AF - 42781�.
N° 632
Owaer + : � � r ��.,, �,
Architect
Builder ` ' " Y, � �
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V�8 �,e Of 1''1'�luey' �.
BU�LDING PERD'IIT
Office of IN3PEQ1'O$ QF BiT�DIN(,�S
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F'ridley, Minn. , 19- `y^'_
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LOCATION OF BUILDING
No. � Street � �i . Part of I�t
Lot Block A tion or Sub-Division ` �� � f �
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DESCRIPTION OF BUII.DING
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1+'ront �� Depth F`� � Height_,;� 8toriea � Manner oP Construction ';^
To be used a� � To be completed _�' ,� ,�,-% E.yttmated Coat '`' ''�:; '��
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Permit 1� hereby graated to ,�. a: ����;>' R�� � �
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the building described in the above statemeat. This permit is gtanted
upon the eapreae condition that the person to whom it is granted, and his agente, employees aad workmen,� in ali
the work done in, around and upon said building, or any part thereof, ehall conform ffi all respecte to the ordi-
nancea oP Fridley, Mina., regar8i�lg the conetruction, alteratioa, maintenance, repair and moving of buildinga
avithia the city ]imlte� aad thie pePmit may be revoked at any time upon violation ot anq of the provlsions oP said
ordinancee.
- :_3*!_�tor oP BuildYngs.
AG�r �vn swoxiv s�rA�r
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, i herebp agree to do the proposed work in accordance with the description
above set forth and according to the paovusions of the ordinances of Fridley, and, being first duly
swora, I hereby atate and sg,y that the facts stated by me and contained in the above permit are
true as therein atated.� ��' �
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Snb�cri'bed aad sworn to before me at Fridley, Mfunesota, th;s ���" �•"``' .
da,y of �' A_D. 19 � y' - � � ��` "' ° `��
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Village of Fridley, Mi;nn.
BUILDING PERMIT �°• 15 8 0
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Date: ,�:... � t .. .................
' '���'��'�G' . : :' . . -!�-� #�"�' . . .�•` ;•
Owner.....�..... , ... ....
Address . ���,�i . . . �°. : :��. . ... .. . ...
Builder....................................... .....
Address.............................................
� ��� OC ION UILDING
No. . . . . . . . . . . . . . Street . . . :°. . . . . . . . . . .:�� . . . . . . Part of Lo . . . . . . . . . . . . �
'°,��, , glo� ddition or Sub-Di 'on .�`�� °� ��°�
Lot..�. ..... ... ............ � � .. �....�......... ........
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Corner Lot ...!".�.... Inside Lot�...... Setback .�:.� ..... Sideyard ..... � .....................
DESCR[PTION OF BUILDING
be Used as: A �, � �
� .. .. ...� . .... �.... ..... . ........
Front �� Dep� d fIeight �. � Sq. Ft. Cu. F't.
. . . . . . . . . . . . . . ��. . . . . F'r t . . . . . . . . Depth . Height . . . . . . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . .
���,+� ,�
Type of Construction . . . . . . . . . . . Est. Cost � . . . . . . . . . To be Completed . .���. . .�. . . . • • • • • •
In consideration of 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 village of Fridley. � {� P
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�a c i ation of the payment of a fee of . � . . . . . . ., permit is hereby granted to . . . .. .. . . .. .. .. . .
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. .. ..... .... . t� c�nstrvet the Uuilding or addition as descxibed above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employe�es and worluc►en, in all work
done in, around and upon sa.id building, or any part thereof, shall conform in a71 respects to the ordinances of
Fridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of bu�ldings with-
in the village limits and this permit may be revoked at any fime upon violation of any of the provisions of said
ordinances. f
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. . . .. ' . �' . �°.���:�:`� .. Building Inspectoi
�_ �a� _ �•
NOTICE:
This permit does not cover th �construction, installation or aiteration for wlr� , plumbing, gas heating,
sewer o� water. Be su�e to see tlf *°epilding Inspecto� for separate permits for � items.
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Ci of Frid.le , l�dinn. �� ��
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BUILDING PEIi1V�IT N� 4 4 8 8
`
Date: ------� _`__... _...--•-------_... �.� __.._�._--------••--------_..
Owner: .�..C.?..�:�.._YL..�I...�Cf .............��� /_]....1_�.$$'....... Builder ...-�--�-�--..........-�-�---�...�----------•-----------_._.....---..........___....
Address ..� �.y�.� .� ..7..-..� f•-L✓-�-�._-�!�•. Address ---�--�--......----------- ---------.../..�...__...----•------------------•---•-----•-------.._._._
��'�� � , ,L�CAT90Ni OF BUILDI{�1G
No. .- -- �� . ..... ....... Street _ .-�C..'-j ---(�l� ...�,..°�......_._..... ��.�-- �- ... --.......--------... Part of Lot �--/� -- �--.._...._......_...._....__..._......_. ..--_ •--
Lot .--._.......% ..................... Block --��--�----.....��----...................... Addition or Sub-Division --..�-..�..�( -.�-•-- ��1Y4_��.....�.��.....
Corner Lot ........... �............ Inside Lot ....._............ - . ......... ... Setback .... --........ ._.......... • � --- -. Sideyard ..-----........... --
Sewer Elevation
Foundation IIevation
DESCRIPTION OF BUILDlNG
To be vs . i. J
-- ... ......... . ._. . ............ . Front ---��--�-. Depth _.L-....�.._.. Height .. � Le ... Sq. F� ."!-_.��_ Cu. F� '.���fJ
___ .............._...................................... Fro t .._.._... --- -.. Depth _.� Height - �;_�_. . Sq. F't. ..._......_......... Cu. F`t. _..._......._........
Type of Construction -.�"'.�. .��'.--,�---�'12....�'..._.. Est. st..��,�.�,��..__.__.._._.. To be Completed ......._--------.-------- ---
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THlS �gR�MI� C�t:�ES s�;�nT ,�_UTHC��9'� G°5���.���
1� . ��: �� , � . �,�- . . .. �1 ��1.,�' ., � -� ,-
In considera.tion of the issuance to me of a permit to construct the building desex7 above, I agree to do
the proposed work in accordance with the description above, set/�e�h'�nd in co�li e with rovi 'ons oP
ordinances of the city of Fridley. � j � —�
��
In consideration of the payment of a fee of $.��.-_--.., permit is hereby granted to--------------------------......--_----•----...--.------
..r.._.�__.....--------.._._...._...----_-.--_----... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is gran,ted 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 buildings
withia the city ]imits and this permit may be revoked at any time upon vioja�iqn of any of th) provisions of said
ordinances. /1 ///% � �
Building Inspector
NOTICE:
This permit does not cover the wnstruetion, installallon foe wiring, plumbing, gas heating, sewer or water. Be sure te see
the Buildine InspeNor for seperate permfts for these Nems.
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Ownera
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Addre�s
APPLICATION FOR BUILDING PERMIT
CITY OF IrRIDLEY, MINNESOTA
LOCATION OF BUILDINCi
A ��
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No., f �3� 9_,_ 3tree� 1�� °�� �� �� . Part of Lot'
s' � ' '
Lot _„�� ock �,� Atld3tion or Sub.D3v.,(�
Corner Lot v,Inside Lot�Set Ba.ck 5ide-Yard
3EW�t ELEVATION FOUND�TION ELEVATIOAI
Applicant attach to this form Certificate of Survey of Lot and proposed build3n�
location.
DESCRIPTION OF BUILDIIJG
To be used as : ,�� � o� ��L�
Front ,�,.,�_, Depth /� ` Height f
Sq. Ft. �_ ��� . g"t.
Front Deptla Iieight
Sq. Ft. Cu. Ft. �
. J• •r
T�rpe of Construction ,�°-r a lU�'� �I�stimated Cost,����.�
- - -�
To be
3'he undersigned hereby makes application for a permit For the work herein specif3ad,
agreeing to do all work in strict accordance with the City Ord3nances and ruling of
the Department of Buildings, and hereb� declares that all the facts and representa-
tions atated 3n thia application are true and correct.
�/ .a —
DATE 7'�° I� �,� r� �„_ SIGNATURE
(A Schedvle of Fee costs can be found on the Rever�e Side.)
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BUILDING PERMIT FEE SCHIDULE
Section 2,� The Inspector of Buildings sha.11, before issuing any permit
for the erection of any build3ng or structure, or for any addition to
any exi.ating building ar atructure, or for any alterations or repe.irs
to any existing building or structure, upon application therefor, require
the paa►ment by the applica.nt for such permit of fees to the amount herein
below set £orth and in th� manner herein provided to-wit: °
2.1. For any such permit for the erection of any fire-proof building� other
than a garaga, warehouse, factory or gra.in elevator, or for the erection of
any fireproof ad@ition, for similar occupancy, to ar�y existing Uuilding
sha11 be at tlie rate of �1.40 for ee.ch one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For ang auch permit for the erection of any fireproof garage, ware-
housQ, factory or grain elevator,�or for the erection of any f'ireproof
'_, s�ldition, for similar occupency, to any existing bui].ding shall 1�e at the
rate of �1.25 for each one thousand cubic feet, classified as "fireproof'�
by Section 502 of the Minneapolis Build3ng Code.
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2.s. For any such permit for the erection of any non-fireproof building
other than a garage, warehouse, faetory or grain elevator, or any non-
fireproof addition, for sim3.l,ar occuparacy� to any exist3ng building.
Permit $1.� for each one thousand cubic feet.
GARAGF�S
2.l�. For any such permit for the erection of any non-fireproof gaxage,
warehouse, factory or grain elevator, or for the erection of any non-
fireproof addit3on, for s3.milar occupancy,, to any existing building
for each �uch building or addition. Ninet� Cents for each one thous�d
cubic feet or fraction thereof, in the cubical contents thereof with a
minimt�m of �00�
For the pux'pose of computing fees for building perm3ts the cubical contents
of any building or addition to a uniform. height throughout by multiplying
the grourid axea covered fr�m a point six.(6) 3nches below the floor line of
the basement or cellar to the average height ot' the upper surface or to the
average height of the roof surface vf the main gable of a pitched roof.
2.5. For repaira or alterations to an exiating structure, the fee sha,11 be
at the rate o� �3.00 for each Five Hundred Dolla�,g ($5�0•00), or fraction
thereof in the cost of all propoaed work.
2.6. In no case sha11 the fee charged for an�r permit as set forth in
Section 2 be less than �L,..00.
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SUBJECT P.
City of Fridley 2 2 3 5
AT THE TOP OF THE TWINS g � i L D I N G P E R M I T
� ` RECEIPT NO.
� `y _.___ COMMUNITY OEVEIOPMENT DIV. � .�r �
r � � PROTECTIVE INSPECTION SEC.
Q
i = �
� �'�'1 � CITY HALL FRIOLEr 55432 NUMBER REV. DATE vpGE OF AVPROVEO BY
��-��� � �'' 612-571-3450 910-F15 3/24/94 � �
JOB ADDRESS 6589 Fridley Street NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 6 Oak Grove Additon SHEET
2 PfiOPERTY OWNER MAIL ADDRESS ZIP PHONE
John/Lola Taylor 6589 Fridley Street NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Merchants Maintenance & Const. 12020 Radisson Rd NE, Blaine 785-0904
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO
6 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Miscellaneous repairs including egress windows, two new doors, siding
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNIN(3 SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 �9 � OOO ��F. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFO ANCE OF CONSTRUCTION. � LOB.00 Fire SC $9.00.
� PLAN CHECKFEE TOTALFEE
� � ��`�4 License SC .00 126.50
SIGNATUREOFCO�TORORAU R12EDAGENT IOATEI WHEN P PE l VALIDATED THIS IS VOUR PERMIT
� � 3��y 9�
SiGNATUREOFOWNER�iFOWNERBUILDERI �DATEi BL G�N P ��pTE
1VEW
ADDl+d
ALT'ER
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ConstructionAddress:
Legal Description:
Owaer Name & Address:
Coniractor: ��%��t�c%r,�-
Address: � � �
. � . � �CITY OF FRIDLEY �
SINGLE FAMII,Y AND �UPLEXES R-1 AND R-2
� � Building Permit A.pplicafion � �
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L��:�'f� I� 1� • � � G �"� �f.
Effe,ctive 1/1/94 �
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9��
Tel. # �? � ° C� 4��� �
MN� LICENSE # C� �L�� �
Tel. # � —� r t� �
Attach to this application, a.Certificat� of Survey of the�
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF I11�ROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARA�E AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: f.�a i � � /��CZ-� ��, ���� � �� _ .� - �= � �� �
�E'�f 1�'S' •
L
Corner Lot [� Inside Lot [) Ft. Yd Setback Side Yard Setbacks
�
Type of Construction: l2�! �e ��.;�►�v� Estimated Cost: $ ��� =
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = � Ft x$ _$
�)DATE: APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Conirol
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE UNLY
$ / O��a Fee Sch�ule on Reverse Side ��
$ °J °� .001 of Permit Valuation (1/lOth%)
$ Gj S� $.50/$1,000 Valuation
$ $800 per SAC Unit
$ � . °% $5.00 (State Licensed Residential Conhactors)
$ Alt. "A° or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Ne�c�;ssary [ ) Not N�essary [ ]
� /26�;
0
• � ' BUILDING PERMIT FEE SCHEDULE �
-�� • . � . � .. • • . . . .
The Ctuef ' Building Official shall, before issuing . permits for� the erection of any building or structure,
or for any addition to any existing bnilding or structure, or for any alteration or � repair to any existing
building or slrucfure, upon applica6on therefore, require the pay�nent by the applicant for such permit
of fee.c to the amount herein below set foith and in the manner herein provided to-wit
TOTAL VALUE
$1 ' � ' to $S00
$501 to $Z,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,OOU,001 and up
FEFS
$15 (Minimum Fee is $15 plus surcharge)
$15 for � fust $S00 plus $2 for each addifional $100 or
fraction �.thereof, �to and including � $�,OOU - .
.$45 for fust $2,000 plus $9 for each additional $1;000
or fia.ction thereof, to and including $25,OQ0 � •
$252 for first $2S,IX10 pl�s $6.50 �or each additional $1;000
or fraction thereof, t�. and including $50,000
$414.50 for first $50,OOp plus $4.50 for each additional
$1,000 or fracbiom thereof, to aad including $100,000
$639.50 for first -$100,0U0 plus $3.50 for each additional�
$1,(�10 or fraction tl�reof, to and including �$500,000
$2039.50 for ifie fust $500,000 plus $3 for each additional
$1,000 or fiaction thereof, to and including $1,000,000
$3539_50 for the fir� $1,OQ0,000 plus $2 for each additional
$1,000 or fractioa thereof �
DRIVEWAY DEPRESSION ESCROW
(Coacrete Ct�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gut�er only - Driveway width plus 6 feet tim�s
$13.50. �
Alternate "B": Removal and replacement of curb and gutzea and install a 3 foot wide .
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION O� FOUNDATION
Permits for coastruction 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 consbruction site.
A Certificate of Survey of the lot, showing the l�oa of the foundation once it has it has been
constructed will be required before proceeding with the framing.
.
�
G
John & I�ola Taylor
65a9 rridley St.
Fridley, MN 55432
Phone: 571-6453
North E�try:
1. Install complete new door and frame ��ith painter's finish. Complete with hardware.
2. Install new deadbolt to door, Schlage or equal. Supply 2 lceys and key alike
to other door.
Kitchen:
1. Instal new steel insulated exterior door (south entry), prehung, with window,
hardware, locYset with deadbolt, weatherstripping and threshold. Castlegate
or equal. Reuse trim. Supply 2 keys and key alike to other door. Includes
painter's finish.
Bathroom:
1. Remove window in shotaer wall and frame opening. Insulate and finish interior
and exterior to blend with adjoining work.
2. Redo sho��er walls. Install water resistant drywall, Durocic or equal.. Install
3-piece fiberglas wall liner with molded soap dish, white color. Seal joints.
Haul away old.
Southeast Bedroom:
1. Install new window replacements. (2DH) Window to be vinyl framed with welded
corners, insulated glass, screen, lacicset, weatherstripping and hardware.
Set into existing openings. Benada or wqual. Owner's choice of color.
Reuse trim. Haul away old windows and storm/screens.
Nori;heast Bedroom:
1. Install new window replacements, same as specs. for southeast bedroom. (3DH)
One window must be sized for egress. Confirm location with owner. ,
Basement:
1. Install a wood handrail continuously along both sides of basement stairs.
Reworlc trap door to accomodate,handrail. Apply painter's finish of owner's
choice. '�
2. Replace top tread of basementi, stairs with new. (existing slants)
3. Remove fuel tank from basemen� and haul away.
�cterior : .�
1. Install new siding. Remove old siding. Install Tyvek or equal weather barrier
over sheathing. Install new vinyl siding with backer board. Alside or equal.
Rework items that interfere t�ith the siding application. Owner's choice of color
and style. NO NEW SIDING ON GAIILE ENDS
2. Cover entire cornice/eave area with aluminum. REplace rotted boards. Wrap
entire area taith .019 baked enamel prefinished aluminum. Vent soffit area with
� aerated material. Alcoa or equal. Owner's choice of color.
3. Install new wood, pressure treated or equal, platform and steps off so�zth entry.
Install posts on footings and confirm layout with owner. Platform to be 4'x5'.
4• Tuckpoint black chimney and secure to house wi-th band and lags.
Plumbing:
1. Install new water h�ater, 40 gallon, natural gas, AGA or UL listed, energy
saver, State or equal. Plumb ana vent. Haul away old unit.
2. Install back flow preventer to laundry and exterior faucets, self-draining.
3. Install new shower/bathtub fixture, anti-scald (thermostatic or pressure-
balancing type) chrom� an� 3gpm showerl�ead. Delta Monitor or equal.
e
�t
� Jolin & Lola Taylor - Page 2
Plumbing Cont.
4. Install new lavatory faucet fixture, chrome, two handle, with drain control.
Delta or equal.
5. Install new water closet, white vitreaous china, floor mounted with closed
coupled �ank, water saver, anti-siphoned ballcock mechanism, shut-off valve,
new flange/wax seal and seat. Kohler or equal 1.6 low flush)
6. Install new ]citchen sinlc faucet fixture, chrome two handle . I�lta or equal.
Install shut-offs to water supply lines. Correet leaky trap.
7. Reset trunk line back 20 inches for new door installation.
Electrical:
1. Protect wall receptacles within 6'0" of kitchen sink with GFI.
2. Protect wall receptacle in bathroom with GFI.
3. If recessed light in ceiling above bathtub is not proerly rated for moisturP,
install new recessed light fixture with proper rating.
4. Install 20 amp wall receptacle in southeast bedroom for window air conditioner.
5. Ground water meter.
6. Install 20 amp wall receptacle for laundry facilities.
7. Replace kitchen switch.
8. Add on circuit panel to fuse box.
SEPARATE PERMITS REQUIRED FOR
WIRiNG, HEATitVGI PLUMBING AND SIGNS.
sue�etr PERM
City of Fridley 019 8
AT THE TOP OF THE TWINS g � I L D 1 N� P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ��� �
i j V �����', . �
r � � PROTECTIVE INSPECTION SEC.
� i �
� /�"1 � CITY HALL FRIOLE� SSIai NUMBE�1 pEV DATE PAGE O� AG7qOVE0 BY
�""� � �'' 612-571-3450 9t0-Ft5 9/10/99 / /
JOB AOORESS 6589 Fridle Street NE
1 LEGAL �OT NO. BLOCK TpACT Oii AODITION SEE ATTACMED
oesca. 1 6 Oak Grove Addition SMEET
2 PROPERTY OWNER MAIL ADDR�S$ 21P PMONE
John Taylor
3 CONTRACTOF; MAIL ADDRESS ZIP PNONE LICENSE NO
Greg Faulkner Remodelin 1005 Hubbaxd St S P 5 - -
4 ARCHITECT OR OESIGNER MAIL ADDRESS 21P PMONE LICENSE NO.
5 ENGINEER MAIL ADORESS 21P PHONE LICENSE NO
8 USE OF BUIl01NG
Residential
7 CLASS OF WORK
O NEW � ADDITION O ALTERATIQN �X AEPAIFI O MOVE 0 REMOVE
9 DESCRIBE WOFK
Reroof house and ara e 14 S Teax-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment mu.st comply wi�h the State Bui.lding Code.
SEPARATE PERMITS ARE REOUIREO fOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCV �OAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONS7RUCTION 20NING SO. fT CU FT
AUTMORIZED IS NOT COMMENCED V�1ITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOii A PERIOD OF /20 DAYS A7
ANY TIME AfTER WOqK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING
I NEREBY CERTIFV THAT I MAVE READ AND EXAMIN�O TNIS APP�ICATION STALLS GAAAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS yp�VATION SURTAX
ANO ORDINANCES GOVERNING TNIS TYPE Of WORK WILL BE COMP�IED
WITH WMETMER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT $1224 .61
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMtT FEE SAC CNARGE
PROVISIONS F ANY OTHER STATE OR �OCAI LAW REGULATING CON-
STRUCTI N R TME PERFORMANCE O CONSTRUCTION .�4%.90 Fire SG �..22
�//O /� � PLAN CHECK FEE TOTAL E
� � Lice C 5.0 73
T E OF CON • AACTOp OA AUTMOA�ZED eGENT �D1TEi N ROP I A E �S IS Y E I
i
r
S�GNOTUAEO�OWNEA���OWNEpBU4DEAi �DATEi Bl �NSP - O�TE
NEVir[ ] �
ADDN
ALTER
Effective 5/10/99
[ l CITY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII.DING PERMIT APPLICATION
a
Construction Address:
Legal Description:
Owner Name & Address: �1 o�t �r /� ,� /� �, S c� � Tel. #
�� ' \
,�p� ��
�
I rl �P /^ �
Contractor: �a '--� �� � NIN LICENSE # o? d/ 3�'� 08-
Address: ��9� �` ��, Sf� ia u I .�5�oy Tel. # ��9 - `�/ o �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIP'I'ION OF IlVIPROVElVIENT
Length Width Height
Length Width Height
Length Width HgtlGround
�
,
Sq. Ft.
Sq. Ft.
Sq. Ft.
� �-A�2 a ��
, v � �. �
Construction Type: Estimated Cost: $ ����
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ - t
/ �s�
DATE: / �� y APPLICANT: L '�"� Tel. # � F 9- y/ 0 3
�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ .90
$ l, �? �
$ �/
$
$ S-- UD
$
$
$
$
$�` .��Y�
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$S.QO (State Li�ens�d Reside�tial Conttactors}
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering �
Agreement Necessary [ ] Not Necessary [ ]
� ��
BUII.,DING PERNIIT 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� �
$2,�1 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,0�1 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
fracrion thereof, to and including $2,000
$69.25 for fi.rst $2,00�0 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
$1,000 or fraction thereof, to and including $100,�0
$993.75 fdr first $100,OG0 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $SQ0,000 plus $4.75 for each addi±ional
$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 Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
�lternate "�": Removal and reglacement c�f curb aud 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 w�ill
be required before proceeding with the framing.
Building MECHANICAL
Inspections RESIDENTIAL APPLICATION
763-s�2-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE2-19-09
DATE `�
SIT'E ADDRESS �
THISlAPPLICANT 1S:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATTON
PERNIIT TYPE
TYPE OF WORK:
❑ OWNER
Permit
Rec ived B�!
Date�e�' d:' � � � �
ADDRESS: � CITY STATE ZIP,
PHONE:
COMPANY NAME:,,�
CONTACT PERSON:
STATE LICENSE #_
PHONE
FAX
.1��� �� . �I �
�GLE FAMILY � TWO FAMILY ❑ TOWNHOUSE
❑ NEW ❑ REPLAC�MENT ❑ ALTERA7'ION/REMODEL
FEES ARE BASED ON SI0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZEJBTU
MFG: MODEL:
SIZE/BTLI
MFG: MODEL: SIZE/BTU
A/C $25.00 . FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $]5 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $]0.00
_BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 �GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $I5.00
0
TH[S IS AN APPL1CATlON FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acla�owledge 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 case of all ork which requir ^ eview and approval of pl s. , �
SIGNATURE OF A��LICANT �� PRINT NAME L-l. IV DATE� '^
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED•TO PROCESS PERNIIT
RESIDENTIAL PERNIIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-LTP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603,2
a. A�CA Marival D - ' - - - - - ----
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
�'rom: City ot Fntlley To: 6518826982 Page� ?J2 O�ate: 3I231207 0 3:04:42 PM
�u�lding
Inspcctions
763-572-3b04
763-502-497? FAX
�
1�A1't:��� �'
SITL� AUD1tkSS
TtQS APP�.�CANT LS:
PLUMBII'�G P�.t xo�
RESID�NT'L�L APPLICAT���I Rcccived .By:.,.._
C1TY QF FR,�I�LEY nace �tc�'d:�
O OW N I:lt
YOUR EaV1A1L A.L�URtl.^.S �
�cvreu�� i NAME-
OWNEBJ Apv�s; CiTY STA7�TLIY
TENANT ""
rHaN�:
SUBMIT A COPY OF gTA7k. LILtiNSL'
YOU[t STATE
LtCFSVSEr a01�0 AND szar� uONU a
CERTLP'[CA7EOF AnOri►�CS:��
liV9U[tANCE PHANt�
PERINiI' 7'YPE
TYFE OF WOR[Gs I O Ntw
DESCRlP'i'10N OF
� Y fY 1 _^ racr un'rt ���
�9 ucr v.�7t _ /
r7T �� C.9TY ' i ��`�T/ATC�%I f•
� � Nw% __/�� " � — lG��
XAMILY � TWO I'AM1LY O T0IVNHOl1'SE
�RLPLAI:CMtNT
NEE.ri Alit kiASkD ON SID.00 F�R RIXTUH�, �]iC�P7 WHk� NbTEU. MUlTU!lI:S: (INUICAT� TQTAL NUMBh;R ON tJ►CH L01Y1. MINIMUM NL�.
S3S.5Q.
IiA7H SINK/LAV kLQOti URAINS 5HnW�YYt WATER PIP1�0
YI3ATFn'UK CiA5 PiINNG (NttU CITY L1Gj � SWlMNIING �'tXll W►AT1sR S(INTNER (i35)
CI.II7TFIh'S WASHER T K�T4'MEN S�NK � WAT�R C1.ng�T t�aCKNLOW TKl:�. (S1S)
U15HWA3Hl:R U►UN[9RY TItAY WwT�lt HFAT�R j39S} IKIR 1R:tiCAT1f)N
^' � W AT� M�T �li _ f�7' H�R
t p�,�Rfi.� �« :.,,,;;...�
.�.....� _:,�:��.. ..
�
TH19 iS AIV APPLIGTLOht MOR A PtiItMIT T�T VAL�U UN'fIL P&�C�55HD
I hcr�by arpiy !or a plumbing pc�rnit aad 1 atknowlodga that thc infornmtion abovo iH mmploto and aecurdto: t1�at thc work wi;l bo in
confa�mancc with �c ordioanco� a cadav af chc City of Fridloy and wirh �hc Minncaom Conam,�ctian Cadat; st�ar 1 uadcratan� �h� i.�
�tot a pericnit but on�y en appllcari fdr nnit k i� s�ot w Nt�t withaut a permit �n sito; tl�at tho wmk will bo in accordancc
wiih thc approvod pl� in tho • f a ilc w6t vi . r •w and approval pf pl�.v.
SIGNATUR� OF AP1'LICANT _ . _ _ _ _ _ IUNT NAME ` ]C�I �' 1 �17]C�C]_� G_�UA7�___��I��
City o� Fridtey
�u�di.�� inspections Depav-tment
b431 Univcrsity Ave�rue NE, Fridley. NIN 55�32
7ti3-5?2-3604
FII#�:7�3-502-49?7 •
Wd b0�04�6 060Z/£Z/£ :a;eQ � :a6ed unnou�un :wa� '