�?���'�s,���� tla�n� e �r��ce oi �+�rvey �r tF�+
�- ;. .�.� �n9th tl� p�p�ed c�tna�tl�n c�r�m +o� ifi to ece�l�.
p�E�GRIl�TI�M QF IMI�AAV�MEM'T
I�MN[�.pIR�A; �.�ngth��..Wldth._..,....,�— HN�Itt,.�____,....P... �.�._„_,r.._...-
�,�►Q�n��: L�►��,,�____� w�tn � H�r��w_�____ sa. F�. __._�____-�-
�i�:AR�4: I�ength �, Width �____,� Mg�/Qround ___,,,,,,_ 3q• PL .._.,�-_--.—
�a�� ri��a: ...�...
� ' ���7 .�()
(xta�i�itf'►JG�i�I i -���_ �^) " � ,�.�,�' � � �8tlfYl� �4� �
C�rld�nr�y �.w� i�► �C�1 WliitP� M�s��: ,.._, �'t. � � Ft � ,,,,,_,�Ft x $ ■'�,�..._...
�,�: o- 4 -�� �
A���r�: C a.� I-- �.e�.�.,, T�.�_� -� ���� 3
��II (fi��l) 6�����(HI !�r ��rriih F�ren� tf rri�l}N�� !n e��ll�atl�n, ��� ta 7t�1•67l�2S7 K umin,g sred3l: card a�nd we wlll oeA
ys+u ft�r err�i �rui��i�mi.
pem�� ��
��� �evl�a�v
�Ire �car+�#`��r�e
�t�k,� �t�h��
SA� Ch��
-- �i�+a�m�a���a�f:►��
�d�,'k� �ul ����luw
�r����,�, �=��,i��U�
f-'ii►�; f=c+tis
��a��r ��lriln �%tt�t.c��
TCaTf�L
� �7 ��' �r � ���► -
_
� �ea s�h►e��r�� on f��Y�r�� si�
� • B6% e�f E���iriit �ee
�► ° v .�tV�t sfi P'��rr�it �`�lue#ican (�/'10tF�%)
��. / � �.�Q/�1,Q00 V�I��tia�
� �135U p�r 5AC Un�
.�� ��,00 (St�t� Li�n���t R��l��r�tia# �ontr�a:I�ts)
+'� �ilf. "A° or %\ t. "�"�b(dVe ---'— - -
�� ,_,� ����,UO ��r►��t���1�� Pl�n Revlew .
r _ Fc�� G�t�rrr�ir�el l�y �ngin��ein�
��� __ fl�jia+s3tr���it Nt�° . �fy � j hl+G� !�l��r/
�����
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Building
Inspections
763-572-3604
DATE �J / �,L "c
�--�-,�.`
STfE ADDRESS I
THIS APPLICANT 1S:
TENANT
CONTRAC'1'OR
SUBMIT A COPY OF
YOUR STATE LICEIVSE
WITH APPLICATTON
�pE oF wo�c:
BIJILDING
RESIDENTIAI� AFPLICATION
�
CITY QF FRIDL�Y
O OWNER
r
STATE LICENSE !/
O BASEMENT FIMSH
� DECK
YOUR E-MAIL ADDRESS Q2 Cd q, �,
�., �1vt�/Ui � r�c���..t o /�/i�
�COIVTRACTOR
`i' �iiG � Q'�-
�' 1'1 � O� CiTY�Y ��
z`7 I °�7 S�� �
��rim�5 y+1c �
��:�' EXP DATE� 3�--- 3 ��— d
�._�e.r��. S u '� � Of l cnv
� - 3 L2�7 FAX �7 Lo 3 � �F'��I ^ V '� �
.I�ROOF
0 SIDMG
DESCRIBE WORK BEING DONE: CL� -�('�-� ��i _
SIZE OF IMI�ROVEMENT ��
�tOOFIlVG LENGTH
NUNIBER OF SQU � HOUSE NLY
❑ HOUSE & GARAGE
PR� g�; � ATTACHED GARAGE
❑ DETACHED GARAGE
PROPOSID HEIGHT:
OSIDING
O Almninum
O Other
�V�G OPENINGS OYes pNo
OR FOR NEW OPENINGS-DESCRIBE S1ZE OF
OPENING CHANGES &
TYPE OF WINDUW Tn RF tAfc�re i r cn NUMgER OF WINDpWg I
�n vat,u,arl�lvN, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.C�EE SCHEDULE)
,�..,v �. �-..� ��, , ,
OSoffit
❑ Trim
O Fascia
LOCAITON OF WINDpWg
O DRAIN T1LE
D OTHER
�
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Fermit No.:
Received By:� _
Date Rec'd: � � G
�a�N z�SS3o 3
BASEMENT IZ�tODELIN S 1Rnnrr
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural membe�s to be u�d
FOR NEW CONSTRUCI'ION INCLiJpING DECKS,
ADDITION PORC FC S11Rj�R�•
1. Sitc Plan/Survey shawing the existing structures
and proposed project,
2. Two sets of construction plans
3. Energy Calculations
a l.e lD . L.� See Back Page for Fee Schedule
$�^ 65% of Building Permit Fee
$ �� .001 times the total job valuation
$ � .0005 x Perrnit Valuation Minimum $.50
$ • � $5.00 (State Licensed Residential Contractors)
$ $1675 per SAC Unit (Plans to MWCC for determinallon)
$ ft+dft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
G —7 . tn . - • - --
THIS LS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the c�se of all wor� hich requi�r,�es review�nd a�pprovai of plans.
SIGNATURE OF APPLIC �`� PRINT NAME _iA ,G(,_ "� y� DA7.E ��'�2 I�
0