AF - 42348City of Fridley, Minn.
BUII.DING PEI�IT N° 5'7 3 5�
Date: -�-=—��""' �_�,�„°' �t �
Owner: � �.°°':_ `�*'�����' •� Builder � -�. ___�.._ ��,�
AdBress __._.__.._— � Address _ �__� _.._...._ ______._.
���� �, _ ,r � � O.�CAT���
No. �� treet �''�.-�L_
Lot � _ Block __.�; Adclition or
Inside Lot �� Setback �.� � Sideyard
Corner Lot
Sewer IIevation
fVG
I.ot
Foundation IIevation
�
DESCRIPTION OF BUILDING
T � v� .
, f� .�''f ,�i ,�f
•� Front �'" Depth ��?"' � Height ��_' Sq. Ft. •� 7
_ Front Depth eight �.� Sq. Ft �
i ,-,�r� '4� �:.�
Type o Construction Est C `���r_..—.:- To be Completed -
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Cu.
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In consideration oP the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridiey.
�'
In consideration of the payment of a fee oP $_��.-.., permit is hereby granted to.—
to construct the building or addition as descxibed above. This permit is granted upon
�he express conditfon that the person to whom it is granted and his. agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buiidings
within the dty ]imits and this permit may be revoked at any time upon violatio� of any of the provlffions of said
ordinancea ,�`1 , n -
Building Inspector
NOflC�
This permit do� aot eove� t6e eoealroeHon, ieatallaMon fe� vriring, plumbing, gas hea�Tmg, sewer or wa�er. Be wre to aes
ihe Buildiag lospaetor fo� aeperate permito for these (tsms.
_ �. � - �: �+�. 4 � . �
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OWrle� � @
Ad�res
APPLICATIO�T F0� BUILDZNG PERMIT
C=TY OF I'RID�EY, M�INESOTA
�
� ��
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ilder -
r.�Tao�v oF su=r�naN� .
No a � � 1 � Street �/� ��� �' i� , , �art o� Lot
Lot __ '�w_____ �lock_„�,,� „� Aadit�.on or Su'bdivatsion_
Cornor Lot �nside Lot �--� Setback � S _Side-Yasd ✓c) .
SETr1ER ELEVATION I�'OUNDATiON ELEVATIOi1T
Applicant attach to thi.s form Certi�icate of survey o� Lot and
proposea build�.ng location.
7eo Ioe used as o
DE�CRIPTION OF BU2LDINa
iaront______ Depth Height
Sq. Ft. Cu. Ft.
Front_,� Dep•�h Height
� G ��.
�-�/ �%l� 2 �
��
Sq. Ft. Cu. Ft.
� Est�nate� COS•t �� � � �
�ype of Const=uction____. , _._. _�_- -
To be Completed _,r,,,,,, � �'�� � ` � �-- , , ,
The undersigned hereby makes application for a permit �or the work
h�rrein specified� agree�.ng to do a.tl work in strict accordance with
the City"of Fridloy Ord�.nances and ruling o� the Department of 8uild•
ings,�and hereby declares that all the fac�e aand represen�ations
�stated in this applicat3on are true and corr�ct. �
(Schedule of Fee Cosfa can be �ound on the Revarae �i�de).
� . . �- �,"`1
� ..'�> �
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�U3LDING PERMY� I`EE SC�TEDUl►E
Secic3on 2. The �nspector o� Builc�im�s shall, be�o�e issuing any
pex3n3.� ror the escec•�ion ot any bu�.lding or s�-xuc�ture, or for any
addiicion to any oxis�� �uildinc� or sf�cuc�ure, or for any altera�tions
or �epa�.rs to any oxis�cing build�n� or structure, upon applica�ion
�h�re�or, require �he pay�aent 1oy t�ae a,�p].ican� for such permit of
rees �o the amount he�e:i..r► belova set forth and j.n the matzner herein
pYOV3.ded to wi�to
2.1. For any such po�nit �or the erection o� any fire-p�coo:� bu3.lding,
o�lner than a garago, wascehouse, �'actozcy or gra3n elevator, o�c �or �the
erec'cston of atiy f�re-ptoo� add3tion, �or similar occupancy, to any
exist��g building s1�a11 be a� the rate o� $1.40 for each on� thousand
cub�.c �eet, or grac�ion thereof, �n such cubical conten�s,
2.2. �or any such �er�n�.tc �or �he erection of ar�y fire-proor" garage,
vaaxehouse, �ac�toacy or gra�.n e�levator, or �or the erection or any �E3re-
prao� ad�ition, ior sim3.lag occupancy� �to any exis�ting building sha11
be at the ra�ta of $1,25 �or each oae thousand cubic feet, classified
as "�igeproof" by Sec�ion 502 of the Mlnneapolis �uilding Code.
HO�
2.3. For any such pe�n�.t for the erec�ion of any non-�ireproo� louild-
�.ng o�her �than a garac�e, warehouse, �ac�osy or graj.r� elevator, or any
aon-fc�reproo�E add3i:�.on, for simila:� occupancy� to ariy exis�ing building
Pelcnni�t $1.00 for each ono thousand cubic �Eeet.
G13t�AGES
.�._
2.a . �or any such �erm�.�t �or �ch� �rec�ion or any non�firep�oo�E
garac�e, warehouse, �acto�y o� graat.ai eleva�or, or for the erection og
any non-iEireproox add�tt3.on, �Eor �ima�.lalc occu�ancy, to ariy existing ,
�uilo�ing or �or each sue13 building or adc3ition. Ninaty Cen�s gor each
one fihousand cubic �ee� or �raction �hereof, in the cu�oical coatents
ihereof wi�ch a min�rmuun o� $4,00.
For �he purpose or computing fees for louilding perm�.ts the cubical eon-
ten�s o� any buil��ng or addition �to a uni�orm height throughou� hy
multiplying iche groun� area covered �rom a point siac (6) inches below
�:he �loor line o� �he basement or cella�c to the avesage height of the
upper surface or to fche average hef.gh� of the roof surface of the �a9.n
gable o£ a p�.tched rooi.
2� For repairs or alte�cations to an ex�.s�ting structure, the fee
shall be at �he ra�e oi $3.00 per each.Five FTundr�d Dollars ($500.00)
or �ract�.on �hereoi in t;he cost o� all proposed work.
2.6a in �o case sha11 �he fee charged ior any perm3t as set �orth �n
SeCt�On , 2�_ b� 1eSS t3--�� $4.00 O l� '- Y.�
MINDER ENGINEERING CO.,INC.
ENGI NEERS AND SURVEYORS
LAND 9uRVEYiNO 901L8 TESTINO //
CIVIL �. MUNIGIDAI ENOINEERING LAND PLANNINO }`(
�'e418-56T" AVENUE N. J
�/I INNEAPOUS 2?, MINN.
KE 7- 3637x �<;�{ `= -'�xi,�� ' I � ,'�)
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WE HEREBY CERTIFY THAT TH►5 IS A TRUE AN� CORRECT REPRESENTAT►ON OF A Sl7RVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESGRIDED AND OFTNE LOGA710N OF ALL BUIl.D1NGS, IF 1>1.1Y, TNE2EON, ANO ALL V1516LE EtJCROACHMENTS,
IF ANY� FROM ORON SAIO LAND. MINDER ENGINEERING CO., INC.
�,?��,�"'`,�-' r..o.i�5`i
OATED TM�S �nYoP ' ENG�13fyER5 AND SuRVEYO�R-5
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City of Fridle�► �
AT TME TOP OF TME TWINS gU I L D I N� P E R M I T 3 i 9 5 5
i ` T �, RECEIPT NO.
� `y _.__' COMMUNITY QEVEIOPMENT DIV. ���_3604� �� �
r � � PROTECTIVE INSPECTION SEC.
� . �
� � �"'1 � CITY MALL FRIOLE� 'SS�32 NUMBER pEV DAT6 PAGE OF AVPROVED BY
�""� � �'' 612-571-34,50 91Q-F15 7/5/O1 � �
J08 ADDRESS 7844 Firwood Way NE .
1 LEGAL ��T NO. BLOCK TFiACT OR ADDITION SEE ATTACNED
oescR. 7 2 Pearson� s Craigway Estates 2nd Addition SHEET
2 PROPERTY OWNER MAIL AOOFiES$ ZIP PMONE
Jason & Kel�y Bellamy 7844 Firwood Way NE 763-502-1332
3 CONTRACTOF MAIL AODRESS Z�P PMONE LICENSE NO
M J Construction 8071 Rsncher's Rd, Fridley, Mn 55432 763-785-8851
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PNONE UCENSE NO,
20233970
5 ENGINEER MAIL AODRESS Z�P PHONE LICENSE NO
ti
8 USE OF BUILOING
Residex�tial
7 CLASS OF WORK
p NEW 0 AOOITION � ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace 11 windows within existing openings; reside house
9 CMAN(3E OF USE fROM T�
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive bar.rier be placed over exterior sheathing to protect the inter.ior
wali covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
ba.rrier. Vinyl siding is not a wea.therproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Provide smoke detectors in all sieeping rooms and on all levels of the
. dwellin.g per Section 310.9.1.2 of the 1997 Uniform Building Code. Ca.�
and flash al� exterior open�ngs ,
TYPE OFCONST. OCCUPANCY GROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOF ELECTiiICAL. PLUMBING, MEATING,
VENTILATING OR AIF CONDITIONING.
TMIS PEf;MIT BECOMES NULL AND VOID IF WQRK OA COI�STRUCTIpM zpNING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED VjIITHIN 80 OAYS. OR IF CONStRUCTION
OR WORK IS SUSPENDED Oii ABANqONED fOR A PERIOD OF tZq DAY$ AT `
ANY TIME AFTER WORK IS COMMENCED. ` NO. DWIG. UNITS OffSTREET PARKING
I HEREBY CEfiTIFV THAT I NAVE READ ANp EXAMIN�O TMIS APPLICA710N 1 STA�LS GAFAGES
AND KNOW TME SAME TO BE TF1UE AND CORRECT. A�� PROVISIO�NS OF LAWS yp��JATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE Of WORK WI�� �� COMP�IED 13�OC% �G.SO
WITM WHE7MEii SPECIFIED NEfiE1N OR NOT. TME GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTNORI7Y TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CMAFGE
PROVISIONS OF ANY OTMER STATE Oii IOCAI LAW REGULATING CON- �237.25 F e SC �13.00
STqUCTION OR TME PERFOfiMANCE OF CONSTFUCTION
e PI,AN GMECK FEE TO A� FEE
Licen C $5.0 $261.81
S�GN4TUQE0�CO �pACTOQOp4UTHOp�2E0OGENt iD TE� ME PiiO R VAUOAT THIS IS VOUR PERMIT
� �O
SGN4TUAEO�OWNEp��FQWNEpBULLDER� �O�T�� � :s_. BLD �NSO � qptt
y^ _
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N� Il
ADDN []
ALTER [ j
Construction Address:
Legal Description: _
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
Effective 1/1/2001
(763) 572-3604 Bldg Insp
�p������
i�
Owner Name 8� AddressC �lSl'�'� �a-�,.� U ��� �(f,�� Tel. # 7� 3��r� �-����
Contractor. (�� ('�rlStrur �'c�� � MN LICENSE # � L7 0� ��� �L�
Address: �i � I�1�'1C .��,�5 F2� t�r�`C7� �A � Tel. #`�1.��� "-7 � �� g��• �
LNING AREA:
GARAGE AREA:
DECK AREA:
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. Ft
Length Width
Length Width
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
OTHER:
�lc�c� l 1- W 1 ncA c�c.� �
��
Construction Type:,� fl ���'c�,u V ! (1La . �1(,�I� Estimated Cost: $ � � ; � �O� �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x� _$
DATE: � � � APPLICANT: �r� GC�.Q._ ����� I �l/( J C ' hYlcS-�i"�C.�i c�l. # %(� � � % �� " ��S �
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
�t��r1�
STIPULATIONS:
Call (763) 572-3604 for Pennit Fees if mailing in application
$ -1 ��� Fee Schedule on Reverse Side
$ / � • �� .001 of Permit Valuation (1/10th%)
$ , 5� $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ 'S ,00 $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 [ ]
$ �(p��
a•
BUII.DING PERMIT 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
$25,001 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.� for each additional $1,000
or fraction thereof, to and including $25,OOQ
$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,Q00 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,0� 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 C�rb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
�
°,
Building
Ynspec�ions
7G3-572=3604
s���� rv�ux�ss '�i�,
THfS APPI.ICANT I5:
�ROFERTY QWN$R/
T�1V/�WT
SUE3M17' A CPPX OF
YOUR STAT� WC,ENSE
QdITH AYPLI(;q?'ION
;t'ItOFERTY TYpE
'�XFL OF
�
DESCRIBE WQ�K BEIIrTG
SIZE OF IMPRl7'V�MEN'i'
�T�TI;:LDING
RESI�IENTIA;I:, AFF'L;��ATIO�T
CITV' UF �RIDLEY
ADURESS
17 OVYN�R
�.�t�tt�ss:_� , ' CrrY
PHC1N�: —
NAME:. �.s9 �s'i�e� �/j �'/ � �� � v
51'ATF,1.(CENS� # � '� I
O BAS�'+MBNT FIIdISH
011�K
��� oF sgu�s _,_,.
��
PIiUP�3SSD S1ZE:
PROP�.i�3D HEl(3I3'T:
.�
❑ Aluminum '
Q Other�.
�?VlNDOWfi
IN �JC1STlNG pPOVAVGS DYes G1Tio
QR �UR 1VEW flPENIN(DS-D�SGJtI$E SIZE OF
OI?ENIN� CF�IE►AiCL�S �
T1TE OT WAlDC16V 7� H� INSTALLED
ALL FEE� AR�; �ASED O1V V.
TOTAL JQ� VA,
��� TiXP LIATE �/r30�--
?�i / O�rG1TY�
Z FA,x �o - 70�-- - `�y�
�UC1iUNf Sl"LE
CT10N $�}j� °
� OAItAC*F�5FIED [] W�pp�qrg
C1 RO�F ❑ U1tA(N 77LE
0 SIDING �T�
r, �...,.... ,...., .......
Q aousc orn.Y
❑ �ous� �a c�aa�
❑ AT7'A{;HEE1 GARAGE
� DEFACI•iCD GARA('iE
OSufiit
0 Trim
❑ Ma9cia
L4CATION OF WINC1(7WS
t iv[v, [ivc:i,u��l�iC: THE COST OF 1
THE 1997 U.$.0 F'EE SCHEDiJL�)
�"1, OCCi1PANCY
NQ,:
D�1,� I�,ec'd:
1, ExfstingTtoa
2. Propc�l �I�q
3, List oPstruct�
FOR 1�1EW CpAfSTRUC
A? '' � 5 di P�R 1
1. 5ho Pte�/Sur
aTU! pmgosed
z. Two seis uf m
3. F,n�gy Caicu
['�rmit Fee $ � See �sek Page far Fee Sch�dule
P� ���w � 65% of nuilciing �ermit Fee �
Fire S�chergQ $ .001 times the tot�l jab vr�luation
S��'�� $ .0005 x P�rmit dalu�dan M;nimum �.SU
Ltcenso $urcharge $ � $5.40 (Stete l,ic�nsed Residential Contrr�xctors)
S�� �'� � �1G75 �r SAC Unit (I�laas to MWCC fpr decernii;
Curb Cur Escrow $ ft+ b ft=. fC x$21= $
Erosion Control $ $450 Gonser�+ation Plun Review
Park �'oe � Fee Uetermined by �ngineerin�
SQwer Maul Cha�"gc� $ Agreement necessary {) Non Nece��ry ()
Toi�l �1ue $ ll��alte checks a ble to: �i of Fridle
THIS CS AN APPLICAT[pN �UR A PERMIT NOT VAL1D UNTIL FRp��S�D
I 6ereby �pply fvr a building permit and I acknowledge that the informaeicm above is complote and accur
canformar►ce wYth the ardin�n ci�ti of the City of l�ridl�y �nd wi#1� the Minn�sota Construotion Codes,
permit but anly en applicaf n for s pernLit work is not to start without a permit; r1u�t the worl� will be in a
pl�n ia cho case nf all ork reyuires review d appruv�! of plans.
SIGNA'PURE OF AFPLIGA �1 nn n,rm ti� � sec�i IJ_�ne� d1r�- I/le! �,e9c _
TP, ZIP
s . r�.
SUBMIT•
�.
lao •
membors to be u�t
)IV� IRTCLUp1NG DECKS,
',� BNIIT:
shDwing d�e existin� ggu�p�ry�
1e4�.
I{{RL1811 �1�81i6
rha,t the work wili lle in
I underst�nd this is not �
�dance with fhe xp�sroved
Zd Wd�b:b0 Z00Z �ti •a2W L.8ZtiTZS�9Z: 'ON Xti.� halA?a� ,}o Fi�.t�: WOa�