AF - 42323�
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Caty of Fridley, Minn..
BUILDING PERMIT NA '7234
Date: � ""
Owaer: Builder
Ad�iress - Adaress
o LOCA►T N B DING
No. /�yx-�� 3treet y _ Part o t
Lot �_ 81ock �� Adaitlon or Sub-Divlsion �
/ `J,
Corner I.ot — Inside Lot `� Setback "� 1� Sideyard .r� � T/ o
Sewer IIevation Foundation IIevation
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DESCRIPTION OF BUILDING
vsea � �
� Front ��.� neprb xeight ..��� sQ. b-t. l�� ca. FL
Fro� � Depth fTeight � Sq. Fk _�� . Cu. Fk ���
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�►pe of ctton � J ° F�t. .���--T°o be Completed
In can�deratfon of the isauance to me of a permft to conatruct the bwllding described above I agree to do
the proposed work 9n accordance with the d�scription above set forth and in cbmpliance with afl provisiona of
ordinances oP the dty oP Fridley. �.�f� �-°f i� �
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In conafderation of the paqment of a Pee oP $�,� , permit fs hereby graated to
to conatruct the buflding or addition as d�crlbed above. Thiape rmit is granteti upon
the express condition that the person to whom ft is graatsd aad his agents, employees and workmen, in all work
done fn, arouad and upon eaid huilding, or anyp� thereof, ahall conform in all reapecta tfl the ordinance� of
FridleY� Minnesota reg lacation, conatruction� alteration, maintenance, r+epair and moving of buildir►ge
ordinaacea. dty ]imits and� permft may be revoked at any t3ane upon violal3on of an,y of the provYsiona of said
Bu91di�►S �
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Minrro�ol�s3?,
- .- �1'�IGlNEERINGr, INC. �°'°
- SUntei•d-6066
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7J�is is a fi� ond c�recf 2prese�tof'wv► a�!'a wrrec, e�'fhe houndao^ies of"f1� /mrd obare desu�ibed orxlc�'/lie /asafian a�'a!/buildr�ys,
i�i�yy, fharov, �d o/1 ris;ble anr�aodrm��s .�'ony, �i � an s�rd l�ul. Tha.urvrtf is mod� a� n camect�n rrith a mcv�fy� /a�, �nv
er�rr9 pb�d m fltt p�Iy �cr �o Ga�y a osw�ed am�pf 1b l�f�ler a�'s��rl, ma�i�e or off�r �esff ��ia�% by fh �ta►, y('
su�/i n�fya9e. /frs ana�sfaid ard aqr�ed nv maRUntnts /,�re �Z» �►ed {�a►� lYie �vrPvx �l'�/shvt� /Df/uxs w-b�i� ar'oers.
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SuBJECT
City of Fridley 33495
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
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; � T NO.
• COMMUNITY DEVEIOPMENT DIV. ����
� � �: - --
r � � PROTEC7IVE INSPECTION SEC.
� _ �"'� � CtTY MALL FRIOLE� SS132 NUMBEA AEV O�TE P�GE OF �vPROVED Br
�""� � ��' 763-571-3450 910-F t 5 5/ 6/ 03 � �
JOB ADDRESS 1420 Fireside Drive NE
t LEGAL LOT N0. BLOCK TiiACT OR ADDITION SEE ATTACMED
oescA. 5 2 Gunderson Terrace SFIEET
2 PfiOPERTY OWNER MAIL ADORES$ ZIP PMONE
Gary Shoberg 1420 Fireside Drive NE 763-786-5658
3 CONTRACTOR MAII ADDRESS ZIP PNONE LICENSE NO
Premier Home Enhancers 9707 10 Ave N, Pl outh, MN 55441 763-513-0110
4 AHCMITECT OR DESIGNER MAIL ADORESS IIP PMONE LICENSE NO.
20063301
5 ENGINEER MAtL AODRESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION � FiEPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear-off
9 CHAN(3E Of USE FROM TO
STIPULATIONS
Under�ay-ment must comply with the State Bui�ding Code.
SEPARATE PERMITS ARE RE�UIRED FOF ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAO
VENTILATING OFi AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7RUCTION ZONING SO. FT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOfi A PERIOO OF 120 OAYS AT
ANV TIME AfTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIfY TNAT I MAVE iiEAD AND EXAMINEO THIS APPLICATION 1 STA��S GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE Of WOiiK WILL BE COMPLIEO
W�TH WHETHER SPECIFIED HEREIN OR NOT- THE GRANTING OF A PERMIT �3,744 $1.Z7
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE Oii CANCEL TNE pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- $83.25 Fire SC �Z.SS
STRUCT OF T PERfOfiMA � STRUCTION
PLAN CMECK FEE TOTAL FEE
�� C� L ens SC $5.00 $92.07
N4TUA O� CONCf7AC TMOAIZE AGENt i0 rEi yy pqppEq�V VALIDATED THIS IS VO R_ E �
S�GNAfU�7E O� OWNEA��� OWNEp8U4DEAi �DATE� BIOG � �
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NEW [ ]
ADDN [ ]
ALTER [ ]
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CITY OF FRIDLEY Effective 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPI.ICATION
���- .�- ���C� . _ .
Construction Address: / �'� o'�cc�z��e �� ��� ��
Legal Description:
Owner Name & Address: �� . ��?-1 �� Tel. # �� � ° ��� ' ���
Contractor.�✓��e�,� � e e� _� D ,�� MN LICENSE #�� �20063301
Address:���Ca`� � l ��i�,�� . � :�������� Tel. # �� � °°�/ � °� l f U
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LNING AREA:
GARAGE AREA:
.'. , DESCRIPTION ,OF II�IIPRCIVEM�NT
,.. _ ..
., d .. . . . .—.j . . �... . ... . ... - ...... w.
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
DECK AREA: Length
OTHER:
Width Hgt/Ground Sq. Ft.
Construction Type: � � ! Estimated Cost: � � � 'l �7"• CA � � "
Driveway Curb Cut Width Needed: F. 6= Ft — _$
DATE �(r' J�� APPUCANT: Y Tel. #��3 J�I� '�9 t o
Call (763) 572-3604 for Permit Fees if mailing in application. a 3-5 -1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
..TOTAL ... . ._ .. . .. ..
$ � � �2S
$ �` s�`�.
$ � � �? �
$
$ -,�-�'. ��
$
$
$
$
� �o� �_�
7
CITY USE ONLY -
Fee Schedule on Reverse Side
.Q01 of Permit Valuation (1/10th°la) . , , ,
$.50/$1,000 Valuation
$1275 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 [ J Not Necessary []
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BUII.DING PERNIIT FEE SC�ULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any e�sting 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 prwided to-wit: , , ,
TOTAL VALUE
$1 to $500
$501 to $2,0�
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$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 $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,0� 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 fo� 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 �
cux� cv�r Escxow
(Concrete Curb� 5treets OnIy)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00.
Permits for constivction will l� issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the consiruction site.
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
� R
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 FAX:
: 1420 FIKESIDE DR NE
: 123024130062
: GUNDERSON TERRACE
: LOT 5 BLOCK 2
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALTERATION
571-1287
PERMIT NO.: 2004-01460
DATE ISSUED: 09/Ol/2004
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114-
OWNER
SHOBERG GARY C& KERRY S
1420 FIRESIDE DR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 da.ys
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date_
ELEC PERNIIT FEE - MIN (RESn
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 117431
�r;,raxa i� r�iuvu r� xr;c�uu�li rvx wvxK u rt�x �r� lir;�c:xin�li a�uv�.
20.00
0.50
20.50